Why is New York ablaze while California is just simmering?

April 8, 2020

That’s a question that I’ve been pondering…
==============

Today’s WSJ had a piece titled “The Art of Coronavirus Modeling”.

Its main point was that statistical models are “tools, not oracles” … that the drastic recent changes in the Murray Model’s forecasts is evidence that models are, by their nature, imperfect and shouldn’t be used as sole determinants of policy.

I agree with all of that, but it’s not new news.

What caught my attention was that the article offered up some clues and conjecture about a  question that has been on my mind: Why is New York ablaze with coronavirus while California is just simmering?

image

Here’s what the WSJ offered up on the question…

Read the rest of this entry »

April 9: COVID-19 Tracker

April 9, 2020

Cumulative U.S. Deaths 
14,797  Worldometer
14,808   JHU

IHME Model Cumulative US Death Projection:
60,415 by Aug. 4 Rev. DOWN 21,351 on 4/7

image

=============

1,940 Daily New Deaths   Worldometer
Consecutive high days in DNDs
1,104 in NY+NJ+CT

IHME Model Peak DND Projection:
2,212 on April 12  Revised DOWN 918 on 4/7

image

=============

State Deaths to Date Worldometer
See: Why is New York ablaze while California is just simmering?

  • NY+NJ+CT = 8,107  55% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 12,558 85% of US Total
      Top 12 Average = 79 Deaths per Million
      Top 12 = 48% of U.S. Population
  • Mass. & IL moving up; PA added
  • MD 124 Total Deaths  21 DNDs

image

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Some determinants of urban viral contagion…

April 8, 2020

In a prior post, we recapped the IHME Murray Model — the coronavirus forecasting model foundational to the Coronavirus Task Force’s thinking.

And, in a subsequent post, we concluded that — given historical precedents — data modelers would be well served including some measure of urbanization in their models.

image_thumb[2]

Digging a bit deeper, I came across a study by a group called Heartland Forward.

The study report has lots of data, charts and maps.

The study proposes determinants of high rates of contagious infection … some of which are directly related to urbanization.

============

In essence, the Heartland Forward study proposes these urban-related determinants:

  • Population density … Density can be evaluated at a macro level (state, metro area); at a neighborhood level (how closely are people packed during their day-to-day activities?); and at the residential level (how many people are living in the home or apartment?). The micro levels (neighborhood and residential) are most relevant when it comes to contagions: how many people does somebody come in contact with at home, at work, in transit?
  • Prevalence of mass transit: While mass transit is convenient. efficient and environmentally-sensitive in normal times, it’s potentially a liability at times of contagion. For example, some experts hypothesize that a fundamental difference between California and New York is their primary mode of transportation.  New York has a heavily used mass transit system;    California is infamous for auto usage.  When it comes to these times, isolation in car beats being jammed in a subway car with dozens of potentially contagious fellow passengers.
  • Supply chain interconnectedness … The presence and magnitude of import, airport  and trucking hubs can be a liability in times of contagion. The more “stuff” that is transiting an area raises the risk that some of the stuff may be virus-bearing. That applies to people, too.
  • Reliance on tourism and hospitality … The flow and volume of both domestic and foreign travelers to and through an area raises the risk. Think: Super Bowl in Miami and Mardi Gras in New Orleans which may has triggered the local outbreaks

Again, historical precedents indicate that pandemics naturally thrive most in big cities.

When data modelers are shopping for behavioral measures of urbanization, the above factors are worth considering.

============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

April 8: COVIDS-19 Tracker

April 8, 2020

Cumulative U.S. Deaths 
12,857  Worldometer
12,911   JHU

IHME Model Cumulative US Death Projection:
60,415 by Aug. 4  Rev. DOWN 21,351 on 4/7  

image

=============

1,970 Daily New Deaths   Worldometer
See technical note at end of post
Big spike up in DNDs
1,031 in NY+NJ+CT

IHME Model Peak DND Projection:
2,212 on April 12  Revised DOWN 918 on 4/7

image

=============

State Deaths to Date Worldometer

  • NY+NJ+CT = 6,998  55% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 11 Total = 10,658 83% of US Total
      Top 11 Average = 63 Deaths per Million
      Top 11 = 43% of U.S. Population
  • MD 103 Total Deaths  12 DNDs

image

================

Technical note: Worldometer’s calculation of DNDs sometimes falls out of sync with their reporting of Total Deaths. Probably due to reporting issues on granular state data. We check the Worldometer Total Deaths against the JHU reporting … and do our own calculation of DNDs by comparing day-to-day Total Death numbers.

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Good news: dogs can’t catch coronavirus…

April 7, 2020

Bad news: cats can.

=============

image

With the coronavirus spreading rapidly around the world, some pet owners have raised concerns about whether their pets can become infected and pass the virus along to other animals and, oh yeah, people.

According to a report in Nature, researchers at  Harbin Veterinary Research Institute in China have concluded:

Cats can be infected with the COVID-19 coronavirus  and spread it to other cats.

“The results suggest that cats should be considered an element in the effort to control COVID-19, but that they’re not likely to be a major factor in the spread of the disease.”

The researchers also found that ferrets are also highly susceptible to coronavirus

The US Centers for Disease Control and Prevention recommends that people infected with COVID-19 limit contact with their cats, including avoiding petting, being licked and sharing food and utensils.

==============

Some good news: dogs are not susceptible to coronavirus infection.

Nor are chickens, pigs, and ducks  likely to catch the virus.

Whew.

==============

Update: It’s reported that 4 tigers and a lion at the Bronx zoo are infected with the coronavirus.  Contact tracking has ID’ed an asymptomatic infected zookeeper as the carrier. Raises a couple of questions:

  • Why did the zookeeper violate the 6-feet social distancing rule?
  • How did they get scarce test kits to use on lions and tigers?

==============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Raise your hand if you want to be in the placebo group…

April 7, 2020

We opted for a “doctor supervised off-label test” instead of a randomized control test. Here’s why.
==============

American Society of Hand Therapists (ASHT)

Dr. Fauci has consistently dissed the use of hydroxychloroquine because there hasn’t been a large-scale, double-blind control test proving its efficacy.

There are plenty of field reports, patient testimonials and doctors prescribing the drug “off-label” (or even using it themselves as a prophylactic).

But, Dr. Fauci advises that we all just chill for a year or so until the “proper” scientific testing is done.

That point-of-view hits close to home.

Here’s a very personal story…

Read the rest of this entry »

April 7: COVID -19 Tracker

April 7, 2020

Cumulative U.S. Deaths 
10,943  Worldometer
10,993   JHU

IHME Model Cumulative US Death Projection:
81,766 by Aug. 4  Rev. DOWN 11.765 on 4/4 

image

=============

1,323 Daily New Deaths   Worldometer
See technical note below chart
3-day average relatively level

IHME Model Peak DND Projection:
3,130 on April 16  Revised UP 486 on 4/4

image

Technical note: Worldometer’s calculation of DNDs sometimes falls out of sync with their reporting of Total Deaths. Probably due to reporting issues on granular state data. We check the Worldometer Total Deaths against the JHU reporting … and do our own calculation of DNDs by comparing day-to-day Total Death numbers.

=============

State Deaths to Date Worldometer

  • NY+NJ+CT = 5,967  55% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 11 Total = 9,089 83% of US Total
      Top 11 Average = 63 Deaths per Million
      Top 11 = 43% of U.S. Population
  • MD 91 Total Deaths  24 DNDs

image

================

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

“Pandemics naturally thrive most in big cities”

April 6, 2020

In a prior post, we recapped the IHME Murray Model — the coronavirus forecasting model foundational to the Coronavirus Task Force’s thinking.

The model’s developers make clear that the model does not consider either population density or the utilization of public mass transit.

In other words, it doesn’t consider the effect of urbanization.

image

I expect that the model will be refined to consider the urbanization variable since Dr. Birx keeps saying “we’ll be drilling down to the county level” …  and since some pandemic historians note that pandemics naturally thrive most in big cities.

Here’s what they’re talking about…

Read the rest of this entry »

Fact Check: Cuomo was told in 2015 that NY would be15,783 ventilators short…

April 6, 2020

… and, he still hasn’t taken NY-based Remington Arms’ offer to make ventilators.
=============

It has become a daily ritual: Gov. Cuomo warns the NY needs 40,000 ventilators and the Federal Government (think: Trump) is letting him down.

He conveniently forgets to mention that  his own public health task force told him that NY would be 15,783 ventilators short if hit by a “severe” pandemic … and provided him with “ethical” guidelines for rationing ventilators if faced with a shortfall.

image

More specifically …

Read the rest of this entry »

April 6: COVID-19 Tracker

April 6, 2020

Cumulative U.S. Deaths 
9,620  Worldometer
9,648   JHU

IHME Model Cumulative US Death Projection:
93,531 by August 4   

image

=============

1,166 Daily New Deaths   Worldometer
See technical note below chart

IHME Model  Peak DND Projection:
2,644 on April 16 

Dotted red line is 3-day moving average
image

Technical note: Worldometer’s calculation of DNDs sometimes falls out of sync with their reporting of Total Deaths. Probably due to reporting issues on granular state data. We are validity check the Worldometer Total Deaths against the JHU reporting … and do our own calculation of DNDs by comparing day-to-day Total Death numbers.

=============

State Deaths to Date Worldometer

  • NY+NJ+CT = 5,265  55% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 11 Average = 56 Deaths per Million
  • CA, FL and bottom 40 states are all
    10 or fewer Deaths per Million

State                    Deaths     % US      Population   Deaths / MMimage

================

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Trump quadruples down on Hydroxychloroquine…

April 5, 2020

… and broaches the “elephant in the room” re: ventilators
=============

Just in case you missed yesterday’s Task Force press conference …

As usual, there was lots of repetition — from prior days and within the news conference.  Reporters asked the same questions. Trump gave approximately the same answers and the medical scientists gave the same dignified but elusive answers.

There were a couple of very noteworthy takeaways:

1. Trump kept cycling back to Hydroxychloroquine.

His basic line of reasoning: Now that we have “millions of doses” available, a lengthening list of positive “anecdotes” and small-scale studies, decades of safe usage …  and nothing else in our therapeutic quiver … “what have we got to lose”.

Fauci’s repeated answer: because there haven’t been large-scale, closely supervised, double-blind randomized, controlled tests … is, in my opinion, sounding increasingly out-of-touch with the realities of this war.

I was waiting for some reporter to ask Fauci: “Have their been randomized controlled tests on  the effect of locking down a country?” Of course, that didn’t happen.

Somewhat exasperated, Fauci resorted to “Doctors can prescribe it if they want.” … which is only partially true since Cuomo and a couple of other governors have limited HC  prescriptions to hospitalized patients.

Cutting to the chase: Oddly, Trump’s presidency is now largely dependent on the success of hydroxychloroquine.  If it works to substantially blunt the pandemic’s impact, he wins.  If it doesn’t, he loses.

===============

2. Trump explicitly broached a very sensitive question regarding ventilators.

Read the rest of this entry »

April 5: COVID-19 Tracker

April 5, 2020

Cumulative U.S. Deaths 
8,454  Worldometer
8,503   JHU

IHME Model Cumulative US Death Projection:
93,531 by August 4   

image

=============

1,051 Daily New Deaths   Worldometer
See technical note below chart

IHME Model Peak DND Projection:
2,644 on April 16   

image

Technical note: Worldometer’s calculation of DNDs has fallen out of sync with their reporting of Total Deaths. Probably due to reporting issues on granular state data. Starting today, we are validity checking the Worldometer Total Deaths against the JHU reporting … and doing our own calculation of DNDs by comparing day-to-day Total Death numbers.

=============

State Deaths to Date Worldometer

  • NY+NJ+CT = 4,576  54% of US Total
  • Top 10 Average = 48 Deaths per Million
  • CA, FL and bottom 40 states are all
    under 10 Deaths per Million

image

================

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

State-by-state COVID19 Deaths – Total and Per Capita

April 4, 2020

A reader asked “What happens when state-by-state numbers are normalized to per capita?”

So, we pulled the numbers together…

============

Below are the 16 states with the highest number of cumulative COVID19 deaths to date.

The right-hand column normalizes the numbers to “Deaths per Million” based on population.

Technical note: As loyal readers know, I think the oft-mentioned death rate (Deaths divided by Confirmed Cases) is very problematic.  The denominator should be Total Cases … but, that number is unknown because of the untested, asymptomatic cases.

image

The current total U.S. Deaths Per Million (DPM) is 22.6.

Obviously, NY is in a world of its own at 165.5 deaths per million (DPM).

The other high rankers (highlighted in red) are LA (79.7 DPM) and NJ (72.3 DPM).

The low ranking states (high cumulative deaths but low DPM) are highlighted in green: CA (7.1 DPM), FL (7.7 DPM) and PA (8.0 DPM).

My take: the standout states are CA – which was early infected but appears to have things relatively under control) and LA – which is high on the list in both total deaths-to-date and DPM.

==============

Let’s cut the data one more way … sorting by Deaths Per Million.

Read the rest of this entry »

Why did Trump initially play down the coronavirus threat?

April 4, 2020

Let’s make this a multiple choice:

  1. Because he’s a stupid, anti-science dufass
  2. Because he’s a pathological liar
  3. Because he that’s what his science advisers were telling him

Roughly half of the country would probably pick #1 or #2 because they hate Trump and get all of their news from the left-leaning MSM (which would likely go 100% for #1 or #2 ).

Well, it turns out that the real answer is #3.

We previously posted Dr. Birx recent admission that she “didn’t see this coming.”

What about Dr. Fauci – world renowned infectious disease expert, media-crowned truth teller, and key Trump science adviser?

Well, it turns out that circa late January and early February, Dr. Fauci was saying:

This not a major threat for the people of the United States, and this is not something that the citizens of the United States right now should be worried about.

Here’s a video clip of Dr. Fauci saying just that on January 21…

click to view a 30 sec. videoimage

  • For more examples. see non-partisan RealClearPolitics mash-up of public statements by Dr. Faucii and  other ranking members of the scientific community.

My point isn’t to trash Dr. Fauci … it’s just to provide a plausible explanation for why Trump initially played down the virus.

Perhaps, he wasn’t defying the scientists … he was listening to them and channeling their working hypotheses.

==============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

April 4 – COVID-19 Tracker

April 4, 2020

1,328 Daily New Deaths   Worldometer

IHME Model Peak DND Projection:
2,644 on April 16   

image

=============

7,403 Cumulative U.S. Deaths  Worldometer 

NY = 3,218  43% of US Total

IHME Model Cumulative US Death Projection:
93,531 by August 4   

image

=============

State Deaths to Date Worldometer

  • NY + NJ > 50% national deaths

image

================

US -NY Deaths Worldometer JHU

Daily New Deaths (DNDs):
NY DNDs Double prior day
Non-NY DNDs Flat day-to-day

image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Dr. Fauci gets grilled on Hydroxychloroquine…

April 3, 2020

This is the interview that I’ve been waiting for…

There is a growing list of anecdotal evidence, field tests and doctor sentiments in favor using Hydroxychloroquine (HC) to treat coronavirus patients.

See our posts for more detail:

The plural of “anecdotes” isn’t “data” … or is it?

Hey, Dr. Fauci: Here’s a randomized control study for you…

But, the beloved Dr. Fauci says to hold off until there are closely controlled, large scale randomized tests of the drugs safety and efficacy, even though such tests would take several months at the best.

This morning he was “confronted” with the evidence and, in effect, asked to defend why he’s slow-rolling use of about the only therapeutic drug that’s currently in our coronavirus quiver.

Predictably, he trashed the studies (“not sufficiently robust’), dismissed the doctor surveys (“we don’t decide based on what doctors  feel”) and rejected current usage patterns (“doctors can do whatever they want”).

The 5-minute segment is worth viewing.

Depending on where you stand on the Hydroxychloroquine situation, you’ll either think the guy is a champ or a chump!

click to view the video
image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Dr. Birx was asked about the reported “false negatives”…

April 3, 2020

… and, her answer made me very nervous
==============

Yesterday the WSJ reported that:

“Health experts  now believe nearly one in three patients who are infected are nevertheless getting a negative test result.”

For details and links, see our post:
WSJ Shocker: 1 in 3 infected patients gets a ’false negative’ test result.

I expected that the story would send shockwaves around the DC science community and, for sure, be a reporter’s question at the daily Coronavirus Task Force press conference.

I was half-right … Dr. Birx was asked the question: “What about the report of 1/3 false negatives?”

Paraphrasing her answer:

1. We have to look into that – probably anomalies since….

2. Test results across sites are fairly consistent … and about what we’d expect.

3. If true, 1/3 false negatives would  mathematically give an unrealistic incidence rate.

Let’s drill down on each of those answers:

Read the rest of this entry »

April 3: COVID-19 Tracker

April 3, 2020

COVID-19 Deaths (Daily & To Date) Worldometer

image

=============

963 Daily New Deaths Down Slightly  Worldometer   

image

Projected Daily New Deaths   IHME Model

  • Peak DND Projection: 2,644 on April 16

image

=============

6,075 Cumulative U.S. Deaths    Worldometer   

image

Projected U.S. Deaths  IHME Model

  • Up 10,000 since 3/31/2020
  • NY = 16,261  17.5% of US Total

image_thumb16

=============

State Deaths to Date Worldometer

  • NY + NJ > 50% national deaths

image

================

US -NY Deaths Worldometer JHU

Daily New Deaths (DNDs):
NY DNDs Down from prior day
Non-NY DNDs Up day-to-day

image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

WSJ Shocker: 1 in 3 infected patients gets a ’false negative’ test result.

April 2, 2020

If this true, it explains why NY is still on fire.
==============

First, the basics.

Only people who are symptomatic are supposed to get a coronavirus test.

If a person tests positive, they are either given clear directions to self-quarantine, or if their symptoms are severe, they are admitted to the hospital for care.

If a person doesn’t have coronavirus but tests positive, the consequences are pretty minimal: the patient is hospitalized until recovered (or the docs detect the testing error) … or the person is sent home to self-quarantine for 2 weeks. That’s basically no harm – no foul.

But, on the other hand, if a person has coronavirus and test is negative (i.e. the test misses the coronavirus), the patient is sent home (i.e. denied hospital admittance) and sent back home, believing that they’re clean of coronavirus.

English translation: they’re back in circulation not knowing that they are infected … and, most likely, infecting other people.

==============

Here’s the showstopper …

The WSJ is reporting that:

“Health experts  now believe nearly one in three patients who are infected are nevertheless getting a negative test result.”

The WSJ article is based on anecdotal evidence from the field … lots of credible anecdotes.

See: Questions About Accuracy of Coronavirus Tests Sow Worry   and
The plural of “anecdotes” isn’t “data” … or is it?

Adding credibility to the story is the FDA response:

In a statement Monday, the FDA said it is balancing the need for more testing with its prerogative to ensure tests are accurate.

Right now, the FDA’s priority remains getting more tests into the field.

If these reports are true, they might explain why coronavirus is spreading like wildfire in NY … despite the stay-at-home orders.

===============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Hey, Dr. Fauci: Here’s a randomized control study for you…

April 2, 2020

Its conclusion: Hydroxychloroquine helps patients!
=============

image

As reported in the New York Times

Based on a randomized control study, Chinese researchers report that:

  • Coughing and fever eased a day or so earlier in the patients who received hydroxychloroquine, and
  • Based on CT scans, pneumonia improved significantly in 80.6% who received hydroxychloroquine, as opposed to 54.8% in the control group.
  • Only 2 patients had minor side effects from hydroxychloroquine: One had a rash and another had a headache.
  • The illness turned severe in four patients — all in the control group.

According to Dr. William Schaffner, an infectious disease expert at Vanderbilt University:

“The findings strongly support earlier studies suggesting a role for the drug (hydroxychloroquine)”

Digging deeper…

Read the rest of this entry »

April 2: COVID-19 Tracker

April 2, 2020

COVID-19 Deaths (Daily & To Date) Worldometer

image

=============

Daily New Deaths UP  Worldometer   

image

Projected Daily New Deaths   IHME Model

  • Peak DND Projection: 2,644 on April 16

image

=============

Cumulative U.S. Deaths    Worldometer   

image

Projected U.S. Deaths  IHME Model

  • Up 10,000 since 3/31/2020
  • NY = 16,261  17.5% of US Total

image

=============

State Deaths to Date Worldometer

  • NY + NJ > 50% national deaths

image

================

US -NY Deaths Worldometer JHU

Daily New Deaths (DNDs):
NY ~ 1/2 of US DNDs
Non-NY DNDs Flat day-to-day

image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Birx: “I didn’t see it coming”

April 1, 2020

There was a stark admission during Tuesday’s Task Force press conference.

Trying to tar President Trump, a reporter asked Dr. Deborah Birx why the administration initially downplayed the potential severity of COVID-19.

Her answer wasn’t quite what the reporter was fishing for:

When the initial data started coming out of China, the thinking was that this was more like SARs, not a global pandemic.

The medical community interpreted the data as if it was serious, but smaller than (it turned out to be)

Hmm.

Isn’t that what Trump was saying in early January?

I wonder where he got his info … the medical community, maybe?

click to view
image

==============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

About the slow roll-out of testing kits…

April 1, 2020

Over the weekend, the NY Times published a long article on the corona virus testing snafus.

image

The article is relatively balanced and worth reading.

Here are my takeaways from the article…

Read the rest of this entry »

April 1: COVID Tracker

April 1, 2020

COVID-19 Deaths (Daily & To Date) Worldometer

image

Daily New Deaths UP  Worldometer   

image

Projected Daily New Deaths   IHME Model

  • Peak DND Projection: 2,607 on April 16

image

=============

State Deaths to Date Worldometer

  • NY over 40% of national deaths

image

================

US -NY Deaths Worldometer JHU

Daily New Deaths:
Non-NY +70%

image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

‘Most Likely’ Forecast: 84,000 COVID Deaths …

March 31, 2020

Read this before tonite’s Coronavirus Task Force Press Conference!

=============

According to the WSJ and other sources:

White House coronavirus coordinator Deborah Birx said its assessment of how the pandemic would unfold closely mirrors the University of Washington’s Institute for Health Metrics and Evaluation, the so-called Murray Model.

As of this morning, the total number of COVID-related deaths in the U.S. stands at 3,173.

The current Murray Model’s ‘most likely’ forecast is 83,967 COVID-related deaths during this epidemic cycle … with the 95% confidence interval ranging from  38,242 to 162,106.

image

Underlying that forecast, the Murray Model estimates that Daily New Deaths (DNDs — the number that we’ve been tracking) will quadruple from its current level of about 500 DNDs, peaking at about 2,200 in mid to late April.

image

Here are some of the key components and assumptions in the Murray Model…

Read the rest of this entry »

March 31: COVID Tracker

March 31, 2020

Total Deaths to Date Worldometer

3,173 Yesterday (March 30)
2,592  March 29
2,229  March 28
1,704  March 27
1.301  March 26
1.036  March 25
  784  March 24

Daily New Deaths Worldometer

581  Yesterday (March 30)
363   March 29)
525    March 28
403    March 27
268    March 26
252    March 25
225    March 24

Daily New Deaths UP

  • Prior day appears to be an outlier … probably the result of missed reporting deadlines

image

===============

State Deaths to Date Worldometer

  • NY over 40% of national deaths

image

================

US -NY Deaths Worldometer JHU

Daily New Deaths

image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Do ventilated COVID patients recover or die?

March 30, 2020

Ultimate Medical Hackathon: How Fast Can We Design And Deploy An ...

Medical data modelers are indicating the need for tens-of-thousands (or hundreds-of-thousands) of ventilators.

Gov. Cuomo has understandably been clamoring for 40,000 ventilators … just for New York.

Ventilators are being redeployed from hospitals in low virus-infected areaa to the nation’s hot spots.

President Trump has emptied the national stockpile of ventilators,  enlisted corporate volunteers (e.g. Ford, GE) to produce ventilators and activated the DPA to get GM into the ventilator business.

Innovative med-tech companies  and university researchers are making ventilators using 3-D copiers.  Researchers at the University of Minnesota have designed a basic  MacGyver-like ventilator that is being prototype produced.

Sounds like a reasonable medical priority  … and impressive multi-sourced response.  I’m all in for going full throttle on ventilators.

That said, I’m curious …

The implied underlying assumption is that ventilators will save a lot of lives.

Is that a valid assumption?

Read the rest of this entry »

March 30: COVID Tracker <= UPDATE

March 30, 2020

As I indicated on this morning’s update, the Daily Death statistics seemed to be too good to be true. Apparently, some states were later than usual reporting.  The GOOD NEWS: Daily New Deaths did drop in NY and ROC (Rest of the Country). One day doesn’t make a trend, but it’s a nice number to report.

Total Deaths to Date  Worldometer
2,592 Yesterday (March 29) 
2,229  March 28
1,704  March 27
1.301  March 26
1.036  March 25
   784  March 24

Daily New Deaths  Worldometer
363  Yesterday (March 29)
525   March 28
403   March 27
268   March 26
252   March 25
225   March 24

Daily New Deaths DOWN
Updated Worldometer data 

image

===============

State Deaths to Date Worldometer
Not adjested for revised Worldometer data

image

================

US -NY Deaths  Worldometer   JHU

  • Daily New Deaths DOWN
    Updated Worldometer data

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

The plural of “anecdotes” isn’t “data” … or is it?

March 30, 2020

Sometimes, anecdotes are sufficient to inform decisions.  Hydroxychloroquine may be one of those cases.
==============

image

In my business analytics course, I used to preach the conventional wisdom that “anecdotes aren’t data” … and “make decisions based on data, not anecdotes”.

Those are good principles, but they don’t always hold.

And, when I was operating in the real world, I didn’t always follow them.

More often than not, business decisions must be made despite incomplete and sometimes conflicting data.

Read the rest of this entry »

March 30: COVID Tracker

March 30, 2020

Total Deaths to Date  Worldometer
2,489  Today
2,229  March 29
1,704  March 28
1.301  March 27
1.036  March 26
   784  March 25

Daily New Deaths  Worldometer
265  Today
525   March 29
403   March 28
268   March 27
252   March 26
225   March 25

Daily New Deaths DOWN
Too good to be true? Reporting?

image

===============

State Deaths to Date Worldometer 

image

================

US -NY Deaths  Worldometer   JHU

  • Daily New Deaths DOWN
     Too good to be true? Reporting?

image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

2015: Bill Gates warned that we’re not ready for the next epidemic …

March 29, 2020

In a 2015 TED talk, Gates hit the nail on the head, but his warning wasn’t heeded:

Today the greatest risk of global catastrophe is a highly infectious virus rather than a war.

Not missiles, but microbes.

We’ve invested a huge amount in nuclear deterrents.

But we’ve invested very little in a system to stop an epidemic.

We’re not ready for the next epidemic.

More transcript excerpts below, or
click to view the TED talk

image

Lessons from the Ebola epidemic

About 10,000 people died (during the Ebola epidemic), and nearly all were in the three West African countries.

There are three reasons why it didn’t spread more.

So next time, we might not be so lucky.

Maybe there will be a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market.

So there are things that would literally make things a thousand times worse.

==============

Preparing for the next epidemic

We can build a really good response system.

What we need is preparedness:

If there’s one positive thing that can come out of past epidemics, it’s that they can serve as an early warning, a wake-up call, to get ready.

If we start now (in 2015), we can be ready for the next epidemic.

=============
Thanks to LWH for feeding the lead.
=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Dr. Birx (and a majority of Americans) approve of Trump’s handling of coronavirus crisis

March 29, 2020

Last week, White House coronavirus response coordinator (and media-certified truth-teller) Dr. Deborah Birx praised President Donald Trump’s attentiveness and ability to analyze and integrate data, linking his capacity to do so with his business background.

Asked her perspective on Trump’s performance both with the public and “behind the scenes”, Dr. Birx responded in an interview:

He’s been so attentive to the scientific literature and the details and the data.

And I think his ability to analyze and integrate data, that comes out of his long history in business, [has] really been a real benefit during these discussions about medical issues.

Because, in the end, data is data, and he understands its importance.

And that all comes from the president seeing the data and then really directing these policies and the guidelines that go out to the American people.

Not bad for a guy who the media tags to be anti-science (and stupid).

And, based on the latest polls, the public seems to agree with Dr. Birx, not the media.

Here’s the data…

Read the rest of this entry »

March 29: COVID Tracker

March 29, 2020

Total Deaths to Date  Worldometer
2,229  Today
1,704  March 28
1.301  March 27
1.036  March 26
   784  March 25

Daily New Deaths  Worldometer
525  Today
403   March 28
268   March 27
252   March 26
225   March 25

image

===============

State Deaths to Date Worldometer 

image

================

US -NY Deaths  Worldometer   JHU

  • NY: +98% Daily New Deaths
    Rest of US: -6% DND

image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Hydroxychloroquine’s coronavirus benefits ID’ed in a 2005 study … scientists dropped the ball!

March 28, 2020

Scientists bet that the next pandemic wouldn’t be a coronavirus … and didn’t do randomized controlled tests of hydroxychloroquine.  Now they want the tests before approving the drug.
==============

Christine Dolan is a former Political Director for CNN and is now an Investigative Journalist, for a site called Just the News.

Her latest piece caught my eye:

image

Here’s Dolan’s top line:

Since the COVID-19 pandemic burst upon the world, scientists have been scrambling to conduct clinical tests on possible treatments, both old and new, like HIV cocktails, remdesivir, and anti-malaria drugs.

Their answers are weeks or months away, even as the disease spreads and claims more lives now.

But it didn’t have to be this way, experts say.

Government and private scientists could have taken the lessons and promising indicators gathered from prior coronavirus outbreaks dating to 2002 and turned them into clinical trials for the medicines that showed the most hope.

But instead the scientific world bet that the next big pandemic would emanate from a more traditional flu and not a coronavirus like Sudden Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS).

That bet proved wrong in 2020.

Here’s the scoop…

Read the rest of this entry »

March 28 – COVID Tracker

March 28, 2020

Total Deaths to Date  Worldometer
1,704
  Today
1.301  March 27
1.036  March 26
   784  March 25

Daily New Deaths  Worldometer
403  Today
268   March 27
252   March 26
225   March 25

image

===============

State Deaths to Date Worldometer 

  • Pareto (80-20 Rule):
    80% of deaths in 20% of states


image

================

US -NY Deaths  Worldometer   JHU

  • NY: +40% Daily New Deaths
    Outside NY: +59% DND

image

=============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

About that forecast of 2 million coronavirus deaths in the US…

March 27, 2020

During yesterday’s press conference, Dr. Deborah Birx opened with remarks about a study that was generated doomsday headlines of over 2 million covid-related deaths in the U.S.

image

Dr. Brix says “This is really quite important” so let’s drill down…

Read the rest of this entry »

March 27: COVID Tracker

March 27, 2020

Worldometer Daily Top Line

1.301 Total Deaths to Date – Today
1.036  Total Deaths to Date – Yesterday
   784  Total Deaths to Date – 2 Days Ago

  268  Daily New Deaths – Today
  
252  Daily New Deaths – Yesterday
   225  Daily New Deaths – 2 Days Ago

image

===============

State Deaths to Date Worldometer 

  • NY + WA ~ 1/2 US Deaths
  • Pareto (80-20 Rule):
    80% of deaths in 20% of states
  • CO (24), TX(23), CT (21)

image

================

US -NY Deaths  Worldometer   JHU

  • NY = 100 New Daily Deaths
  • +5 from prior day

image

===============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Giddy-up: Vatican offers fast passes into heaven…

March 26, 2020

Or, you can call them “stay-out-of-hell (nearly) free cards”
=============

Headline, Vatican City:

Pope forgives sins of those impacted by coronavirus.

image

There are some conditions that must be met.

Do you qualify?

Read the rest of this entry »

March 26: COVID Tracker

March 26, 2020

Worldometer Daily Top Line

1.036 Total Deaths to Date – Today
   784  Total Deaths to Date – Yesterday

  252  Daily New Deaths – Today
  225   Daily New Deaths – Yesterday

image

 

===============

State Deaths to Date Worldometer 

  • NY + WA = 1/2 US Deaths
  • LA, NJ,GA, MI on the rise
  • Pareto (80-20 Rule):
    80% of deaths in 20% of states

image

================

 

NY-NYC Deaths  Worldometer   JHU

  • NYC = 82 New Daily Deaths

image

===============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Majority approve of the way Trump is handling the crisis.

March 25, 2020

According to the latest 5 polls reported by RCP, a majority of Americans (53.6%) approve of Pres. Trump’s handling of the coronavirus.

Gallup’s most recent number pegs the number at 60%.

image

Bottom line:  the public opinion hasn’t been  substantially swayed by the grenades that CNN, MSNBC, etc., have lobbed at him, including:

1. The ban on travelers from China was racist, xenophobic and totally unnecessary.

The truth-telling scientists now retrospectively praise the action for temporarily fire-walling the virus.

==============

2. Calling the virus — which started in China — a “Chinese virus” is racist and xenophobic.

Best press conference line: Is it xenophobic to refer to “Chinese food”?

==============

3. Because of Trump’s incompetence and his refusal to accept WHO test kits, testing was delayed and promised quantities of test kits were late to market.

In the March 18 press conference, Dr. Brix stated unequivocally that the CDC was following protocols put in place by the prior administration.

“Other tests that were being used around the world  provided more false positives and false results than the ones that will be deployed in the U.S.  The delay in the distribution is the result of a flawed production process that has been remedied.”

==============

4. Trump ‘dissolved’ the NSC’s pandemic response office resulting in a slowed recognition of the outbreak.

A holdover Obama appointee (Beth Cameron) got canned and her responsibilities shifted to Tim Morrison – the NSC’s senior director for counterproliferation and biodefense.

Even Cameron concedes that the biodefense staff unaffected.  Her “people” weren’t impacted by the cut back and “biological experts do remain in the White House and in our government.”

==============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

March 25: COVID Tracker

March 25, 2020

Worldometer Daily Top Line

784 Total Deaths to Date

225 Daily New Deaths – Today
140  Daily New Deaths – Yesterday

image

===============

State Deaths to Date Worldometer 

NY = 1/3 US Deaths
NY + WA = 1/2 US Deaths

 

image

================

NYC Deaths   JHU

NYC = 3/4 of NY Deaths
NYC = 1/4 US Deaths

image

===============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Pelosi’s coronavirus prescription…

March 24, 2020

Senator Tom Cotton’s provides a summary of Pelosi’s 1,400 page counter-proposal to save us from this terrible pandemic.

It’s ‘must-see TV” … well worth 5 minutes.

click to view 5-minute CSPAN video clip

image

Items covered:

  • Bailing out the USPS
  • Corporate board diversity targets
  • Early & same day voting
  • National minimum wage
  • Enhanced retirement benefits for newspaper employees
  • Allowing Fed employees to do union work “on the clock” and get paid (by taxpayers) for it.
  • Bail out funds to cities (whether impacted by coronavirus or not)

==============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

The power of anecdotes…

March 24, 2020

Trump & Cuomo have jumped aboard the Hydroxychloroquine train, spurred on by pop-docs like Dr. Oz.

Dr. Fauci is “hesitant” because there haven’t been scientifically-pure randomized controlled clinical studies …  just “anecdotal evidence”.

Memo to Dr. Fauci: Don’t underestimate the “power of anecdotes” in shaping decision-making and public opinion.

=========

In my Business Analytics course, I had students read a couple of excerpts from a book called Think Twice: The Power of Counter-intuition by Michael Mauboussin.

In a chapter called “The Outside View” the author reports findings from a medical study that investigated the relative importance of hard data and anecdotal evidence when patients select from among treatment options for serious health conditions.

Patients were given the hard scientific data about a treatment‘s success rates and an anecdote about a case history.

Some anecdotes were positive (the treatment was a success), some were negative (the treatment failed or had complications), and some were neutral (neither a clear success nor a dramatic failure).

Below is an extract of the study’s results summarizing the percentage of respondents selecting a treatment given the hard data on its success rate and a related anecdote of a specific case’s outcome.

image

Let’s drill down …

Read the rest of this entry »

March 24: COVID Tracker

March 24, 2020

Worldometer Daily Top Line

582 Total Deaths to Date

140 Daily New Deaths

image

===============

JHU Daily Top Line
image

===============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Finally, legit reasons for testing…

March 23, 2020

For a couple of weeks, I’ve been asking:

Since doctors say that  the treatment for symptomatic patients is the same whether a patient tests positive or negative for coronavirus, why all the fuss over test kits?

Over the weekend, I finally gleaned answers to my question.

Note: I use “gleaned” since no “experts” seem willing to explicitly say so

===============

1. Patients who present as symptomatic — but test negative — can be sent home to sleep off the flu rather than being admitted to a scarce hospital bed.

The consensus seems to be that roughly 90% of symptomatic patients who are tested are negative for coronavirus.

For them, self-quarantine is sufficient.

It makes sense that they be tested off-site (say, in a drive-thru testing site … and kept clear of doctors’ offices and hospitals.

==============

2. Healthcare personnel who treat coronavirus-infected patients need periodic testing to protect themselves and others.

By definition, these heroes of the fight are constantly exposed.

If they get infected, they deserve the benefit of immediate care …  and, should be isolated

==============

That said, we need to ID the hidden carriers — the asymptomatics who are infected.  That calls for a broadscale, rapid test.

==============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Monday: Sharp increase in new deaths.

March 23, 2020

458 Total Deaths to Date  Worldometer

==============

Daily New Deaths: Sharp increase +117
Worldometer

image

===============

JHU Daily Top Line

  • Note: JHU has started categorizing NY into regions … NYC 99 , Suffolk 12, Other NYC 34 … Total NY 145

image

===============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Sunday: Daily COVID-19 Tracker

March 22, 2020

348 Total Deaths to Date  Worldometer

=============

U.S. Hot Spots  JHU

image

==============

Daily New Deaths: Slight Decline; NY +20
Worldometer

image

===============

Follow on Twitter @KenHoma

>> Latest Posts

#HomaFiles

Hydroxychloroquine: NY to start “clinical test” …

March 21, 2020

Kudos to Cuomo for nudging the Feds
=============

image

You’ve probably heard some chatter about  Hydroxychloroquine.

Hydroxychloroquine is a decades old anti-malaria drug that some researchers  are advocating for “repurposing” to attack COVID-19.

Here’s what you need to know

Read the rest of this entry »

How will we know when we’ve turned the COVID-19 corner?

March 21, 2020

Here’s the COVID-19 number that I’m watching.
==============

Cutting to the chase, I’ve concluded that the most reliable number being reported is the number of COVID-19 related “Daily New Deaths”.

According to Worldometers – the best data aggregation site that I’ve found so far – there have been 275 COVID-19 related deaths in the U.S. so far.

image

That chart looks exponentially ominous … but remember that we’re looking at relatively small numbers.

Note: Over 60% of the fatalities are clustered in 3 states WA, NY, CA — with half of those in Washington.

=============

So, I think it’s more useful to look at “Daily New Deaths” …. if that number keeps going up then, by definition, we haven’t turned the corner.

When that number starts trending down then, by definition, we have turned the corner.

Here’s what Worldometers is reporting on “Daily New Deaths” for the past 3 days: 41, 57, 49.

image

Don’t get too excited about yesterday’s drop in fatalities … again, keep in mind that we’re dealing with small numbers.

In the unlikely case that the number stays around 50, then it’s time to celebrate.

Keep in mind that during flu season, we rack up about 250 flu-related deaths per day.

Bottom line: If you want to know if we’re starting to turn the corner, keep your eye on the number of COVID-19 related “Daily New Deaths”.

Choose the level of aggregation based on your specific interest … world, nation or state.

Note: I’ll be focusing on the U.S. national number … and the national number less the 3 state hot spots.

=============

Why “Daily New Deaths”?

Read the rest of this entry »

Was South Korea’s COVID success really attributable to testing?

March 20, 2020

Testing — which wasn’t as “mass” as headlined — is only part of the story. 
=================

It’s indisputable that South Korea has done a masterful job attacking COVID-19.

image

How did they do it?

Practically all of the punditry has centered on SoKo’s fast-to-market and aggressive testing procedures.

For example, Time says: “Countries (such as Korea) that have flattened the curve made testing widely and freely available, using innovative approaches like mass drive-thru test centers.”

Forbes said: “South Korea’s cumulative curve has indeed flattened somewhat. That’s primarily due to the government moving swiftly to ensure free and widespread public testing for COVID-19.

The implication: If the US just had more test kits and pop-up testing stations, we’d be able to get this outbreak under control pronto.

But, there’s way more to the story  … SoKo also took strong enforcement actions based on the test results. 

Here’s the story….

Read the rest of this entry »