COVID-19 models, COVID needs, and New York

The New Neo Posted on by

I came across these charts the other day, and I’ve been trying very hard to figure out certain things about them. The charts are an attempt to compare the projected need for ventilators, hospital beds, and ICU beds with the actual supplies of those things, and calculate what will be needed versus what will be available at peak (a date calculated to be April 15 – a date few of us were inordinately fond of before, and this new association is not likely to further endear it).

Here are my questions; so far I haven’t been able to find the answers – although the answers may be there; I just haven’t been able to find them at this point.

Did the modelers take into account the fact that elective surgeries have been stopped?
Did they take into account the tent hospitals that are being built, or the ships that are being sent to various coastal cities that need them, or the medical personnel who are being recruited (from the military, retirees, etc) by the government?
Do they assume this peak of April 15 will be reached all over the US all at once? That seems unlikely to be the case.

Also, I see (for example) that on their graph of predictions for ICU bed needs (go here and click on the “ICU beds” tab to see the chart), it says that for Mar 31 (yesterday) 21,569 ICU beds would be needed. But on the chart for the USA at Worldometers (which may or may not be accurate, although it’s what everyone seems to use) it says the number of cases in the US that are serious or critical is presently 5004, and that yesterday it was 4576. That’s a huge disparity between the model and what’s actually being reported. And I’m not at all sure that all serious cases go to the ICU rather than regular hospital beds, so the disparity may even be greater than it seems.

Now, it may well be that 4576 and 5004 are too low and perhaps way too low, since 912 people died yesterday in the US. Did about a fifth of all the ICU cases in the US die in a single day? Seems unlikely, although I have no figures on whether it’s possible I can’t really tell who’s right and who’s wrong, and how many people are actually in ICUs in the US right now.

However, let’s look at what the chart predicts for ICU beds and need. It says that at peak we will need 38,849 beds and at that point we will be 18,905 beds short. By my calculations, that means that they are saying that the most ICU beds we’ll ever have available for COVID patients would be 19,944 (that’s 18905, the shortfall at peak, subtracted from 38849, the need at peak).

But they are also saying (if I’m reading their graph correctly) that on March 31, yesterday, there was a need for 21,569 ICU beds. If that is correct and that actually was the need for ICU beds yesterday, it would mean that we’re already short about 1.5 thousand ICU beds as of yesterday. But I have read nothing about that. And in fact, most states have no problem at all right now. New York is stressed, but that’s where a huge number of all the cases are right now and even they apparently have not run out of ICU beds, although the press is loaded with predictions that they soon will (here’s just one example of the many articles like that).

And that is not the whole country; that is New York, which at the moment has something like 1/3 of all US cases and about 2/5 of the deaths so far. I’m not saying they won’t run out of ICU beds there – in fact, I would be surprised it they didn’t – but it’s the model I’m talking about at the moment, and its projections don’t even seem to fit what’s actually happening right now.

Am I doing the math wrong? I’m tired of the number crunching and checking and re-checking, so I may be getting careless and making errors. But I just can’t make head or tail of that ICU bed chart compared to reality – not that reality is easy to get figures for, either. For example, that last article I linked contains this interesting passage about New York City’s resources and needs:

Yet [NY Mayor] de Blasio has refused to publicly share how many beds or ICU beds remain available at city public and private hospitals. Instead, he has said he’ll keep updating the public about how much longer the city’s resources can last given the available beds and ventilators needed to keep the sickest patients alive.

That makes it impossible to know whether the city’s ICU bed availability has gone below 300 at any point — or whether the numbers have since been boosted and by how much.

Do they just not know? That wouldn’t surprise me. Or are they hiding something? That would not surprise me either. Are they very close to running out for real, and don’t want to further panic people? That would not surprise me. Or are they okay for now, and want to make things seem even worse than they are (as if they’re not bad enough) to keep people in line as well as get more resources from the feds? Wouldn’t surprise me either.

South Korea’s COVID experience – so far

The New Neo Posted on by

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…

The New Neo Posted on by

…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

The New Neo Posted on by

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.

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

The New Neo Posted on by

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

The New Neo Posted on by

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

The New Neo Posted on by

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

The New Neo Posted on by

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

The New Neo Posted on by

What wonderful people:

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.

COVID roundup

The New Neo Posted on by

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.