Tag: SARS CoV-2

Unmasking

The CDC’s revised health guidance has a lot of people celebrating — taking off their masks and rejoicing. From a psychological standpoint, I get it. But, from a functional perspective? I don’t get the mask hatred. There’s some work we do outside (cleaning chicken coops, mowing grass, using a chainsaw) where it’s great not to inhale dust and pollen. Since we’ve got masks, we wear them. Even if SARS CoV-2 were completely eliminated from the solar system, I don’t want your cold. Or your flu. Or whatever other respiratory illness.

Before we had Anya, I thought I had an amazing immune system. I was rarely sick — like once every five or ten years. Since Anya started school — preschool, grade school — I’ve learned that I just didn’t have much exposure to pathogens. With a kid in school, everyone in the household was sick basically from November through April. I cannot believe vast swaths of the population spend half of the year sick! This past year, though? Not a sniffle (well, at least not a sniffle until pollen started blowing around in visibly yellow clouds). Why wouldn’t we continue to wear a mask and avoid the gamut of respiratory illnesses?!

On stimulus means testing

Means testing is just as bad as offering a payroll tax cut. “Hi, family that made 100k in 2019, made 95k in 2020, but hasn’t had anyone employed since mid-December … you’re rich, so suck it!” sounds better than “Hi, family who made 100k in 2019, made 95k in 2020, but hasn’t had anyone employed since mid-December… you’re out of work, so suck it!”. But they’re both essentially the same statement.
 
I’d thought about including some sort of opt-out process. But if you don’t *need* the money, nothing’s stopping you from donating it to the local food bank / homeless shelter / etc either. Or saving it in case you get laid off three months from now (yes, I know “saving the stimulus money” … but what’s bad on a macro level isn’t always bad for the individual). So an opt-out infrastructure is a bit of theater that adds expense and delay (i.e. a Bad Idea).

Military Intel, Russia, and COVID

As I’m reading that Russia tripled their reported COVID death toll, I cannot help but recall an old rule of military intel analysis. If the report is a good thing (e.g. amount of grain produced this year), halve it. If the report is a bad thing (here, the number of people dead from a virus), double it. I never took the maxim literally, but rather thought of it as a reminder that ‘the bearer of bad news’ was not something you wanted to be within the Russian government. Thus numbers picked up from internal reports were apt to be CYA inaccurate.

Not sure if that rule was meant to apply to revised numbers (basically our fake numbers are off by a power of ten, so we’re going to adjust within the half/double rule to produce stats that are within the realm of possibility) or if not (reality was so readily apparent that the official numbers had to be revised close to reality).

School’s out for winter

My local school district is moving to remote learning for what’s left of December and a few weeks in January. Not unexpected, and a part of the reason we chose a different learning option for Anya this year. The Superintendent’s message highlights the two big problems I expected with in-person learning. Firstly, 28 positive cases resulted in 467 quarantined individuals. That’s about 16 people in quarantine for every infected individual. The district had about 3,000 students before some percentage opted to use virtual learning this year. Add some 300 staff — they’ve had about 15% of the school out in quarantine in the past three weeks. And that’s before any increase in infections from Thanksgiving. Secondly, people who send their kids to school with COVID-like symptoms (I believe they have a special nurse’s office in each school for those kids to hang out in all day so people who have to swing by the nurse’s office to get medication or a scrape patched up aren’t exposed to a room full of sick kids) and even while awaiting test results.

Liberatarianism is great in theory … but, in practice, the entire point of the belief system is that you’re free to make whatever choice you decide to make. Even if you want to ignore the bears.

Understanding Exponential Growth

Using the data from https://covidtracking.com/data/national/cases: in the most recent seven day span (10-16 November), 1,056,346 people in the US have been infected with this coronavirus. The total number of cases yesterday was 11,047,064. That means 9.562% of the *total cases* in the US were new cases in the past week.

 

This is how exponential growth works — and why you heard a lot about ‘flattening the curve’ earlier in the year. If you put a penny on the first square of a chess board, double it and put two pennies on the second square, double it and put four pennies on the third square, and continue in that fashion … mathematically, you have 2^n pennies on each square, where n is the numeric sequence of the square, 0-63. On the last square in the first row, square #7, there are 2^7 pennies — 128 pennies, or a buck and twenty eight cents. Not a lot. And the end of the second row, you have 2^15 pennies — 32,768 pennies. That’s $327.68 — over three hundred bucks. A lot more than a buck, but not a huge amount of money. But you’re up to 2^23 at the end of the third row — 8,388,608 pennies or $83,886.08. Eighty three grand is a lot of money. By the time you get to the mid-point on the board, the end of the fourth row, you have 2^31 pennies on a square. 2,147,483,648 pennies for $21,474,836.48 — over twenty million dollars. A lot of money, but it’s possible. The second half of the chessboard is where exponential growth becomes unsustainable. The end of the fifth row is 2^39 — 549,755,813,888 pennies. The end of the sixth row is 2^47 — 140,737,488,355,328 pennies. The end of the seventh row is 2^55 —  On the final square, you have 2^63 … 9,223,372,036,854,775,808 pennies for $92,233,720,368,547,758.08 … 92 quadrillion dollars. If the going price of Earth is only five quadrillion dollars, you’re putting a marker for the entire solar system (and then some) on that last square.

And that ignores the accumulating total — while you have 92 quadrillion dollars on the final square, you have another 92 quadrillion dollars on the entire rest of the board. Now, obviously, we are not doubling our rate of infections every day. But we’re entering “second half of the board” territory just the same.

Large Numbers

It’s often difficult to conceptualize large numbers — something that allows statistics dealing with large numbers to convey something other than reality. I think I heard Trump say the government is ready to vaccinate 200k people a day. That sounds like a lot of people (it is a lot of people), but there are a lot of people in the US: an estimated 328.2 million according to a quick Google search.

 

That’s four and a half years to vaccinate the current population of the US at 200k a day, every day. Which doesn’t take into account new people being born (or aging into the range where a vaccine is administered). The CDC shows 3.79 million births in 2018 — of course that number changes every year, and it’s been decreasing. But at 3.5 million births per year, new people still add a few months to the vaccination timeline. About four and three quarter years to vaccinate the US population. And that assumes a one-dose vaccine. Administering two doses to everyone, at 200k people per year, would take just under ten years. Saying ‘it could take us five years to vaccinate everyone’ isn’t nearly as impressive sounding as ‘we can administer 200,000 vaccines each day’ — but it’s the same thing.

Changing Your Mind Due To New Information Is A Problem?!

Back in 2004, John Kerry was roundly derided for being a “flip flopper”. In the political context, I never thought the term meant simply someone who changed their mind but rather someone who lacked conviction and changed their mind to match the prevailing popular opinion. Now, even that meaning, I had trouble seeing as problematic in a representative democracy. If 80% of the people I represent thought X last year and now think !X … wouldn’t they want me voting a different way this year? While Kerry attempted to explain his votes — approving military action but not a funding source — nuanced discussion isn’t effective in American political discourse.

I’m reminded of this as people protest wearing masks. I questioned the advice not to wear a mask in March — it was illogical except from a scare resource allocation strategy (i.e. if you’re sheltering in place at home where drive-through grocery pickup is the totality of your exposure … save the mask for someone with more risk). There wasn’t any research to support wearing a mask because there wasn’t much research about SARS-CoV-2 at all. But, in March, there was research on the transmission of other virus. Maybe we didn’t know if aerosol transmission was possible, but it’s basic risk mitigation to take not-too-awful precautionary measures to prevent an unknown risk. Several months later, there is research. But the odd line of thinking that means a politician who changed their mind about a vote or had nuanced reasons that their vote for “the same thing” differed seems to mean that emerging scientific research does not warrant revising one’s initial opinion.

Some in the Republican party remind me of my daughter’s default defiance. I’ve heard her refuse to eat ice cream because one of her parents told her to (and her automatic response to just about any request is “No!” or “Why?!”). The Republican party is currently objecting to the NY DA preventing the NRA from continuing to misappropriate donor funds (i.e. how dare you charge the guy who robbed me!?), refusing to wear a mask that at worst does nothing and at best prevents the spread of an infectious disease because they’ve been told to do it.

Death Panels

Texas is going to start sending the least likely to survive home to free up healthcare resources. A few months back, Italy had been floating some metrics for determining who got sent home and who rcv’d treatment. Had a few friends freaked out over the inhumanity of it, but … there’s a limited resource exceeded by need (and a metric may make it easier for healthcare workers charged with delivering awful news to families). To act like the choice is between this awful scenario and something awesome — like we could have this most-apt-to-survive-gets-treatment rule or everyone would immediately be treated (successfully, of course) for whatever ailment — is living in a fantasy world.

Those aren’t the choices available. What we’ve got without “least likely to survive get no treatment” seems to be either first-come-first-serve or highest-bidder. Neither of those are great algorithms for determining who is saved. A “death panel” sounds inhumane (and it’s obviously branding from an opposition group), but some outcome prediction to determine who gets treated … well, I guess it sucks for those with unlimited cash to ensure they’re always going to be the high bidder because they’ve now in the same boat as everyone else. But it’s about as close to an equitable solution as you can get in an awful situation.

One of my biggest problems with politics is the short-attention-span theatrics of it all. Both death panels and now — yeah, someone can come up with a terrifying phrase to make a solution sound unthinkable. But talk about the options and the rational for the approach for an hour and it’s a different picture.

I wish progressives would get better at branding and marketing — yeah, we’ve got death panels. But you’ve got the medical treatment auctioneer. This vial of insulin goes to the highest bidder — and Anne Rice wins this round. Sorry, all you penniless rubes. If you’re not in a coma in two hours, we’ll have another auction.

Hopefully people will be a little more understanding of treatment allocation based on predicted outcomes next time we talk about universal healthcare.

Mid-stream

Hospitals have been instructed to provide SARS-CoV-2 data to HHS instead of CDC. CDC falls under HHS so it’s a little like having the “parent company” handle something some subsidiary used to do. Which means the move isn’t as alarming as some people are making it out to be. The ‘parent company’ will authority to more readily mobilize resources, and moving responsibility for a project to the parent company can signify the importance of the project.
Which isn’t to say I think it’s a good move … from an IT perspective, CDC has the infrastructure in place to handle the reporting & publicizing of data. About the best case would be a reorganization — same people supporting the same thing, but adding in the uncertainty of a new organizational structure (new processes, new priorities, a new person’s take on what you should be doing). If HHS is taking over that system, there’s opportunity for failure because the new people don’t know what the old people know. If HHS is bring up a new system, there’s a LOT of opportunity for failure because, well, it’s a new system. Mid-disaster isn’t when I’d want to change my reporting process. Maybe run two in parallel because the new one is going to provide some great new insights. But I would never say “hey, everyone, stop using A and move over to B on Thursday”.
Additionally, it doesn’t inspire confidence that the HHS website has been throwing a lot of connection errors since the announcement. I expect it’s a load problem as people begin to learn what HHS is … but ‘the guy who cannot keep his website online will be taking over statistics for us’ is not exactly the direction I’d move critical reporting.