I suppose I'm used to it, but I noticed long ago that people don't think like I do. Most of the time it's simply because I will do more math in my head and bound a problem during the discussion and I can see I've lost people. Sometimes it's just because I approach problems differently. This morning, I saw the headline on Rantingly that Nebraska State Senator Mike Groene of North Platte had said, "I finally got my wish and contracted the Covid-19 virus." For months, now, I'll hear the news report some number of new cases, and I'll say, "cool!" Are you going "WTF?"
First off, the vast majority of those cases are either false positives or totally asymptomatic. Never treated, let alone hospitalized or in ICU. Second off, every real case with real antibodies is one person closer to herd immunity - which means the virus simply has a hard time hopping around the population because there aren't enough susceptible hosts. It has plainly happened in many other countries and infection severity has gone down as the doctors have learned to handle the cases better.
Allow me to illustrate a simple example of "most people don't think like this." I've been reading William M. Briggs - Statistician to the Stars! as he talks about the pandemic. He presents this plot of "excess deaths" by year, data from the US CDC. I've marked up the plot to point out some features.
The plot has a periodicity to it, so that it's not a relatively straight line. The periodicity marks the winter and flu season. It's easy to see there are bad flu years, like 2018, and easy years like '16 or last year. They tend to alternate, but not strictly. So superimposed on a background of about 52,000 deaths per week (7500/day) you can see a slight upward trend and modulation based on severity of the season. The observation is that bad years tend to alternate with better years. One of the mechanisms is that the flu and its complications tends to take out sicker people, especially elderly. If the flu season is milder, like 2019, people that would have died to a stronger flu are now a year older and (on the average) more fragile. People that might have died in '19 are then more likely to be killed by the flu (or other things) this year. I think that partially explains why the death toll from Covid was so high last spring; the pool of people in nursing homes and other facilities was more frail from being a year older than during last year's flu season, then the idiot governors of those northern states shoved Covid patients into the nursing homes. I don't think it works the other way; that people who survive a bad flu year are less likely to be taken out the next year.
Briggs also made the effort to extract an estimate for flu and pneumonia deaths, toward the bottom on the scale, and then ends that plot with the "with" and "from" Covid deaths. You can see the worst of it was back around late March, early April, and the easily predicted transition from Northern Temperate profile to more like Northern Tropical peak around June (see Hope-Simpson plot here). We're transitioning to the Northern Temperate winter profile again, which will be a third peak, but since the '20 season was particularly bad, the pool of people likely to die coupled with the advances in treatment should keep the death toll lower than last spring's peak.
Another interesting plot he puts up is the deaths by ages from all causes along with the "with" and "from" Covid from CDC data as well.
As Briggs puts it, no matter what age you are, you're about 10 times more likely to die of something else, rather than Covid and complications.
Briggs makes a big point of pointing out how so many people are worried about this with no justification.
He goes on to show another plot of CDC data showing a mysterious absence of the flu. The flu disappeared after week 14 of '20 and in October, when it starts showing up again, the CDC shows nothing. They've stopped testing for it. I feel bad about taking more of his data, so go read.
In this day when the most innocuous thing requires a disclaimer, I should give one. Every death is a tragedy to some family, and many people will think it's heartless to talk about deaths as if they're just numbers. Further, the one thing we all know is that some day we will all die. I don't mean to sound heartless, I just think the best way to understand what's going on is to look at the numbers and understand as much as humanly possible. Or more.
First off, the vast majority of those cases are either false positives or totally asymptomatic. Never treated, let alone hospitalized or in ICU. Second off, every real case with real antibodies is one person closer to herd immunity - which means the virus simply has a hard time hopping around the population because there aren't enough susceptible hosts. It has plainly happened in many other countries and infection severity has gone down as the doctors have learned to handle the cases better.
Allow me to illustrate a simple example of "most people don't think like this." I've been reading William M. Briggs - Statistician to the Stars! as he talks about the pandemic. He presents this plot of "excess deaths" by year, data from the US CDC. I've marked up the plot to point out some features.
The plot has a periodicity to it, so that it's not a relatively straight line. The periodicity marks the winter and flu season. It's easy to see there are bad flu years, like 2018, and easy years like '16 or last year. They tend to alternate, but not strictly. So superimposed on a background of about 52,000 deaths per week (7500/day) you can see a slight upward trend and modulation based on severity of the season. The observation is that bad years tend to alternate with better years. One of the mechanisms is that the flu and its complications tends to take out sicker people, especially elderly. If the flu season is milder, like 2019, people that would have died to a stronger flu are now a year older and (on the average) more fragile. People that might have died in '19 are then more likely to be killed by the flu (or other things) this year. I think that partially explains why the death toll from Covid was so high last spring; the pool of people in nursing homes and other facilities was more frail from being a year older than during last year's flu season, then the idiot governors of those northern states shoved Covid patients into the nursing homes. I don't think it works the other way; that people who survive a bad flu year are less likely to be taken out the next year.
Briggs also made the effort to extract an estimate for flu and pneumonia deaths, toward the bottom on the scale, and then ends that plot with the "with" and "from" Covid deaths. You can see the worst of it was back around late March, early April, and the easily predicted transition from Northern Temperate profile to more like Northern Tropical peak around June (see Hope-Simpson plot here). We're transitioning to the Northern Temperate winter profile again, which will be a third peak, but since the '20 season was particularly bad, the pool of people likely to die coupled with the advances in treatment should keep the death toll lower than last spring's peak.
Another interesting plot he puts up is the deaths by ages from all causes along with the "with" and "from" Covid from CDC data as well.
Briggs makes a big point of pointing out how so many people are worried about this with no justification.
Young (under 65) healthy people are not being killed by the doom—or much of anything else. Yet it is this demographic most panicked and most influential. We all have more to worry about with flu. That is, we usually do. But there is a problem with the flu: it seems to have disappeared, an impossibility.I should add that the people he talks about worrying the most, saying "mask me, lock me inside" don't seem numerate enough to understand data. Everything's an anecdote, "my sister's friend's yard guy is only 40 and he got Covid and died!" (never mentioning or even realizing he was the only person within 200 miles like that).
He goes on to show another plot of CDC data showing a mysterious absence of the flu. The flu disappeared after week 14 of '20 and in October, when it starts showing up again, the CDC shows nothing. They've stopped testing for it. I feel bad about taking more of his data, so go read.
In this day when the most innocuous thing requires a disclaimer, I should give one. Every death is a tragedy to some family, and many people will think it's heartless to talk about deaths as if they're just numbers. Further, the one thing we all know is that some day we will all die. I don't mean to sound heartless, I just think the best way to understand what's going on is to look at the numbers and understand as much as humanly possible. Or more.
Me 45 no prexisting condition. Covid+ 30 day still dealing with ailment. Had the flu b4 had sars1 from international travel 5 years ago. Not just the flu. Side effects are worse than sars1. Pretty scary virus. Hope no one gets it and hope I have only minor lung damage so I can still enjoy athletics.
ReplyDeleteSorry to hear that. My wife and I had the '14 flu - I had a flu shot, she didn't - and I think for both of us it was the worst, most lingering flu of our lives. For a solid six weeks, I think I got 50% of my daily calories from sugar-free cough drops. CDC data doesn't show that as a bad year.
DeleteStatistics never really apply to the individual; they describe population tendencies. Much like the old saw that you can drown in a stream with an average depth of 2", statistics can hide important information. Brings to mind the one that goes, "statistics are like bikinis: what they reveal is suggestive but what they conceal is vital."
I don't know anyone who has the flu this year. Do you? Does that mean that the flu and the common cold are finally gone? I see flu shots being peddled, but why should I get one?
ReplyDeleteI had the 19-20 seasonal flu. I've had allergy attacks and colds worse than late season 2019 flu-flu.
DeleteMeh.
Heck, used to get worse garbage from when cow-orkers would bring their micro-parasites to work so they could go to the doctor's (rather than keep the diseased vermin home and take a friggin sick-day like you're supposed to.)
Just like with the normal seasonal flu and normal seasonal sniffles and normal seasonal colds, the vast majority of 'hot' cases of the Covidiocracy are easily treatable by not treating the Covid itself, but the secondary infections. Once the secondaries are under control, then the body is full up to attack the Covid directly and win.
ReplyDeleteThe main killer that Chinky-Pox seems to use is interstitial pneumonia. That is, pneumonia of the icky membranes connecting and surrounding the actual air sac portions of the lungs. Which, because it's not the air-sacs, is hard to hork up and hard to treat, because, well, nebulized steroids can't reach past the air-sacs and tubes.
Control the pneumonia infection before it gets farther than 'walking pneumonia of undetermined origin' (which a lot of people had in late November and December 2019, and January and February 2020. And that undetermined origin is... Covid. Wu Ping Cough. Chinky-Pox. Whatever you want to call it) and you control the recovery. Let it get to full-blown lungs-shut-down pneumonia and even without Corona, that isn't really life sustaining.
To put this all in perspective...
In February 2002, my wife's gall bladder decided to try to kill her. So off to the ER we went. She spent 2+ days on a bed in the hallway of the ER because ALL the available beds were full of old people (and younger folk with really crappy lung function) shuffling off their mortal coil, or not, from that year's particularly nasty seasonal flu. That killed many much more people that year world-wide than did the Covidiocracy, the Cororna-Chan.
Makes you wonder, doesn't it, what made Covid19 such a 'killer deadly world pandemic?'
Note: Wife has compromised lungs from way too much bad stuff. She got 'a flu-like but not flu' illness in late November (our town is full of ChiCom college students... hmmm.... I wonder.... hmmmmm....) and it wasn't until we (Her, Me, our Doc) attacked the walking pneumonia that followed the 'flu-like but not flu' did she recover. Even in her thrashed lungs, her overall relatively good health allowed her to shrug off what the Doc now says is Corona-Chan.
Yeah. Corona-chan. Could be bad, could be mild. Like all seasonal flu attacks, some, like Anony up top, get hit hard for no understandable reason other than 'Dude, Rona hates you' while others, sick and in ill health, shrug Rona off like water off a duck's back.
My personal feelings? It's all genetics, once they really look into it all. Some people seem to be more 'genetically at risk' to this or that virus than others right next to them.
It will be interesting to see what the medicos actually figure out what happened once the onus of politics and stupidity are removed from the equation.
And unfortunately, Briggs' statistical skills combine with what he doesn't know about science in general, and epidemiology in particular.
ReplyDelete1) There are "good" flu years and "bad" years. But it's not a 1- or 2-variable problem set.
a) There are always older people. But surviving flu one years, and being one year older, doesn't, ergo, make you another year older and thus more likely to die the next year. That's kindergarten math thinking.
b) How many other conditions does any given Grandpa or Grandma X have?
c) What is their general health condition?
d) Did they get a flu shot that year, or not?
d1) Did the flu vaccine witch doctors guess the mutations well, and formulate a great shot (a year with a shot with 95% efficacy) or poorly (a year with 15% efficacy).{e.g. in 2018, IIRC, there were 635 individual strains of flu rampant in the US, and that year's shot had about a 15% effectiveness. This is nigh on to worthless, relatively speaking.}
d2) Was there even a shot at all?
(In, to my best recollection, around 2010, there was no flu vaccine available at all. Whichever year it was, it was a record low flu year. Because CDC and FedGov bombarded the airwaves with PSAs telling people to "Wash your goddamned nasty hands!!! in so many words, and mirabile dictu, old people and parents of young children actually did it!. Flu visits to the ER that year were negligible.
(cont.)
"d1)...a great shot(a year with a shot with 95% efficacy)"
DeleteGot any examples of that, Aesop? In my recollection, a "good year" is when the flu vax dartboard results in a 50+% efficacy. A "great year" please provide examples. As for a "bad year" 2018-19 finished up that way at about 9% IIRC.
(cont.)
ReplyDeleteThat exact level of concern, plus masks, and distancing, is why, by all accounts, this year's flu season cases will probably be contained in a thimble.
Yes, it was world-record assholian to put known COVID + patients into convo homes, which are the lowest form of medical care other than anything found in the Turd World, and you get a perfect storm of the most vulnerable patients, and the most execrable level of care not delivered by actual gypsies and witch doctors (and in most convo homes, there's little difference between them. The fact that they reek of sh*t and piss the moment you walk in is what poker players call a "tell".) Those deaths were, indeed, low-hanging fruit.
That such deaths may have accounted for nearly half the initial wave is bad.
it does nothing for the next wave, unless you stop doing that. I have yet to hear that it's no longer policy. And even if it was, that overlooks the obvious problem: Kung Flu presents asymptomatically in up to 50% of cases (which is why checking for fever temperatures at building entries is like looking for elephants by searching trees: asinine and pointless).
and it's those exact asymptomatic Gilligans who are going to continue spreading this virus around, until it hits the susceptible victims, and makes them critically ill, or kills them.
(cont.)
(cont.)
ReplyDeleteSome of them, yes, will be the aged, infirm, an with levels of disease that were killing people at age 66, on average, in 1933. (That's why FDR had Social Security kick in at 65; FedGov expected you to be dead within a year anyways. And then medicine went and started extending average life expectancies into the 80s. See if you can guess why it's broke.)
Yes, we know a little bit better what to do (and not do) to care for those hardest hit. Which will make about a 1-25% difference in fatalities in subsequent waves. because those in the roughly 3% likely to die, are still going to die. So maybe now the death rate goes from about 3% to 2.7%.
The biggest problem with those prognosticating from ignorance in general is overlooking the fact that most of the population, in this or any country, has yet to be exposed to the virus.
E.g., Califrutopia, at this point, has tested about 10% of 40M people.
The rate of those infected, at some point, is running damned near 10%.
With millions tested now, rather than dozens, those numbers (unlike Biden's vote tallies) aren't going to widely fluctuate, right up until you throw open the gates, eliminate any precautions, and start spreading Kung Flu virus like it was welfare money.
Then, the more people you infect, the more people will die.
(cont.)
(cont.)
ReplyDeleteDoes infection confer immunity?
I have no goddamned idea. neither does WHO. Neither does CDC. neither does Pfizer, or any-effing-body else.
I have one firsthand example of repeat infection, hospitalized in front of my face. I have dozens of cases reported anecdotally.
I have seen zero literature explaining this.
I have seen or heard of zero literature documenting exactly how widespread this is.
No one knows how much, or how widely, the original strain is mutating.
Thus any claims of vaccine efficacy are so much bullshit.
Any claims of herd immunity are so much whistling past the graveyard.
Any extrapolation of how bad this is going to be, with those exact unknowns being so glaringly obvious, are nothing but Bandini Mountain, with a sewage frosting from downstream of the septic plant.
Do I want fiat lockdowns again?
HELL NO!
Make a case, trot out evidence, not SWAG bullshit, and weigh the benefits and costs.
Then have the legislatures pass laws, or not, and have governors sign or veto them.
Y'know, like republican government has worked going back to, oh Magna Carta, or even Rome and Greece.
I went over a month in a SoCal ER with no likely COVID patients. I tell you, it was heaven. A crappy night with no COVID patients was like old times.
That ended last week. Just about 3 weeks behind the spike in cases, we just had, on my shifts alone, 3 slam-dunk sure-as-hell-got-it COVID patients. I had 2 of them personally, and one of them was the re-infection. When I left yesterday, we had a guy who literally desatted from 80% to 60% in the two minutes it took to get him from the triage tent to an iso room inside. He was in his 50s.
the ICU nurse who died from my hospital got it from a patient who was uninfected, then exposed by an asymptomatic patient in a regular ward, brought it to the ICU, and infected 10 nurses there before they knew it was a COVID case. That nurse was in her early 50s, not her late 80s.
Times, in 25 years of my career, that happens with flu: never.
Not one goddamned time.
Not even a consideration.
I can listen to statistical bullshit from people who don't know what they don't know, or I can believe my lying eyes, backed up by medical evidence, and common sense.
You guess where I'ma come down on that one.
Mutations? It's a cold. There is a reason why nobody has ever bother to even try to make a vaccine for colds before.
DeleteIn early July, there were 5 identified strains. In August, there was a separate strain specific to the Dallas-Fort Worth area. The news stopped talking about it after that, because people started asking the right questions.
Does infection confer immunity?
DeleteI have no goddamned idea. neither does WHO. Neither does CDC. neither does Pfizer, or any-effing-body else.
I have one firsthand example of repeat infection, hospitalized in front of my face. I have dozens of cases reported anecdotally.
If nobody gets immunity to it by infection, we're all gonna die. No vaccine will ever work because the antibodies they produce won't protect us. We'll just keep getting it over and over until we all die of it (or die of boredom from having it over and over). (That last lame joke was sarcasm).
How many cases of it has your hospital seen? 1,000? 25,000? If the rate of people who get it again was 10%, you'd have seen 1,100 (well, 10% coming back over and over). Noticeable? I'd guess maybe you'd notice, based on just about nothing. 25%? That would be noticeable. You'd start saying, "hey, weren't you here last month?"
Don't get me wrong, I'm sure everyone has seen these reports, I just think if it was a big fraction, you and your peers would notice that you keep seeing the same people over and over. There's probably some immunodeficiency involved that a subset of people have that cause them to not develop proper responses.
And Aesop has come by to cheerfully tell us all we're going to die horrible deaths unless we stay at home forever. As if there has never before in the history of ever been a cold and flu season. As if viruses disappear after a year or two. As if a relatively few (yes), mostly older (yes) people dying was a cause for civilizational panic and mass suicide.
ReplyDeleteNice try, Slick, but no, no, no, and no.
DeleteIs that all you can scrape up to sling, or did you have something to contribute besides gratuitous derision?
In this day when the most innocuous thing requires a disclaimer, I should give one. Every death is a tragedy to some family, and many people will think it's heartless to talk about deaths as if they're just numbers.
ReplyDeleteThat is the way actuaries look at the world. Which means that is the way that Insurance is built.
Now you should look at one thing besides how likely something is to happen. That is the cost of if it does happen. And the cost of insuring and/or mitigating the effects. Which is why you have fire insurance, and probably don't have hurricane insurance. The result is equally bad - you lose your home - but the cost is radically different. It is one of the many reasons I didn't buy real estate in Florida. Not the only reason.
"Probably" is a weasel word seldom seen in scientific literature.
ReplyDeleteIts primary use is to make "I don't know, but I'm guessing" sound like "this is highly likely", without necessarily having the benefit of any actual evidence.
I fine with simply saying "I don't know".
On the merits of your query, we've probably seen something around 200-300 cases, and hospitalized 50+. (Those are SWAGs; I don't have access to the hard numbers.)
So seeing one out of 50 a second time is a pretty high number. But the unknown variables are large enough to march Hannibal's Elephant Corps through, with a band and a wagon train of camp followers.
Since nigh on 50% of all infections are totally asymptomatic, anyone - including me - could claim that all of them (or none of them, or any percentage between 0-100) were also repeatedly re-infected. And no one could make any meaningful rebuttal, because no one has any wild effing idea what rate it is.
Neither bluff and bluster, nor guesses, will answer that question.
Time and research will.
And while you were joking, the idea that something can re-infect and no vaccine is possible would lead to total death is recockulous.
We know this by looking no farther than chicken pox, or HIV, FFS.
Lack of a vaccine, and the possibility of re-infection are not a necessarily a death sentence for anything. And a low CFR overall, despite the impossibility of a vaccine, are not mutually exclusive propositions.
Call me when someone plugs in confirmed values for a lot more variables with this bug, and I'll be properly ecstatic.
Until then, people like Briggs, talking out of their other end, about that of which they are wholly ignorant, is pumping the wrong kind of gas on this fire: bio-methane.
Incidentally, a co-worker dropped by last month. He took a travel ICU assignment to the Denver area for 13 weeks.
DeleteHe reported zero cases of re-infection.
Because he took care of 40 ICU patients with COVID, and 100% of them died.
He's pretty much sworn off working in the ICU again anytime soon (like for the next 5 or more years.)
And our ICU is now staffed at exactly 50% of the rate it was last spring, so it's forcing us to try and manage critical patients in the ER for days instead of hours. Which is great for you, if you're a mortician.
Extrapolate infections among medical staff, burnout, and so on, into the calculations of how bad successive Kung Flu waves are going to be, and let me know how we'll cope with a spike only 2/3s as bad, when we only have 1/2 the staff to care for them. We're also running the ER with about 50-60% of normal staff; everyone's tired of things as they are, and with no end of Gilligans in sight teeing up the succeeding waves.
Which is exactly what I warned about would happen waaaaay back when; not about deaths, which as I also noted, was about the 100th thing to worry about with this pandemic, after the other 99 things ahead of it, with far bigger consequences, and which tend to snowball into each other.
"confirmed values for a lot more variables with this bug"
DeleteNever going to happen.
Too many people are abusing their power in controlling peoples lives and livelihoods.
The worst tragedy of this year long fluster cluck is that WE WILL NEVER KNOW the real numbers. (that ain't science)
I scrolled through the Cook County ME's spreadsheet of deaths and at least one gun suicide is listed as a Wuhan death and at least 5 80+ year old deaths with metastasized cancer listed as Wuhan.
There are no FDA standards for Wuhan testing so we don't even know what the rates are (because liberal don't want anyone to ask questions)
I scrolled through the Cook County ME's spreadsheet of deaths and at least one gun suicide is listed as a Wuhan death and at least 5 80+ year old deaths with metastasized cancer listed as Wuhan.
DeleteWhen they started to pay more reimbursement for Wuhan Flu than other diseases they effectively incentivized lying about it and never knowing the truth. We're not only paying for the lies, we're paying extra.
I spent the last 20 years of my career working in a field where "root cause analysis" was the protocol. The idea of not having a clue about the costs vs. the benefits is so insane to me that I live in a permanent state of cringe. We hear only a tiny fraction of the real costs.