Archive for April, 2020

So, how far & fast does a virus spread?

April 30, 2020

Here’s a crash course on the subject.
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In a press conference last week, Gov. Cuomo started talking about the “virus reproduction rate” and, channeling Germany’s Chancellor Merkel, declared that NY can’t be reopened until it is under control. WSJ

Sounds reasonable, right?

Yeah, but what the heck is he talking about?

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Fasten your seat belts and let’s do some fun math today…

(more…)

April 30: Key NATIONAL Data

April 30, 2020

2,369 Daily New Deaths Worldometer
> 7-day trend is level @ ~2,000

737 NY+NJ+CT 31% of US & dropping             

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

Cumulative U.S. Deaths 
61,635
Worldometer

IHME Model Cumulative US Death Projection:
72,860 by Aug. 4  Rev. DOWN 1,213 on 4/29 

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click for Key STATES Data
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Click to see the video that YouTube blocked:
The contrarian California docs who are challenging the scientific consensus.

April 30: Key STATES Data

April 30, 2020

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 32,412  53% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 51,234 83% of US Total
      Top 12 Average = 325 Deaths per Million
      Top 12 = 48% of U.S. Population
      Bottom 39 Average = 60 Deaths/Million
  • Maryland 1,078  +62

State-by-State Data – Top 12

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Related Posts:

Flattening the COVID-19 curve

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

Still more about the NY antibody test results…

April 29, 2020

What about the 3% of New Yorkers floating around while infected but asymptomatic?
==============

In a prior post, we squeezed the NY antibody test results pretty hard and estimated that about 600,000 New Yorkers are walking around at any one time infected with the coronavirus but exhibiting no or very mild symptoms. That means that about 3% of NY’s population are asymptomatic “hidden carriers” who may be unknowingly spreading the disease.

To understand their significance …

Most infectious disease epidemiology models are built on the “SEIR” construct: how many people are susceptible to a virus … of them, how many are likely to get exposed to it … of them, how many are likely become infected … and of them, how many are likely to recover, perhaps with some degree of immunity. The modelers then calibrate a virus’s behavior, estimating how long it takes people to move from susceptible to exposed to infected to final resolution (recovery or death).

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My former strategy students should recognize the SEIR construct as a basic hierarchy-of-effects model, similar in design to, say, the classic marketing awareness – trial – repurchase model.

And, the spread effects are a classic Bass Diffusion Model application with infected people playing the role of “innovators” and susceptible people playing the role of “imitators”.

Let’s dive a little deeper…

(more…)

April 29: C-19 Key NATIONAL Data

April 29, 2020

2,463 Daily New Deaths Worldometer
> Big increase from prior day
(likely under-reporting in prior 2 days)

> 7-day trend is level

996 in NY+NJ+CT 39% of US              

image

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

Cumulative U.S. Deaths 
59,256
Worldometer

IHME Model Cumulative US Death Projection:
74,073 by Aug. 4  Rev. UP 1,665 on 4/28
According to IHME: upped b/c “presumed deaths” added by CDC in mid-stream; long NY plateau; states opening before Aug.4

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click for Key STATES Data
=============

Related Posts:

Flattening the COVID-19 curve

About that forecast of 60,000 coronavirus deaths

April 29: Key STATES Data

April 29, 2020

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 31,675  54% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 49,466 84% of US Total
      Top 12 Average = 313 Deaths per Million
      Top 12 = 48% of U.S. Population
      Bottom 39 Average = 57 Deaths/Million
  • Maryland 1,016  +71

State-by-State Data – Top 12

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Related Posts:

Flattening the COVID-19 curve

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

Uh-oh: With C-19 bearing down on Maryland, our area hospital furloughs 1,000.

April 28, 2020

Victim of the moratorium on elective surgery.
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Talk about timing…

On Sunday, I broached a sensitive topic with my wife: Which hospital should we go to if we catch the coronavirus?

We’re heavily biased towards teaching hospitals, and the docs at Georgetown Hospital were amazing during Kathy’s grueling bout with breast cancer.

But, we concluded that Georgetown – a metroplex hospital — would probably be overrun with cases.

So, we started leaning towards our large, modern local option: Anne Arundel Medical Center

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Then, on Monday, the news hit

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According to the Annapolis Capital Gazette

“Anne Arundel Medical Center has furloughed 1,000 employees.”

Say, what?

In accordance with federal guidelines, the Annapolis hospital canceled all elective surgeries and “ambulatory service” … which are the economic backbones of the hospital.

But, up to now, the C-19 patient load has been very light.

Bottom line: the hospital has been patient and revenue light for a month … facilities are underutilized … and the hospital is bleeding red ink.

So, there was no choice but to lay-off medical staff … they became victims of the coronavirus!

Nonetheless, the hospital says not to worry:

These furloughs do not impact our commitment or ability to safely supply and equip our hospitals to combat COVID-19,

We have trained and redeployed hundreds of staff to support the expected COVID-19 surges in the state of Maryland.

Apparently, AAMC’s predicament is not unique.

The guidelines were obviously developed with the C-19 hot spots’ hospitals in mind … and, the one-size-fits-all rules made other hospitals collateral damage.

Sad, but true.

The contrarian California docs who are challenging the scientific consensus.

April 28, 2020

YouTube blocked the video, but …   we’ve got it here!
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Drs. Dan Erickson and Artin Massih are ER physicians with 40 years of hands-on experience with viruses and respiratory infections.

They’ve been digging deep into the coronavirus, stress-testing the consensus science and the public policy that’s derived from it.

Their approach:  analysis based on science, logic and “the actual facts of the case, not predictive models”.

Their general findings aren’t particularly controversial: “COVID-19 came here earlier than previously believed, is more ubiquitous and, ultimately for the general population, is less deadly than originally thought.”

So, why are they getting blocked?

(more…)

April 28: C-119 Key NATIONAL Data

April 28, 2020

1,391 Daily New Deaths Worldometer
> 7-day moving average 2,041
> 7-day trend is downward

541 in NY+NJ+CT 39% of US              

image

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

Cumulative U.S. Deaths 
56,803
Worldometer
56,253  
JHU

IHME Model Cumulative US Death Projection:
74,073 by Aug. 4  Rev. UP 1,665 on 4/28

=============
click for Key STATES Data
=============

Related Posts:

Flattening the COVID-19 curve

About that forecast of 60,000 coronavirus deaths

April 28: C-19 Key STATES Data

April 28, 2020

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 30,650  54% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 47,475 84% of US Total
      Top 12 Average = 301 Deaths per Million
      Top 12 = 48% of U.S. Population
      Bottom 39 Average = 54 Deaths/Million
  • GA +70  … likely under-reporting
    in prior 2 days
  • Maryland 945  +35

State-by-State Data – Top 12

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Related Posts:

Flattening the COVID-19 curve

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

NY Antibody Test < UPDATE>

April 27, 2020

Phase 2 Results
===========

Gov. Cuomo reported Phase 2 results today.

Bottom line: Results are virtually identical to the Phase 1 results.

14.9% of the sample tested positive for coronavirus antibodies …  that’s up slightly from the Phase 1 results.

That projects up to 2.80 million New Yorkers.

Given the current number of cases (293,381), 2.6 million (89.8%) of the already infected people were, by definition asymptomatic — having no or mild symptoms.

The deaths to infections rate (.8%) was the same in both phases.

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Trump to scale back press conferences … whew!

April 27, 2020

Has he been reading the HomaFiles?
==============

Last week, we (and a zillion other observers) advised the President to dial back on his participation in the daily Task Force press conferences … and, rather, maintain his visibility by holding his own occasional “hot topic” news conferences.

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Looks like he’s taking the advice.

A couple of things appear to be motivating the welcomed relief….

(more…)

Dr. Birx scolds the press and millennials …

April 27, 2020

“Headlines are irresponsible … and most people don’t read the full story”.
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The poor media.

For weeks, they’d been fawning over Drs. Fauci and Birx for their Trump-thumping truth-telling.

That caricature started to unravel when Birx admited that “I didn’t see this thing coming” … then Fauci laid blame for the testing “failings” on the scientists … and then, both Fauci and Birx testified that Trump listens to them and has based big decisions (e.g. the lockdown) on their data and recommendations.

That was bad, but things got even worse in weekend interviews when Tapper, et. al., tried to get Birx to throw Trump under the bus for telling American idiots to drink Clorox and Lysol.

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Birx didn’t take the bait, instead responding:

Well, I think it bothers me that this is still in the news cycle.

I think I have answered that question.

I think I made it very clear in how I interpreted that …  and so has Dr. [Anthony] Fauci and everyone associated with the task force.

I think I have made it clear that this was a musing … a “dialogue” between President Trump and scientists. 

I think the president made it clear that physicians had to study this {sunlight and disinfectants].

Sources:    Axios   RCP   Politico

And, she went in for the kill …

(more…)

April 27: C-19 Key NATIONAL Data

April 27, 2020

1,147 Daily New Deaths Worldometer
> Best day in nearly a month
> 5-day trend is downward

>Note: Weekend reporting has tended to under-record the number of weekend deaths, carrying some over to Monday & Tuesday

504 in NY+NJ+CT 44% of US              

image

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

Cumulative U.S. Deaths 
55,412 
Worldometer
54,841  
JHU

IHME Model Cumulative US Death Projection:
67,641 by Aug. 4  Rev. UP 1,665 on 4/22

=============
click for Key STATES Data
=============

Related Posts:

Flattening the COVID-19 curve

About that forecast of 60,000 coronavirus deaths

April 27: Key STATES Data

April 27, 2020

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 30,137  54% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 46,454 84% of US Total
      Top 12 Average = 294 Deaths per Million
      Top 12 = 48% of U.S. Population
      Bottom 39 Average = 52 Deaths/Million
  • GA under 10 new deaths for 2nd day
  • Maryland 910  +35

State-by-State Data – Top 12

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Related Posts:

Flattening the COVID-19 curve

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

More about NY’s antibody test results…

April 26, 2020

So what about the 14% who tested positive for antibodies?
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Let’s start by flashing back to what we said before the test results came in:

Estimates from other earlier-infected countries indicate that only 15% of people infected by the coronavirus experience severe symptoms.

So, given that NY has had about 250,000 confirmed cases (which required severe symptoms), we would expect that the total number of people already infected in New York is 1.67 million (250,000 confirmed cases divided by 15%) … which is 8.6% of the NY population (1.67 divided by 19.5).

OK, the first wave of testing found that 14% of sampled New Yorkers tested positive for coronavirus antibodies … indicating that they had been infected.

That projects up to about 2.7 million people (14% times 19.4 million population).

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For details, see: NY antibody test results

So, is 14% testing positive for antibodies good news or bad news?

(more…)

April 26: C-19 Key NATIONAL Chart

April 26, 2020

2,039 Daily New Deaths Worldometer
> 5-day trend is downward.
> 7-day average 2,177

961 in NY+NJ+CT 38% of US              

image

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

Cumulative U.S. Deaths 
54,256 
Worldometer
53,934  
JHU

IHME Model Cumulative US Death Projection:
67,641 by Aug. 4  Rev. UP 1,665 on 4/22

=============
click for  Key STATES Data
=============

Related Posts:

Flattening the COVID-19 curve

About that forecast of 60,000 coronavirus deaths

April 26: C-19 Key STATES Data

April 26, 2020

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 29,633  55% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 45,541 84% of US Total
      Top 12 Average = 289 Deaths per Million
      Top 12 = 48% of U.S. Population
      Bottom 39 Average = 51 Deaths/Million
  • FL & GA under 10 new deaths 
  • Maryland 875  +77

State-by-State Data – Top 12

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Related Posts:

Flattening the COVID-19 curve

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

How many social contacts are people having during stay-at-home?

April 25, 2020

And, how risky is it to have contact with people outside of your household?
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In a previous post, we reported a Gallup survey that indicated at least.2/3s of Americans were making a reasonably serious attempt to isolate themselves during the stay-at-home.

A new Gallup survey reports that 74% are isolating themselves “completely” or “mostly”.

That’s pretty good compliance.

And, Gallup goes a step further in the current study to calibrate what “completely” or “mostly” mean by asking respondents how many people they came in contact with — not counting fellow household members — during the past 24 hours.

Note: The forecast models generally assume that social distancing practices, including stay-at-home, reduce contacts by about 40% … 25% for work contacts and 75% for general social contacts.

The conclusion: Adults practicing social distancing generate at least 90% fewer contacts per day than those who are making little effort to social distance.

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On average, survey respondents had 9.9 contacts in the past 24 hours.

Let’s dig a little deeper into the numbers…

(more…)

April 25: C-19 Key NATIONAL Chart

April 25, 2020

1,974 Daily New Deaths Worldometer
> Down from prior 3 days
> 7-day average 2,149

744 in NY+NJ+CT 38% of US              

image

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

Cumulative U.S. Deaths 
52,217 
Worldometer
51,949   
JHU

IHME Model Cumulative US Death Projection:
67,641 by Aug. 4  Rev. UP 1,665 on 4/22

Related Posts:

Flattening the COVID-19 curve

About that forecast of 60,000 coronavirus deaths

April 25: C-19 Key STATES Chart

April 25, 2020

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 28,672  55% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 43,841 84% of US Total
      Top 12 Average = 278 Deaths per Million
      Top 12 = 48% of U.S. Population
      Bottom 39 Average = 49 Deaths/Million
  • Maryland 798  +50

State-by-State Data – Top 12

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Related Posts:

Flattening the COVID-19 curve

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

Flashback: “The Tipping Point” by Malcolm Gladwell.

April 24, 2020

The forces that trigger epidemics.
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Malcom Gladwell, a pop-culture observer and author, hit it big 2 decades ago with his book The Tipping Point: How Little Things Can Make a Big Difference.

Primarily aimed at marketers, this best-seller provides a construct for understanding why some products and ideas languish and never gain traction … while others take off and rise quickly to broadscale acceptance.

Much of Gladwell’s thinking is derived from his study of contagions and epidemics … which makes it relevant today as we try to understand the coronavirus pandemic.

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Gladwell suggests that there are 3 key elements that need be present for an epidemic to reach a “tipping point” and takeoff: (1) Content – the infectious agent, (2) Carriers – the individuals who transmit the infection, and (3) Context – the environment in which the infectious agent  operates.

Let’s drill down on each of those…

(more…)

Squeezing the NY antibody test results…

April 24, 2020

Estimate: 3% of the NY state population are infected asymptomatics .. in circulation and potentially infecting others.
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In my business analytics course, I used to nudge students to “squeeze the rock” .. to get as much possible information out of each test or piece of data.

OK, let’s apply that principle today …

In a prior post, I opined that NY antibody tests were missing an information opportunity.  If they also swabbed the random sample for C-19 diagnostic tests, they’d also have an estimate of the number of infected asymptomatics who are currently in circulation in NY.

OK, it was a missed opportunity.

But, let’s not fret.

We can squeeze the data to get a rough-cut estimate of  the number of infected asymptomatics who are currently in circulation in NY.

Let’s do some arithmetic …

(more…)

NY’s missed testing opportunity

April 24, 2020

NY’s antibody testing program is highly commendable … and, it’’s already generating some very useful data.

But, I wonder..

Why aren’t they swabbing the same people for coronavirus diagnostic tests?

Doing so would tell us how many asymptomatic “hidden carriers” are currently in circulation.

My view: that’s one of the most important pieces of missing information … especially if it’s done on a periodic basis, say, weekly.

Would give us a good sense of how infectious the population is right now.

April 24: C-19 UPDATE

April 24, 2020

Today’s Headlines
Death toll over 50,000
2,562 Daily New Deaths Worldometer
IHME forecast 67,641 by Aug. 4

Must Read: About that forecast of 60,000 coronavirus deaths…
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KEY CHART: Daily New Deaths (DNDs)

2,562 Daily New Deaths Worldometer
> 7-day average 2,229

967 in NY+NJ+CT 38% of US              

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Cumulative U.S. Deaths 
50,243 
Worldometer
49,963   
JHU

IHME Model Cumulative US Death Projection:
67,641 by Aug. 4  Rev. UP 1,665 on 4/22

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STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 27,928  56% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 42,376 84% of US Total
      Top 12 Average = 268 Deaths per Million
      Top 12 = 48% of U.S. Population
      Bottom 39 Average = 46 Deaths/Million
  • Maryland 748  +50

State-by-State Data – Top 12

(more…)

Sure, Theranos was a disaster…

April 23, 2020

… but it offers some ideas for today’s crisis.
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OK, Elizabeth Holmes is a likely sociopath who charismatically defrauded investors out of billions of dollars and made fools of a lot supposedly smart, highly influential people.

In a nutshell: Holmes was 20-something Steve Jobs wannabe who visioned  that blood tests could be done from a single drop of blood and built a $9 billion company around the concept,

Here’s a 5-minute clip on Holmes & Theranosimage

There was a rub, though.

Holmes (and the company) crashed & burned when it was finally discovered that Theranos was Oz – the concept didn’t work.

Holmes is currently under Federal indictment, with a trial scheduled for this October.

Putting those dirty details aside for a moment, there are some things we can learn from Holmes and the Theranos saga.

Let me explain ….

I recently re-watched the 20/20 TV version of the Theranos story (titled “The Drop Out”) … this time, I watched with an eye to “learnings” that might have relevance to the coronavirus crisis.

Here are my takeaways…

(more…)

NY antibody test results…

April 23, 2020

~14% tested positive; over 21% in NYC
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Gov. Cuomo announced the first round of results from NY state’s broadscale coronavirus antibody test.

With 3,000 of the planned 14,000 tests completed 21.2% of NYC residents tested positive for coronavirus antibodies … an indication that they have already been infected by the virus (and recovered).

Interpreting those results requires a bit more number crunching: statewise, 13.8% tested positive … that projects to roughly 2.7 million New Yorkers

As of today, there have been 269,519 confirmed cases in NY state … that means that roughly 2.4 million people have been infected but had no or mild symptoms — so they weren’t given diagnostic tests. These are the so-called “hidden carriers”.

Said differently, based on these test results,  90% of New Yorkers who have gotten infected by C-19 have had no or mild symptoms. That’s a big deal.. perhaps the key takeaway from these test results! 

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As of today, NY has reported 20,792 coronavirus-related deaths … which given the estimated 2.7 million infectees implies a virus death rate of .8%

Nursing homes need tests with instant results!

April 23, 2020

Otherwise, viral spread with a high fatality rate is a matter of “when” not “if”.
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Let’s connect a couple of dots today…

First, the obvious has suddenly become evident: nursing homes (and other long-term care facilities) are sitting ducks for the coronavirus.

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Why is that?

Nursing homes present a “perfect storm” challenge: highly vulnerable, cloistered patients in close, constant contact with non-resident shifts of care-givers.

Let’s unpack that description and its implications …

(more…)

April 23: C-19 UPDATE

April 23, 2020

Today’s Headlines
2,338 Daily New Deaths Worldometer
IHME forecast  UPPED to 67,641
Maryland into Top 12; Washington out

Must Read: About that forecast of 60,000 coronavirus deaths…
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KEY CHART: Daily New Deaths (DNDs)

2,338 Daily New Deaths Worldometer
> 7-day average 2,174

1,092 in NY+NJ+CT 47% of US              

image

Cumulative U.S. Deaths 
47,681 
Worldometer
46,785   
JHU

IHME Model Cumulative US Death Projection:
67,641 by Aug. 4  Rev. UP 1,665 on 4/22

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STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 26,961  57% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 40,548 85% of US Total
      Top 12 Average = 257 Deaths per Million
      Top 12 = 48% of U.S. Population
    Bottom 39 Average = 39 Deaths/Million
  • Maryland into Top 12; Washington out

State-by-State Data – Top 12

(more…)

Let’s make the Task Force press conferences watchable…

April 22, 2020

A streamlined cast of presenters and an audience filled with subject matter experts would make the updates more informative.
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I am a news and data junkie, I am immersed in the coronavirus situation, I am Trump-tolerant and I am rooting for us to get out of this health-economic crisis as soon as possible with the fewest deaths and least economic damage.

So, I watch most minutes of most of the daily Task Force press conferences.

I am a passive TV watcher, even during sports events in which I have emotional (or financial) equity. I don’t cheer wildly for TD passes or yell at the TV when there’s an interception.

That said, I am on the verge of throwing shoes at the TV during the Task Force press conferences.

Note: Don’t say “stop watching”.  That would just be conceding defeat.

What’s the rub?

They are too long with too much predictable politics and too little pertinent new coronavirus information.

From the podium, there are too many vaguely supported reassurances and too much repetitive in loco parentis. I get that I’m supposed to wash my hands and stay at home.

From the gallery of reporters, there are too many questions that are politically-skewed, gotcha-intended, off topic or just plain stupid.

Note: I know that teachers (and retired teachers) are supposed to say “there’s no such thing as a dumb question”.  People who offer that admonition obviously didn’t sit through any of my classes.

So, what to do?

(more…)

If test kits are scarce, let’s test the right people!

April 22, 2020

Test kits are scarce and we are testing the wrong people.
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First, a quick primer on testing …

A testing system has two major components: the analysis machine … and a “kit” containing all the necessary chemicals (aka. “reagents”) and supplies (e.e. nose swabs).

Simple analogy: The analysis machine is like your trusty Keurig cup-at-a-time … and the testing kits are like the coffee pods that go into the machine. You need both parts to do a test or make a cup of coffee.

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There are plenty of analysis machines around, but they are made by several different suppliers … all of whom have uniquely different test kits.

None of the suppliers routinely carry a pandemic level of kits in inventory … the economics of doing so would be burdensome and some of the reagents have shelf lives. Ramping up to pandemic levels is a challenge because many of the kits’ components come from, you guessed it, China.

So, we’ve got plenty of lab capacity (analysis machines) … but a shortage of test kits. That makes the test kits the constraint or “pacing item”.

The shortage will eventually be filled, but until then, it’s critical that the scarce kits be used to test the right people.

We’re not doing that …

(more…)

April 22: C-19 >> ALERT! <<

April 22, 2020

A very bad day…
> Highest Daily Deaths toll so far
> IHME forecast  UPPED to 65,976

Must Read: About that forecast of 60,000 coronavirus deaths…
=============
Today’s Headline
DNDs UP from prior day
IHME forecast  UP to 65,976

KEY CHART: Daily New Deaths (DNDs)

2,824 Daily New Deaths Worldometer
> UP from prior days
> Highest DNDs total so far
> 7-day average 2,214

1,232 in NY+NJ+CT 44% of US
> UP 44% from prior day                    

image

Cumulative U.S. Deaths 
45,343 
Worldometer
45,075   
JHU

IHME Model Cumulative US Death Projection:
65,976 by Aug. 4  Rev. UP 5,668 on 4/21

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STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 25,869  57% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 38,682 85% of US Total
      Top 12 Average = 242 Deaths per Million
      Top 12 = 48% of U.S. Population
    Bottom 39 Average = 39 Deaths/Million
  • MD 562 Total Deaths  +46 DNDs

State-by-State Data – Top 12

(more…)

Let’s make COVID testing actionable…

April 21, 2020

We might be testing the wrong people.
===============
An earlier version was posted on March 22 

COVID-19 testing has been getting a lot of attention recently since availability of test kits has been late and slow.

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  • TV pundit-doctors complain that they can’t get tests done on their patients.
  • Some people are anxious to know if they have been infected.
  • Scientists are dismayed that they don’t have enough data to accurately calibrate the problem.

The current answer: Prioritize diagnostic testing to sick people who have COVID symptoms (and want to be tested)… 

My question: Is that the right answer?

I think not…

(more…)

NY antibody test results will give us clues about our future health risks…

April 21, 2020

 … and may either vindicate or indict the shut-down.
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Last week, Gov. Cuomo announced that New York will begin the “most aggressive” antibody testing in the country this week.

The goal: To determine the true number of people who have been infected by the coronavirus.

Specifically, NY will administer around 14,000 tests this week to a random sample of individuals.

That’s a good thing.

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Teaching point: I always coached my students to develop hypotheses before doing analyses or launching a test.

In high uncertainty situations — like the coronavirus infection rate — I nudged them to imagine the high & low results that might be reasonably possible … and, pre-assess the implications at each extreme.

Let’s play that game for NY’s antibody testing…

(more…)

April 21: C-19 UPDATE

April 21, 2020

Must Read: About that forecast of 60,000 coronavirus deaths…
=============
Today’s Headline
DNDs UP from prior day
7-day moving average 2,156 DND

KEY CHART: Daily New Deaths (DNDs)

1,954 Daily New Deaths Worldometer

856 in NY+NJ+CT 44% of US                    

image

Cumulative U.S. Deaths 
42,513 
Worldometer
42,364   
JHU

IHME Model Cumulative US Death Projection:
60,308 by Aug. 4  Rev. DOWN 8,533 on 4/16

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STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 24,553  58% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 36,416 86% of US Total
      Top 12 Average = 228 Deaths per Million
      Top 12 = 48% of U.S. Population
    Bottom 39 Average = 36 Deaths/Million
  • MD 516 Total Deaths  +30 DNDs

State-by-State Data – Top 12

(more…)

About that forecast of 60,000 coronavirus deaths…

April 20, 2020

The past couple of days’ data suggest that, nationally, we may have reached an apex for this wave of the coronavirus.

So, I thought it would be a good time to revisit the longer term projections…

I think that there’s a lot of misunderstanding about the oft referenced IHME forecast which is currently pegged at slightly more than 60,000 (down from an original projection of about 80,000).

image

Two key points:

1. 60,000 is IHME’s best case …  it assumes that all states are locked down until Aug.4 (which isn’t going to happen) … even then, as presented on the above chart, the IHME confidence interval ranges from 60,000 (most likely) to 140,000 (worst case)

2. The forecast is the cumulative number of deaths until August 4 … it’s not the number of cumulative deaths over the life of the virus (or even this wave of the virus) … certainly, there will be additional deaths after August 4.

Important: Keep in mind that  “flattening the curve” doesn’t reduce the total number of projected deaths, it just spreads them over a longer time period.

Any reduction to that total will be due to the virus dying out naturally, introduction of a virus neutralizing vaccine or introduction of life-saving drugs or therapies.

For discussion purposes, let’s hang our hat on 60,000 and August 4..

Right now, we’re sitting at roughly 40,000 deaths to date (40,565 to be precise).

Pause for a moment and consider the implications of those last 2 sentences.

(more…)

April 20: C-19 UPDATE

April 20, 2020

Trending: WaPo: “A glaring scientific breakdown at the CDC”
=============
Today’s Headline
DNDs down 16% from prior day
3-day moving average DOWN 

KEY CHART: Daily New Deaths (DNDs)

1,550 Daily New Deaths Worldometer

800 in NY+NJ+CT   52% of Total US
DOWN significantly 2 days in a row

image

Cumulative U.S. Deaths 
40,565 
Worldometer
40,689   
JHU

IHME Model Cumulative US Death Projection:
60,308 by Aug. 4  Rev. DOWN 8,533 on 4/16

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

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 23,627  59% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 34,821 86% of US Total
      Top 12 Average = 218 Deaths per Million
      Top 12 = 48% of U.S. Population
    Bottom 39 Average = 34 Deaths/Million
  • MD 486 Total Deaths  +23 DNDs

State-by-State Data – Top 12

(more…)

WaPo: “A glaring scientific breakdown at the CDC”

April 19, 2020

“The impact was devastating to the country.”
=============

Today, the Washington Post published a scathing report that details how the scientists at the CDC screwed up the launch and deployment of C-19 testing … leaving the medical community and policy-makers flying blind in the early stages of of the US coronavirus spread … and, information-short as the nation tries to transition back to re-opened normalcy.

image

WaPo’s general conclusion:

The CDC’s performance with the test kits marks an unparalleled low in the 74-year history of America’s heretofore premier institution for combating the spread of catastrophic disease.

More specifically, WaPo reports a disastrous mix of scientists’ hubris,  protocol violations, slow reactions, and missed commitments.

Here are some details ….

(more…)

April 19: C-19 UPDATE

April 19, 2020

DNDs down 27% from prior day
3-day moving average DOWN 

KEY CHART: Daily New Deaths (DNDs)

1,867 Daily New Deaths Worldometer

1,347 in NY+NJ+CT   53% of Total US
DOWN significantly from prior day 

image

Cumulative U.S. Deaths 
39,015 
Worldometer
39,090 
JHU

image

IHME Model Cumulative US Death Projection:
60,308 by Aug. 4  Rev. DOWN 8,533 on 4/16

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

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 22,827  59% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 33,520 86% of US Total
      Top 12 Average = 210 Deaths per Million
      Top 12 = 48% of U.S. Population
    Bottom 39 Average = 32 Deaths/Million
  • MD 463 Total Deaths  +38 DNDs

State-by-State Data – Top 12

 

(more…)

What Drs. Fauci & Birx said about testing…

April 18, 2020

I watched, so that you wouldn’t have to…
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During the press conference yesterday, Drs. Fauci, Birx, et. al., gave a technical presentation intended to educate us on their testing plan (and fend off critics like Gov. Cuomo).

image

In general, I was frustrated by the presentation which was way more “academic” and credential-building (e.g. “what we did re: HIV”) than practical (i.e. here’s what we’re going to do and how it impacts you) … and, still didn’t answer many of my questions (e.g. going forward, exactly who will be tested? how & where will they be tested? how will the test results be used? how can I get a test? what are my odds of getting infected? why does testing require a doctors Rx note? what about the false negative problem?).

As expected he dufass politico reporters asked no meaningful drill-down questions.

That said, I drew some significant takeaways from the presentation …

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

Point of emphasis: There is adequate testing capacity deployed to support the phased Open America plan. But, “the full potential of testing capacity still needs to be unlocked.” Birx

But, testing  is only a supporting component of the plan and is not “the panacea”   … it’s a diagnostic tool and a source of information for policy-setting … more testing will not stop the virus … it will help for priority-setting but we’ll still dependent on social-distancing and therapeutic interventions.

More specifically…

(more…)

April 18: C-19 UPDATE

April 18, 2020

KEY CHART: Daily New Deaths

2,535 Daily New Deaths Worldometer
UP slightly from prior day; level w/ prior 3  

1,347 in NY+NJ+CT   53% of Total US
UP slightly from prior day 

image

Cumulative U.S. Deaths 
37.175 
Worldometer
37,079 
JHU

Note: Both Worldometer and JHU have “absorbed”  the NY addition of “presumed” C-19 deaths.  So, there is a step increase in cumulative deaths (starting on April 16). Daily New Death counts are not effected.

image

IHME Model Cumulative US Death Projection:
60,308 by Aug. 4  Rev. DOWN 8,533 on 4/16

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

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 22,007  58% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 31,996 86% of US Total
      Top 12 Average = 201 Deaths per Million
      Top 12 = 48% of U.S. Population
  • MD 425 Total Deaths  +76 DNDs

State-by-State Data – Top 12

(more…)

Your DNA may protect you from C-19’s worst symptoms…

April 17, 2020

Maybe 23and Me has a socially redeeming value, after all .
=============

According to Bloomberg

Some people experience Covid-19 as nothing more than a mild cold, and others exhibit no symptoms at all.

Then there are the thousands who sicken and, often, die.

No one knows why there are such huge discrepancies in symptoms and outcomes.

One theory: It is locked deep in our genetic makeup.

So, a global consortium of scientists is working to unlock the mystery of the disease’s dramatically varying symptoms.

(more…)

April 17: C-19 => SCRAMBLED DATA

April 17, 2020

This morning, the WSJ reported that — based on their analysis of data from Johns Hopkins University:

In the 24 hours ending at 8 p.m. Eastern time Thursday, 4,591 people have died from Covid-19,

The prior record was 2,569 on Wednesday.

Worldometer – my primary source for C-19 fatality numbers – reported 2,179 Daily New Deaths.

So, based on 2 credible sources, C-19 deaths yesterday either increased by 2,022 (to 4.591) … or, they decreased by 390 (to 2,179).

That difference between estimates certainly falls into the category of “statistically significant” … especially hours after a government plan is announced to re-open the country for commerce.

I have greater confidence in Worldometer’s data analysis, so I’m going with their 2,179 DND number (with more explanation of the black bar to follow later):

image

My conclusion: Yesterday’s Daily New Deaths declined slightly from the prior day. … but the 3-day moving average is trending up slightly.

But, there’s a looming question:

What the hell is going on?

(more…)

What’s your Body Mass Index?

April 16, 2020

It’s a predictor of severe Covid-19 symptoms!
============

A couple of weeks ago, I heard a couple of frontline docs observe than many of the most severe Covid-19 patients were overweight.

body mass index for adults

Just an anecdote, but I stored it away as a clue.

Well, turns out that there’s data supporting the docs’ anecdotal evidence…

(more…)

Let’s play “Are you ready to”

April 16, 2020

OK, relatively soon, the economy will be re-opened … though, I’m not exactly sure what that means.

image

Here’s the rub…

Just because some activity is allowed to open, doesn’t mean that the public will be partaking.

Based on a recent Gallup poll, the vast majority (70%) say they plan to take a “wait & see” approach to resuming activities.

That makes sense, and the poll is directionally indicative, but decisions will likely relate to specific activities.

So, let’s play “Are You Ready To”….

 

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

 

For example, when the economy opens, will you be ready to…

  • Take a bus or subway?
  • Ride with others in an elevator?
  • Work in an open space office?
  • Meet with colleagues at work?
  • Participate in conference room meetings?
    =============
  • Take a plane flight?
  • Take a cruise?
  • Stay in a hotel?
  • Go to a vacation resort?
    =============
  • Go to church?
  • Dine in at a restaurant?
  • Go to the gym to workout?
  • Shop at a discount or department store?
  • Attend a class with 30 other students?
  • Go to a big crowd sporting event?
  • Go to a movie or a play?
  • Get a haircut?

You get the idea…

What other activities should be on the list?

==============
Thanks to MC for feeding this idea.

April 16: C-19 UPDATE

April 16, 2020

KEY CHART: Daily New Deaths

2,490 Daily New Deaths Worldometer
Level from prior day  

1,103 in NY+NJ+CT   46% of Total US
DOWN slightly from prior day 

image

Cumulative U.S. Deaths 
28,554 
Worldometer
30,985 
JHU

Note: NYC added 3,700 “presumed” covid cases.  It appears that JHU has added (some of) those deaths to their numbers, but that Worldometer has not (to preserve continuity with prior data).  We’re trying to unscramble the impact on the historical comparisons.  For now, we’re just going with the Worldometer data.

image

IHME Model Cumulative US Death Projection:
68,841 by Aug. 4  Rev. UP 8,436 on 4/13

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

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 15,610  55% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 24,115 85% of US Total
      Top 12 Average = 151 Deaths per Million
      Top 12 = 48% of U.S. Population
  • MD 349 Total Deaths  +47 DNDs

State-by-State Data – Top 12

(more…)

Did Trump pull a Br’er Rabbit on the Governors?

April 15, 2020

Let’s start with a refresher course on the story of Bre’r Rabbit:

image

Br’er Rabbit was constantly being pursued by Br’er Fox, who had personal dinner plans for the rabbit.

One day, when grabbed by Br’er Fox, the helpless but cunning Br’er Rabbit pleads, “Do any thing you want to me, but please, Br’er Fox, don’t fling me into the brier-patch.”

That prompted Br’er Fox to do exactly that.

But, Br’er Rabbit was born in this brier patch, and was  at home in thickets.

So, the resourceful Br’er Rabbit used the thorns and briers as a safe haven and the threatening fox was thwarted.. Source

OK, what does the story of Br’er Rabbit have to do with the coronavirus, the governors and President Trump?

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In this Monday’s press conference, Trump went off on his “total authority” to determine the start and speed of the country’s re-opening.

I found that odd since Trump resisted calls that he order a nationwide shutdown.  Rather, he was steadfast the the Feds could provide guidelines, but that the ultimate decisions were in the hands of the governors. Why the change of heart?

Predictably, the press went wild on “King Trump – the authoritarian despot”.

Governors (think: Gov. Andrew “Not My Fault” Cuomo) started shrieking “unconstitutional” … asserted that they were in charge … and threatened to sue to maintain control over the re-opening.

Then at the Tuesday press conference, Trump did an about face, saying that governors would be in charge … that Feds would just provide support … and. most important, the governors would be held accountable.

The press reported: “Trump folds under pressure from Governors”.

BINGO! The light bulb went on.

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

A friend of mine has long opined that “Trump is playing chess while everybody else is playing checkers”.

I used to think that was a long reach, but over time, I’ve started to think my friend is right.

Think about it.

For the past couple of months, Trump has been held totally accountable for the coronavirus response.

Even when unjustified, the press and governors laid every stumble at his doorstep.  Why are the test kits late and few? Why doesn’t NY have enough ventilators? Etc.

My view: Re-opening the economy is going to be long and messy. There will be stumbles, retreats and disappointments.

Why would Trump want to “own” that whole process? Why would he want to be the only person held accountable things that happen — large and small?

Answer: He wouldn’t.

But, if his opening position had been that the governors own it and they’ll be the ones held accountable, he would have been accused of shirking his buck-stops-here responsibilities. The press and governors would have rebelled.

Instead, he pulled a variation of Br’er Rabbit’s “get what you want” gambit… getting the governors to deprive him of the authority … and  demand that they get the authority (and accountability).  They united to throw Trump into the thicket patch.  So there, Mr. President!

Now, when things large or small go haywire, Trump can simply point to the accountability-demanding governors.

Check … and CHECKMATE!

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

Addendum: A loyal reader alerted me to a similar analogy – Tom Sawyer tricking his buddies into painting a fence for him. See Trump Whitewashes the Fence

April 15: C-19 UPDATE

April 15, 2020

A VERY BAD DAY !

KEY CHART: Daily New Deaths

2,420 Daily New Deaths Worldometer
UP 69% from prior day  

1,209 in NY+NJ+CT   50% of Total US
UP 50% from prior day 

image

Cumulative U.S. Deaths 
26,064 
Worldometer
26,057 
JHU

 

image

IHME Model Cumulative US Death Projection:
68,841 by Aug. 4  Rev. UP 8,436 on 4/13

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

STATE DEATHS  Worldometer

Summary

  • NY+NJ+CT = 14,310  55% of US Total
       NY+NJ+CT = 10% U.S. Population
  • Top 12 Total = 22,043 85% of US Total
      Top 12 Average = 138 Deaths per Million
      Top 12 = 48% of U.S. Population
  • MD 302 Total Deaths  +37 DNDs

State-by-State Data – Top 12

image

Related Posts:

Flattening the COVID-19 curve

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

The video that CNN won’t let you see

Bill Maher on “Virus Shaming”

April 14, 2020

Bill Maher is a darling of the left when he’s trashing Trump … but they seem to be having difficulty accepting his politically incorrect wit when it’s aimed at them.

This is Classic Maher … must watch TV.

click to watch video
image

Thanks to JC for feeding the lead.

The video that CNN won’t let you see…

April 14, 2020

At yesterday’s press conference, President Trump defended himself against the NY Times hit piece … using a montage of video clips.

CNN cut away from the press conference, calling it a “propaganda video”.

Of course, CNN thinks that you should trust them, not your lyin’ eyes.

Watch the video, then you decide.

image

P.S. Also during the press conference Dr. Fauci put to bed any notion that Trump when dallying when he should have been deciding.

Fauci said that the first time he and Dr. Deborah Birx recommended strong mitigation efforts to combat the coronavirus, President Trump agreed with them, and immediately made the decision to go forward.

He also added that when he recommended that the guidelines to slow the spread should be extended by a month, Trump agreed and approved gave the go-ahead.