Archive for the ‘Coronavirus – Covid 19’ Category

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 …

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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?

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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…

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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…

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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 …

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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…

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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 …

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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?

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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 …

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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…

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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).

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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.

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WaPo: “A glaring scientific breakdown at the CDC”

April 19, 2020

“The impact was devastating to the country.”
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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.

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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 ….

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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).

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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 …

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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…

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

April 17, 2020

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

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What’s your Body Mass Index?

April 16, 2020

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

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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.

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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”….

 

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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?
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  • Take a plane flight?
  • Take a cruise?
  • Stay in a hotel?
  • Go to a vacation resort?
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  • 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?

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Thanks to MC for feeding this idea.

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:

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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.

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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!

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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

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
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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.

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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.

Shocker: NY Times concludes that it’s all Trump’s fault…

April 13, 2020

Hindsight: “Woulda, coulda, shoulda”
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Now, that Drs. Fauci & Birx are telling us that the pandemic is nearing its apex, the New York Times thought it was the perfect moment to let a worried nation know that they had broken the case: it’s all President Trump’s fault.

click to read the article
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Cutting through the political rhetoric, the Times appears to have 5 main beefs with the way Trump has handled the situation:

  1. He didn’t run around yelling “FIRE! FIRE! FIRE!” in January.
  2. He was slow to pull the trigger on the Chinese travel ban.
  3. He didn’t move quickly enough to place replenishment orders for medical supplies and equipment.
  4. He botched the roll-out of the testing system.
  5. He waited too long to order social distancing and shut-down the economy.

OK, let’s drill down on those one at a time.

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WaPo: Nope, Trump didn’t call coronavirus a hoax …

April 13, 2020

Biden said he did … and it got him 4 Pinocchios.
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Seems like this one just won’t go away…

Fortunately, the fact-checkers at the Washington Post — not exactly a right-wing, Trump-loving rag — looked into the “said it was a hoax” claim when Crazy Joe started running it in a campaign ad.

What did they find?

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Let’s start with the ad’s “manipulation”:

The video shows a montage of intentionally unflattering clips of President Trump.

So far, it looks like a standard Internet campaign ad.

At the 10-second mark, the camera shows a tight shot of the president saying “coronavirus” and then cuts to a wide shot where he says, “this is their new hoax.”

What’s wrong with that?

The fact-checker explains….

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Remember when Cuomo (and the media) trashed Trump for not believing the models?

April 12, 2020

Now, the Gov. says all of the models and projections were wrong (but it’s not his fault)
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You could see this one coming a mile away…

A couple of weeks ago, Gov. Cuomo repeatedly (and loudly)  sounded the alarm that New York needs 30,000 ventilators from the Feds .. and urged President Trump to use the Defense Production Act to force companies to make more ventilators, pronto.

Trump pushed back, saying that the numbers just didn’t pass the smell test.

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Countering that was easy pickings for Cuomo, who immediately shot back.

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Gov. Cuomo defended the state’s request for 30,000 more ventilators to save coronavirus patients.

After all, he gathered predictions from Weill Cornell Medicine, the CDC and blue chip consulting firm McKinsey and Company.

All the predictions say you could have an apex needing 140,000 beds and about 40,000 ventilators. We only have 11.000.”

Upping the ante, Cuomo decided that he could use the situation to school the seat-of-the-pants President.

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Why have the model’s forecasts dropped so much?

April 10, 2020

The explanation is really quite simple
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Pundits are jumping all over the modelers – specifically, the team at Washington University’s IHME – accusing them of being inept or politically motivated.

I don’t think either of those accusations are true.

Here’s why…

Let’s start with the numbers.

The initial IHME projection, made on March 25, was 81,114 “deaths from COVID-19 over the next 4 months in the US.”.

At that time, the 95% confidence interval (in layman’s terms: the range of uncertainty) was 38,242 to 162,106.

For more detail on the IHME Model, see our previous post:
What you need to know about the IHME Model

Note that the confidence level was explicit … and admittedly very large.

The IHME forecast has been revised at least 5 times since March 25.

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Note that he current projection (60,415) is well within the original confidence interval (38,242 to 162,106) … it’s not some sort of wildly whacky outlier.

Still, let’s drill down on the initial forecast (81,114) and the current projection (60,415).

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How strictly are you complying to stop the spread?

April 10, 2020

Take the Gallup stay-at-home gut check and see how you compare.
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Drs. Birx & Fauci have repeatedly praised us for  staying home to stop the spread … reassuring us that mitigation is working.

Well, how are we doing?

Gallup surveyed America to find out.

Before revealing the results, slot yourself along Gallup’s stay-at-home spectrum.

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“Thinking about everything you’ve done in the past 24 hours, which of the following comes closest to describing your in-person contact with people outside your household?”

  • Completely isolated myself, having no contact with people outside my household
  • Mostly isolated myself, having very little contact with people outside my household
  • Partially isolated myself, having some contact with people outside my household
  • Isolated myself a little, still having a fair amount of contact with people outside my household
  • Did not make any attempt to isolate myself from people outside my household

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OK, let’s see how you compare to other Americans….

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Why is New York ablaze while California is just simmering?

April 8, 2020

That’s a question that I’ve been pondering…
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The WSJ ran 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 IHME 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?

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

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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.

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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.

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Good news: dogs can’t catch coronavirus…

April 7, 2020

Bad news: cats can.

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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.

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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 

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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

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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.

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State-by-State Detail

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“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.

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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…

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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.
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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.

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More specifically …

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Trump quadruples down on Hydroxychloroquine…

April 5, 2020

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

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

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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…

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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.

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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.

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

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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.

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Follow on Twitter @KenHoma

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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

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Follow on Twitter @KenHoma

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

April 3, 2020

… and, her answer made me very nervous
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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:

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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.
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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.

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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.”

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

April 2, 2020

Its conclusion: Hydroxychloroquine helps patients!
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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…

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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

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Follow on Twitter @KenHoma

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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.

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The article is relatively balanced and worth reading.

Here are my takeaways from the article…

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What you need to know about the IHME Model…

March 31, 2020

This is the model on which the Coronavirus Task Force has most relied.

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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.

An early-on Murray Model’s ‘most likely’ forecast was 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  peak at about 2,200 in mid to late April.

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

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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

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State-by-State Data

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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?

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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.
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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.

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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?

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State-by-State Data

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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

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Here are some transcript snippets from the talk …

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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…

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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

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State-by-State Data
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In 2005, scientists bet that the next pandemic wouldn’t be a coronavirus …

March 28, 2020

They dropped the ball on development of test kits, vaccines and, oh yeah, testing of hydroxychloroquine.
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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…

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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

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State-by-State Data

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