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Saturday, June 27, 2020

Informed Opinion On Covid?

My wife and I were lamenting yesterday the glaring lack of transparency regarding SARS CoV-2 (i.e., Covid). I've long since come to the view that this lack of transparency on the part of most of our State and local governments and the public health authorities can only be explained by political motives. There's no health related reason why, at this point, we should not have access to the data that they have. Not to put too fine a point on it, Lib Prog fear mongering must be behind the lack of transparency. The fact of the matter is, you know and I know that--after months of the pandemic--there is no lack of relevant data out there, collected by government health officials. Yet somehow that relevant data is, for the most part, not being pushed out to the people (you and me) who need it to respond rationally. It's as if there are people or 'folks' who don't want us to know, who don't want us to be part of the decision making process.

Amid the talk of a new surge of "cases", I want to know what a "case" is, how that relates to hospitalizations and deaths, and who these people who have become "cases" actually are. More, I'd like to know how they became "cases."

Now along comes the State of Florida--and Avik Roy to explain what's going one there. Maybe this data--which unfortunately doesn't include data on contact tracing, the "how"--will suggest a rational course of action. I don't think Roy can be mistaken for a hardcore Trump apologist. This data raises serious questions about what's currently going on, both medically and politically. It's certainly a useful starting place for informed discussion:



If you want to understand what's going on with #COVID19 right now, the best place to look is Florida, because they do the best job of anyone in terms of data transparency. Note the different age distributions of cases, hospitalizations, & deaths in their regular report.




The full report is here: floridadisaster.org/globalassets/c…. The point is that not all hospitalizations are the same. If you're 85 and you've been hospitalized with #COVID19, the risk of death is 61%. If you're 35-44, the risk is 5%. If you're 25-34, 2%.

So, when you see reports about rising numbers of hospitalizations, it's critical to ask: what's the age distribution of the people being hospitalized? We talking about elderly or young people? Without that information, "hospitalizations" statistics are far less useful.

For those who like to see this data visualized, here's a chart




of the mortality rate of hospitalized #COVID19 patients by age bracket (in honor of UF grad @GreggGirvan the bars are in retro Gator blue). Not all COVID hospitalizations are created equal.

Here's a similar chart, but this time of the death rate for #COVID19 *cases* in FL. Age trend is even more pronounced, b/c the death rate for COVID *cases* for people under 55 is well below 1%. So when people talk about rising cases, 1st q to ask is: what's the age distribution?



Finally, here's the age distribution of the *hospitalization* rate of Florida #COVID19 cases. Here again, you see that the frequency of hospitalization is much higher for the elderly.




The reason I'm walking you through all of this is because the recent rise in hospitalizations in Florida is driven by younger people. This appears to be true in Texas as well, though I don't think we have data sources in Texas that break out the distribution as well as Florida's.


19 comments:

  1. I have to admit I stopped paying attention two months ago. The nonstop talking heads on every cable and legacy TV channel babbling about whatever their ideological producers put in front of them to read became unbearable. Local news networks were just as bad. The "news" morphed into a disinformation campaign from which it has not recovered - kind of like how they cover politics in my view. One sided.

    DJL

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  2. In Los Angeles County we have had PhD Barbara Ferrer, the county health officer (without a single degree related to medicine) holding us prisoner. Looking like a badly embalmed cadaver herself, she receives little respect. How can someone who looks so unhealthy herself be an expert on the public’s health? Our little town seems to perc along … We still see lots of masks. Our heavy Chinese population has worn them for ages; now the rest of us do so that we can do our shopping. Stores require them.

    Tried to listen to the COVID committee’s update yesterday. Finally shut it off as Dr. Birx plodded through endless charts the TV viewer could not really see.

    Like Mark, I wonder now what a case is. With the mass testing that has gone on, is a positive reading a case? And they’ve added congestion and a runny nose to the symptom list. In allergy season (which my doctor once told me was all year in California) that could be any of us.

    More than anything we hate being perplexed - and bamboozled.

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    1. Yeah, Bebe, and for her trouble, Ferrer gets a juicy Total pay & benefits package of over $450K per year, for having an M.A. in "public health".

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  3. 1941 pages Long? Wow. Basically Autogenerated with Little Analysis.

    My 2 cents:

    Number of tests has doubled in the past 30 days for Florida.

    Protests seem to have had a huge factor in the increase, based on the dates.

    50% of deaths came from Nursing Homes

    Per another article deaths per 100,000 in Florida is 15. NY was 161.
    https://townhall.com/tipsheet/guybenson/2020/06/26/cuomo-florida-played-politics-with-coronavirus-and-lost-n2571346

    I read some place that the death per hospitalization is going down. That would be a good graph to have.

    Graphing death rate verses usual death rate would be helpful for more context.

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  4. Interesting article at American Greatness. Actually a string of tweets:

    https://amgreatness.com/2020/06/26/data-suggests-protests-led-to-covid-spike/

    This has been my thinking from the time the mass protests were occurring in parts of Los Angeles and Santa Monica, with protesters/rioters/looters in crowds for hours over a period of days, and the timing of the so-called “spike” in Los Angeles County.

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  5. "Remember yesterday, when I published an email asking about possible double-counting of cases in Arizona? And then the state said no, it wasn’t double-counting. Must just be coincidence that the number of #Covid hospitalizations fell 300 and ventilator use plunged 25% overnight."

    https://twitter.com/AlexBerenson/status/1276571617808781312

    "Badly misleading from @ScottGottliebMD. What Florida REALLY says: 17,500 people 35-44 have tested positive (so AT LEAST 175,000 people that age, probably many more, have been infected). 1230 have been hospitalized. 59 have died. 59. Out of 175,000+. 1 in 3000 cases, at most."

    https://twitter.com/AlexBerenson/status/1276595534552346624

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  6. Two of my brothers are MDs. They take Covid-19 seriously, so I do, too.

    However, I have a feeling that something doesn't fit. Covid-19 is a potentially serious illness that I don't want to get, but it doesn't rise to the level of a world-changing catastrophe. It kills a small percentage of people, mainly the elderly and those who are already sick. But so does the flu, and a bad flu virus like 2017-2018 or apparently 1968 kills as many or more people than Covid-19. I can't help but suspect that other things are in play.

    This doesn't prove anything, but last year, I said that if I were among the powers that be, I would try to crash the economy before the election. Lo and behold, here we are. Is it an instance of "never let a crisis go to waste"? I can't prove it either way. But I wonder.

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    1. It was reasonable to be very concerned about Covid when it first appeared, based on the fact that it might have been a follow on to the original SARS as well as the fact--almost certainly known to government health officials at a very early stage--that it was probably a gain-of-function engineered virus.

      However, as the virus' limitations became known, no adjustments were made and it became apparent that the Left was seizing on it for political purposes.

      I'm still in favor of precautions, but precautions that are tailored to the known facts. Problem: the authorities mostly seem to be hiding those facts.

      Delete
  7. My biggest frustration is that there is NO source of information, opinion, fact, or figure that I can trust. I suspect that Trump, long known to be a germophobe, was bamboozled early on, and is slowly, steadily, trying to dig out from under the disinformation he's been fed. And with every statement he makes, I have to ask "What is it that he is NOT telling us that he would like to but for prudent and strategic reasons can't?"
    What caught my attention early on was expressed best by Glen Reynolds (Instapundit, May 29, 4:27pm): "So here’s a thought: What elevated this in my mind from “oh, the annual rumors of a new disease outbreak in China” to “holy crap, better pay attention” was the Chinese government’s own rather dramatic response. Hypothesis: They knew it had leaked from the lab, but weren’t sure yet which infectious agent had leaked from the lab, hence the dramatic response, more appropriate to a much deadlier disease. Second hypothesis: From this, we can assume that there is a worse infectious agent in that lab. Or at least that there was."
    At this point, with the best synthesis I can make of very suspect data, is that we know a good deal about susceptibility, co-morbidities, and prophylactic treatments possible (HCQ, zinc, vit D, etc.), and I continue to maintain the best state of health I can.
    One thing I have learned from half a century studying history is that yes, the world is indeed going to hell in a handbasket, AND ALWAYS HAS BEEN, from the viewpoint of the present moment.

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    1. I believe that Trump really didn't have much choice as things happened. As you say, he's steadily digging out.

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  8. Trump was still going through impeachment when the Wuhan CoronaVirus became an issue. And the Democrats would have loved to impeach him over his response. That entire dynamic has been in the background guiding Trumps response. I was surprised he did the China travel ban so quickly.

    The problem was Trump did not realize how incompetence and bureaucratic the FDA and CDC were initially (testing debacle is a poster child of that). And they are bastions of anti Trumpness (Fauci wrote basically a love letter to Hillary). Plus how much PPE was made in China, and the US stocks were depleted. And the Governors in the worst hit states are Democrats and wanted to blame him. And the press (95% anti Trump coverage) would love to blame him. All this endangered his re-election.

    With all this in mind, I’ve been surprised how well Trump has done. He moved the responsibility to the Governors, a brilliant political move, and done a good job escaping all the traps set for him, and fixing a lot of problems. The initial mask response was stupid.

    PPE and Ventilators are no longer issues. Several vaccines are being tested. Hospitals were not overwhelmed. We escaped a depression. And the death rate is down significantly, and states are reopening.

    I wish the us had been more like Sweden on shutting down, but it was just not politically possible.

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    1. A good reminder on all counts. Sweden is significantly higher than US in death rate.

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  9. Agree on Sweden, it seems the higher death rates in Sweden are due to Nursing Homes - they have giant nursing homes, and among immigrants that live in close quarters, and do not practice social distancing, and have the belief it's God's Will - Inshallah. Plus they are not required to wear masks.

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  10. My wife (Taiwanese) and I were having a chat last night about Taiwan vs. the US's response. She does not think much of the US response...

    Taiwan did an amazing job, but they shut down travel from China much faster, and they had PPE and actually knew how to clean public transport, and take other measures against a virus. Taiwan got badly hurt from SARS, and learned from it. There was bipartisan agreement in Taiwan on taking action against any chance of a virus from China that did not exist in the US at that time.

    In the US, Coronavirus is still out of control UCI and Berkeley in the Fall are going to be online only. The recent uptick in cases seems to be due to the protests. About 50% of all deaths in the US were in nursing homes. Due to the incompetence of the Government, such as advice on wearing masks, hand sanitizer, and testing, I don't see Coronavirus is going to go away in the US, till there is a vaccine. There may be one by the end of the year. The good news is for most people CoronaVirus is not that deadly. Most deaths are older people, with pre existing conditions such as obesity, diabetes, etc. Yes, that makes my parents and my wife's Father prime targets.

    From what I can tell, there are still no great ways to treat Covid 19. This entire area got very politicized. Hydroxychloroquine seems to help if used early, but I am not sure how widespread it is used in the US. Trump recommended it, which made many instantly against it. 

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    1. Trump and the health establishment were reacting to fear of a more virulent SARS, so that's understandable--except the insane support for gain of function research, which isn't on Trump.

      This is interesting:

      https://outkick.com/cdc-now-estimates-there-have-been-over-20-million-coronavirus-cases/

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  11. This news article is less misleading than most, but it still makes readers do extra work to figure out the facts:

    * Eighty-five people tested positive for Covid-19. "At least 10" had no symptoms, which means that officials tested a lot more than 85 people. We don't know the total number of tests, so we don't know the infection rate.

    * Of the 75 or fewer people who had symptoms, most "have only shown mild symptoms," which could mean anything from slight sniffles to flu-like illness.

    * In a younger crowd, you'd expect most people either not to get infected at all, or to be asymptomatic, or to have only mild illness. That's consistent with the article but the specifics are missing.

    So it's another fear headline shouting "plague!" on an article that leaves out key details. That's how opinion is molded in people who are only half-paying-attention.

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    1. Check out this article, it's on point:

      https://outkick.com/cdc-now-estimates-there-have-been-over-20-million-coronavirus-cases/

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  12. https://bit.ly/2VuV2iu

    Reported "cases" are supposedly new infections, right? Nope. CDC & some states (Texas) are inflating the "cases" to include antibody tests, which are by definition not current cases.

    “You’ve got to be kidding me,” Ashish Jha, the K. T. Li Professor of Global Health at Harvard and the director of the Harvard Global Health Institute, told us when we described what the CDC was doing. “How could the CDC make that mistake? This is a mess.”

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