Some COVID-19 Data

Some data from New York City

Introduction

The following analysis and write-up was done by dcleve. I appreciate the time and effort he put into writing this up. I corrected a couple of typos but and did a bit of formatting, but I did not research or write this. My thanks to dcleve for taking the time to lay this out.

Unhappy lungs

The analysis

This is my effort to figure out where we are with Covid-19, without doing exhaustive research.
The summaries available from the CDC are vague, and US data appears poor due to limited testing, and deliberate underreporting. To get better understanding, I looked to overseas reports.
So – what is the risk from the disease? It has a moderate death rate, and is a dangerous disease, to people in every age group. But the risk increases with age. Also, there are multiple reports of long term health consequences in survivors. So both death and disability are risks.

The risk of death is skewed in many reports in three ways: by under-reporting of infections, by under-reporting of deaths caused by the disease, and by snap-shot reports before the ill people have either died or recovered. The best data on total fatality rate would come from a country which tested a lot, and reported tests accurately, and has pretty much beaten the disease. I looked at New Zealand, which had a 2% fatality rate, and S. Korea, which had a 2.4% fatality rate, as the best data sources.


The most useful breakdown of death rate by age I could find was from China. Here is a link to the Chinese fatality rate data by age, showing the risk of death if one gets infected. This Chinese study showed an overall death rate of 2.25%, with men ~1% more at risk than women (~2.75% vs 1.75% death rates). With the average from China matching the more recent data from New Zealand and S Korea, this seems like trustworthy data.

There is some additional useful data in this Chinese study about the effect of pre-existing conditions. Long-term health concerns like diabetes and cancer increased individual risks to between 6-10%. The risk of death to those without health complications was ~0.9%. So, this table can be adjusted by ~3X up for those with pre-existing conditions, and down by ~2X for those without.

However, as a statistics caveat, older patients almost all have health complications, so the oldest patient data likely tend to mix these two effects, and these multiplication rates would give inaccurate predictions for the top two categories. I will take my own guess at this in my own table below.

Death, unfortunately, is not the only risk. As I noted earlier, a significant number of survivors have major organ damage post-recovery, the most common being significant lung scarring, and strokes. I was not able to find much in the way of statistics on this. One of the few sources I found was a UK estimate reported by Vox:

"The UK National Health Service assumes that of Covid-19 patients who have required hospitalization, 45 percent will need ongoing medical care, 4 percent will require inpatient rehabilitation, and 1 percent will permanently require acute care."

I am treating all “need ongoing medical care” as long term effects. This is per “hospitalized” patients, which I couldn’t find a good estimate on. I tried piecing together bits of data to figure this out: China reported 5% of cases were severe -- and 13% had significant symptoms -- it is not clear how either of these relate to hospitalization rates in the UK, but one can assume UK hospitalization is at least 5%. Using my 2.25% overall death rate estimate, if 5% hospitalization ==> 2.25% death rate, and 45% of the 5% need ongoing care, which is also 2.25%, then the rate of post-recovery injury is about equal to the death rate.

If I assume that severe symptoms track with age the same rate the deaths track with age, then , if one cares about BOTH death OR long-term injury, one can double the death rate numbers for Italy to come up with health risk.

Here is my best estimate table:

Age Average health risk (death or long-term health issues) Risk without preconditions Risk with preconditions
80+ .........29.6% ..... 7.5%*..... 44%*
70-79 ......16.0% ..... 4.5%* .... 27%*
60-69 ......7.2% ....... 2.5%* .... 15%*
50-59 ..... 2.6% ....... 1.0%* .... 6%*
40-49 ..... 0.8% ....... 0.3% ...... 2.5%
10-39 ..... 0.4% ....... 0.15% .... 1.25%
Overall average 4.5%
Note, * is my guestimated adjustment to decouple age and preconditions

Note, there is risk in every age group, even among the healthy. A 0.15% risk for younger healthy people is a risk that most would not like to take – it is one death or disability for every 667 people who catch the disease. As a check – this is about the rate seen in the US aircraft carrier – one death in ~800 cases.

How is COVID-19 transmitted? Early studies focused on contact transmission – COVID-19 was found on computer mice, door handles, etc in hospitals. This IS a way it can be transmitted. But there has been a lot of evidence for a while that airborne transmission is the greater risk. The spread in cruise ships, even when passengers were in lockdown, shows it can go through ventilation systems. But the lack of spread within the apartment buildings locked down in China shows that larger spaces and better filtration than on ships can limit its spread inside a building. The lower rate of spread in east Asia, where people wear facemasks, vs the US and Europe, shows facemasks help. When New York and Italy imposed face mask requirements on their populations, in ADDITION to social distancing, they both turned the corner on the disease.

How to stop the disease: the strongly controlling countries of China, Taiwan, Japan, S Korea, N Zealand, and Australia have almost eliminated COVID, because they were willing to mandate extreme measures, country-wide.

The US government has not set policy in the US -- the initial lockdown was initiated by sports leagues, and then the implementation of mandatory restrictions has been an uneven patchwork state-state. And none of our state mandates have even remotely approached what the successful countries noted above have done. This is why the US leads the world in COVID deaths.

Reopening an economy only makes sense if the COVID infection rate has been brought under control, so that normal behaviors do not carry a high risk of infection. This is what the successful countries above have done, and they are opening safely. They did not reopen until the "curve" had almost re-hit zero. If the undiagnosed COVID infection rate in the country were only a few thousand, and we had tracing, the US could open safely. We instead have millions of undiagnosed cases, so full re-opening will just lead to an even more massive infection rate nationwide.

The states which have reopened anyway, have seen an increase in COVID rates. By reopening before taming this disease, they insure they will never get a "second wave" because they will never end the "first wave".

Enough individuals have noticed the difference between effective responses and the US response, and self-imposed more extreme personal behavior, that the US death and infection rates have not been nearly as bad as they could have been. This is particularly true for "reopening", where we have not seen the massive increase in infections that one would expect. This is BECAUSE so many people are not listening to their governments, and are instead trying to personally apply more stringent transmission control, to minimize their own risks of catching COVID-19. Self-protection like this, while officially re-opening, will pretty much insure a long-term economic recession, as a significant fraction of the population tries to save their lives and health.

Long-term: The demonstratedly successful long-term approach is for the US to re-impose strict national controls, but this time with masks, testing and contract tracing. This brought the disease under control in China, even thought it was initially widespread. And it worked in most of the countries around China.

A second long-term solution would be if we develop a vaccine. Widespread vaccination would end this threat. The earliest plausible dates I have seen for a good vaccine to have been shown effective are Jan-Feb of next year, which would then need to be followed by mass production and distribution, which would take months more. The earliest I think mass vaccinations are possible would be ~1 year from now. However, there have been some diseases where developing a vaccine took up to 30 years, so ~1 year to get a vaccine may be wildly optimistic.

The US policy is effectively "spreading the curve" -- distributing deaths over months and years, so that morgues are not overwhelmed. The curve would not be spreading if individuals were not exceeding state guidelines, we would instead be seeing a massive infection spike. Spreading the curve could eventually bring this infection under control through herd immunity, which needs ~80% of the population to have gotten the disease. The rational choice under a "spread the curve" policy, is to over-protect oneself, letting the rest of the population get the disease and its risk of death or debilitation, then only re-engage society after herd immunity brings levels of infection under control.

How long this would take depends on how successful people are at preventing the spread though personal protective measures. There are not very many random tests of the population to see what the infection rate nationwide has been. One recent random study in Indiana showed a 2.8% infection rate as of May. If one extrapolates this out to the US population, we are currently under 5%. If our rate of spread is ~1% per month, it would take ~75 more months for us to get to herd immunity IE~6 years. (emphasis added by me)

Personal protection if disease is untamed: The worst infection rates have occurred indoors when people are in close proximity. Cloth or simple paper facemasks and hand sanitizer help, but with long-term exposure in hospitals, the staff still suffer from significant infection rates. If one has to go indoors, exposure time seems to matter. Quick trips indoors are lower risk, while long exposure indoors is of greater risk. For longer term exposure, the meat packing plants with their high transmission rate show that masks alone do not stop the disease fully, and that social distancing plus masks helps. The cruise ship results, with the disease traveling between small cabins, show that infection can occur at greater than 6-ft “social distance” separation, and any additional distance above 6-ft is also helpful.

Personal protection should therefore be to avoid possible infection circumstances (proximity to those not in one’s household, or being indoors outside one’s household) as much as possible, and always wearing masks, and regularly hand sanitizing.

"It's deja vu all over again"

Today, in Tulsa Oklahoma, kicks off the first so called “presidential rally” of the year, for second-term wannabe, Donald J. Trump. We already know in advance that there will be a full court press on hand to cover it.

Of course, as was true in 2016, today's broadcast coverage plays right into Trump's political agenda. I.e., he needs his media foils, and all the better if they’re present, right there in the crowd, to unload on... not to mention the additional perk of millions of dollars worth of the free publicity he will get.  Yep, it's a total "win-win" for Trump.

True, like that unruly teenager who steals the car keys when no one is looking, it is important that we adults all stay aware of what Trump is up to. But is the press, by giving him such national attention, only making things worse?  Emboldening his chances of winning re-election?

We know Fox will be there, in all it’s “fair and balanced” glory. But does the "left-leaning” “lame stream media” willingly play right into Trump’s “nasty p-grabbing hands,” by pimping themselves out to Trump with such "news" coverage?

What do you think?  Should or shouldn’t the media cover the Trump’s rallies?  Will you be watching??

Thanks for posting and recommending.

The Trump Cancer Spreads in the Federal Government

Multiple sources are reporting that the president’s pick to run US overseas broadcast operations has fired the heads and/or governing boards of those agencies with no reason given for the mass firings. Michael Pack is a conservative and ally of the radical extremist Steven Bannon. Various sources are reporting concerns that the political independence and neutrality of the American voice abroad will become mostly or completely conservative partisan propaganda.

The New York Times writes:

“WASHINGTON — A conservative filmmaker who recently took over a United States global media agency removed the chiefs of four news organizations under its purview on Wednesday night, according to people with knowledge of the decision, in an action that raises questions about their editorial independence. 

The filmmaker, Michael Pack, also dismissed the head of a technology group and replaced the bipartisan boards that govern and advise those five organizations. The boards, which all have the same members, are now filled largely with political appointees of the Trump administration, including Mr. Pack as chairman. One board member works for a conservative advocacy organization, Liberty Counsel Action. 

The moves were criticized by congressional officials, including a leading Democratic senator, and former diplomats as an effort to turn the news organizations under the United States Agency for Global Media into partisan outlets. The organizations receive funding from the American government but operate independently.”

The Washington Post writes:

“Mr. Pack also dissolved the boards of the first three of those networks, which operate as grantees of the U.S. government; a bipartisan cast of luminaries including Secretary of State Mike Pompeo and former ambassador Ryan Crocker was replaced by low-level Trump political appointees from unrelated federal agencies, along with Mr. Pack and his chief of staff. The sole outside board member comes from the far-right Christian group Liberty Counsel Action, which is known for its militant anti-LGBTQ advocacy.  

Mr. Pack offered no explanation for his actions, but issued a self-congratulatory news release quoting himself as saying that “every action I will carry out will be geared toward rebuilding the USAGM’s reputation, boosting morale and improving content.” 

In fact, in a stroke, he has accomplished the opposite. Disheartened agency insiders tell us that the new CEO seems bent on carrying out a purge of what Mr. Bannon has described as an outpost of the “deep state” and converting it into another vehicle for promoting Mr. Trump.  

The president has made no secret of his contempt for the “disgusting” VOA; in April, a White House statement falsely and ludicrously claimed its news reports had disseminated Chinese propaganda. After Mr. Trump bullied supine Senate Republicans into confirming Mr. Pack, despite unresolved ethical questions, it was a foregone conclusion that VOA’s top leadership, including Pulitzer Prize-winning journalist Amanda Bennett, would be forced out. But Mr. Pack’s purge also extended to respected RFE/RL head Jamie Fly, a former Republican Senate staffer, and Middle East Broadcasting Networks’ Alberto Fernandez, another Republican. Was it because they can’t be counted on to convert their organizations into Breitbart-like propaganda outlets?”

Given the president's corrupt, self-serving partisanship and his blatant contempt for truth, it is reasonable to believe that those taxpayer-funded broadcast operations will become radical partisan propaganda operations focused on serving to help the president’s re-election campaign and his own financial situation. 

The president can help himself financially by having foreign government and businesses patronize his commercial properties, including paying bribes to them under cover of doing legitimate business, in return for flattering coverage by America’s official but now corrupted and subverted broadcast voice. This will be an appealing option in corrupt countries and/or by American enemies like Russia and China. 

What about Russia and the secret phone calls?

On June 1, various media sources reported that the president had spoken by phone with Russian president (probably for life) and dictator-kleptocrat Vladimir Putin. A few days ago, media sources reported that the president had decided to withdraw many American troops from Germany, something that Putin very much wants to see. Putin wants to clear US influence from Europe as much as he can so that Russia can step in to fill the void that a US withdrawal will create. In essence, Putin wants to destroy all Western European democracies and convert them to a murderous dictatorial kleptocracy like Russia.

Beginning at about 5:10 of a 10 minute interview shown here, former Defense Secretary Robert Gates discusses the need for soft or non-military American power, including a broadcast voice to counter propaganda from authoritarian powers Russia and China. Gates argues that the decay of American soft power has been going on for decades, and the American broadcasting voice is now weak and incapable of adequately defending democracy or truth. Gates argues that if countries do not go to war, they fight using propaganda. Gates’ comments were prompted by what is happening with the appointment of Pack to head US foreign broadcast operations. Gates argues that we have eliminated or greatly reduced funding for all of America’s sources of non-military power.

Under these circumstances, it is very likely that part of what the US president is doing is gutting what is left of US soft power to open the door more for Putin to try to destroy European democracies and to divide Europe from the US. In return for that favor, Putin will reward the president in various ways, including financially. My guess that (i) getting US troops out of Germany, and (ii) gutting and corrupting the American foreign broadcast are the major parts of what the president and Putin discussed in their secret phone call a few weeks ago.

America is in deadly serious trouble. We have what amounts to a Russian agent in the White House, a corrupt, spineless GOP in congress and a sick society where about 30% of republicans believe the president is doing his job so well that he qualifies as the best US president. 

Book Review: The Misinformation Age

Introductory comments

The authors of this book rely on mostly on computer modeling to suggest means to combat dark free speech or propaganda. Their modeling analyses fit well with past events where false beliefs have arisen, usually by propagandists working for specific economic interests that (i) need to combat or negate scientific knowledge that threatens their profits, or (ii) want to create a false story that is not supported by evidence. Surprisingly to me, their conclusions usually match the beliefs I have arrived at by studying cognitive and social science and in my years of personal experience in dealing with politics. Since my current beliefs were not formed by computer modeling of how information flows in social groups or networks, I consider the book to be an example of consilience. Consilience is the phenomenon where evidence from independent, unrelated sources “converge” on the same conclusion, thereby usually (but not always) making it more likely to be true.

Probably because of how well this book fits with my own beliefs, I highly recommend this book and Sissela Bok's 1999 book, Lying: Moral Choice in Public and Private Life (a chapter review is here). Both are short, non-technical, easy to read books. Together those books allow people to get a solid handle on (1) how America managed to sink this far in terms of detachment form reality, rationality and honesty in politics and political discourse, and (2) the undeniable, profound immorality behind what got us here. I found these two books to be perfectly compatible. The Misinformation Age is weak on the relevant moral concerns, but Bok covers it extremely well.

Because there is so much great material in this book, I will probably write one or more separate reviews of the four chapters that The Misinformation Age contains. This review will be kept general and emphasize the main themes of how propaganda arises and persists and steps that can be taken to try to blunt it to some extent.

Book review

The 2019 book, The Misinformation Age: How False Beliefs Spread, was written by Cailin O’Connor and James Weatherall (O&W). They are professors of logic and philosophy of science at the University of California Irvine. The book is fairly short (186 pages) and easy to read for a general non-science audience. The book focuses mainly on how information flows in social networks and how it can be corrupted by both propagandists and well-meaning scientists. The book does not spend much time with human psychology or other factors such as personal biases or morals. Those topics are relevant and important but have been covered in other books. The key point the book tries to convey is that social factors are key to understanding how information spreads, especially false information.

Not surprisingly, the role that social media plays in the spread and persistence of misinformation is a theme that runs through the book. In essence, social media is a source of all sorts of networks that propagandists and special interests now routinely rely on to spread their message and influence public opinion and policy. O&W describe in detail five or six situations where important truth is subverted for a period of time, sometimes decades. This includes detailed discussion of how:
1. the tobacco industry created false doubts and stopped regulations about the bad health effects of cigarettes;
2. the chemical industry created false doubts and stopped regulations about the bad effects of chemicals (CFCs) on the ozone layer;
3. the electrical utility industry created false doubts and stopped regulations about the bad effects of acid rain from coal-fired power plants; and
4. all kinds of industries created false doubts and stopped regulations about the bad effects of carbon dioxide produced by burning of fossil fuels (this doubt and profound industry resistance to truth still exists today and still blocks meaningful policy action).

Common industry tactics to derail the spread on truth to both society and policy makers include (i) creating doubt about how solid the data is and advocating for delay for more data and analysis before regulations are put in place, (ii) creating controversy by recruiting respected experts to advocate false realities that industry wants people to believe, (iii) attacking scientists and claiming they are politically motivated to distract attention from the quality of the data that can't really be attacked directly, and (iv) funding scientists who are inclined to believe the industry's version of reality.

Regarding the false ozone propaganda, O&W write:

“Industry advocates ([e.g.., DuPont] urging a wait and see approach to CFCs into the late 1980s and beyond were right that the evidence linking CFCs to was not definitive. It still isn't. We cannot be absolutely certain about the ozone hole, about whether CFCs caused it, or even about whether ozone is essential for protecting human health. The reason we cannot be certain is that all the evidence we have for this claim is inductive -- and as Hume taught us inductive evidence cannot produce certainty.” 

The issue that O&W referred to was how propagandists literally question what truth is. That is a line of thinking that goes back to the Greek skeptics of a few millennia ago. They believed that maybe nothing can be truly known. From what I can tell, this reflects a human trait that evolution left us. It seems to me to be incredibly easy to create doubt about things that are true but most people are not familiar with. That happens all the time with complicated science-related issues including climate change and vaccines.[1] Because no one can know everything, including scientists, we have no choice but to rely on the knowledge of others. That means that we are susceptible to misinformation and cannot avoid it. O&W write:

“When we open channels for social communication, we immediately face a trade-off. .... Most of us get our false beliefs from the same places we get our true ones, and if we want the good stuff, we risk getting the bad as well.”

Suggested defense tactics

O&W suggest tactics that can reduce the ability of false information to spread and persist. One is to somehow get social media sites to change algorithms to expose small groups to be exposed to content from other sources. In essence this is a proposal to weaken silos or echo chambers where people are not exposed to contrary information or ideas. Another tactic is to recognize that some beliefs aren't worth supporting or even allowing on private platforms such as social media. O&W comment:

“.... we should stop thinking that the ‘marketplace of ideas’ can effectively sort fact from fiction. .... Unfortunately, this marketplace is a fiction, and a dangerous one. We do not want to limit free speech, but we do want to strongly advocate that those in positions of power or influence see their speech for what it is -- an exercise of power capable of doing real harm. It is irresponsible to advocate for unsupported views, and doing so needs to be thought of as a moral wrong, not just a harmless addition to some kind of ideal ‘marketplace.’”

A third suggestion is to change the way science is done or reported in several ways. One suggestion is to increase the statistical power of research protocols. That typically involves increasing the size of test groups. For statistical reasons, propagandists are able to find support for false beliefs more easily in small studies than in large studies. This is a common tactic that propagandists use to sow doubt about truth. Larger studies tend to give the ‘wrong’ result less often than small studies. Among members of the public, there is a widespread false belief that a single study establishes truth. In most cases that is not true and multiple studies are needed. By widely spreading false results that even independent scientists sometimes generate simply due to statistical variability in different systems under analysis, the few negative results can be seen to outweigh the majority of positives. There tends to be noise in most research and that noise is used to sow doubt.

To deal with human bias and psychology, O&W recommend complete cessation of industry funding for research. Both real world and modeling data show that even scientists who are honest tend to be influenced in the direction that industry wants the data to support. This problem is exacerbated by sophisticated propagandists who seek out scientists to fund based on their use of protocols that tend to give results that industry wants. This is a subtle form of influencing both the scientific community and the public to accept false beliefs or truths.

 O&W describe other tactics to try to blunt the power and persistence of false information. They see this as an endless war between forces of truth and forces that want society and/or government to accept a different but false reality. Once a defense tactic to block or neutralize lies and deceit is found, it creates a powerful incentive for propagandists to find a way to neutralize the defense. O&W admit that the problem looks bleak and complicated but they argue that defense of democracy requires nothing less than an aggressive defense, even if it is expensive or labor intensive.

One thing that O&W believe is reasonably certain is this: Propagandists are not going to stop doing what they are doing. The damage they are causing is sufficient to warrant a reevaluation of democracy and its institutions, which they believe are failing in the face of new mass communication technologies and the tidal wave of lies and deceit it is spreading throughout society and government.

I find their arguments persuasive.

Footnote:
1. I'm unsure that evidence related to ozone and adverse health effects really is purely inductive. Inductive means inference of general laws from particular instances. The evidence is rock solid that (i) ozone absorbs high energy UV light, (ii) some high energy UV (UVB) can cause skin cancer and eye damage and (iii) decreases in atmospheric ozone lead to increases in ground-level UV radiation. I guess I don't understand what induction is.

The Real COVID-19 Death Toll

An analysis by the BBC of COVID-19 deaths suggests that the death count is significantly higher than officially reported. This is not very surprising. Many countries have responded with chaos, confusion and incompetence. Also, politics is relevant. Officials in some countries, e.g., the US, continue to pretend that everything is better than it really is, so the data may intentionally under count the deaths.

The analysis is based on excess deaths. Excess deaths are the number of deaths above officially reported deaths in view of the normally expected number of deaths if COVID-19 was not a factor. In the plot below, excess deaths are shown in blue, the dotted line is normally expected deaths and red is officially reported COVID-19 deaths.

For the US, the BBC analysis estimates there were about 26,968 excess or unreported COVID-19 deaths between Feb. 16 and May 2. Most of those deaths were probably directly caused by COVID-19. After May 2, the BBC data shows that reported deaths and actual deaths were basically the same. Presumably, that reflects more competence and/or honesty in death reporting in the US. Thus, one can reasonably add, say, about 23,000, to the official US death count to get a better feel for the real direct COVID-19 toll.

NO ANGST THREAD

CORONVIRUS cases surging again in some countries and in some states in this nation.

JOHN BOLTON'S book will be all the gossip over the next week or longer.

ONGOING protests and examples of police misconduct continue.

SUMMER, with Climate Change increase in heat waves and monster hurricanes likely.

THE Biden vs Trump debate will intensify.

ANGST will rule this nation, one way or another, whether the angst is climate related, Coronavirus related, election related, protest related, or White House related.


SOOOOOOOOOOO …

WHILE ALL THIS is fodder for lively debate, heated discussion, virulent arguments, and increased blood pressure, I have to ask a simple question:

WHAT DO YOU, yes YOU, do to get relief from it all, get away from it all, get some peace of mind from it all, take a holiday from it all, put it all out of your mind?

WHAT IS … YOUR Chill Pill?