My cousins’s daughter’s Facebook post brought an article that exhibits a mask behavior I find very annoying: People who needlessly do things that elevate their own risk of infection with Covid-19 and then complain that the others don’t wear masks! As if other people not wearing the masks is the principle driver for possible exposure to Covid.
The article is Coronavirus: There really are mask deniers out there. I had to spend a weekend with them written by a Paul Ruehl, who must truly be a brainless moron.
In the article, Paul, who lives in LA, had arranged to spend the 4th of July weekend in a vacation rental Napa. You can read the whole thing, but Paul’s knickers are in a twist because two of the other people who shared the vacation rental would not wear masks.
Ok. Usually, I sympathize with those complaining about non-mask wearers. Usually, those complaining are trying to do things that everyone must do and it really would be nice if everyone wore masks at the grocery store or in retail outlets and so on.
The problem with this Paul fellow is that I can’t help noticing the numerous decisions Paul made that are contribute to risk of exposure. This Paul guy undertook optional travel to mix with other people who also took optional travel. That’s incautious on Paul’s part. Paul knew some people in the group were complete strangers to each other; also incautious on Paul’s part. The specific details about rules regarding social distancing were not ironed out before the travel plans were made. Yet more lack of caution on Paul’s part.
Are these too risky? Ok? To some extent that is a judgement call. I personally would not make those choices. Paul seems comfortable taking risky behaviors of his choice.
Well, sorry Paul. Contrary to the claim in title of your article you didn’t have to spend a weekend with non-mask wearers. You could have never planned a vacation with people flying in from out of state. You could have ironed out rules about mask wearing and social distancing before driving down. Even failing all that, you could have turned around and driven home when you realized the two out-of-staters weren’t going to wear masks.
If you’d made any of those choices, you would have avoided spending a weekend with non-mask wearers. Paul: you chose to spend the weekend with non-mask wearers for reasons of your own. Now you are bitching about it.
A couple of notes:
“what happened to majority rule in our (former?) democracy?”
Does the author really think that political rules control private situations? [Not intended to be rhetorical — it seems that he does. I wonder if his kids’ votes were of equal weight to the parents’ in his house. Or if he went out to dinner with friends, and one insisted on treating, while the other 2 want to split the tab…No end of situations.]
And in the end, he did not get infected. His self-inflicted angst was the only downside. No evaluation of relative risk – just “I want masks”. I understand wanting masks; it should provide *some* reduction in risk. How much? I don’t think anyone knows. But the author made masks into a huge issue. Especially since, as lucia noted, the whole trip was elective.
HaroldW,
I thought the same thing. He voluntarily got into a social situation. “Majority rules” isn’t the rule for those. If one particular person is the host it’s “Decline invitation or leave if you don’t like the hosts rules”.
This group didn’t seem to have a couple who was the host.
I would venture to say it provides less protection than deciding to not share a vacation home with 5 other people, at least one of whom you haven’t even met before. I mean relative to Paul one was “new boyfriend of long time female friend”? From out of state? Paul had probably never, ever, ever met this guy. And I would bet money Paul’s “new girlfriend” had met neither “long time female friend” (who lives out of state” and certainly not “new boyfriend of long time female friend”.
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I think masks are prudent. But wrt to other decisions, that was just window dressing. That’s why I think it’s “theater”. He’s a writer. He now wants to write an “article” about this “issue”.
Lucia,
Sure, that was annoyingly stupid. Honestly though, it’s pretty low key / garden variety stupidity compared to most of the crap I read these days. Peaceful protests in Oregon, despite the fact that rioters have been trying to burn down a federal courthouse out there for two months now. These aren’t riots, they’re merely peaceful protests which ‘intensify’. Antifa is a myth, according to Nadler. Defund the police, abolish prisons, because BLM; never mind the fact that minorities are the people who are most victimized by crime when the police are muzzled. Grammar is racist. Pull down the statues. The 1619 project wasn’t meant to be a history, it was meant to be journalism, whatever the heck that’s supposed to mean. If you’re not practicing racial discrimination as an antiracist, you’re a racist, AFAICT according to Kendi.
I mean really. The ocean of B.S. out there right now seems so deep and wide that Paul there is hardly noticeable against the background noise in my view.
[Edit: Oh, OMG, I almost forgot! Men don’t have to have periods anymore, and we need to talk about that, proclaims the Atlantic!]
lucia,
You’ve got this right except maybe you were too kind to the guy. Masks would have been at best a tiny mitigation of the real risk. There is is no real evidence they do much good but there is lots of evidence that sharing indoor space with infected people for an extended time is a great way to get infected.
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He wrote: “I genuinely believed … we could find a common ground.” Right. The common ground is where *I* say it is.
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Was he really expecting everyone to spend 300 bucks on disposable masks? Or for everyone to bring about 15 reusable masks and wash them every day? I am guessing the answer is no and that he didn’t do those things himself. Mask as a magic talisman.
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Of course, mark is absolutely right about the real stupid and dangerous stuff. But somehow, I think the big stuff and the little stuff is connected.
Sorry. I misattributed to Atlantic. It was actually some random site called Scary Mommy I was talking about with the men menstruating thing.
Mike M.
I agree. Moron Paul defined “common ground” as “everyone does what I decree”.
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What’s even more idiotic on Paul’s part is he was actual told they didn’t intend to wear masks. Yet he didn’t cancel his weekend in their presence. He just for some mysterious reason thought they would come around. Why? They presumably would have thought they communicated their position (which they had) and he’d decided to accept that position because (a) he said nothing more and (b) he still came on the trip.
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Whether the non-mask wearers were “reasonable” or not they had alerted him of their plans!
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I have no idea what sorts of masks he expected. I know that if I traveled, I would bring my washable masks. But honestly, I would never take flights with stop overs and an Uber drive to spend a “vacation” where I had to wear masks all day. Never. I just wouldn’t take the trip.
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It’s an easy call. I think the problem for someone like Paul is the call involves him giving up something he wants to get something he wants. He’s rather someone else gave up something.
Mark,
No argument that this is a little-bitty thing compared to the protests. But the whole mask bitching is so widespread on social media. And if we read the bitching, the combination of bitching about others while not really walking the full walk is really wide spread.
Fair enough.
I thought the bit about drinking was strange, maybe it was just a joke I didn’t get.
I was under the impression that drinking a lot of booze depresses the immune system.
I do think it’s meant as a joke. . . (I also suspect that the planned trip to Napa Valley was always intended to involve quite a bit of wine. Napa is beautiful. But…I mean… wine tasting!
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I haven’t been keeping up with every world leaders advice. But it does appear that in March:
“Belarus’ president dismisses coronavirus risk, encourages citizens to drink vodka and visit saunas”
https://www.cnbc.com/2020/03/31/coronavirus-belarus-urges-citizens-to-drink-vodka-visit-saunas.html
Evidently, the president of Belarus in early July claimed they are doing ok. I haven’t hunted down data.
https://112.international/politics/lukashenko-announces-belarus-victory-over-covid-19-52699.html
I see now. Thanks Lucia. I’ve never been a wine drinker & Napa didn’t register.
Lucia,
“Moron Paul defined “common ground†as “everyone does what I decreeâ€.
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That is a good working definition of most any ‘progressive’. And if you dare to not do what they say, they will attack you as an evil person who should lose your job and never be allowed again to function in public. The witch hunters in Salem are their role models. Maybe ‘Paul’ and ‘Karen’ are actually the same person.
We went on a tour of Napa when I visited my sister back when she lived just out side San Francisco. It was fun.
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Champaign was consumed. Fine dining was also involved.
have the vaccine.) It’s a nice trip. The area is pretty and the weather tends to be nice compared to many other areas. But I’m sure the overwhelming majority of those who schedule weekends in Napa are going there for wine tasting and tours of wineries. We went on several tours and learned a bit about bottling, wine making and so on.
Twice I tried wearing a surgical mask while shopping. Both times about half way through I had to pull it down for a few minutes due to getting slightly dizzy. I have low blood oxygen and the mask lowers it even more. Twice in a row was enough for me to say never again. Those episodes wearing the mask were my most troubling health concern this year.
I’ve only had one person make a comment about no mask and simply told them I have a medical condition which won’t permit me to wear one. I also told them their scarf didn’t do much and they would be better off simply keeping their mouth shut. Conversation ended there.
Since end of Dec. 2019 I’ve been on Hydroxychloroquine, one 200mg tablet twice daily for arthritis. Also take a daily multi-vitamin to keep up my vitamin D and Zinc. At age 74 I feel fortunate to be on it.
I always spell Champagne wrong. (Betraying my roots. . .)
Lucia,
I spent a couple of days last October visiting wineries in Napa. There are so many small ones that it would take a couple of weeks, plenty of money, and a good liver, to visit a significant fraction. It was fun, but I really only encountered two wines (out of many tasted) that I found exceptional… both were very limited in production volume and available only directly from the winery…. at an eye-popping price.
At the judiciary committee meeting today held to hear Barr’s testimony, Rep. Nadler lectured Republican members of the committee about not wearing masks and for “violating the safety of the members of the committee”. As he lectured, he was not wearing a mask over his mouth or nose.
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It seems that both Republicans and Democrats have been wearing masks except when they speak. Mask theater indeed.
SteveF,
My brother in law picked the wineries. He loves wine and lived near enough he’d gone on several tours so he picked ones he liked. We went to Chandon Vineyard and some others.
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I’m sure I wouldn’t be able to organize a really great tour on my own. It was fun. But for sure, the purpose of a Napa Valley tour is wine tasting. Unless you have family there there is little reason to go there.
Lucia,
I only visited Napa because it was on the way from Yosemite to the giant redwoods area north of Napa, both of which were much more interesting than Napa. I like wine, but I wouldn’t choose to travel somewhere just to see wineries.
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I did note that camping in all of the parks is becoming ever more limited. Many former camping areas are not just closed to camping, but completely inaccessible. A 10 mile long roadway through a forest of giant redwoods was blocked by a park ranger….. public access to the forest is no longer allowed. The message is clear: we really don’t want people here.
SteveF,
Unless I had won $200 million in the lotto and had developed some sort of “constant travel bug”, I also wouldn’t travel to Napa just to see wineries. The main purpose of the visit was to see my sister in San Francisco. The occasion may have been my nieces baptism.
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Kevin organized a day trip to nearby Napa. It was an outing that made sense. I really can’t imagine doing what the “mask-refusing” couple did — which is take a flight and long uber drive to spend a weekend in Napa without there being something rather more to the trip. So I assume the motivation of the “long-time female friend” was to get together with people she thought were close friends.
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Honestly, I feel sorry for the out of state couple who spent so much money and so much travel time for an outing that, in the end, could not have been very enjoyable. They share part of the blame for not ironing out the rules about mask wearing before coming. But they aren’t the ones writing that whiny article– Moron Paul is. He shares just as much or more blame than they do.
Bob K,
Twice now I’ve seen some healthy doctor on TV news trying to demonstrate that mask wearing does not lower blood oxygen or raise blood CO2. But the demonstrations are flawed because they don’t show what the blood chemistry was before putting on mask(s), only that it was in the normal range afterward. Besides being completely anecdotal it was also completely unconvincing.
Lucia,
” So I assume the motivation of the “long-time female friend†was to get together with people she thought were close friends.”
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I suspect the level of closeness among the friends is now somewhat diminished. Having to deal with an infantile, sanctimonious as$hole like Paul, and spending a bunch of money in the process, tends to damage friendships. Were it me, I’d have suggested he leave and offered him what he paid for the rental if he would leave. But that’s just me, and I have no reputation for social grace.
Yep. But honestly, I wonder if they were very close to begin with.
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When Paul “suddenly realized” that ‘long time female friend’ who lived out of state (and far, far from Napa), he didn’t phone or text “long time female friend”. He contacted San Francisco based “wife in married couple” to communicate his concerns. Then “wife in married couple” relayed back their response.
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So they may not have been that close to begin with. Quite likely “married couple” was the core couple who thought up the idea to bring two other couples. Turned out to be a mistake.
The self-description paragraph explains the basic problem:
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“It scares the hell out of me, and it’s ravaging this country physically, economically and psychologically.”
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And most of the ravaging is because of folks like him! The craziest thing of all is that the no-mask issue was explained clearly to him ahead of time… if he is scared as hell of coronavirus, why not just cancel? He didn’t. What an as$hole.
Mask deniers, nice. That’s especially precious considering the history of “science” and masks. We have Karens, now I guess we have Pauls.
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My guess is there is more to the story, as is common in these type of cases. My first guess is the house was rented pre-covid and the guy was going to lose his money if didn’t go. So he went and spent the entire time in covid paranoia and had a bad time. Took it out on anyone but himself for a bad decision. I wouldn’t say I’m “terrified” of covid like Paul says, but I’m definitely into learning how to reduce risk. I am not going on shared vacations with other people now. I’m not going to weddings, etc. If I did go on a shared vacation my assumption would be that there would be no masks worn in the house, but masks worn out in public. Spending days indoors with people is basically a “masks are not a prophylactic” situation. If somebody started feeling bad or coughing then masks on, and the sick should leave.
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“We’d finally have a common cause to cure our divisiveness”. Yeah, as long as it is all done your way there is no divisiveness. Funny, that. Surely terms like “We, the mask wearers”, “We, the mask wearers”, and “mask deniers” are not divisive.
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I think people should wear masks, but I’m never going to be a Paul.
Oops, used, the d word in my post. It’s in moderation.
Tom Scharf,
Oh, there is definitely “more to the story”. Paul’s bitch-about-others post is very selective in what it leaves out. That post at USA today also does not run comments which, perhaps, lets him indulge in that strategy because he isn’t confronted with the obvious questions that many readers would wonder about:
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1) When did you make these arrangements? (Pre covid? Post?)
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2) If post… well… huh?!!!??!!! If pre, why didn’t you cancel when California went into it’s first lock-down? ( Loss of deposit? Not enough brains to have foresight? Figured the epidemic would be over and it was worth the risk? Or actually, maybe you’re just invited to a friend’s time share and aren’t out of pocket anything? We don’t know.) So basically: did you decide to persist in exposing yourself and risk later spreading because you don’t want to be out of pocket $$ for “no good reason”? (IOTW: you think your $$ is more important than not risking your health of that of others.)
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3) Even apart from the whole Covid thing…. Did you really think a weekend vacation with one couple you seem to know, another that consists of one person you only kinda-sorta know and the other a complete stranger and your new post-Covid girlfriend made any sense? It sounds like the sort of money saving arrangement college students might do. Then they grow up and get jobs (so more money) and learn from past experience of being stuck for a weekend with someone they consider an a**hole. So they don’t do this sort of thing anymore (or if they do take this risk, they make an exit plan!)
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4) This was Napa. Did you go on wine tasting or was the rental pre-stocked with wine? Did you use the public restroom while on a wine tasting tour? Did you siddle up to bars set up to serve others? Possibly all outdoor post covid. But still… near people. Mask or no mask, that increases your likelyhood of being exposed. (Your mother may be right to not be willing to let you visit!!)
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5) Did you stop to use public restrooms on the 7 hour drive from LA to Napa? Buy gas? More potential exposure. Less than an Uber, but Paul seems to think some risks of getting or spreading it are worth it. They are just the risks he picks. (This is not uncommon. But he’s writing an article and bitching!)
All these sorts of questions would have arisen in comments. Paul supporters would also exist. But really, Paul would have been presented these questions. As it happens: we don’t know. But these are obvious questions and it’s hard to imagine answers that don’t reflect badly on Paul.
DeWitt Payne,
My med. records usually record 92-93% oxygen. That is after having been sitting for awhile before the test and no mask. While that isn’t low enough to require supplemental oxygen it is still below what is considered normal. Never had/have dizzy spells while walking around with no mask. I think the walking around for 15-30 min while shopping with a mask lowered my oxygen sufficiently to cause the problem.
Haven’t had any problems with businesses. If questioned at all I simply tell them I have a medical condition which prevents mask wearing.
Bob K,
And that’s exactly my problem with those doctors on TV claiming to demonstrate no effect on blood chemistry of masks. They’re healthy individuals not exercising. And even then they don’t do measurements with and without masks. Now if they were running on a treadmill with their pulse rate at least in the cardio range with and without masks and found no difference, I would be both surprised and a lot more impressed.
If you are starting to feel light headed, your O2 sats are probably closer to 85%. You can buy small finger pulse oximeters for $20 to $40 now. Normal people will reliably read 95% to 100% with these devices.
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I’ve done a lot of medical testing with these devices. Healthy people are brought down to 70% for 10 minutes or so during testing to validate the oximeters. People who consistently read below 90% likely have cardiovascular / respiratory issues of some kind. 90% to 95% isn’t dangerous by itself, but is a warning sign that the body isn’t getting the normal amount of oxygen into the bloodstream. I believe they use this as a threshold of when to hospitalize a covid patient.
DeWitt,
Just in case you would be interested in the type of mask I was wearing. I see no point in wearing total junk. Here is a link.
https://preceptmed.com/15300-fluidgard-160-procedure-mask/
You can’t tell me a scarf equals that, and even that doesn’t give sufficient protection.
I collected a few of those mask while going to the hospital for various treatments. Just ask and they’d say sure, go ahead.
One would expect if the lungs were getting the same volume of fresh air through the mask compared to no mask then the O2 sats would not change. You have to breathe harder through the mask though. It’s not hard to believe that somebody right on the edge of a functional respiratory system might be compromised by the mask if it reduced their air exchange.
Tom Scharf, Thanks for the input.
What method do they use to bring a healthy persons oxygen level down to 70%. Exercise?
You might do better with a standard mask that has less filtering, it will probably reduce airflow less. I’m not a mask expert though.
Subjects lie on a bed or sit in a chair wearing an oxygen mask over their mask/nose and the O2 levels are gradually reduced. Blood oxygen levels are monitored with pulse oximeters and blood gas analyzers using blood draws (the gold standard).
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Normal people rarely have significant O2 level reductions during exercise. Maybe 1% drop, the body just adapts by breathing faster and harder. It would need to be extreme exercise. If you can’t supply enough oxygen to your muscles to keep going they respond by making you feel really bad and making you stop what you are doing, ha ha. The blood can only deliver so much oxygen even if it is fully saturated. When the system is being taxed the return blood supply has lower oxygen levels.
Tom,
Thanks for the explanation.
One of the few examples of balanced reporting I have found on the Portland protests, told from both sides.
https://apnews.com/1dd1bb39093a3691f4e78093787ab877
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“You see a lot of commentary on social media about, ‘Well, they’re wearing protective gear so that it’s not going to hurt them.’ Okay, I’ll put the same protective gear on you and I’ll throw a brick at your head and you tell me if you feel comfortable with that,†said a senior U.S. Marshals Service official who’s overseeing the response in Portland.”
The oxygen-hemoglobin dissociation curve is highly non-linear. For pulse oximeters readings near 100 (O2 saturation), large changes in oxygen partial pressure produce minimal changes in O2 saturation. So it is hugely misleading to show that exercise or wearing a mask only reduces O2 saturation from 100 to 99. That could correspond to a huge change in O2 partial pressure as measured by an arterial blood gas test. But if your O2 saturation is 90, then the same change in O2 partial pressure would produce a large change in O2 saturation. So it is entirely plausible that a mask is physiologically problematic for some people.
Mike M,
“The oxygen-hemoglobin dissociation curve is highly non-linear……….So it is hugely misleading to show that exercise or wearing a mask only reduces O2 saturation from 100 to 99.”
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Do you have any data to show the absolute change in oxygen content for a change from 100% to 99% in saturation (or ideally a curve over a range of saturations)?
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I have read that the O2 saturation level in blood returning to the heart is in the range of 75%, which suggests that there is a normal drop of ~25% in saturation between supply and return. IOW, tissues function constantly on an average O2 saturation near midway between ~75% and ~100%. This makes me wonder how much reduction in deliverable O2 a reduction of 1% in arterial blood saturation could make.
Tom Scharf (Comment #188451): “One of the few examples of balanced reporting…”
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That American Pravda article is anything but balanced. Yes, it treats the federal agents with some sympathy as people, so it is not as unbalanced as it might be. But it also depicts them as clearly on the wrong side, acting in an indiscriminate and unjustified manner. While the rioters. which the authors call “protestors”, are depicted as being clearly on the right side, acting in a justified manner.
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People who set out to destroy property and to deliberately injure others are not protestors. They are rioters.
SteveF (Comment #188463): “Do you have any data to show the absolute change in oxygen content for a change from 100% to 99% in saturation (or ideally a curve over a range of saturations)?”
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Not something that shows that range in any detail. Only things like this: https://en.wikipedia.org/wiki/File:Oxyhaemoglobin_dissociation_curve.png
Note that the O2 partial pressure in air at sea level is about 160 mm Hg.
Article: https://en.wikipedia.org/wiki/Oxygen%E2%80%93hemoglobin_dissociation_curve
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SteveF: “I have read that the O2 saturation level in blood returning to the heart is in the range of 75%, which suggests that there is a normal drop of ~25% in saturation between supply and return.”
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I am pretty sure that can not be correct. If it were, you could not get a O2 saturation reading in your fingertips of near 100%. I think that 25% change must refer to O2 partial pressure.
Mike M,
This site shows the characteristics of arterial and venous blood samples: https://acutecaretesting.org/en/articles/central-venous-blood-gas-analysis
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If I am reading it right, the saturation is in fact ~75% in venous blood, and >95% in arterial blood… saturation in chemical terms is normally the number of molecules absorbed versus the possible number that can be carried (which is 4 O2 molecules on average per hemoglobin @100% saturation). The curve you link to does show the partial pressure of O2 over hemoglobin at 75% saturation is only 40% as high as atmospheric pressure of O2. Which just means hemoglobin has a strong affinity for O2. The swing in saturation (>95% to ~75%) multiplied by the volume of blood flow and the blood hemoglobin concentration is the delivered quantity of oxygen. So delivered oxygen is proportional to the swing in saturation.
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I believe fingertip oximeters are calibrated to account for the mixture of oxygenated and deoxygenated blood in the fingers, and can be misled by blood flow restriction to the hands or even by cold temperatures (where blood flow to the fingers is reduced to reduce heat loss). Fingertip oximeters only give an approximate value for saturation.
I’ve seen data with return blood supply as low as 40% when the tissue is demanding a lot. Pulse oximeters attempt to only measure the arterial supply. They do this by isolating the pulsatile portion of the signal (the venous return pulses much less, but it does a little) and measuring the differential absorption of red and IR light usually through the finger. Effectively these devices are looking at the color of your blood. Oxygenated blood is bright red.
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This SpO2 measurement tracks blood gas analyzers closely (within a couple %) except for exceptional conditions such as carbon monoxide poisoning which it cannot discriminate but blood gas analyzers can.
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Oximeters are calibrated, they don’t read directly from the theoretical absorption curves, this accounts for a lot of stuff in the measurement that is not a direct blood reading. The cal curves are determined experimentally and every vendor is a little bit different. They tend to read high at room air because clinicians like high readings, ha ha. There is fractional/functional SpO2 measurements but it’s really splitting hairs for the intended use.
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Reduced blood flow is referred to as low perfusion and makes the measurement more difficult due to the small size of the pulsatile signal. Advanced signal processing helps this tremendously, but accuracy is reduced in these cases by a couple % typically.
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A bigger problem is motion artifact which can confuse the isolation of the pulsatile signal. You want to remain still during this measurement even though advanced oximeters are pretty good at rejecting this nowadays. This will normally make an oximeter read too low, likely due to venous blood being sloshed around.
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I designed and built pulse oximeters for over a decade, including electrical design and firmware.
SteveF (Comment #188467): “If I am reading it right, the saturation is in fact ~75% in venous blood, and >95% in arterial blood”.
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I think you are reading that right. It is not clear to me if those numbers are for healthy people or critically ill people on ventilation.
A change in a reading of 1% on an oximeter in normal use means nothing, it’s basically measurement noise. Most clinicians won’t care about a change in reading of up to 5% usually, and some people only consider an oximeter error of >7% as clinically significant, as in potentially making bad decisions occur. The default alarm level for a continuous use oximeter is 85%.
Nature publishes article of small study.
https://www.nature.com/articles/s41586-020-2598-9
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“among a sample of 68 healthy adults in Germany who had not been exposed to the coronavirus, 35% had T cells in their blood that were reactive to the virus.”
“The role of pre-existing SARS-CoV-2 cross-reactive T cells for clinical outcomes remains to be determined in larger cohorts. However, the presence of S-cross-reactive T cells in a sizable fraction of the general population may affect the dynamics of the current pandemic”
Tom Scharf,
Thanks for the detailed information on how finger oximeters work.
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“However, the presence of S-cross-reactive T cells in a sizable fraction of the general population may affect the dynamics of the current pandemicâ€
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Ya, 38% of the population having resistance could have some influence on the dynamics. 😉 Like maybe reducing the HIT by somewhere close to 38%. This is important information for both the public and politicians to take into consideration in developing sensible policies. I am better the MSM never says a peep about it.
Heather MacDonald article on government failures with COVID-19 and riots.
Mike M,
“It is not clear to me if those numbers are for healthy people or critically ill people on ventilation.”
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I will defer to Tom, but those numbers (>95%, ~75%) appear to be normal resting values, not people in respiratory distress. It is not just arterial oxygen level that matters, but total delivered usable oxygen. If the heart is not pumping efficiently, total blood hemoglobin is low, or both, then a person can be suffering from lack of sufficient oxygen even if the arterial blood is >95% saturated. Low arterial oxygen should (I think) have much more to do with lung/breathing problems (eg COPD) than anything else.
Taboo Question: Are Face Masks Spreading the Coronavirus?
Also, there are a lot of hand sanitizers out there that contain methanol. You don’t want to use them.
DeWitt,
I think Heather exaggerates a bit. There will be a decline in urban quality of life, because the politicians in those cities refuse to act responsibly to protect the interests of normal citizens. Sure, lots of businesses will close from the coronavirus FUBAR, but in the longer term, I believe the damage will be more due to people voting with their feet to avoid all the bad things that have been happening. Nutty COVID policies are part of it, of course, but just the potential for another COVID-like FUBAR in big cities is good reason to move away. Throw on the refusal of city officials to enforce civil order, the mindless embrace of bonkers lefty ideas like BLM, the ability of many white-collar workers to work remotely, and the inevitable tax increases that a declining tax base will bring on, and it is easy to see big cities not doing well for the foreseeable future.
All the speakers at the John Lewis memorial service took their masks off when they spoke. *sigh* Sure, they were a long way from the audience, but they were speaking for a long time. There was also no social distancing in the audience. Oh, but they were all wearing cloth masks, so that should be OK. I’m going to be curious to see how many cases of COVID-19 result. If there aren’t any or many, then there can be no excuse for restricting attendance at any other church service.
BTW, my oldest son (PhD molecular biology, JD intellectual property law) has not visited his law office in Manhattan since mid March. He says the disruptions from his 2 year old son cost less time than his former commute to Manhattan, and that his productivity is, if anything, higher at home. I rather suspect there are many tens of thousands like my son. NYC is screwed, in part by the virus, but more by the evolution of technology. The big question is: is there any economic reason for a city like NYC to exist? I believe there is a very strong argument that the city costs much more than it generates, and so should decline dramatically in population and, more importantly, in economic contribution, over time. There is nothing economically special that NYC (or any big city) offers beyond effective business connections. That reason exists no longer.
The full DC Court of Appeals has agreed to an en banc re-hearing of the earlier order to dismiss the case against Flynn, and vacated the original order directing idiot judge Sillivan to dismiss the case against Flynn.
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They are trying to force Trump’s hand to stop the witch hunt against Flynn with a pardon. I suspect they will get their wish. Anyone, especially Chief Justice Roberts, who suggests Federal Judges at all levels are anything more than unthinking partisan hacks is disconnected from reality.
Not only has America’s Frontline Doctors been censored. Now their leader, Dr. Simone Gold, has been fired from her ER job.
But the website seems to be back, with a modified URL:
https://americasfrontlinedoctorsummit.com/
My browser gave me a warning when I accessed it.
She was fired from her ER job? If true, this will not go well for the hospital administrators.
So far we have her claim that she was fired because of the video. We shall see if that gets confirmed.
But she has hired Nick Sandmann’s lawyer.
From the Atlantic:
See, as I said above, the John Lewis memorial service. Elsewhere in the article it’s pointed out that there hasn’t been a run on HEPA air filters and that you should have at least a MERV 13 rated filter in your HVAC.
DeWitt,
I read that earlier and priced out filters on Amazon, ha ha. I’m surprised it took so long for anyone to bring up ventilation. If the virus transmission is heavy droplets only then it doesn’t matter but they seem to not really know and aren’t confirming it.
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It should be noted that very large indoor spaces like stadiums are likely almost equivalent to outdoor spaces if ventilated. Not as much wind I guess but it would be interesting to see how different spaces rate with “science”. Certainly crowded indoor dingy bars are worst case.
I read that downtown Manhattan businesses such as traders are opened back up, but less than 10% of employees actually returned. There is no particular reason most global businesses need to be in NYC, but I’m guessing it is the culture that draws them (and in some cases repels them). Whenever the progressives decide they want to tax them into submission they just threaten to leave, or in the case of amazon never show up in the first place.
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A more interesting case is Washington DC, there is no reason we need a physically centralized federal government there, it could be distributed across the US. We can rent the empty space for Amazon warehouses.
” this is completely backwards, because the person who needs to be masked the most is the speaker, not the listeners”
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That was my initial thought. But the speaker is well separated from the audience, while the audience members are close to each other.
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It seems to me that the key question is the relative importance of the initial cloud coming out of the mouth versus randomly dispersed particles in the air. To get infected, you need to get some minimum dose of the virus. Once dispersed in an auditorium, the concentration would likely be very small.
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In a restaurant or office, the biggest risk is the person you are talking to face to face, followed by whoever is upwind of you. Beyond that, there does not seem to be a big issue, unless ventilation is really bad.
Nice White Parents
https://www.nytimes.com/2020/07/23/podcasts/nice-white-parents-serial.html
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Not sure what to make of this one. On one hand it exposes the liberal hypocrisy of vocally supporting socioeconomic and racially integrated schools but never sending their precious kids to those schools, but also blames nice white parents for the poor performance of less fortunate children as if these families have no agency and it’s not commendable to raise your children with strong education values.
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The recent “moral clarity” of the NYT also heavily criticized the reopening of schools and then proceeded to condemn nice white parents who formed pods of their kids to teach them in groups because of the absence of schools as making the racial learning gap worse. The progressive view of education is 100% good intentions and 100% incoherent in execution. They seem to be all in on dragging down the good kids to close the gap.
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I saw a line of 40 kids today walking down a sidewalk for some day camp. One of the things people miss with reopening schools is that these kids have to go somewhere. The virus transmission danger doesn’t change if it’s daycare instead of school.
Tom,
https://babylonbee.com/news/progressive-parents-disappointed-in-how-white-their-children-are
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2768952
Results: “Our final cohort included 145 patients with mild to moderate illness within 1 week of symptom onset. We compared 3 groups: young children younger than 5 years (n = 46), older children aged 5 to 17 years (n = 51), and adults aged 18 to 65 years (n = 48)… The observed differences in median CT values between young children and adults approximate a 10-fold to 100-fold greater amount of SARS-CoV-2 in the upper respiratory tract of young children… Additionally, we identified only a very weak correlation between symptom duration and CT in the overall cohort.”
CT value = number of PCR amplification cycles to reach threshold of detectability of viral RNA.
This makes perfect sense: the immature immune systems of pre-school (and probably lower school) children are less able prevent infection and replication of SARS-CoV-2 RNA. The ability to infect others via droplets SHOULD depend on how much virus is in the upper respiratory tract and symptoms (sneezing) that ejects such droplets. Nevertheless, younger children are reputed to be unimportant in the spread of this pandemic. Could this be because children have been isolated better than any other age groups until summer?
A paper on influenza said that infectious aerosols are generated by shear forces in the narrowest air passages in the lungs and that ordinary breathing expelled more aerosols than coughing during a 15 minute test. So swabbing the upper respiratory tract may not properly measure a person’s potential to produce infectious aerosols. Evaporation during dry winters may allow those aerosols to remain suspended in the air for longer. Some asymptomatic patients show “ground glass opacities” in lung scans typical of pneumonia. (A routine checkup showed I had an asymptomatic “viral pneumonia” one summer when I was about 12.)
The disconnect between viral load, the potential to infect others, and the seriousness of illness is frustrating. This could be because viral load isn’t being systematically monitored throughout an illness and because the most seriously ill people are tested most often. Asymptomatic people are rarely tested and there is no way to know how many days post-infection a test was run.
DeWitt wrote about air filtration: “Elsewhere in the article it’s pointed out that there hasn’t been a run on HEPA air filters and that you should have at least a MERV 13 rated filter in your HVAC.”
The author recommended such filters for schools. Family members flew here and quarantined in our basement for two weeks while still doing work over the internet. Unfortunately both floors use the same HVAC system. So I tried a MERV 13 filter (minimum “hospital grade”) in that system. The problem is that if airflow is reduced too much by a filter or dirty filter, not enough heat will reach the outside heat exchangers, which can ice over and be damaged. Couldn’t find any reliable information on the subject or get any useful info from the system which has a link to the internet for troubleshooting. The longer the ductwork in your system the greater the resistance to flow that adds to the resistance from the filter. I got the impression that systems were designed to maximize energy efficiency (based on a government labeling standard), leaving many owners no choice but to use a coarse filter. A MERV 13 filter is still working in my system, but I didn’t have time to try the MERV 16.
You can buy a portable purifiers that uses HEPA or MERV 16 filters.
The CDC is now “recommending” MERV 13 or 14 for commercial buildings, meaning so states are likely to require change. Rightly or wrongly, if the CDC can’t demonstrate a clear benefit and a sensible cost, they probably won’t require change.
American Airlines sent me a promotional email about their state-of-the-art air filtration system that filters air every 2-3 minutes – AND they have just begun to use it during loading and unloading, too. What have they been doing for the past 4 months? UA (and probably AA) show that you can’t assign yourself a middle seat when you are booking – but they are still selling all of the seats on their flights.
Frank,
Children have been found to not significantly spread the virus in places where schools remained open or were reopened. Children are much more likely to catch the virus from adults than to give it to adults or catch it from other children.
RT-PCR does not measure viable virus; it measures RNA fragments. So the children might be shedding a lot of dead virus.
Frank,
You’ve hit on a problem that makes it difficult for people to implement quick fixes on air filtering. The system includes a number of designed components, and it has to be designed to cope with the pressure drop of the filter at the design face velocity.
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If I were a school teacher, and knew or suspected the building HVAC had course filters, in winter, I’d be tempted to crack windows where I could and bring in a space heater. Whoever is in charge of energy bills would be displeased. The solution wouldn’t be optimum (and I’d also want to think about how my configuration might induce a large scale recirculation and possibly try to adjust my implementation. But I would try to ensure that I got dilution in my room to limit the steady-state viral load in the event a student was infected.
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My home has only to occupants. But if we did have one with covid, I would keep them in a separate room and at least crack the window in that room and close the door. I don’t have a nifty exhaust fan that can be put in a bedroom, but if I did I’d run it. That would exhaust air from the ‘infected’ room and tend to reduce how much mixed into the rest of the house. (Of course, some consideration would have to be made for comfort. But I know my house HVAC is sized to keep up with the amount of exhaust from the kitchen hood.)
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If Covid type viruses end up endemic and we don’t end up with a decent vaccine, bathroom-size exhaust with switches might end up being installed in a number of bedrooms that can them be used as “the sick room” when someone is ill. Running them will increase HVAC costs, but if there is little other choice, people will put them in.
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How much the will help… dunno.
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FWIW: If I lived in a multi-dwelling high rise I might gin up a small window fan that brought IN some fresh air. That would bring fresh air into my dwelling and depending on the path to leaking out, it would tend to repel shared air from other occupants apartments or the common areas. Jim would be rolling his eyes at my paranoia, but I’m pretty sure I would do this.
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Longer term,
Alternatively, we’ll see people put UV systems in ducts. Those also use energy. I don’t know what the cost is, but it’s not something an apartment dweller or homeowner can easily shove into a system.
Frank,
In Sweden, where the elementary and middle schools didn’t close, children in those age groups are a very small fraction of the total case load in the country. So even if the children were shedding active virus, there shouldn’t be very many of them. There was no mention of incidence by age group in your linked article.
I think the problem with UVC in HVAC is that it takes a relatively long time of exposure to kill the virus so just blasting the HVAC with a single UVC is not enough. From what I can tell it is a volume/duration issue that is probably difficult to retrofit. Best/easiest thing to do is just recycle from outside if possible. Unfortunately to make HVAC energy efficient you want to recycle. Many systems might be able to easily increase outside air at the expense of much more energy use and less overall maximum heating / cooling.
Tom,
I’m not sure it takes a long time for UV to kill those virons that are hit with UV. This article suggests 16 seconds near lights mounted on the ceiling of a restaurant:
https://khn.org/news/scientists-want-to-know-more-about-using-uv-light-to-fight-covid-19-spread/
The problems I know of are (1) you can’t have really high concentrations near humans. You want to avoid eye exposure especially and (2) you need to get all that viral laden air to flow past the UV lights.
So some engineering has to be done to get the UV implemented to knock down the amount of any accumulated virus without other harm to humans. This is something of a new need so there aren’t pre-existing solution out there.
Of course, the epidemiolgists are still arguing about whether the virus is spread by aerosols. So some would say we don’t need the UV systems.
lucia (Comment #188550): “So some engineering has to be done to get the UV implemented to knock down the amount of any accumulated virus without other harm to humans. This is something of a new need so there aren’t pre-existing solution out there.”
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There are UV air purifiers on the market:
https://heavy.com/home/2020/03/uv-air-purifier/
MikeM,
All of those include HEPA filters. So the HEPA filter probably does the job of trapping floating virons. I have no idea if the UV is sized to permit enough residence time to do any good. Basically: just because it’s on Amazon doesn’t mean it’s really been engineered in a way that makes sense for the current application.
Mind you: I’d use an air purifier in a sick room these days. The HEPA filter is probably just fine.
Looks like the time/intensity required for UV C light (nominally at ~254 nm) to inactivate viruses and bacteria has been studied by many groups. This paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298127/
suggests ~15 milliwatts per square cm for 1 second deactivates 98% of influenza virus particles. The paper argues for installation of baffled UV C lamps on ceilings in hospitals (baffled to minimize exposure to people!) to control influenza spread in hospitals.
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I have read that commercial UV air systems are normally mounted in a run of straight ducting and use internally reflective surfaces of aluminum to multiply the effective UV dose for air passing through. Claims of >99.9 % effectiveness are common. The air needs to be first filtered to remove dust particles so that virus and bacteria can’t get any protection/shadowing from larger particles.
SteveF,
I imagine during an epidemic, those would be useful in apartments and dorms. By saying engineering has to be done, I don’t mean we don’t know anything. I mean the best practice to implement and deploy in large facilities like high rises, businesses, schools is not known.
Having said that, if I had a kid in college, I might buy then one of those commercial filter/UV air purifiers for their dorm. 🙂
Lucia,
“I mean the best practice to implement and deploy in large facilities like high rises, businesses, schools is not known.”
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Maybe, but there are lots of companies that do commercial installations; reputable companies probably do know what is required to deactivate nearly all virus particles. But from from what I have seen, there is probably more than a bit of hype in the business, because the claimed optical output from the lamps used, combined with the exposure time of air passing through an HVAC duct does not seem sufficient to reach the 15 milli-joules per cm^2 that is 98% effective against RNA viruses…. more typically it would be 1/3 of that unless multiple UV units were used… and they are not cheap.
SteveF,
The head of the committee looking into ASHRAE developing standards posts on Facebook. I follow him because we went to grad school together. He went to my wedding; Jim and I went to his.
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He says ASHRAE hasn’t put together standards for HVAC for Covid yet. There’s a committee trying to pull together infor 🙂
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Honestly, there are a lot of considerations other than just “refresh rate” and “compare viral loads of air coming in to that going out”. Those matter. But you also need to consider things like large scale circulation patterns (because you don’t want a Covid laden sneeze to be blown across people in the room with little dilution before reaching the purifier.) And of course, you actually don’t want overkill or overly expensive.
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If ventillation is better, you want people to ventillate, not install UV. Identifying the best choice is part of coming up with best practice. So I’m not saying things don’t exist. I’m saying currently we don’t know ‘best practices’. Or at least ASHRAE thinks we don’t.
You can read the sort of announcements they are publishing here:
https://www.ashrae.org/technical-resources/resources
They are very generic. (Longer items published are also generic.) There is very little specific information on UV.
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Many advertized HVAC systems do over-promote things– like removing VOCs.
Joe Hiden has painted himself into a corner by severely restricting his choice of running mate. He promised a choice by August 1, then it was next week, now it is the week after that. In other words, just before the convention that has been pushed back by a month. The problem seems to be that his handlers have been floating one lead trial balloon after another and have been shocked that none get off the ground.
I’m no HVAC expert. Air moves through ducts pretty fast though. You would need a pretty long run to get 15 second exposure time for an air volume. As light power diminishes by the square of the distance one would want air traveling quite close to the light source. It could be engineered of course, but maybe not easily retrofitted. I’m not sure if different viruses have different death rates by exposure time, I was under the impression they do.
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If simple filters can be used in HVAC, it seems the cost effective way to do it.
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https://www.cuimc.columbia.edu/news/far-uvc-light-safely-kills-airborne-coronaviruses
“Based on their results, the researchers estimate that continuous exposure to far-UVC light at the current regulatory limit would kill 90% of airborne viruses in about 8 minutes, 95% in about 11 minutes, 99% in about 16 minutes, and 99.9% in about 25 minutes.”
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I think the regulatory limit they are referring to is the human exposure limit, so using overhead lamps.
Mike M,
Yes, the whole “has to be a woman” thing has restricted his choices. The woke-BLM hing has now made it almost inevitable that he chooses an African American woman. Whoever he chooses, it will not turn out well for him. If it is a white woman, that demotivates the extreme left. If it is a crazy-left black woman, that scares most everyone. (note: Biden looks even older than his years, so his VP would have to step in)
If 15 seconds kills viruses under UV, will one second kill 1/15?
MikeN,
Not really linear. It looks like the “damage function†is linear with UV dose, but the fraction of virus inactivated is not. The rate of lost active virus appears higher at lower dose than at high. Essentially it is an exponential approach function…. each added equivalent dose drops the fraction of survivors by e^(-1). They can never guarantee 100% sterilization…. it is 90%, 99%, 99.9%, 99.99% etc.
The anti-racists have demanded the VP be a women of color, no other qualifications were demanded, such as policy positions, ha ha. Pointing this out as the definition of racism and sexism makes one racist and sexist. The media willfully complies with this unassailable logic. I think we have made it to Idiocracy.
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On the sane side, the VP will obviously be the attack dog for all woke issues because in the new world order it is improper to attack “marginalized” people regardless of their logic. The VP will bait Trump and Trump will comply. Both sides want a fire fight on identity. The rest of us want all of them put on a garbage barge and pushed out to sea.
FL’s case counts are officially declining based on a two week average. Deaths are still either level or increasing slightly at around 175 a day. The drive by of the tropical storm is going to corrupt the numbers for the next few days.
Tom Scharf (Comment #188580): “Both sides want a fire fight on identity.”
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I disagree. Trump does not want a fight on identity, because Trump does not practice any sort of identity politics. But Trump will accept a fight in order to protect the country from identity politics.
Tom Scharf,
Why do you say FL death count is around 175/day? According to FDOH, it’s around 120/day, per
https://experience.arcgis.com/experience/96dd742462124fa0b38ddedb9b25e429
I agree that the count is not yet decreasing. Data from the 7-10 days tends to be adjusted later, presumably due to reporting delays.
HaroldW,
From your link:
Florida from July 27-August 2 from worldometers.info averaged 175.6 deaths/day. July 20-26 averaged 125.3 deaths/day.
DeWitt,
Thanks, I hadn’t noticed that caveat, but had observed the updating.
Worldometers appears to post the difference between today’s total and yesterday’s, without looking at the actual date of death. The totals should come out the same, of course. But I’m surprised that the FDOH site doesn’t show any recent day with a figure close to 175.
HaroldW,
The hurricane might have something to do with that.
Sweden continues to trend downward in deaths, with the most recent valid data (considering reporting delays) of ~8 on July 18. If the recent trend continues, Sweden will drop to ~3 per day within a month. Herd immunity is the most likely explanation.
HaroldW,
The Florida dashboard site will likely reach somewhere in the vicinity of 175 for the first of August, but the data for August 1st won’t be complete on that site until about August 15. Worldometers just reports the difference between total deaths from one day to the next…. so you have to use the 7-day average to get a reasonable guestimate of the true underlying rate. The Florida method is more accurate, but you can only see the true numbers two weeks after the fact.
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Same thing happens in Sweden, BTW.
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One thing I find interesting is that by the time Florida’s cases and deaths drop to low levels, the total deaths per million population will not likely be much lower than Sweden’s…. though still much lower than New York, NJ, CT, Massachusetts, RI etc. Seeing DeSantis beaten up every day by the MSM, in spite of Florida’s relatively low death rate, betrays a frightening level of dishonesty.
SteveF,
And that’s not to mention largely ignoring CA and Democrat Gavin Newsom like Fuller did above.
“Herd immunity is the most likely explanation.”
Other explanations are possible. Transmission rate is declining – estimated at 0.6. Social distancing has to be considered as well. As I am sure you would tell me, leaping to preferred hypothesis without considering other options is all to easy.
https://www.euronews.com/2020/07/28/sweden-s-coronavirus-spread-slows-but-immunity-still-a-puzzle
An article in our media, https://www.stuff.co.nz/travel/destinations/europe/122306184/coronavirus-life-in-sweden-a-modified-happiness-during-the-covid19-pandemic was comparing reality of life in Sweden to NZ under level 3. People doing what we did, but voluntarily.
Before choosing a Swedish approach to pandemic (which has also badly affected their economy), countries need to consider whether it would work with their culture.
While I find the papers on pre-existing T-Cell immunity extremely encouraging, I dont think that is reason to dismiss models that predict increasing infection rate with relaxing of social distancing (eg the lastest from Annan). That t-cell immunity also has to be baked into R0. If it didnt exist, R0 would be even higher.
Phil Scadden,
“If it didnt exist, R0 would be even higher.”
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Sure. But it doesn’t change the influence of resistant people on the course of the pandemic. If ~38% of people are resistant from T-cell cross reactivity form earlier coronavirus infections and 12% are children below age 16 (who rarely get or transmit the virus), then the succeptible population is only ~50%. Yes, that implies double the “true Ro”, at least among susceptible individuals, but it also helps explain why herd immunity effects become apparent long before we might otherwise expect. Social distancing clearly has an impact (look at case rates in many states in the USA after people ‘relaxed’ their behavior). But “flattening the curve” didn’t make the virus disappear, nor will it. In the end, herd immunity will drive infections (and deaths) to very low levels. If an effective vaccine becomes available, that will help (especially for the very old and in places like NZ where a large fraction remain vulnerable), but for most regions it will be a minor factor.
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BTW, I thing this: “Before choosing a Swedish approach to pandemic (which has also badly affected their economy), countries need to consider whether it would work with their culture†is a red herring. Sweden’s economy has clearly done better because of their approach. Yes, they too have suffered, but that is in part because their neighbors mostly contracted… more than they did. The reality is this: Florida, with a culture which could not be more different from Sweden’s will likely end up with a death rate not very different (I suspect a bit lower). That has nothing to do with culture; it is mostly the reality of the virus. To the extent possible, protecting the most vulnerable from infection is the best option while the overall population moves toward herd immunity…. the rest is just politics.
Phil Scandden,
Because of the definition, I think what’s more correct is our estimate of Ro would have been higher. The initial estimates were based on the doubling rate of infections (or deaths), the estimate of time to infection (from Wuhan data) and the assumptoin there was zero herd immunity. The first two assumptios wouldn’t have changed– but if we thought only 50% of people were susceptible, the math applied to the doubling rate would give a different Ro.
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I’m never quite sure the various recent papers make this clear. I haven’t read them carefully.
To some extent: we will see what we will see. Right now, in Illinois as restrictions are relaxed detected cases have been rising but death’s falling. The number of tests has sky rocketed– so the rise in detected cases may be partially due to that. But in the past could of weeks the positive rate has also risen. So….
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I sooooooo wish I could go out dancing. But… not yet.
SteveF, that would mean a quarter of the virus killed in one second.
Three passes of air through the duct would get you to 40% virus remaining.
Getting a one second exposure could be done cheaply at the HVAC units without going into wall ducting.
For many building units, if the air is being refreshed from the outside, this would not be necessary- the key would be claring out the inside air rapidly.
MikeN
Yep. Using UV vs. fresh air is basically a trade-off. If you could have killed 25% of the virus on each pass through the AC, you could get the same reduction by bringing in 25% fresh air. So the issue is: how much do you have to heat, cool, humidify or dehumidify the fresh air.
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So, adding a small exhaust fan to a sick room and counting on infiltration through imperfect seals might be the cheapest most reliable method in a home. Or not.
But “flattening the curve†didn’t make the virus disappear, nor will it.
ok, I might have this wrong, but my understanding is that virus does disappear eventually if R remains <1. Herd immunity of 60% rather than 100% is enough because at that level, R drops below 1. If your culture allows for close to normal functioning while keeping R <1, then you are mostly ok. Florida is also benefiting from get hit much later than Sweden. It would be massive inditement on medicine if IFR did not drop with time as better strategies are discovered and a similar issue if nursing home management didnt evolve strategies to keep the virus out. In places where multi-generational houses are common (not Florida is my guess), keeping the virus out is a lot tougher.
Phil Scadden,
“It would be massive inditement on medicine if IFR did not drop with time as better strategies are discovered and a similar issue if nursing home management didnt evolve strategies to keep the virus out.â€
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There certainly have been changes in practice (and in state regulation, at least in Floria) to reduce the chance of spread in nursing homes. It is reasonable to expect that would have an effect on overall death rates. Education/awareness among the elderly who live outside nursing homes may also have had an impact…. the very elderly people I know are being very careful….. not so the 20 year olds. Aside from some use of hydroxy chloroquine/zinc/antibiotic regiment, I have read nothing about improved treatment protocols. We will see only later if medical care has actually improved significantly. What is very clear is that each decade of age above ~40 increases chance of death by a factor of about 1.5. The most obvious explanations for much lower death rates (per confirmed case), in Florida and elsewhere, are 1) more testing (so more confirmed positives) and 2) more young people catching the virus, who very rarely die from it.
Phil Scadden (Comment #188610): “I might have this wrong, but my understanding is that virus does disappear eventually if R remains <1."
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Simple models say that. I am not sure about more complex models. But reality says that is not true at all. Viruses do not disappear unless vaccination is used to drive immunity far beyond the herd immunity level.
I have read nothing about improved treatment protocols
Well no shortage of literature. eg
https://www.medpagetoday.com/infectiousdisease/covid19/87131
https://www.covid19treatmentguidelines.nih.gov/overview/management-of-covid-19/
Mike M. Ok, viruses might not disappears – after all mutations in flu and colds result in new infections where no immunity exist.
However, an epidemic ends when herd immunity is reached – or more to point, a little after R<1 is reached for any reason.
Yes, epidemics eventually end. Nobody said otherwise.
steveF – “Florida, with a culture which could not be more different from Sweden’s will likely end up with a death rate not very different (I suspect a bit lower).”
Are you implying that if Florida had just done as Sweden (no lockdowns anywhere), then it would still have ended up with similar toll to Sweden? Given the differences in culture, I find that pretty unlikely.
Comparisons between Sweden and Florida are apples and oranges. Sweden is more rural and Florida has more travel in a country with the largest outbreak in the world. Sweden is 3.2 times larger with half the population.
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I’m not sure what the differences in culture even are, I don’t even know what FL’s culture is and I’ve lived here 30 years. Florida is mostly a transient state and is a mishmash of the entire US. It is quite common in FL to ask where people are from, ha ha. There are more “natives” now than there used to be though. Florida’s population is 10x larger than it was in 1940.
Tom, the cultural question is whether if the government asked nicely for everyone to social distance, avoid groups, avoid travel and dont go to work when sick, would a useful no. of people comply. “useful” being a very large percentage of the population. My impression is that too many would complain about constraints on liberty but then I have never been there and media impressions can be misleading. Maybe if the government asked rather than directed, you would get better compliance.
Phil Schadden,
The guidelines say little more than “give them oxygen if they are short of oxygenâ€. They offer nothing “newâ€, and come right out and say so:
That suggested protocol is unchanged from April, yet deaths per case are much lower. I suspect there is pretty widespread use of hydroxychloroquine/zinc/antibiotic, and that is something new, but the lack of blind placebo controlled studies makes the effectiveness less certain. Only time will tell if that treatment is really effective. Plenty of doctors are convinced it works, but doctors are human.
Phil Scadden,
I think totally voluntary requests to social distance would not have worked well in the US at least early on. There’d be no anti-mask protests, but we’d still have the BLM ones. The partiers on the South and West side of chicago would still have partied on (they did with non-voluntary rules anyway.)
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Some voluntary distancing would have happened, but not as fast as it did when the government started cancelling things like parades, closing schools and so on. Closing businesses shut resulted in much more social distancing than we otherwise would have had.
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Still, it’s always hard to say for sure. At this point– reopening– social distancing is sort of a habit for people. So some of it is going to stay in place. I’m not sure the rules are really making more people stay at home. There’s lots of violations.
Phil Schadden,
There is no doubt that Floridians would not consistently do all the things you suggest. The noble Swedes are much more likely to follow those suggestions than those damned liberty loving Floridians. But the question is: does that ultimately make any difference in how many people die? I think in the end, the results will be similar.
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Certainly those most susceptible have to avoid exposure, or you will see New York City like death rates among the elderly (apparently several % of the elderly in much of NYC died). Among younger people, who in Florida did not initially catch the virus due to the many shutdowns of businesses, stores, restaurants, colleges, etc., there is very little risk of death from the virus. Those younger people DID catch the virus in NYC before all the mandates went into effect, so NYC is past herd immunity. With restrictions lifted, younger Floridians, and unfortunately some older ones as well, are now contracting the illness. Florida either is or will very soon be past the HIT as well. The only thing that matters is if the pandemic subsides with more or fewer deaths. On that account, Florida, despite many of its citizens holding unfortunate political views about liberty, will be far better off than a host of places with populations who’s political views you find more sensible. The virus doesn’t care about politics.
SteveF,
I’m not confident about anyone (other than possibly Sweden) passing herd immunity. I’m not even totally confident Sweden has passed real herd immunity which would be the level that prevents the virus from spreading if they go back to social contact at the level before the pandemic.
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But you’re right that (absent a vaccine) the path to the true end of the epidemic may involve roughly the same number of people dead almost everywhere. New Zealand may be an exception because it’s borders are more easily controlled than elsewhere. But many countries are playing whackamole now. If the vaccine arrives tomorrow, they’ll be able to stop playing whackamole and will have saved lives. If the vaccine takes a decade, Sweden’s strategy will have been best.
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I don’t think the vaccine will be here tomorrow; I suspect it will be here in less than a year. Given various sacrifices and also what’s possible, I think rules are a tough call.
Lucia,
Only relaxing of rules in places like NYC will show for certain if real herd immunity has been reached. In Sweden, there are few rules to relax, so I am not sure how you could judge with certainty, unless there were a sudden surge in cases… indicating HIT has not been reached. The behavior of the Swedes (at least as seen in photos and videos) doesn’t seem at all restricted, so it may not be easy to verify if individual behaviors have changed the value of Ro in Sweden.
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“If the vaccine arrives tomorrow, they’ll be able to stop playing whackamole and will have saved lives.”
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Sure, but once again, there is no certainty a vaccine will be very effective, nor when it will be commonly available. I will be very surprised if you are offered a vaccine within the next 12 months, even if some people are. In places where restrictions are hurting businesses (and that is most places!) there is a significant economic cost of whackamole which will continue until the population is mostly immunized. My fear is not of the virus, but of how the pandemic will increase chance of damaging public policies whenever any significant threat arises in the future. My hope is that future calm analysis will show how unreasoning fear drove unnecessary public policies.
SteveF
Sure. Of course I meant if the an effective widely available vaccine arrives tomorrow…
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I agree it’s not clear that we’ll have one soon.
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There are other things I wish would happen sooner: Widely available cheap LAMP testing could really help in schools. All kids and teachers could be required to be tested the day before the first day of school (with staged arrival dates). Any kids or teachers that are positive could be required to stay home. For the first week at least, all kids and teachers could be tested daily. After a while, that could be dropped to each kid being tested weekly (or have a pooled test daily.)
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These tests have higher false negatives than the nasal swaps, but “no test” is sort of the ultimate false negative!
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This sort of testing could largely reduce the concern that it’s hard to get 8 year olds to social distance. (It’s hard to get adults to social distance.)
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Similar things could be done for university courses, dorms, meat packing. But psychologically there is a strong need in k-12 right now.
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Unfortunately, we don’t have these tests widely available. I understand it’s partly due to regulatory burdens. (I’ve read part of the “concern” is the false negative rate. But really, even a 50% false negative rate would be better than no testing!)
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Heck, I wouldn’t mind LAMP testing for my ballroom dance lessons. I know by ballroom teacher would love it!
https://www.fiercebiotech.com/medtech/sorrento-picks-up-color-changing-covid-19-saliva-test-built-by-columbia-university
Any such test would have to be based on saliva and be extremely fast. The claimed analysis time of 30 minutes looks too long for on-site screening. If you had to present a negative result from the day before (or 2 or 3 days before) to enter the school that would be more workable, but even that would be a challenge depending on how often testing would have to be repeated. But Sweden’s experience with keeping kids below age 16 in school should be informative about the need for blanket testing for grade school kids.
SteveF
That’s why I think they would need to have kids make an appointment the day before and be tested. They you’d at least know they weren’t infected the day before. Then test every day for the first week.
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I agree Sweden’s experience should be informative. But many parents and teachers are terrified. Like it or not, education about Sweden’s outcome isn’t going to calm them all.
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The real issue with the above test is cost. If it’s cheap, it can be done. Pooled testing might be fine (if it’s possible. It might not be. That vial looks only large enough for one person’s spit.)
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If they pooled tested 20 kids in a 1st grade classroom, and get negative, they don’t need further testing of the cohort. They could at least catch any problem before it spread. If Sweden’s experience holds they’ll get a whole bunch of negatives, but that’s ok.
Here’s another fast tests. UIUC is evidently going to test all students several times a week. The article also does modeling on spread. To stem spread, it’s better to use a somewhat lower sensitivity test very often than to use a higher sensitivity test infrequently.
https://www.sciencemag.org/news/2020/08/radical-shift-testing-strategy-needed-reopen-schools-and-businesses-researchers-say
The vast majority of the US is only being kindly asked to do social distancing, et. al. The point being that enforcement by the power of the state is pretty sparse. A few restaurants are getting shut down but protests are allowed to occur. Not many people are getting fined for masks, but it occurs in some places. The social pressure to comply is pretty high now, walking around in my grocery store without a mask will get you noticed, and not in a good way. I see people in some establishments wearing their masks around their chin, only to pop them up when a customer walks in. I think they are missing the point, and the government would be wise to run some public service TV ads, etc. explaining these things.
Tom Scharf (Comment #188648): “I see people in some establishments wearing their masks around their chin, only to pop them up when a customer walks in. I think they are missing the point, and the government would be wise to run some public service TV ads, etc. explaining these things.”
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Why are they missing the point? Real question. If they wear the mask when nobody else is around, they are loading it up with germs that can then get reaerosolized when they talk to the customer or, even worse, happen to cough or sneeze. I suppose that whether that is a problem depends on how quickly the germs die on the mask.
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On the other hand, PSAs giving dos and don’ts would seem to be an essential part of any public health campaign. But that would be too much work. Much easier just to issue a diktat and be done with it. So what if it inconveniences the proles without doing much good, as long as the people who matter are free to ignore the rules. Almost makes one think that public health is not the real point.
Tom Scharf
IF the main mechanism for transmission is droplets, this ought to be ok since the mask is meant to protect when you can’t social distance. After some distance, those drops fall the the ground, where they don’t suddenly rebound up and become breathable.
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I see everyone cleaning floors constantly. (This despite the fact that all the announcements now say fomite trasnsport is not important.) It seems to me you could practically eat off most floors in retail at this point! (Well, except for the Covid that might have settled down in the past 30 minutes. But of course, no one eats off a supermarket floor, so it really doesn’t present much danger.)
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If transmission is aerosol, then ventilation and filtration are the main protection. Masks don’t filter aerosols very well, though they filter some. You as a customer and they as employees better hope the HVAC system is adequate!
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Of course, those in the store should wear them when they are near each other but sometimes they aren’t near anyone.
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It isn’t fun to wear a mask all the time. Not suprisingly, people aren’t going to be very motivated to wear it during times when… well… the discussions of how and why they work suggest they aren’t needed. (Pre-covid, surgeons didn’t mask up when discussing operations with loved ones in the hallway. That wasn’t where it was needed.)
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Dropping the mask when no one is around is the sort of behavior one might expect from people who hear what the experts are saying, process what they say, understand it and believe it.
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So given the explanations of why or how masks work, I don’t quite know what public service announcement or explanation could really explain why everyone in the store should keep the mask on when they are the only one in the store. I mean… unless they lie about what we know about masks or how we think they work, there really isn’t any public service announcement that will explain why you should wear a mask when you are alone in a store.
It depends on how much lighter aerosols really matter, and if the masks are useful to limit those. If somebody is coughing up a storm or talking really loudly without a mask on I don’t won’t to be walking into hygiene theater after that. If it’s just heavy droplets then perhaps it is inconsequential. Some people wear them with the nose exposed which is pretty non-compliant.
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It’s these very questions that need to be answered by science. As always I am distressed as to how thin the veneer of science knowledge is here. I haven’t seen any messages of “only wear them in presence of others indoors”, so it is an open question I suppose.
Aerosol transfer is a likely source of transmission, and the government is getting the time in air for droplets wrong.
http://archive.is/PBxkM
Tom Scharf,
If the are alone, they aren’t likely to be talking up a storm. If they are coughing, they should go home.
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Wearing with nose exposed is non-complaint. But that’s different from if someone is alone.
The aerosol question appears to be an open one. But those promoting masks most strongly seem to favor the “it’s droplets not aerosols” position. If that’s their position, then a more detailed public service announcement would need to suggest they don’t need to wear them when alone in the shop. (Mind you, it might be wise from a customer relations POV. But that’s not a “the science issue.).
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They can only sustain the “all the time” position if they think it’s aerosols or if they say we think they work, but we aren’t entirely sure why. But in the former case, they need to start making suggestions about aerosols.
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If the latter, they can say “just in case it’s aerosols, you should wear all the time.” Or something. They don’t want to admit the latter. 🙂
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Honestly, I think masks are wise in crowded places. Some “anecdotal” evidence suggest they help. But… no one is going to clarify much because the evidence is not bullet proof. We certainly don’t have evidence to distinguish things like whether they are necessary when 1 person is the sole occupant in a building.
Some supposed expert on NBC this morning while discussing returning to face to face schooling made the claim that masks reduce transmission by 80%. I seriously doubt that assertion can be backed by data. Needless to say, it being the Today show, no reference was cited.
DeWitt,’
I’m sure that’s not backed by extensive science! But no one is going to point that out.
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At best, I think they know what fraction of different size particles are caught by different types of masks worn correctly. I’d suspect trapping some particles will decrease transmission some amount. I doubt we know if trapping 80% of particles in exhaled breaths reduced transmission 1%, 50% or 99%.
Here is a factor in the big recent jump in deaths. Texas had been reporting very low numbers of deaths on Mondays. But on Monday, July 27 they reported 675 deaths, compared to an average of 186 for the 7 days since and an average of 154 for the 7 days prior. The COVID tracking project says:
https://covidtracking.com/data/state/texas#historical
So that boosts the 7 day average by 90 deaths for any interval that includes that date.
And then:
That correction does not appear to be reflected in the tracking project’s numbers. I don’t know how much overlap there is between the 631 added and the 225 over count.
lucia (Comment #188656): “At best, I think they know what fraction of different size particles are caught by different types of masks worn correctly. I’d suspect trapping some particles will decrease transmission some amount.”
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I think that is right. But the particles trapped by the mask, especially a cloth mask, are the ones that are going to fall our of the air quickly. So the mask may not be trapping the particles that need to be trapped.
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Studies on masks for influenza indicate that surgical masks reduce transmission by perhaps 20%, but the error bars include zero. Cloth masks will be even less effective.
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But the actual result might be *much* worse because of risk compensation. If people think that masks make them and others safer, they will engage in behavior they would otherwise avoid. If the perceived reduction in risk is greater than the actual reduction in risk, then the net result could be increased risk. So telling people that masks are much more effective than they actually are could have an effect opposite to what is desired.
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Let me restate that: Telling people how great masks are could actually increase transmission. Not because the masks increase transmission, but because they lead to behavioral changes that increase transmission.
MIkeM,
I’ve seen papers and both types are trapped. A larger fraction of the bitter ones are trapped, but small ones are also trapped.
I was dubious of this theory back when “the experts” were advising against masks; I remain dubious. I tend to think on balance the mask wearing reminds people why they are wearing it and they become more cautious. In fact, the behavior effects of mask wearing might be one of the main reasons “masks work”.
DeWitt,
“Needless to say, it being the Today show, no reference was cited.”
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Today, like every day, fluff programs like Today provide only content-free blather.
Hummmm… I wonder if you must always wear a mask when you go on a date? At what point should you “trust” the other person enough to not wear a mask? Is it before or after becoming… ahem.. intimate with them? Rhetorical questions all, but still humorous I think.
SteveF…..
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Well… we do know one thing: Don’t wear it with your nose hanging out.
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Colleges are trying to scare-guilt their undergraduates to not party. That presumably will extend to not dating. That’s not going to work. At best, they’ll be able to avoid huge parties. They may fail at that.
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They need some sort of LAMP testing or pooled testing or something. Their only other hopes to keep cases from rising during the fall semester
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(a) hope the student population is near or past herd immunity.
(b) continue purely online with no on campus meeting.
(c) prayer/finger crossing.
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Oh, (a) will also involve prayer or finger crossing.
Lucia,
a) Not a chance…. at least in most places. Policies have been put in place to almost guarantee young healthy people don’t get the virus. Which makes it problematic for them to attend school after age 15 (when susceptibility rises rapidly). Maybe in Florida, New York City, Massachusetts and NJ there is a chance, but all those places except Florida are not going to try.
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b) Few parents are going to want to pay $50,000+ a year for their child to watch videos of professors. Most colleges are in deep trouble. I hope they cut the nonsensical courses and associated professors, not the substantive ones, but that is probably too much to hope for. I mean, how could any college continue functioning without a department dedicated to race-studies for transgender individuals who are very woke.
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c) Not a chance.
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In sum: Public policies continue to screw young people.
SteveF,
Yes. The hopeful side is many college students will be asymptomatic, meaning they will emerge unscathed. Some will just “have a cold”. But some will get very sick, and some will die. It won’t be as bad as old folks.
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The professors OTOH: that’s where the hit could come harder.
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Schools will have a tough PR problem if they appear to protect professors much, much more than students.
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Mind you: the professors activities will make them a bit more protected than students in a dorm. Lecturing courses, they are usually the one speaking most. They are usually at least 6 ft from a front row of desks (and can organize a room to ensure it.) In their offices, they are generally alone.
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Dorms are going to be the big issue. I’d probably buy my kid an air purifier even though the degree of protection is highly uncertain!
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Lots of people are going to be nervous.
First Tianjin in 2015 (registered as a 2.9 earthquake), now Beirut (registered a 3.3). I recommend not storing large amounts of crazily explosive materials near population centers, but who am I to question this wisdom? Call me a conspiracy theorist, but I’m not really buying that was a fireworks factory as an initial report suggested. Perhaps a Hezbollah rocket factory. The red color of the cloud is probably a clue.
Tom,
I also think the fireworks factory is dubious. We’ll see. But yeah…. why so much near a city center?! I think large cities should have zoning that enforces “no huge stock piles of explosives”.
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I remember having trouble trying to figure out how we could keep large amounts of vegetable oil in a building on the Hanford site!
But the question is: does that ultimately make any difference in how many people die? I think in the end, the results will be similar.
Well that is a hard hypothesis to test, because Florida did do lockdown so no easy way to see what would have happened if they tried a Swedish approach. I note that Stockholm (worst affected) has pretty similar population density to Miami, so comparisons would probably not too dissimilar.
” On that account, Florida, despite many of its citizens holding unfortunate political views about liberty, will be far better off than a host of places with populations who’s political views you find more sensible.”
Well long way from endgame yet, but my money is on bet that Florida, with 340/m deaths so far is also going to end up far worse off than many countries with politics you would find abhorrent. Oh, and I am very much a fan of liberty in the Locke sense, but at moment the word seems to be a dog whistle in the US cultural wars.
Phil Scadden,
If you look at the florida history, there was a peak, a decline, and then a much larger peak. The sort-of-kind-of lockdown in Florida clearly did suppress rapid growth in cases until things started to open up. So I think the comparison with Sweden, if one is going to be made, should be with the second much larger peak… and that should be done when both have seen deaths decline to a few percent of their peak rate. I’m not sure which countries with policies I abhor are the one you are talking about, but I very much doubt Florida is going to catch up with the UK, Italy, or Spain on a per capita basis… all with draconian public policies I abhor.
Lucia,
Here is the CDC data for fatalities by age group over time: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
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The 0 to 25 group doesn’t move off the baseline. Yes a few young people will die (most often with other health issues), but a few young people die from all kinds of causes. The principle issue of opening colleges is really the risk to professors, administrators, and other staff… not the risk to students.
The risk is also to their parents, grandparents, and if the parents work with vunerable people, then to them as well.
Also, one hopes that no government could be as incompetent in aged care management as the UK; but for Spain and Italy, the damage was pretty much done BEFORE any of the draconian measures that you dislike. The virus has spread widely enough, fast enough to get a high kill. Both seem to stand as examples of what happens if you react too slowly, magnified by population age structure and cultural features like high contact and multigenerational households.
Phil,
I guess college students should go off to school and stay there until the semester is over…. wait, that is pretty much what I did 50 years ago, without a covid panic. No risk to all those you are concerned about.
Barring a vaccine/treatment the reality is the politics may just be choosing the rate at which people die, not the total, once there is a global wide spread contagion. That’s what the simple numbers of an infection say.
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It was flatten the curve, then reopen safely and keep the contagion in check. It would appear an operational economy and containment are simply not possible, and political confirmation bias doesn’t affect outcomes.
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Stopping the contagion early is the real game, and that game has been decisively lost by any measure.
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Delaying the deaths has real advantages waiting for a treatment or vaccine. It’s still a noble and likely useful goal. However I don’t see any place lasting another 9 months in lock down with record economic contraction and unemployment. What I do see is an enormous amount of moral posturing against that obvious fact. I saw large numbers of people in Germany last weekend doing very heavy partying in the WSJ. When winter comes and climate drives everyone indoors up north, what is likely to happen? People don’t want to stay locked in their houses for 2% of their lives to avoid a 1/1000 chance of dying.
The WSJ says the explosive material in Beirut was ammonium nitrate like the 1947 Texas City explosion. If the temperature and pressure get high enough in a fire, it can detonate. The Wikipedia article on Texas City says the fertilizer grade ammonium nitrate contained petrolatum, rosin and paraffin wax to prevent clumping. That would increase the explosive power. IIRC, the ideal mix for ANFO (ammonium nitrate/fuel oil) explosive is 85% ammonium nitrate and 15% fuel oil, so not much organic is needed. The red color would be from nitrogen dioxide.
The reason it was in Texas City is that the port of Houston banned loading of ships with ammonium nitrate.
Oops. I agree. “College” means “high school” here – I sometimes forget.
The Lebanese government says the warehouse had explosive materials in it. Thank you Captain Obvious. They said it was old confiscated ammonium nitrate that’s been there for six years.
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Before the 2nd explosion there were lots of popcorn sounds / flashes which may have been munitions, or a … ahem … fireworks factory next door which apparently uses valuable port real estate for it’s manufacturing facility. You just have to wonder about a government that allows a fireworks factory to be built next door to a “fertilizer” storage facility.
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Iran and now Lebanon are having problems keeping some of their buildings from exploding lately. Israel is being speculatively blamed of course. I can’t possibly see what can be gained by blowing up fertilizer and fireworks.
Plasma transfusion with antibodies lowers mortality rates
https://www.wsj.com/articles/convalescent-plasma-reduced-death-rate-among-covid-19-patients-study-data-signals-11596594390
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“Patients who at three days or less after diagnosis received plasma containing high levels of antibodies against the coronavirus had a mortality rate of 6.6% at seven days after the transfusion. That compared with a mortality rate of 13.3% for patients who got plasma with low levels of antibodies at four days or more after diagnosis. That indicates reduced mortality of about 50%, the researchers said.”
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Sounds like some pretty sick patients were getting the transfusions.
That suggested protocol is unchanged from April, yet deaths per case are much lower. I suspect there is pretty widespread use of hydroxychloroquine/zinc/antibiotic,
Given NIH recommendation against it, https://www.covid19treatmentguidelines.nih.gov/whats-new/
it doesnt seem that likely to me. What I do see is remdesivir. Just the development of clear clinical guides, understanding comorbities and risk saves lives. Clinicians have clearer idea about what to expect and how to prepare for it. Something completely missing at the start.
Phil,
Active prescriptions for hydroxychloroquine in the USA have approximately doubled (an extra 350,000 prescriptions). Somebody is taking the drug. The results of several double blind prospective studies should start to become available in September.
Phil Scadden (Comment #188681): “What I do see is remdesivir. Just the development of clear clinical guides, understanding comorbities and risk saves lives. Clinicians have clearer idea about what to expect and how to prepare for it. Something completely missing at the start.”
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CFR is down by a factor of 4 or 5 in the US. Although remdesivir probably makes a contribution, the supply is limited and when used reduces deaths by about 20%. Better clinical management probably also helps, but I don’t see how it can be more than a minor part of such a large change.
As SteveF says, a lot of people are taking hydroxychloroquine, so that could be a factor.
Likely the biggest factor is who is getting sick. With not-at-risk people circulating more and better controls in nursing homes, the distribution has changed to people who are younger and/or less vulnerable.
Tom Scharf,
A fire with red/orange smoke followed by a detonation is what you would expect with ammonium nitrate. So unless the fire was arson, I seriously doubt that Israel or any other group was responsible. IMO, if it had been deliberate, then it would have been a detonation followed by fires, not the other way around.
Just one random guy’s tweet, but he suggests that the ammonium nitrate has been sitting in that warehouse for seven years. Nothing nefarious, just … administrative incompetence, maybe.
https://twitter.com/HachemYassin/status/1290702640930791424?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1290702640930791424%7Ctwgr%5E&ref_url=https%3A%2F%2Fwww.redstate.com%2Fshipwreckedcrew%2F2020%2F08%2F04%2Fabandoned-shipment-of-ammonium-nitrate-behind-the-explosion-in-beirut-today%2F
Lebanon’s PM says the same.
https://www.indiatvnews.com/news/world/beirut-blast-cause-revealed-2750-tonnes-ammonium-nitrate-explosion-lebanon-prime-minister-639690
So far I haven’t seen a single mention of the Texas City disaster in the coverage of Beirut. Don’t reporters do any research before they write articles? I know, silly question. The quantity of ammonium nitrate, at least in the ship Grandcamp was a little over 2,000 metric tonnes. But there wasn’t a chemical plant and oil refineries in the vicinity in Beirut.
Interesting article on hydroxychloroquine:
https://www.realclearpolitics.com/articles/2020/08/04/an_effective_covid_treatment_the_media_continues_to_besmirch_143875.html
Not all of the evidence cited is convincing, but what happened in Switzerland is striking. They were using hydroxychloroquine aggressively early in the illness. They stopped when WHO withdrew their approval. Deaths shot up. They then went back to hydroxychloroquine and deaths came down dramatically.
From the summary:
I’m finding it hard to believe all that ammonium nitrate was sitting at customs for years. I think customs officials would have sold it off as fertilizer.
SteveF, open the dorms early, and try to get students infected. This will protect other employees as they get immunized.
50 years ago, there was a pandemic of Hong Kong flu, killing 100,000 in America. Do you remember anyone talking about it?
MikeN,
So you think that the ammonium nitrate was trucked in recently and a fire was set hoping that there would be a detonation? I find that exceedingly hard to believe. Bureaucratic incompetence, however, is a lot easier to believe.
It’s blindingly obvious from the video of the detonation (not an explosion, there was a shock wave which means high explosive) that the agent was ammonium nitrate. The color of the smoke cloud is diagnostic. Read the description of the Texas City disaster.
Mike M,
The resistance is strong to any covid treatment which makes a return to normal any more likely before November, and that seems to me at least in part politically motivated.
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Watching the CDC bureaucrats carry on about how covid 19 treatments are ineffective, in spite of significant evidence to the contrary (like Switzerland’s experience), reminds me a little of the forecasters at the national hurricane center…. those folks appear to be actually rooting for every tropical storm to become stronger and more dangerous. I guess they want to maintain alarm so their jobs are more important. The recent weak tropical storm that ran up the East Coast is a perfect example of the problem. Each and every public advisory was dire, with warnings of extreme rain, flooding, storm surge, constant danger of strengthening of the storm, etc. But it was all BS.
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At the exact same time the NHC was projecting “hurricane force surface winds” based on wind models, I checked actual conditions for three different weather stations in the Bahamas, which were sitting in the middle of the storm and the highest reported surface wind speed was 45 MPH… with light intermittent rain. I don’t know how they can with a straight face “project surface winds over 75 MPH” and “heavy rain” when the ground truth from three different weather stations showed that was rubbish. In the end, Florida suffered no heavy rain, no flooding, no storm surge, and very little wind. It was much the same all the way up the East Coast.
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Those involved at both the CDC and the National Hurricane Center should watch “The bridge Over the River Kwai”, because they seem to have lost touch with their real objectives.
MikeN,
“50 years ago, there was a pandemic of Hong Kong flu, killing 100,000 in America. Do you remember anyone talking about it?”
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I was in college at the time, and it was a non-event. Nobody paid any attention to the flu.
The CDC has an interesting data set on their web site: weekly total deaths in the USA (2020, all causes) and weekly deaths from covid, for each age group from infants to over 85. Among all groups over 55, covid increased total deaths in exactly the same pattern… rising quickly to a peak of ~35% above “normal” deaths back in April, followed by a decline to about 12% above normal deaths by June. There was no similar pattern among younger people; for people below 25 covid increased the (very low!) death rates by ~1% to ~9% and hardly changed at all from March until now. So the big drop in IFR seems driven mainly by a big drop in fatality rates among those over 55. Either the elderly are mostly avoiding exposure, or treatment of the illness is dramatically improved. I believe it is most likely the former.
SteveF,
What the CDC and the FDA are doing to ‘test’ the effectiveness of hydroxychloroquine against SARS-CoV-2 would be equivalent to testing the effectiveness of Tamiflu and the other antiviral drugs against influenza by only giving it to people who have been hospitalized for influenza. They know better. In fact, you have only 48 hours after showing first symptoms to take Tamiflu or any of the other three approved influenza antivirals for it to have a significant effect.
From the CDC website:
The 1957 influenza pandemic killed 70,000-116,000 in the US and at least 1 million (some estimates are a lot higher) world wide. Given the increase in population from 172 million in 1957 to 331 million and from 2.87 billion to 7.79 billion today, that would be equivalent to 134,700 to 223,000 in the US and at least 2.7 million globally.
Beirut Explosion: Probe Focuses on Why Tons of Explosives Were Stored at Port
https://www.wsj.com/articles/beirut-explosion-kills-at-least-100-injures-thousands-11596620481
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“The explosives originally entered Beirut’s port on board the Moldovan-flagged Rhosus, which set sail for Mozambique from Georgia in 2013, according to a senior Lebanese politician, an army official and a Middle East security official.
Shiparrested.com, a shipping industry newsletter, wrote in 2015 that the vessel carrying 2,750 tons of ammonium nitrate was forced to dock in 2013 in Beirut due to technical problems and was subsequently abandoned there by its owners.
Port authorities deposited the explosives in a warehouse in the port and were supposed to dispose of them safely, according to the newsletter.”
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Looks like bureaucratic incompetence.
Nobody paid any attention to the flu. So a feature of those pandemics was a passive government reponse, right? Since US population has doubled, that would be equivalent to 200,000 deaths today. I think US is on course to get close to that.
So the question then would be, what would the eventual toll be if the state governments had been similarly as passive? People have noted CFR is dropping, and claim that is partly due to improved treatments of some sort (rather than just change in age structure of infection), so that would imply death rate would have been higher if government had just let it rip.
MikeN (Comment #188710)
August 5th, 2020 at 1:38 pm
50 years ago, there was a pandemic of Hong Kong flu, killing 100,000 in America. Do you remember anyone talking about it?
I spent 4 days in hospital and almost died. In Australia schools were closed because it hit children so hard. As a pandemic it only had a very short duration compared to Covid.
Andrew Kennett
Well… they may have been. But I was only about 10 years old, so I probably didn’t pay any attention.
Tom Scharf,
“People don’t want to stay locked in their houses for 2% of their lives to avoid a 1/1000 chance of dying.â€
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That is right, at least for many people. But public policies in many places are much worse: They say “You must stay locked in your house for 2% of your lifetime, not to reduce your personal risk, which is very close to zero, but to reduce the risk to people very near the end of their lives.“ Not to mention widespread economic losses, disrupting the education of children, and unemployment among those least able to afford loss of income. IMO, it is just bad public policy that costs much more than it is worth.
I think fast Covid tests for everyone are around the corner. UIUC is testing everyone every 3 days using fast tests this upcoming fall. Those who get a positive will be quarantined (then retested with the more accurate test). Racine Wisconsin has their firemen running fast tests (on a sort of experimental basis. ) These tests are cheap (as in $0.07 for materials.)
The main thing blocking commercial fast tests is regulations. If we had them, my ballroom studio could have their teachers tested every day. They could require students taking lessons to get tested.
Preditction: I think regulations will change (fingers crossed). We’ll have these on the market is…. 2 months.
(Predictions are hard. Especially about the future. I’m probably too optimistic about regulators. . .)
Lucia,
Regulations that keep people from doing what they want are put in place very quickly, and with little or no consideration of negative consequences. Lifting existing regulations is what is very slow. IMO, this just reflects an upside down set of political priorities, combined with the standard “your cost, my benefit†that interests groups always support… so long as the benefit is theirs. Do barber and hair dressers need to be licensed/certified? Of course not. Yet they are, most everywhere. All kinds of useless regulations exist, and do real economic damage. I would not hold my breath waiting for the FDA to approve new covid tests…. especially if they might actually compete with incumbent testing labs.
SteveF,
I know. But Covid medical regulations are tending to get lifted. So I’m hopeful. Were it not for the pandemic I’d know getting them lifted would be impossible. The big issue with the tests is going to be getting those with the power to change regulations from being appropriate to controlling medical devices used for clinical diagnosis to those used for epedimiological monitoring.
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A cheap $1/vial test (that can even be pooled) to test kids in school that detects detects whether a kid or teacher is contageious would be a huge benefit for schools meeting. It would really help parents and teacher’s anxiety. Catching kids who are contageious and isolating them until they can be sent home would just be huge.
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Obviously, this would also be huge for pork processing plants and anywhere with congregate living. It would be terrific for my ballroom dance classes. (The studio has few enough private clients that they could get us to test ourselves.)
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Lots of people would be much more willing to isolate themselves after a “positive” test. Not to mention– if you get the positive quickly– well before symptoms– it would actually become possible to treat people early. So early treatments (should we have any) because more useful. (Most doctors will insist on the more reliable test before most treatments. But patients will then be on the radar at the beginning of their illness.)
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These fast tests are possible– as evidence by the fact that they are being done.
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The Racine Wisconsin story is interesting. Turns out the mayor’s younger brother was a research md on the team developing a test. They mayor saw his brother’s paper on Facebook, called them, and working together, the team and the mayor got sort of “test” implentation of the technology going in Racine. That’s why the firefighters are the labor! (Collecting spit, warming, titrating, sending city workers their tests.)
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We could have these tests long before the vaccine. (We still will want the vaccine, but a $1 test would be a huge breakthrough.
Oh– you an watch the video I posted on the next post. It’s an hour… so…. (I used the setting to double the speed which makes it 1/2 an hour.)
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I didn’t btw first hear about these tests from that video (which I saw on Mosher’s twitter feed.) I’d been seeing people tweeting about cheap LAMP tests, then I saw the UIUC article… then I googled and saw the Racine WI tests. Then I saw the video.
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We’ll see. If regulation was sane, they’d change them within 2 weeks. But… I’m betting 2 months. (Of course, I could lose that for the reasons SteveF says.)
Lucia,
I hope you are right and the fast, cheap tests using saliva get approved quickly. But I wouldn’t put money on it. The FDA bureaucrats have pretty much absolute power over these things, and we know what absolute power does to people.
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Many years ago I visited Merck’s West Point PA site several different times over two years. It was a huge facility with many thousands of people working there. The site was vast, so they had constructed a large multi-story parking garage, which was directly connected to one of the larger buildings (where administrators worked), so some people could avoid walking through bad weather. Lowly visitors like me had to park at a distant parking lot, and then walk to and through the parking garage to enter the building. As you might expect, there were many “choice” parking places near the building entrance permanently assigned to ‘important’ employees… VP’s, department heads, etc. But the dozen or so most desirable parking places were permanently assigned to “FDA Staff”. They were empty each time I visited. Merck understood clearly what mattered to their business; they were terrified of the FDA, and no doubt still are.
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BTW, I think it is probably safe to say Florida is now past it’s peak in cases. (https://www.worldometers.info/coronavirus/usa/florida/) The peak in deaths is likely to come the next few days. (The Florida dashboard will give a more accurate peak date, but that won’t be available until some time after August 20.)
SteveF,
I agree Florida is past their peak.
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It took me a while to google– because I wasn’t familiar with an acronym. Evidently, one of the possibilities is having the tests get a
CLIA examption.
https://www.cdc.gov/labquality/waived-tests.html
My understanding is the difficulty is the threshold regulators want to set for defining an “erroneous” result. The problem is the standard used– which is what % of live virus is present compared to when the more expensive tests will give a positive. The viral load in a patient rises with time, and the cheap tests need a larger viral load to flag a positive.
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So, from a sort of “lab” POV, the more expensive tests look somewhat “better” and have potential for fewer false positives.
Stepping back and using an epidemiological point of view, a test Because of the way virus grows in an infected person, The difference in time between when the two test trigger a false positive is small– as in less than a day. So, if you can test people every 3 days for $1 a test, and the test is easy, you catch a much higher proportion of people who are infected. So you can isolate them.
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There are evidently other “concerns” (which would when you think of what we really need are “stupid” concerns). For example: some regulators have their knickers in a twist about tests where people who take the test don’t report in their result– whether positive or negative.
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Yes…. cheap tests would screw up the statistics. . . But that’s just a stupid reason to not have every kid in school be tested every 3 days, not letting everyone taking an airplane be tested preflight, not allowing people to drive to another state provided they test. Not allowing meat packers to catch Covid early. It’s just dumb.
There seems to be a of magical thinking on testing.
Racine experiment:
https://www.wired.com/story/a-wisconsin-city-experiments-with-a-faster-diy-covid-19-test/
Sounds pretty labor intensive. It certainly takes a lot more than a few seconds of the technicians time. And it says nothing about equipment cost.
The 7 cents comes from here: https://www.medrxiv.org/content/10.1101/2020.04.23.20076877v1
I went looking for real world info and found some for a TB test from the Stop TB Partnership using the HumaLoop T and LoopampTM PURE DNA Extraction Kit (from a PDF file.) $6 per sample for consumable, about $4000 for equipment (special price for developing countries), batches of up to 16 samples, results in an hour. Specifically designed for field use with minimal training (2 days).
Sure, scale might improve the numbers. But they are likely a lot closer to reality than somebody flogging what they hope their new method might someday be capable of.
At an optimistic $10 per test, testing everyone in the U.S. every day would cost a trillion dollars a year.
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lucia (Comment #188746): “If we had them, my ballroom studio could have their teachers tested every day. They could require students taking lessons to get tested.”
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Yep. They’d just have to show up an hour early and spend the hour isolated from each other. Plus pay twice as much per lesson.
Mike M,
Yes. Their current process is labor intensive. I don’t see how that makes it “magical thinking”. In the first place: the firefighter supported process is not intended to be the final commercial process. The companies are working on automated processes. It’s pretty common for various types of tests to be going on at the same time when someone is bringing a new process together.
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I also think you are applying a ridiculous standard here:
First: it’s true that if we applied it to everyone every day, we could probably cruse the virus which might be a nice thing. We’d have to keep doing it forever or at least until everyone entering the country can be tested. But that doesn’t mean this is the only possible way the test could be useful.
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(1) Every three days would be sufficient to isolate nearly everyone who is contagious to keep them from passing on. That would knock the effective Ro well below 1. So, the virus could be contained. This knockes the cost down.
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(2) Even a $10 per test is a heck of a lot cheaper than NY and Chicago decreeing everyone coming from targeted steps going into a 14 day quarantine. Ideally, everyone gets tested an hour before a flight and can’t board if they trigger a positive. Failing that, the test is processed while they are in flight. They are intercpeted on landing and told to isolate. (They can be retested with another test. That’s what UIUC is doing with it’s test.)
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(3) A $10 per test could be given once every three days to people working in meat packing plants. People who get a positive could be sent home. I bet employers would find this a net savings relative to having people get sick.
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(4) It’s been proposed these tests can be pooled. A $10 test using a pooled sample could be used on groups of students in k-12 where masks and behavior is going to be difficult to monitor. It’s fine to insist that ‘the science’ indicates kids don’t pass on the virus, but it’s not entirely clear they don’t get it at all. Right now, for lack of any testing, in person school is being cancelled. Tests like these would save our ass on educational lapses.
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(5) obviously what goes above goes for day care.
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There are all sorts of ways a $10 test with a 1 hour turn around time could help lots of people relative to the current status quo.
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I would suspect that if tests like these became available, and pooling is possible, lots families would take pooled tests every third day. Some would even give up a daily Starbucks coffee or pastry to do it.
MIke M
No they wouldn’t need to do any of that.
Your assuming that the studio itself would do the test.
When I said the studio “could have the teachers tested every day”, I didn’t mean the studio itself would do that. They could just have the teachers take a test at home (if that becomes available) or drop a spit sample off every day. The teachers don’t need to wait for the report. They took a test yesterday also and are presumptively non-infectious. But their Covid will be detected before they become infectious. If the lab calls back positive, they cancel their lessons. No one needs to wait at the ballroom the same way no one is waiting in the tests being done in Racine and the way no one is planning to be forced to wait in the tests planned at UIUC. (They will be testing everyone every three days.)
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If the studio wanted to check whether we complied, they could simply require us to show a slip and reciept from the testing facility with a date stamp fresher than 1 or 2 days. (UIUC is testing every 3 days– that seems to be enough for epidemiology.) The types of people currently taking private dance lessons at the studio would almost universally be happy to do this. We mostly have a friendly relationship with our teachers. We don’t want to risk them!
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I mean, honestly, I don’t want to get sick. But I am more worried about getting my pro or his wife sick. Even though they are younger, one of them has a condition that compromises immunity. And for them, the economic consequences of getting sick is horrible. Even if asymptomatic, they would lose their income stream. If the test existed, I would definitely spend $30/week to take it 1 hour before each lesson. I’m pretty sure all the other students taking private lessons would do the same. And, of course, if they won’t, they can continue with the current protocol of masks.
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I have no idea why you think anyone would need to pay twice as much for a lesson. The studio already has the teachers schedules organized. My teacher Vlad (and his wife Brianna) have 1 pm-6 pm MWF at OakBrook studio, the same times on T, TH at the Naperville studio. I don’t know their timeslots on Saturday or Sunday. They don’t come give a lesson, leave, come back and so on. Their students take slots in the times they are there.
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Even if students had to spit in a cup at the studio and wait at the studio and then wait, the teachers could still be teaching the other student at that time. So there would be no reason for students to pay twice as much because the teacher would still be teaching while the student waited.
lucia (Comment #188758): “There are all sorts of ways a $10 test with a 1 hour turn around time could help lots of people relative to the current status quo.”
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I very much agree that *targeted* use of a *fast*, cheap test would be very valuable. But everybody every three days would be a massive waste of resources unless it would crush the virus in a short period of time. I am very skeptical that it would actually work.
lucia (Comment #188759): “Even if students had to spit in a cup at the studio and wait at the studio and then wait, the teachers could still be teaching the other student at that time. So there would be no reason for students to pay twice as much because the teacher would still be teaching while the student waited.”
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That is what I thought you were suggesting.
The additional cost would be for the full time technician doing the tests. I have no idea what the lessons cost, how many students are in a class, or what the teachers make. So I was just guessing at one tech per teacher at a similar cost.
MikeM.
I don’t think it will be used on everyone every three days. I think in terms of requirements it will be targetted. But I also think lots of businesses would voluntarily pay that cost out of pocket. At $10/test, restaurants will want to advertise that they are spending the money to test their servers, cooks and bartenders. So will lots of places that rely on clients feeling the need to trust the environment.
If it did occur, I disagree with you thatspending the money on testing everyone every three days would be a massive waste of resources. The cost of that project is peanuts compared to everyone wearing medical masks everywhere, all the extra cleaning everyone is doing (the grocery store has it’s floor cleaner running every single time I’m there!), the cost of kids not going to school, and all sorts of other economic costs that are invisible.
I also don’t think that ultimately, the test will need to be $10 per test. That’s just a number you pulled up. Moreover, it’s is the cost of a TB test that is designed to meet a clinical need not an epidmiologic one. That high cost is driven precisely by regulatory requirements that need to be set aside for a COVID test if we are to have something useful for epidimiological purposes.
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The hope (which may be an insane one) is that these tests will not be applied to fast turn around COVID tests whose use is not intended to be to guide clinicians.
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The current regulations for tests are designed for clinical needs. This makes sense because until now that’s been the need for tests. We want tests that doctors can rely on to diagnose patients. The consequence is even tests designed for “field use with minimal training (2 days)” have special “training” requirements. They also have special requirements for controlled conditions and so on and so on. That means you pay for staff, and you have special equiment that creates “controlled” conditions even if that’s not required.
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In many cases, that drives the cost.
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As in: the TB tests you described aren’t like home pregnancy tests which allow a totally untrained woman to self administer the test and get a yes/no answer. The goal the companies workign toward fast turn around lamp tests is like home pregnancy tests– or even simpler actually. But currently, owing to regulations, the companies see no way to sell those even if they work. My hope is for that to change.
MIkeM
No. Because
(a) even if a technician were required for a test, neither the teachers nor the students to take the test at the studio. There are magical devices called “phones” and “email” that allow communication of test results. Even “slips of paper” with “reciepts” and so on would work.
(b) companies are working to have tests that don’t require a technician. For example: home pregnancy test don’t require a technician.
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Right now, path (b) is blocked by regulation for biologic tests that might change someones choice of “actions”. That is: because of the combination of being a “LAMP” technology AND the fact I would use it to decide to quarantine myself, the regulations currently block it without approval that requires it to meet standards set for clinical usage.
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Regulations can be changed. They can be lightened. They can be made more appropriate. I’m generally for that. I think it would be rather ridiculous to require an full time technician in a dance studio when it’s pretty obvious that would not be required. If a technician would be required, the tests could be done at pharmacies. But with some development, no technician need be required.
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MikeM
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I pay $85 for a private 45 minute lesson. One teacher and one student is involved in my lesson. Pre-covid there were often 4 lessons in the studio, right now there are 2. In my case, the other students are my teachers wife and her student. So, the covid issue has cut the number of lessons/hour the studio provides by 50%.
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The studio used to run lessons back to back. They know have a 15 minute pause between lessons to wipe all surfaces and air the place out.
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I know from conversations with Vlad, it’s cut his income by at least 50%. That’s partly due to the lower capacity of the studio and partly due to some students still being scared even with everyone having their temperature taken That’s going to hold for all the other teachers.
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I would happily pay another $30/week to take tests to reduce the potential exposure from me to my teacher. He’d happily take the test to avoid exposure to his clients. Plus, he’s probably have more because some dancers would be less frightened of taking lessons.
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Covid is a huge hit to ballroom dance. There pretty much can’t be any revenue generating competitions, the people who make expensive ($500-$10K each) dresses aren’t selling dresses blah… blah…. Now, I admit ballroom is not a huge component of the US economy, and it’s a bit atypical of other hobbies.
But even at $10/test the cost of testing is nothing compared to the expense for many people who dance. It’s nothing compared to the economic hit to studios.
lucia,
It might be possible for a reasonably large scale in-house testing program to do tests for $10 a pop. But an independent lab would cost more than that. They need space, people to make the appointments, people to deal with all the regulatory requirements, people to provide the customer with documentation, and, of course, the cost of doing the actual test.
No there won’t be a home test for the virus since it requires a temperature controlled incubator. Maybe there could be a home antibody test.
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Edit: What you propose makes much more sense for private lessons than for a class.
Florida reported 123 covid deaths today; looks like the peak in death rate has passed in Florida… so a peak near August 5 for the Worldometers plotting method.
I was wondering if any posters or readers here have had an opportunity to read and digest the Covid SEIR type model being proposed by Google Cloud AI. The link below describes this model and was extracted from the most recent Nic Lewis thread on Covid herd immunity at Climate Etc.
I learned rather quickly of the limitations of a simple static SEIR model and even when I attempted to make my own model that was less static. There remained the limitations due to granularity, inhomogeneous populations and fewer model compartments. I have not finished reading the white paper linked below but I am interested in learning how much of these limitations are overcome and by what model constructions with the proposed model. I am also interested in the validation methods used for the model since I assume that machine learning was applied in developing this model.
https://storage.googleapis.com/covid-external/COVID-19ForecastWhitePaper.pdf
MikeM
You’re still not getting it. The “in-house testing program” is only required due to regulations.
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A 1st response three pack home pregnancy tests on Amazon costs $12.74. That’s about $4.25. A 25 count AccuMed strip pack costs $8.99. That’s $35 each. This is the long term goal of those working on at home tests– and those in the area suggest it’s feasible except for regulatory requirements.
There is nothing technologically difficult about having an isothermal temperature controlled incubator. Look up “sous-vide”. I use sometimes use my souvide immersion device to make yogurt, sometimes for other things.
MikeM
Yes. That’s why I propose it for private lessons:
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That said: students taking group lessons at “May I have this Dance” in chicago might do it for group lessons. “May I” has some strict protocols for people who want to take what the owner calls “Static” group lessons. Those involve people enrolling in a series of lesson (at least 4 once a week), the same people stay in the lesson- no circulating and so on. These lessons permit “contact” meaning they aren’t just sessions on things like “spinds and turns” or doing steps only with the person you came with.
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I know many of those taking the “static” lessons at “May I” take several group lessons a week. If these tests were available, he might add having a recent test to the requirements.
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My guess is this would increase demand for those classes as people would feel safer. I would guess students would just be asked to bring in a note from the pharmacy and some sort of dated receipt. There would be no certainty some might try to weasel around and fake it, but most would just take it.
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There is no doubt it would be more difficult for group lessons though.
Kenneth–
Oh wow! That’s quite a complicated model. Not necessarily wrong with that, but the complication will necessarily result in the possibility of drastic overtuning!
lucia (Comment #188769): “This is the long term goal of those working on at home tests– and those in the area suggest it’s feasible except for regulatory requirements.”
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That might be possible if you want something for your own peace of mind. But a purely voluntary test won’t keep many people from going to work, dance, lessons, etc. or be useful for making people self quarantine.
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lucia: “There is nothing technologically difficult about having an isothermal temperature controlled incubator. Look up “sous-videâ€.”
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Cool. Not at all clear that it is sufficiently accurate for LAMP. How much does the temperature vary from point to point in the tank? I’d guess quite a bit since the tank appears to be uninsulated. And $200 is real money for some people.
A motivated user might well be able to make that work. But nobody else is going to trust a negative result any more than an employer will trust the result from your at home drug screen.
MikeM,
Sure. I could use it for my peace of mind. But you seem determined to close your eyes to the number of ways it would be used for “peace of mind”.
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The existence of such a test would certainly permit people with meat-packing plants to require employees to take tests. It would permit k-12 schools to permit everyone to take a test. Choirs who want to meet could have everyone take the test. The guy in the article above could have asked the non-mask wearers to take a test.
This is a lot of people, and can cut into major super-spreading events. That has a big potential to reduce Ro even if these aren’t used by everyone.
Mine stays within +/- 1 F when I use it in a water batch (which is, of course, the design use and how I use it.) I have a second thermometer I have used to check this.
Likely very little in mine. In the first place, the sous-vide device has a stirrer that’s pretty well sized. In the second, because I’m an engineer, and don’t like the idea of heating my kitchen in the summer, I have these little “thermal insulating spheres” I float on top. Also, I concocted a shroud using old thermal insulation bags.
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Sure. I didn’t spend $200 for my sousvide. More like $40. You can get one at Amazon
https://www.amazon.com/precision-Huispark-sous-vide-circulatory-temperature/dp/B07FDVDZS2/ref=asc_df_B07FDVDZS2/?tag=hyprod-20&linkCode=df0&hvadid=344041385432&hvpos=&hvnetw=g&hvrand=3612600541787897944&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9021544&hvtargid=pla-700860045050&psc=1&tag=&ref=&adgrpid=72020980514&hvpone=&hvptwo=&hvadid=344041385432&hvpos=&hvnetw=g&hvrand=3612600541787897944&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9021544&hvtargid=pla-700860045050
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My “tank” is a (too deep) roasting pan I had around the house. I did pop the extra money for the insulating spheres, but you can get perfectly goo temperature control in a well stirred water bath without them.
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But I realize even $40 is real money to a lot of people. Some people may want to go to a pharmacy. Some may not do it. Some parents of k-12 kids will rely on their kids getting tested at school. They will then not need to spend the $40 sous-vide.
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I know schools constantly complain about being underfunded. But I would suspect most schools can afford a $40 sous-vide, and a roasting pan. The already existing janitor could watch over it. The fact of testing would reduce the amount of extra time the janitor needs to spend on wiping every surface a zillion times a day.
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Mike M
Sure. But employers aren’t brainless. An employer who can’t or won’t trust his employees will get his own $40 sous-vide a roasting pan and test kits and test the meat packers, school teachers and so on when then report to work. As I previously noted: Many employers would gladly do this to avoid having staff get sick resulting in needing to shut down the plant. They are already spending extra money on extra cleaning, ventilating and so on. This test has a potential for being orders of magnitude more effective and especially more cost effective. For large employers that would be true even if they had to hire a technician to run the samples. But the goal is to have a test where that is not required.
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Like it or not, the existence of COVID-19 has increased costs for employers and by a lot more than $10/day/employee. It’s also cut the amount of revenue they can generate in their place of business. A $10/per test screen is nothing compared to the economic loss many are sustaining.
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Plus, many employers want to protect their employees. It’s not like they are all 100% block-sucking capitalists who are merely trying to eak out value from employees with no regard whatsoever for the fact that the employees are human.
Kenneth,
I wasn’t impressed by the Google model at all… too complicated to be useful, and I was reminded immediately of John Von Neumann’s quip about too many free parameters.
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When I got to the part where they said their model failed (badly) when they tried to correlate state median age with number of deaths, I knew they were lost, and stopped reading. It doesn’t matter at all the median age for the whole population, it matters the age profile of the people who get the virus. Whatever factors a model considers (spacial, temporal, social), those factors have to make reasonable predictions about the ages of people who will catch the virus. After all, age is by far the strongest predictive variable for death. New York has a scandalous rate of fatalities because so many old people in the city caught the virus, not because the median age for the city is 35.8 years, which is young compared to the whole country… or even compared to the whole state of NY! I think an improved model would be one that focuses on predicting the ages of those who will get the virus. The authors seem to me much too enamored with ‘artificial intelligence’ and not enamored enough with actual thinking.
SteveF
I think we share the same deep suspicion against “artificial intelligence”. I’m not going to say it never works. But many people want to assume their AI can achieve an IQ of 300 when more likely 70 is possible.
Lucia,
“But many people want to assume their AI can achieve an IQ of 300 when more likely 70 is possible.”
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I would’t go even that far. General intelligence is an extension of sensory awareness; it requires meaningful “embodiment”, like an infant possesses. General intelligence grows in people out of the very broad sensory experience that embodiment provides. Which is not to say true artificial general intelligence can’t exist (I am sure it one day will), but it still seems to me a very long way off. Game playing software based on “artificial intelligence” that learns only by playing a game against itself many times (Google is already famous for this!) easily beats humans, of course. But the “world” of that artificial intelligence is limited to a set of game rules; it is no closer to general intelligence than a screw driver is to something which can drive a screw, drive a car, and translate accurately from Mandarin to English. Predictions of artificial intelligence have been comically wrong for the last 50 years…. I suspect that will not soon change.
SteveF,
Agreed. I guess one thing in my mind with IQ of 70 is that even fairly unintelligent people can sometimes be trained to do very specific tasks in very specific ways following strict rules. But that doesn’t always allow them to work independently and then apply what they know to a different task.
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Despite the apparent “flexibility” of a chess playing AI, it only plays chess. After it knows how to play chess, you can’t just ask it to learn how to make the bed or scrub the tub.
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There are lots of hilarious stories about things AI systems did that surprised programmers who realized they’d over looked implicit rules of the “game”.
Lucia, that comment, for some reason, made me laugh. If it were closer to 70 I might be able to understand more readily what they are doing.
My take is near what you and Steve have noted. I see their end result model with machine learning not that much different than other complex models that are developed from theory and not machine learning. It reminds me somewhat of the situation whereby climate scientists use/select historical ex post facto data to construct models of past temperatures from proxies that are suppose to agree with current observable temperatures – except the climate scientists use little to none of the methods that AI machine learning apply to avoid over fitting their models. Without truly out-of-sample data for validating a model the historical data must be split into training and validating periods which is fine as long as the modelers do not peek at the validation period results.
In this case the Google modelers do show predictions versus actual results for several regions and compare their predictions with other big time models. They also claim to be able to provide explanatory analyses.
Successfully predicting future Covid results based on what policy makers might decide and how well individuals follow their edicts has to be a difficult to impossible task and getting reasonable results may well be simply a matter of momentum over a brief period of time. Predict reasonably closely in current time what will happen this winter (without a prophylactic or vaccine) and I will attribute that success to luck or some special powers and probably not a model. That is not to say that a model that provides some explanatory insights into the variables is a waste of time.
I should have added that the Google modelers attempted to limit and bound inputs and outputs that were based on prevailing science theory and experience whereas the climate scientists modeling proxies for temperature appeared to avoid any a prior science inputs in selecting proxy data and then using all of the selected data.
Nationally, new cases are clearly dropping, after a peak around July 20. Deaths are harder to judge because of the data contamination from Texas in late July, but it looks like they might now be at a maximum of about 1050 per day.
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When I guessed that deaths might not top 1000, I made the mistake of assuming that the lag from positive test to death was still about one week, as it was back in March and April. But it looks like it is now more like two weeks. That led to an underestimate of 1.3% for CFR, whereas it should have been more like 1.5%. If the two week lag is correct, deaths should have reached their maximum and should now be dropping. Time will tell.
Good article on the “effectiveness” of lockdowns:
https://www.realclearpolitics.com/articles/2020/08/07/the_myth_that_lockdowns_stop_pandemics_143899.html
I doubt that the “Trump” administration would deny a state governor end run around the FDA in the Covid pandemic unless it were entirely a political reason. The FDA is a government agency that shows its bureaucratic inflexibility in many matters with that problem becoming more evident in a crisis such as the current one. The FDA operates as inefficiently under a Republican administration as it does under a Democrat one. However, with the media and public operating under a fandom cheering section like we see for sport teams, the government agency failings are not seen as an inherent and systemic one but rather as one that can be attributed to the administration with that attribution depending merely on the partisan fan base and the party in power.
Kenneth,
Me too. I don’t know if the FDA would have their own legal staff to take states to courts. But I imagine if they tried to do something, they would rely on the Justice to do it for them. At best, they’d get lackadaisacal support– which is not what they would want. The risk of losing big time due to their legal-eagles working less than diligently, and having a precedent they don’t like established would not be something bureaucrats would relish.
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Looks like the FDA probably can’t pursue the states anyway.