South Korea’s COVID experience – so far
I’ve read quite a bit about South Korea’s approach to COVID, which involved neither a lockdown nor a shelter-in-place edict. Despite that, South Korea got good results in terms of slowing its deaths down, even though it was stricken quite early and hard.
But there are several aspects of their response that were unique and probably will not be replicated. I’m not sure that most people are aware of them. One factor was that South Korea’s outbreak centered within a particular religious group. Another factor was that although there wasn’t a widespread lockdown or shelter in place, there was a very aggressive form of contact tracing and isolating, made easier by the fact that the outbreak centered on that group (the article quoted is from March 11) [emphasis mine]:
South Korea’s cases of infection had been minimal until the third week of February when cases suddenly exploded in the country’s southeast – a result of chain infections in crowded services held by the secretive Christian sect, Shincheonji.
Some 63% of Korea’s cases hail from the sect, according to government data.
While Shincheonji members are scattered nationwide, the government demanded – and received – its membership list. Contrary to widespread rumors and accusations, a senior government official said the church has cooperated…
The government implemented widespread testing of the church’s 211,000 followers. Those with symptoms were triaged as priority testees; once they were cleared, tests were conducted on those who showed no symptoms to ensure they were not latent carriers.
“From the containment phase, we tried to implement case isolation and case tracking, and this was done in a very aggressive manner,” Kim Dong-hyun of the Korean Society of Epidemiology said.
“We have legal grounds for cohort isolation,” said Kwon. “Rather than being an infringement of human rights, this was for the prevention of epidemic.” Related laws on the books date back to the MERS outbreak and further legal changes take effect in April…
Case tracking was done via CCTV data mining and credit use patterns…
…Korea was lucky in another respect: Its core cluster infected an age range with strong resistance to Covid-19, for Shincheonji concentrated its recruitment efforts on students and the young.
“When you look at the age and the distribution of confirmed cases in Shincheonji you see high portion of those in the 20s and 30s,” said Kim. “Therefore, the fatality rate in this cohort is low.”
Much more at the link.
Most people say “well, South Korea did it,” without having a clue what special characteristics were present there. This is the kind of thing that makes meaningful comparisons difficult unless they include a correction for these factors.
On March 30 I received an email…
…from CVS saying “Your order was delivered!”
I had indeed ordered a package several days ago. But when I checked my snail mail after getting that email, there was no package to be found. After puzzling it over for a while, I decided to actually open the email instead of just reading the subject headline.
The first line of the text was in a very large font, and it said, “Your order was delivered, Jean!”. Happy days.
Underneath, in a smaller font, it said “Delivered Thursday, April 2.”
Does CVS have a sense of humor? Or has it managed to invent a time machine?
Say it isn’t so, Joe
People have been wondering about Joe Biden for a long time. The truth (which some had already suspected) was revealed in yesterday’s appearance, when it become apparent that there was something “off” about the software. It finally became undeniable that yes, this was a robotic automaton with a glitch, and not actually Democratic frontrunner Joe Biden at all.
Does anybody speak Biden? I’d love to know his position on this issue. pic.twitter.com/ojqhbpkSls
— James Woods (@RealJamesWoods) March 31, 2020
The explanation from his staff was simple and understandable:
We don’t want to tire Joe out in this time of worldwide turmoil and strife. And yet he wants to keep in touch with his admiring public. So we thought this would be a good solution, but unfortunately we inserted the software for “Miss America candidates’ responses to questions” rather than the “gaffeless Joe Biden” software. We apologize deeply, and will correct the problem soon.
Several prominent Democrats have said that Biden needs to be nominated anyway, even if he remains just the automaton and the real Joe never emerges. After all, anything is better than Trump.
As stated in a recent article:
Alex Wagner, co-host of Showtime’s “The Circus” and a contributor to The Atlantic, writes an op-ed…entitled “Stay Alive, Joe Biden.” The lede? “Democrats need little from the front-runner beyond his corporeal presence.”
“Voters seem to have coalesced around Biden for his past—who they have known him to be for the past four decades in American politics—rather than for anything in his present. It’s as if Biden exists primarily as an idea, rather than an actual candidate.
“Biden was never really convincing anyone on the stump—his political power at this point is an idea, held collectively, about how to defeat Trump. The work now is to keep that idea convincing enough, for long enough, among as many people as possible, for the corporeal man to actually win….
“Democrats have chosen Biden as their vessel for Trump’s defeat, and that choice is the entire point: The vanquishing matters more than anything else.”
So who needs his actual corporeal presence if it really only represents an idea anyway? The automaton may represent the idea of Biden better than his corporeal body can at this point. And anyway, it’s Biden’s advisors and the Deep State and the usual suspects from the Obama administration who will run a Biden administration.
The Constitution gives qualifications for running for president – age, citizenship, residency – but nothing in it says the candidate can’t be a robotic representation of the citizen with those qualities. After all, a living constitution must evolve with the times. The Biden automaton thinks it’s a person – in fact, it (preferred pronoun: he) actually thinks he is the person known as Joe Biden. Who are we to say that he’s not a better Biden than Biden himself, and fully qualified to represent the idea of Biden to the American people?
I was thinking this, but he said it better
First we have a comment by “Rufus T. Firefly” about how the media will continue this:
Now the media knows it has a shiny, new toy; viral and bacterial infections that kill primarily elderly and infirm Americans. It’s been around forever. And, like clockwork, ramps up every fall and runs for months. And the media knows a panic might cause another shutdown. This has been a boon for the media. Do you think they will let this go this fall when those red circles start popping up on the map again?
They won’t hit Governors with the data and demand action? “Governor Johnson, there are already 100 deaths in your state and estimates are that number will soar in the next weeks, thousands are likely already infected. Governor Smith has already said he may not accept visitors from your state. Why won’t you act?!”
Then there’s this post by Ace, indicating that the original warning that masks don’t work was probably an attempt to keep the public from purchasing them in such numbers that health care professionals would run out. Now, it doesn’t bother me that people in health care would be prioritized; their need is great. And telling us so would probably cause even more panic. But I also don’t like being lied to.
Media misdirection on COVID-19
When I write “media misdirection,” I’m not just talking about the hate-Trump or the anti-US or the pro-China propaganda, although that is certainly commonplace and damaging as well as purposeful. I’m talking about rather neutral scientific articles such as this one at NPR.
It is titled “Why Germany’s Coronavirus Death Rate Is Far Lower Than In Other Countries,” and the title is at least somewhat true: German’s COVID-19 death rate is lower than in quite a few other countries. But it depends what countries we’re talking about.
Germany’s death rate at present is 8 deaths per million, much lower than Italy (206), Spain (177), France (54), Switzerland (50), Belgium (61), Netherlands (61), and Luxembourg (37). For a developed first-world country, Germany is doing well – so far. But so are plenty of other countries: the US (11), Canada (3), and Norway (7), to mention just a few western ones. And just about every other third-world country (there’s a long long list at the link) has hardly been hit at all. (In my discussion I’m going to leave out China and Iran, because I don’t trust their statistics).
So in summary, Germany is doing quite well so far in terms of death rate, as is the US although NPR doesn’t mention that. Both statistics are expected to go up, of course, but the question is how much, and how much relative to the rest of the world.
And that’s just the title.
However, as the article goes on, it becomes clear that the author is not talking about death rate at all. He’s talking about case fatality rate, which is quite a different thing and is dependent on how many cases have been identified. I wasn’t careful about the terminology distinguishing between the two when I first started writing about COVID, although I understood the difference between the two concepts from the start. But quite some time ago I found it necessary to make my language more precise on that score. Why hasn’t NPR done the same?
The article goes on and on and on in that vein, and explaining how it’s a function of testing. That’s certainly true, but why focus on that measure alone (not to mention why call it by the wrong name)? At this point in time it’s a less meaningful statistic than the actual death rate – deaths per million. And Germany still comes out well ahead on keeping that number low so far.
The article is illustrated by a large photo of people in a park, with the subtitle: “Young people gather in the Volkspark am Friedrichshain in Berlin on March 18. Germany’s fatality rate so far — just 0.5% — is the world’s lowest, by a long shot.” No it’s not. First of all, it’s not a fatality rate, it’s a case fatality rate. But second of all, it’s not even the world’s lowest case fatality rate (forget the “by a longshot). A simple look at this chart and a little work with a calculator will tell you that. For example, South Africa presently has a .3% case fatality rate, Iceland has .17%, and Australia .4%. And there are others.
The article does make this interesting point:
“We have a culture here in Germany that is actually not supporting a centralized diagnostic system,” said Drosten, “so Germany does not have a public health laboratory that would restrict other labs from doing the tests. So we had an open market from the beginning.”
In other words, Germany’s equivalent to the U.S. Centers for Disease Control and Prevention — the Robert Koch Institute — makes recommendations but does not call the shots on testing for the entire country. Germany’s 16 federal states make their own decisions on coronavirus testing because each of them is responsible for their own health care systems.
That’s the opposite of the initial reaction in the US, and I think it matters.
You might wonder why I’m bothering to deal with this article. After all, its misdirection is relatively mild compared with a lot of what we read every day. But it’s interesting to me because it’s subtle, and also because to me it’s a bit puzzling. Why get such a simple thing wrong at this point? Why focus on a less meaningful statistic and never mention a more meaningful statistic? And in this article, there’s not even an obvious anti-US slant – if there is one it’s very mild.
[NOTE: I always get nervous when I write a post with a lot of math and do it super-quickly, which is what happened with this one. That’s especially true when I’m criticizing another author’s errors. But I am relatively sure that my readers will fill me in on any errors I may have made.]
Comforting images
USNS Comfort comes to town:
More photos here.
Those photos conjure up childhood memories for me. I was born a few years after the end of WWII, but in my childhood there was still a lot of war consciousness. My parents spoke of the war at times. War movies were regularly shown on TV, and I watched them all. I doubt I ever saw a large floating hospital sip with big red crosses on it like the Comfort, but nevertheless these photos made me think of the unabashed patriotism and national solidarity of those days.
And New York harbor and the Statue of Liberty always make me think of my childhood.
The last two big crises we’ve had – 9/11 and this – both have had New York City as their center.
What we’ve learned so far
Not meant to be an inclusive list. And by “we,” I certainly don’t mean everyone.
(1) China is a bad actor.
(2) Trump was right about China.
(3) Borders are important.
(4) Trump was right about borders.
(5) We need to be more self-sufficient in the manufacture of vital goods.
(6) Trump was right about #5.
(7) Even in a crisis, the press’s top priority is to criticize Trump and the GOP.
(8) Trump was right about #7.
Theoretically at least, a person can dislike Trump intensely and disagree with most of his politics, but the things on the above list would seem to me to be self-evident. So one might think that just about everyone would notice them. WRONG!
Samaritan’s Purse sets up a field hospital in Central Park
Kelly will be among a few dozen nurses and doctors from Samaritan’s Purse, a nondenominational evangelical Christian humanitarian organization, working at a field hospital set up in Central Park — across the street from Mount Sinai Hospital — for patients battling COVID-19, the disease caused by the coronavirus. The organization is led by Franklin Graham, the son of Billy Graham.
The field hospital will have 68 beds, 10 of them in a makeshift intensive care unit for patients who need ventilators. It took 48 hours to build and will be operational by Tuesday, said Melissa Nystrom, a spokeswoman for Samaritan’s Purse, which is working with Mount Sinai Health System.
Seventy-two disaster assistance response specialists from Samaritan’s Purse worked around the clock with local volunteers to build the hospital, Nystrom said.
…”I know I’m going to be working in an ICU, and that’s where a lot of the deaths happen, and so, yes, I am prepared for that,” Kelly said. “As prepared as you can possibly be as a practitioner walking into that kind of situation.”
Her previous assignments with the organization have taken her to the Philippines, Ecuador and the Democratic Republic of the Congo and twice to Iraq.
I am in awe of the strength of people who undertake that kind of risk to do that kind of work.
I also wonder whether some people who have contempt for evangelicals will revise their opinions of them on hearing this news.
This seems too good to be true
COVID roundup
There are so many good articles around that I despair of doing them all justice with a full discussion, so here’s a short roundup of some of the best or most interesting.
(1) Germany has a plan to start testing people for antibodies to determine who has gained immunity to the virus and therefore can go back out into the world:
The antibodies will indicate that the test participants have had the virus, have healed and are thereby ready to re-enter society and the workforce. The researchers plan to test 100,000 members of the public at a time, issuing documentation to those who have overcome the virus.
The researchers will use the information to determine how to properly end the county’s lockdown, including re-opening schools and allowing mass gatherings.
It’s conducted by a research firm. But there’s something somewhat creepy about a country (especially Germany, I must say) issuing certificates of healing to certain people that allow them safe passage into the world, while everyone else must stay put. I understand the need, but it still gives me the willies. Will we do something similar?
(2) There’s an analogy to be made between Trump’s approach to cutting red tape now and his method for restoring NY’s Wollman skating rink, 34 long and winding years ago. I remember, back when Trump was campaigning for the Republican nomination in 2016 and I was so heavily critical of him, many pro-Trump commenters would point out what he did with the rink. My reply at the time (if I recall correctly) was that it was nice but small potatoes and could not even be remotely compared to the tasks of a POTUS. Well, it was indeed relatively small potatoes, but many of the skills involved are the same, and one big one is the need to cut red tape.
(3) Rhode Island is serious.
(4) The governor of Michigan has been threatening doctors and pharmacists for providing a drug treatment that seems safe and has shown promise. I wonder whether Chuck Todd will ask her one day if she has blood on her hands?
(5) The biggest lesson we actually should be learning is this one, which is that government regulations have crippled our response to COVID. Please read the whole thing.
COVID-19: and what of Mexico?
Here’s a good question from commenter “Sharon W”:
Shouldn’t [Mexico’s] numbers be worse than ours, not having enacted any orders and living life in normal fashion? I thought maybe the weather, but I checked Tijuana and it is the same as here in L.A.
Pandemics behave in different ways in different countries and areas of the world, and even in territory within a country. If you look at just the US at present, you can see what I mean. The disease’s effects are mostly concentrated in the NY metropolitan area, with a few other states pretty bad (Washington, Louisiana, Michigan) but nowhere near as bad as NY (and Washington was hit early and hard, and has since leveled off considerably). For all the other states, if we weren’t already alerted to the thing, COVID would barely be a blip on the radar screen. And what of Chicago, one of our largest cities? Why is the number of deaths there from the disease relatively low? And I could point to many other US cities and ask the same question.
You can think of reasons why NYC would be hardest hit: congestion, travel hub, later imposition of social distancing. But I don’t think it really explains all the disparity, although perhaps I’m wrong about that. You can also say – as some prognosticators and politicians do – that NYC is just a forecast of what will happen soon all around the country. And perhaps that’s correct, but I don’t think so and I sincerely hope I’m right in this case. There is little doubt in my mind that things will get worse everywhere before they get better, but how much worse? Hopefully not NYC levels of worse.
As for Mexico – some predict that it will get very bad there [emphasis mine]:
AMLO’s [AMLO is the president’s nickname] advice [no social distancing], experts say, is deadly. What makes matters worse is that his policies over the past few years have set the stage for a profound health crisis. In a major effort to cut government spending, AMLO has reduced funds for the country’s hospitals and medical centers by millions. It’s left the nation short of physicians, medical equipment, beds, and coronavirus tests.
That last part is especially frustrating, because Mexico has been hit hard by outbreaks before. In 2009, the H1N1 influenza was identified, originating in Mexico before it spread around the world, killing about 17,000 people in an initial count. (A 2012 Lancet study estimated there were hundreds of thousands of deaths associated with the disease.) Then, Mexico aggressively tested hundreds of thousands of its citizens to identify clusters of infection and stem the tide against transmission, said Alejandro Macías, the “czar” for the government’s emergency response at the time. “We acted then like South Korea has today,” he told me.
That’s not happening this time. The country has barely tested people, likely accounting for the low official number of 475 cases as of March 26. That comes as millions continued to move freely outside, including tens of thousands who attended a large outdoor festival in Mexico City last week.
So has COVID actually already hit Mexico somewhat, but because there’s little or no testing for it, we don’t know much about it? If a small number (relatively speaking) of people are dying in Mexico from COVID, and if they’re not being tested for it, they will not appear in any statistics unless the numbers finally increase so much that it cannot be ignored.
I hope for Mexico’s sake that doesn’t happen. One thing I can say is that I don’t trust the predictions of experts, either the catastrophic or the milder ones. I just don’t think they know enough at this point to issue anything but a description of possibilities.