The point of all those draconian rules: mitigation

The New Neo Posted on by

The key to what’s going on now is containment and plus mitigation.

To understand, here’s Dr. Fauci – the infectious disease expert on the task force to deal with COVID-19 – talking about the goals of containment plus mitigation, as well as changes in the rules about testing. Containment (limiting the numbers initially and strict quarantines for the infected) was the goal of the travel restrictions and the initial treatment of victims, and mitigation (flattening the curve of growth) is the point of all the social distancing and handwashing and closings:

Comparisons of COVID-19 and H1N1-2009 are instructive, and it is true that the latter killed a lot of people without all this disruption and chaos and economic doom. It the end, H1N1 may even end up having killed more people, and younger people at that, as well as infecting more people than COVID-19, if these current containment and mitigation strategies are successful.

But the reason H1N1 didn’t engender all these closings despite how widespread it was (66 million Americans, although we didn’t understand that until later) and how very contagious, is that its death rate among the infected was actually quite low. The total number of deaths from H1N1 was fairly high (between 12K and 18K in the US), despite the low rate of death only because so very many people caught it.

The special problem with COVID-19 involves several things. The first is that at this point it appears both highly contagious and somewhat more lethal than H1N1 2009, and we don’t really know the figures. We do know that severe COVID cases flooded the hospitals when it hit China and is doing the same in Italy, so the potential for an overwhelmed health care system is there. The stark reality is that modern medicine can only do its thing if hospitals don’t have too many patients to treat at once. In the case of severe and critical COVID, respirators and ICU care are necessary, and those are not in endless supply.

Simply put, H1N1 did not overwhelm the health care system, even though in severe cases ICU care and respirators were also needed. The rate of severe disease among the infected was low enough that the curve of severe H1N1 disease seems to have been naturally flatter and more drawn out over time, so there was no need to flatten it though extreme mitigation strategies. Also – and I believe this is important – it hit in the US and in Mexico first, so we didn’t see any scary goings-on in other countries when we made our decisions as to how to react to H1N1.

There is something appaling about the specter of having thousands upon thousands of elderly (and some not-so-elderly) people dying because we don’t have enough room in our hospitals or enough special equipment or trained respiratory therapists to operate it. That’s different from the way people die from the flu, too, even though their numbers are high. They come in a more stable and steady stream in terms of numbers, even though there is seasonal fluctuation, and ordinarily we are able to give them all every benefit modern science can offer.

Is preventing the terrible prospect I just described with COVID-19 “worth” crashing the economy? Are we trying to control too much? But wasn’t the economy already sinking out of fear of COVID, anyway, because of what’s already happened in countries such as China and Italy? And what about all the closings? Will they even help in terms of mitigation? But weren’t most things closing down anyway, because of fear?

There’s a cascade of fear, and whether it comes from government recommendations, seeing and reading about Italy or China, MSM and leftist propaganda, or just basic human fear of the unknown, the idea is to put in place stops that will cause the curve of death to flatten and allow the health care system to do its job. That’s probably the only way things can calm down. Hopefully, it can happen soon, before too much damage is done.

And I would like someone in charge – a politician or Fauci or someone at the CDC or on the task force – to clearly explain how they think this will play out if things work out as planned. How many weeks will things be closed? Which policies are aimed at which goals? And when will we know we’ve achieved them?

Lies the MSM is telling

The New Neo Posted on by

The lies of the press go on – and on and on. Rather than offer a long description here, I’m just going to link to two of Ace’s posts (this and this) on some of the more recent, destructive ones that have to do with the Trump administration and COVID-19.

These lies do damage to the public and to our country and even the world, and certainly to Trump. The press’s overriding goal of damaging Trump requires that the public be frightened and angry because they think he’s a dangerous and marauding incompetent who is unfortunately in charge during this crisis.

The press is neither stupid nor negligent in doing this. It is a purposeful, recurrent, well-thought-out approach of theirs, involving a highly practiced skill the press has developed which involves taking a kernel of truth and twisting it out of all recognition to convey the opposite impression.

One of the hallmarks of the technique is the truncated quote, but it’s by no means limited to it. Twitter is perfectly adapted for disseminating the lies to the reading public. The graph of the growth of the lie would probably look exponential for quite a while. Then on to the next lie, and the next.

One of those lies is that Joe Biden isn’t cognitively challenged at this point. Remember when the press mocked Trump for saying that he (Trump) could shoot someone on Fifth Avenue and his supporters would still back him? Well, it’s the same with Biden and the MSM’s refusal to point out Emperor Biden’s lack of clothing. They will defend him no matter what he does or what he says, because he is the only candidate they have left. And they know that if he were president it would be okay because he would merely be a cooperative and malleable figurehead (or his VP would) for the Deep State and Usual Players, brought back for the next version of a movie in the Obama series: “Obama II: Leftward Ho.” COVID-19 is the useful crisis they cannot let go to waste.

COVID-19: We are all Lady Macbeth now

The New Neo Posted on by

The COVID-19 handwashing recommendations lead to a rise in OCD symptoms and anxiety.

Makes perfect sense:

But for some people with obsessive-compulsive disorder (OCD), to be warned they must scrub to protect themselves from an invisible enemy, and to do so in a ritualistic way with internal musical accompaniment, is akin to inviting a demon to come for tea. Some of these people have spent years trying not to wash their hands, often as a prescribed part of their treatment.

“It’s definitely put a lot of the internal OCD dialogue back into my life. It’s being reinforced by outside, authoritative voices,” says Erica (not her real name), a long-term OCD patient. “It’s a lot harder to tell yourself that the urge to wash your hands is irrational when everyone on your Twitter feed or on the news is saying: ‘Wash your hands. Nobody is washing their hands correctly.’”

The worsening outbreak affects people with OCD in other ways, too. Chiefly, the spike in anxiety about the virus can fuel existing obsessive fears of contamination and trigger destructive compulsive actions.

Did you know there was a debate tonight?

The New Neo Posted on by

That’s alright. I forgot, too.

It was absolutely wretched. The many examples there of what transpired are truly disturbing, but I’ll just highlight a few for now:

Gone are the days: assuming the risk

The New Neo Posted on by

People used to take things in stride. I realize that by saying that, I sound like an old curmudgeon. But maybe I now understand better why old curmudgeons sound like old curmudgeons.

I grew up, as the somewhat-older author of this essay “Say Your Prayers and Take Your Chances: Remembering the 1957 Asian flu pandemic” did, in an era when nearly all children got a series of diseases that are now mostly distant memories. The vast majority of us survived quite nicely, unlike in previous eras:

Before the Modern Revolution child mortality was very high in all societies that we have knowledge of – a quarter of all children died in the first year of life, almost half died before reaching the end of puberty

Royalty was not immune; look at the record of the children of Peter the Great, for example. It’s horrific. It’s also one of many reasons people tried to have as many children as possible, although a lot of women died in childbirth or shortly after. Another terrible risk that was common in prior eras.

It was much much better when I was growing up. But still, in a few short years and while I was a toddler I had measles, mumps, German measles (is that racist?), and chicken pox, and that’s just what I remember. Polio was rather common, too, although a vaccine was developed when I was in grade school; I remember what a big big deal that was, and what a hero Salk was considered to be.

My only cousin had measles encephalitis when I was about two, and died a few years later of complications from it. I remember his death very very well, and his disabilities too. That’s the sort of thing that makes a deep impression on a child. My mother told me later that, when I had contracted measles not all that long after my cousin had them, she sweated it out because the risks were very clear to her. Another couple who were good friends of my parents had lost a child from measles even before I was born, and I heard about that periodically, too.

No one had to impress on me the seriousness of measles. I knew. And polio? We saw the photos of all those kids in the iron lungs, and we saw children walking around with braces on their legs.

But that personal knowledge is gone, along with those diseases and many others (for the most part, anyway, at least in this country; I’ve written about the anti-vax movement elsewhere and am not going to take it up now, but the lack of fear of certain diseases is partly responsible for the movement).

It’s a wonderful thing that the incidence of most of those diseases has been remarkably reduced. Wonderful, fabulous, a great reduction in human suffering. But there’s been a cost, too, and it’s the increasing fragility of our psyches’ ability to withstand and endure even the prospect of an increase in disease and mortality that mirrors what my generation experienced.

As Clark Whelton, the author of the City Journal essay I linked to earlier, writes:

It’s not that Asian flu—the second influenza pandemic of the twentieth century—wasn’t a serious disease. Worldwide, this flu strain killed somewhere between 1 and 2 million people. More than 100,000 died in the U.S. alone. And yet, to the best of my knowledge, governors did not call out the National Guard, and political panic-mongers did not blame it all on President Eisenhower. College sports events were not cancelled, planes and trains continued to run, and Americans did not regard one another with fear and suspicion, touching elbows instead of hands. We took the Asian flu in stride. We said our prayers and took our chances.

Today, I look back and wonder if an oblivious America faced the 1957 plague with a kind of clueless folly. Why weren’t we more active in fighting this contagion? Could stricter quarantine procedures have reduced the rate of infection and lowered the death toll? In short, why weren’t we more afraid?

His answer is that we were more used to infectious diseases. But a corollary of that is that we would have had to have closed down shop indefinitely. There were so many illnesses around all the time that there was no way to escape. You might say we were fatalistic, you might say we were resigned, you might say we were stupid, you might say we assumed the risk, or you might say we understood that the drawbacks of that sort of reaction were immense as well.

Of course, I wasn’t around in 1918. I wasn’t around when smallpox and tuberculosis or the Black Death killed far far more of the people on earth than any of the plagues of my lifetime have come close to killing. I cannot even imagine how terrible those things were; I don’t even want to imagine. And I doubt that people took them in stride at all. And I think a good part of the dread and fear now is that in the back of our minds – or for some people, even the front of our minds – we know that such catastrophes are still possible. Human beings know they are intensely vulnerable.

But COVID-19 is not shaping up to be that sort of event, and there’s no reason to think it will be. However, although many measures are prudent – handwashing, increased testing, hospital preparedness, some measure of social distancing at least for a while – the degree of fear I see and hear is far greater than anything I can recall in my lifetime around a medical event.

And it’s not just medical events, either. Students demand that colleges protect them from ever feeling bad or bullied or offended by anything anyone says. Woman have become so reactive to the idea of sexual harassment that many have redefined it to include what used to be considered standard compliments on appearance. People start bitter twitter wars about things like cultural appropriation. There seems to be a hair-trigger over-reactivity, a new emotional fragility and vulnerability, that is akin to what can happen when a person fails to develop normal immunities of the physical type, to use a medical analogy.

[NOTE: On a different but related topic, I also can readily recall when a president – any president of any party – would be cut slack by his critics during an emergency, particularly a medical one. Those days of near-reflexive pulling together are gone, long gone. Now it seems the chief focus of the Democrats’ reaction to this crisis is to criticize Trump and score political points. There are hopeful exceptions, though, and that’s why I cheered the reactions of governors Newsom of California and Cuomo of New York:

[From Newsom]: [Trump and I] had a private conversation, but he said, ‘We’re gonna do the right thing’ and ‘You have my support, all of our support, logistically and otherwise.’ He said everything I could have hoped for. And we had a very long conversation and every single thing he said, they followed through on.

Cuomo:

This sort of thing used to be standard and expected. If a politician didn’t do it, people would have been critical of the omission. No more.]

Why hoard toilet paper?

The New Neo Posted on by

Hey, why not?

It lasts, if not forever, a long long time.

It’s pretty cheap – for now.

Doesn’t need refrigeration.

Never goes out of style.

One size fits all.

And no, people don’t think it protects them against disease – except in the sense that if they need to shelter in place for a long time, they might need quite a bit of tp and be unable or unwilling to go to the store to get it.

What’s more, the run on toilet paper (is that a pun?) increases the anxiety, and therefore there’s an increasing spiral of toilet paper buying due to the shortages.

Critical care beds: this may be part of what’s wrong in Italy

The New Neo Posted on by

The number of critical care beds may be – critical.

A while back, while I was trying to figure out why the situation in Italy has gotten so bad, one thing I came across was the idea that Italy doesn’t have that many hospital beds. But when I researched that, I discovered that, although not a star, Italy wasn’t particularly deficient in that regard.

But today I found this, which seems relevant. It’s the number of critical care beds per 100K of population in various countries. When someone is hospitalized with serious respiratory distress related to COVID-19 – or H1N1, or regular pneumonia, or sepsis – ventilation and special care is often needed to save lives. So this may be the more important thing to look at.

The data is a bit old for all the countries, but not so very old. You can see that Italy has 12.5 critical care beds per 100K population. China has 3.6 and South Korea 10.6. The US does rather well on this particular metric: 34.7.

As far as Iran goes, who knows? I doubt the number is at all high.

The death rate for each disease is not some sort of fixed thing. When I wrote about the 1918 flu pandemic, for example, I discussed the wide variation in death rates among countries (India having been especially hard hit). Differences among the health care systems in different countries – even among Western countries, which are not peas in a pod – are relevant today, as well, and this is only one of them. With a severe case of something like COVID-19, time is of the essence and enough respirators and critical care are essential to save threatened lives. Without them, people who might otherwise survive will die.

That’s why all this emphasis is on “flattening the curve” of the growth of a disease in order not to overwhelm the system.

Trump declares national emergency at news conference; Dow rises

The New Neo Posted on by

Here’s the news conference. I’ve queued it up for when Trump starts speaking:

It was long, it was comprehensive, and apparently it was reassuring.

I have only watched a little bit of it, but Trump seemed very knowledgeable and in charge, and the forces brought to bear on fighting this are impressive. He appeared “presidential,” which always hurt the left. That won’t stop a lot of people from trashing him, of course, but perhaps less effectively than before.

[NOTE: On the Dow rise and some press reaction.]

This video shows what the MSM is about

The New Neo Posted on by

After I watched this video, I felt the urge to send it to everyone I know. For just a split second I thought that, if they saw it, they couldn’t deny what they’re seeing.

But almost immediately after I had that thought, I realized that they could deny it and that they would deny it. They’d say that the news people involved used the phrase “Wuhan coronavirus” or “Chinese coronavirus” innocently and descriptively, but when Trump used the same words it meant something entirely different and was a racist dog whistle because racism engulfs his heart and mind.

I can’t watch the video without becoming furious and yet being impressed by what it reveals so succinctly about the MSM members involved: their poisonous hypocrisy and treacherous mendacity, delivered with such sober serious faces:

On the meaning of “pandemic”

The New Neo Posted on by

Now that WHO has declared COVID-19 a pandemic, it’s time for a definition.

The word “pandemic” can describe extreme situations like that in 1918, or milder situations that we barely remember, with far fewer deaths. If you look at the definition of the word, you’ll note that it doesn’t really have much to do with number of deaths so much as geography [my emphasis]:

For the sake of clarification, WHO does not use the old system of 6 phases — that ranged from phase 1 (no reports of animal influenza causing human infections) to phase 6 (a pandemic) — that some people may be familiar with from H1N1 in 2009.

In a virtual press conference in May 2009 on the influenza pandemic, Dr Keiji Fukuda, Assistant Director-General ad interim for Health Security and Environment, WHO said “An easy way to think about pandemic … is to say: a pandemic is a global outbreak. Then you might ask yourself: ‘What is a global outbreak’? Global outbreak means that we see both spread of the agent … and then we see disease activities in addition to the spread of the virus.”

In planning for a possible influenza pandemic, the WHO published a document on pandemic preparedness guidance in 1999, revised in 2005 and in February 2009, defining phases and appropriate actions for each phase in an aide memoir titled WHO pandemic phase descriptions and main actions by phase. The 2009 revision, including definitions of a pandemic and the phases leading to its declaration, were finalized in February 2009. The pandemic H1N1 2009 virus was neither on the horizon at that time nor mentioned in the document. All versions of this document refer to influenza. The phases are defined by the spread of the disease; virulence and mortality are not mentioned in the current WHO definition, although these factors have previously been included.

Also, in a March 2 post, I recommended reading an article with a quote I called “fact-based.” It went like this [emphasis mine]:

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate [for COVID-19] is approximately 2%. In another article in the Journal, Guan et al.5 report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.

Those pandemic influenzas of 1957 and 1968 were actually pretty bad, especially the one in 1957, which I happen to remember. But as I concluded in that same post, when I describe the 1957 pandemic:

There certainly was newspaper coverage then, and news filtered down to children – including me. But somehow the country didn’t self-destruct.