Archive for the ‘COVID-19’ Category.

Masks as Virtue Signaling

I want to thank David Hogg for this remarkably honest explanation for why he wears a mask when it is completely unneeded.

While others may not be doing it strictly to avoid looking Conservative, I do think that many young people wear them because they don't want to be mistaken as somehow anti-social or a Neanderthal.

When I am pressured to put a mask on despite having been fully vaccinated 8 weeks ago, I feel like I am signaling as well -- I am signaling that I am a rube who is meekly knuckling under to an irrational state.  It is certainly an eye-opener to see so many of the supposed members of the counter-culture marching in lockstep with state authority.

Our Personal Liberties Are Now Hostage to the Least Common Denominator of Mental Health

It is unbelievable we are allowing these people to rule us

Here are just some of the restrictions:

  • Everyone at the camp—including staff and every kid over the age of two—must wear masks at all times, unless they are eating or swimming. They should wear two layers of masks, especially when social distancing is difficult, regardless of "whether activities are indoors or outdoors."
  • Campers should be placed in "cohorts," and their interaction with people outside the cohort must be limited.
  • There should always be at least three feet between campers of the same cohort, and six feet between campers of different cohorts. Staff should keep six feet away from campers at all times, whether inside or outside. Distance should be maintained while eating, napping, or riding the bus: The CDC suggests seating kids in alternating rows.
  • The use of physical objects that might be shared among kids—toys, art supplies, electronics—should be limited wherever possible.
  • Camps should not permit close-contact sports and indoor sports, and should require masks regardless.

 

Why Must I Change My Behavior To Protect Those Who Choose Not To Vaccinate?

We are rapidly approaching the point where people who are unvaccinated are that way because they choose to eschew the vaccine.  Here in AZ, which has had a pretty solid vaccination program, tens of thousands of appointments for *free* vaccinations are going unused.  Vaccination rates are falling because people don't want them.

But states like Michigan still require that every citizen's freedoms be restricted until more people are vaccinated.  What if those folks choose never to get the shot?  Are we doomed to the same east-german-style regime forever?

And why should we?  People are making the individual choice that they perceive the risks and costs of vaccination to be higher than that from COVID.  OK, fine.  I disagree with them, but am happy to respect their right to make that decision.  But why do the rest of us still have to tiptoe around them?  They have made their risk choice, why don't we let them live with it and get on with our lives?

The answer is two-fold, and comes back to political incentives.  First, politicians fear they will be blamed for outbreaks of disease among the unvaccinated that raise their state's numbers -- we have lost the ability to talk in terms of individual responsibility and so somehow even when an individual explicitly makes a risk choice, we still want to blame politicians if this choice goes bad.  The other reason is that politicians really don't want to give up the power they have -- they have gained powers unprecedented in American history through declarations of health emergencies and fanning the flames of irrational fears, and they don't want to give those back.  Any excuse to extend the emergency will be grasped.

Why Most of the Pro-Mask Science Quoted in the Media is Absurd

I have been close to writing this post off and on for almost a full year.  Starting back in the early days of COVID when the media used graphics about droplet spray patterns with and without masks as "proof" that masks work to slow the spread of COVID.

I was going to write about how dumb this was, but I assumed that other scientific voices would soon skewer these studies and thus it would be a waste of my time.  But lo and behold, while many careful scientific minds did recognize the flaws in these studies, the large news and social media companies have been pretty diligent about preventing any heterodox opinions on masks from getting wide circulation.

And so it stood until the other day when someone once again threw these droplet studies at me as proof that masks reduce the spread of seasonal viruses like COVID.  OK, here is the problem:

It is best to think first in terms of an analogy.  You have a car and want to prove that at any time of day, you could drive 60 miles across Los Angeles in an hour.  So to "prove" that, you take the car our to a test track and show that yes indeed, your car can sustain 60 miles an hour for extended periods of time.

Hopefully the flaws with this are obvious.  Proving a car can go 60 miles an hour is not the same as proving a car can drive 60 miles in an hour in real world conditions, particularly in LA at, say, 5 in the afternoon.

In the same way, showing that a clean, new mask can stop the projection of droplets of liquid does not in any way demonstrate that they are effective in limiting the spread of a virus in real world conditions.  Others can probably add more to the logic problems here, but just a few are:

  • Are large droplets even primarily responsible for the spread of COVID  (remember, the COVID virus is WAY smaller than the holes in the weave of most masks)?
  • What happens when the mask is worn for a while and becomes saturated from the virus of an infected person.  Aren't they now just blowing out all day through a film of COVID, like a kid blowing bubbles with a bubble wand?
  • Are masks efficacious when almost none of them are sealed to the user's face?
  • Is there any evidence of transmission in certain environments, like outdoors on a sidewalk, with our without a mask?

The fact is that the sum of studies before 2020 on the efficacy of public mask wearing to limit the spread of seasonal viruses were equivocal as best.  No one thought they did much good.  People will respond, "well, you wouldn't want your doctor to do surgery on you without a mask" but in fact even the evidence on post-operative infection with and without surgeon's mask use is equivocal  (it is also an absurd analogy as I don't think anyone in Walmart will be hovering over an open incision in my body for 4 hours).   And certainly most (all?) of the quality studies since COVID on masks and virus spread have shown little or no mask effectiveness (there have been a few studies that have purported to show mask effectiveness but they had cherry-picked endpoints that compared one geography outside of its COVID season with another that was in it -- see more here).

Postscript:  I am in Knoxville for a day and had two different experiences.  Last night at the Lonesome Dove restaurant was the first time I have been in a restaurant where no one, not even the servers, wore masks.   A small return to sanity.  But then the next morning I went to an indie books store near market square that had a couple of people browsing and the proprietor would not let us in because they were over their COVID capacity limit (as I said to my wife, when your business model is heading for a cliff it is probably best not to stomp on the accelerator).

Postscript#2:  I know others have observed this but it is amazing how many of the people who do where masks when they are not required are under 25 -- and essentially immune from any major consequences.  Is this virtue-signaling?  A gesture of solidarity? Fear of authority?  Scientific cluelessness?  It is a very strange time when the young are mindlessly following authority and the older folks are skeptical.   The analogies I can think of is the German youth movement pre-WWI who were big supporters of war as a romantic endeavor and the young Chinese of the cultural revolution.

Update #3:  As a by the way, in case you every get to Knoxville and are looking for a nice place to stay in the downtown or university area, the Tennessean is the place to go.  Only slightly more expensive than other hotels nearby but has really top quality service and rooms  -- Four Seasons level IMO at a third the price.

Virological Calvinism

It is always dangerous when a non-religious person tries to make a statement about religious belief, especially when we get to complicated arguments about double predestination and supralapsarianism.  But for our limited purposes in this post, in Calvinism salvation and damnation are pre-ordained by God at the beginning of time --thus faith and good works have no bearing on being saved or damned.

I have come to believe that this is largely true of COVID-19, ie that the actions of man (at least as far as non-pharmaceutical interventions are concerned) have little or nothing to do with case rates and virus spread in any particular region.  Different geographies have different seasons for the virus, and trying to attribute low case rates or high case rates to the presence or lack of government interventions / restrictions is futile.  You can see that as location after location that was praised or damned at some point for its supposed good or bad handling of the virus have since seen opposite results.

There are a few exceptions to this, but very few.   On the positive side, the accelerated vaccine development programs were a near miracle, producing multiple viable vaccines WAY faster than I ever thought possible.  On the negative side, ordering infected people into long-term care facilities was a disaster.  But beyond these few exceptions, most of everything else didn't do squat.  The great regression analysis someone does someday on virus transmission rates across geographies is going to have seasonal variables, demographics, and urbanization with most of the explanatory power.

2020 Should Have Been The Year We Demanded Reform of the FDA and CDC, But We Didn't. Now It's Come Back to Bite Us.

Many of the early failings in COVID response can be laid right at the doorstep of the CDC and FDA.

Shortages of testing?  The FDA refused to approve an tests except those developed at the CDC, and then the CDC tests failed.  Later, the FDA was really slow and conservative in approving new test approaches (eg home testing).

Shortages of PPE?  We learned that PPE manufacturers were all heavily regulated by the FDA, and FDA rules prevented quick ramp-ups, while liability rules made folks like 3M reluctant to shift N95 masks from non-medical to medical markets.

Slow vaccine rollout?  The FDA was its usual conservative self in approving vaccines, and refused to give any credit to vaccines approved by other western nations.  THEY had to approve it too.

First doses first?  No way, the CDC and FDA would not even consider it.   The conservative approach was to insist the vaccines be used exactly as originally tested, despite testing on the Pfizer vaccine showing that 1 dose of it was over 80% effective.  Now we see the world leader in reducing cases is the UK, which is the one country that did first doses first.

In a sane world, the CDC and FDA would have gotten hammered for what could be described as following peacetime rules in during wartime.  Add to that their ever-shifting and contradictory guidance, and guidance on NPI's that went against the sum of scientific research that had been published pre-2020, and you should have expected a LOT of media scrutiny of them in 202o.   Instead there was virtually none, and if anything the media fetishized and hero-worshipped these agencies.  Why?

As usual, the answer is Trump.  By 2020 the media was in the habit of blaming everything on Trump.  If COVID tests were in short supply, it must be Trump's fault.  No further scrutiny was needed.  In fact, no further scrutiny was wanted, because no explanation excerpt for "Trump's fault" was wanted.  Granted Trump helped them to some extent by his usual habit of off-the-cuff stupid statements.  But the media went ever further -- they wanted an anti-pole to Trump, and these agencies and morons like Dr. Fauci were elevated to sainthood not because they did anything right but because they could be portrayed as not-Trump.

For the media, whatever the FDA or CDC said represented scientific consensus.  Which is a horrible bastardization of science.  The FDA and CDC are not "science" and scientific "consensus", if such a thing is even real, is based on a quasi-antagonistic process of challenge and response between differing hypotheses (a process by the way the media actually undermined by de-platforming one side of many of the COVID-related debates) and not dictats by government agencies.  The FDA and CDC are populated by politicians and government bureaucrats who happen to have scientific degrees.  They are subject to all the same influences and bad incentives as any other political organization.  For example, in the government there are very different risk profiles between action and inaction.  Essentially, bureaucrats are seldom held accountable for deaths and harm from inaction -- if people die because they are slow to approve a new drug or procedure, no one puts that on them.  But they try to avoid at all costs approving something that eventually hurts someone, even if that harm is far less than the benefits of what they approved.  But instead of making all this clear, the media granted them the secular form of Papal infallibility.

So now we arrive at April 2021, and the FDA shut down the use of the J&J vaccine because it has about a 1 in a million chance of causing blood clots and a one in 6 million chance of causing a fatality.  People seem suddenly surprised that the FDA would do such a thing that is obviously so irrational (the number of lives saved by the vaccine is  -- by everyone's estimate -- orders of magnitude larger that those who have died from this side effect that may not actually even be due to the vaccine).

What is surprising to me is that anyone is surprised.  The FDA has ALWAYS acted this way.  Libertarians have called them out of this for years (thus, for example, libertarian-sponsored right to try laws).  In particular, failure after failure of COVID response in 2020 can be laid right at the FDA's doorstep, but we were just having too much fun demonizing Trump to actually look for root causes.  Well, now our inattention has come back to bite us with this absurd FDA decision.  The only good thing that can come from it is the potential that we might finally consider some reforms.

Prediction: Feds Will Be About The Last Government Entity To Drop Their Mask Mandate

Joe Biden is kind of stuck on COVID.  He campaigned on all the things Trump did wrong in his COVID response, but the only policy step of note that I can see that Biden has done differently is to issue a mask mandate for all federal property where Trump eschewed making NPI mandates at the Federal level, preferring to leave it to state and local governments based on their local conditions.  If this is really the case, expect Biden to be about the last man standing on government mask mandates, at least in the US.  My guess is that he will use continued cases or low vaccine rates in some state as an excuse to say that he can't drop the mandate until everyone in the US is ready  (forgetting how insane this is particularly when a more logical Federalist solution exists for the problem).

Biden is trying to claim credit for vaccination rates but it is hard to think of anything he has actually done to boost these rates since most all vaccines are administered by local folks and the vaccines were developed and funded on Trump's watch.  The only major decision Biden has made, which I actually think was a setback, was to declare that the US would not take a first doses first strategy used so successfully in the UK.  Biden has declared a goal of 100 vaccines in 100 days, but this is pretty much meaningless, the equivalent of a random dude running to the front of a parade and claim to be leading it.  Someone in his shop merely took a chart and of vaccination rates and projected it forward and determined about 100 million looked like they would be done in 100 days and so adopted this as a goal, hoping to retroactively convince people they caused this rather than just predicted it.  I would love someone in the press to ask Biden to name three things his Administration did that measurably accelerated the vaccination pace.

Like many, I find Trump irritating and distasteful and I have trouble saying nice things about him but he got a range of vaccines funded and got the US first in line for doses by pre-paying.  Its hard to think of anyone else who did more to help the crisis.  This helps me forget things like the botched testing development, which was really the FDA's and the CDC's fault but a different leader might have kicked those agencies out of their obstinate blocking role and into a more productive mode.

UPDATE:  I will add that the recent CDC / FDA decision to stop the J&J vaccine due to a 1 in a million non-fatal side effect seems like a terrible decision.  Again, possibly not Biden's decision, but like my criticism of Trump and testing, Biden could exercise some leadership here.  This is the price for fetishizing the CDC and FDA as all-knowing consensus voices of "science" that are not to be doubted, even to the point of having heterodox youtube videos taken down.  Because 1) These guys like Fauci are not scientists per se, but government bureaucrats with science degrees.  And as I have written many many times, government employees have incentives that lead to high risk aversion for acts of commission and low risk aversion for acts of omission.  Which means they put much higher weight on a death from a very easy to count and identify side effect that they could have stopped by stopping the vaccine than they do on deaths that are impossible to count or to see that were caused by the vaccine delay.  And 2) the idea of "scientific consensus" is a chimera and a term only used by non-scientists and a small group of government scientists that want to wield their position as a club to exercise power.  Seriously, how does such a consensus even exist if one side never was allowed to debate?  This is consensus as defined by Stalin or Mao.

We Knew About the Disproportionate Danger of COVID to the Elderly From The Very Beginning

In some recent debates over the Great Barrington Declaration, critics of that proposal argued that we didn't know that COVID was only a relatively small threat to healthy people under 65.  But we did know, as early as April or at worst May.  I know I was writing about it.  Just think of all the articles you have read with the theme of "everyone, not just old people, need to be terrified of COVID" and then look at this:

People over 65 make up only 18% of the UK population but clearly accounted for 90+% of the deaths.

Here is the calculus as I see it:  I was 58 when this all started.  Let's assume I have 20 good years.  Hiding in my home and not doing the things I enjoy for a whole year, as preached by Fauci and company, would have wasted 5% of my remaining life.  Instead, by ignoring them and going about my business, I was taking perhaps a 1/2000 chance of dying to the disease or 0.05% (I actually think given my health and weight that this is exaggerated).  These two numbers are not even close.  They are not one but two full orders of magnitude apart.  When presented with these numbers, and given my preferences, it would have been wildly irrational (or demonstrated extreme risk aversion) for me to follow the advice and dictats of the coronabros.

Well, That Was Fast. UK COVID Strain Likely NOT More Deadly

In my post about the Sunday NY Times article on the B.1.1.7 COVID variant, I expressed skepticism that it really was substantially more deadly than other variants.  While this is possible, on average we expect viruses to mutate in a way that they are more communicable but less deadly (there are no rewards in the parasite world for killing the host).

Specifically I said:

My personal bet is that we will see a story buried on page 34 in August saying that original relative death studies for this [B.1.1.7] variant appear to have been exaggerated.  When the NY Times is hyping a scare story that increases the power of government, particularly in a Democratic administration, take the under.

Well, I was wrong.  Rather than in August, the predicted story was buried in the Wall Street Journal one day later

Clear evidence has emerged that B.1.1.7 transmits more easily than earlier variants, which helped enable its rapid spread. Whether the variant is associated with more severe disease and death has been less certain, however...

In the new study, the researchers took samples collected in early November from 341 Covid-19 patients admitted to University College London Hospitals or North Middlesex University Hospital. The researchers sequenced genetic material from the samples to determine the viral variant that caused the infection, used the test results to estimate how much virus the patients harbored and then compared the two groups.

Nearly 60% of the Covid-19 patients had an infection caused by the B.1.1.7 variant, and patients hospitalized with B.1.1.7 were younger, had fewer health conditions and more often received an oxygen mask than those admitted with other variants, the study found.

Yet the researchers didn’t find that those with a B.1.1.7 infection had more severe disease outcomes such as needing ventilation or dying, after accounting for other factors such as age, ethnicity and underlying conditions.

I will be more careful than the NY Times, who cherry-picked one study result on the far end of the scale of results to date, and acknowledge that the study results -- all based on small samples and uncontrolled population groups -- are mixed.  But evidence both of prior meta-studies as well as this new one give us little reason to believe that this variant is substantially more deadly.

Variant Terrorism and the New York Times

Update:  Just one day after this story, the Lancet published a study showing that B.1.1.7 not likely more deadly than other variants.  As predicted below.

The New York Times has scary red maps of Europe on its front page today (at least in the version we get in AZ) implying mass death from new COVID variants.  Given the prominence of COVID in the news and our lives, there is certainly a story here.  But as usual with American media coverage of COVID, there is absolutely no balance here.  The article highlights new developments in the virus, which is helpful, but does so in a largely data-free manager and simultaneously engages in the crudest of rhetorical tricks to make the situation seem far worse than it is.  Here are a few pointers to how to read through this mess.

  • The use of color on the front page maps is not accidental.  When the media wants you to be scared, it uses red on maps and scales it so that even small changes in variables result in a map going from green or white or blue to solid red and orange.    No exception here.  When one glances at the front page, one likely assumes that this is a map of spread of death or new case counts, but in fact it is merely a map of one new variant as a percentage of other new variants.  It says nothing about death or case counts.

  • The article attempts to use certain rhetorical framings to imply that increases in cases and/or deaths are due to this new variant.  For example:

The variant is now spreading in at least 114 countries. Nowhere, though, are its devastating effects as visible as in Europe, where thousands are dying each day and countries’ already-battered economies are once again being hit by new restrictions on daily life.

and this even more egregious example:

What happened this winter in the U.K. was mass death and deluged hospitals on a scale not seen earlier in the pandemic. Since B.1.1.7 was first sampled in late September, 85,000 people have died. Four million people — one out of every 17 Britons — have recorded infections.

So 85,000 people died from this variant?  Well, they want you to think that -- but they were careful that while implying that (which would not at all be true) they do not actually say that.  When you think about it - especially given that there are now dozens of COVID variants - this sentence means exactly nothing.  It's like saying that since Biden took office, thousands of people have died of cancer.  Here is the UK deaths chart (from Google, not in the NY Times article):

You would certainly never know from this article that deaths in the UK have basically gone to zero.  This chart shows exactly the same seasonal pattern we are seeing everywhere, including in places like Arizona where we have had few if any of this new variant.  This picture has become the great totalitarian Rorschach test of the 21st century, with everyone reading their own preferred causes into these seasonal humps (opened too soon! variants! spring break! evil Republican governor!)

By the way, I will save you clicking through the Times link above that says "mass death and delayed hospitals" in an attempt to see the data.  There is none. Just like with the overloaded hospital meme in the US, the article is quotes from a few harried doctors and funeral home managers and zero data.  The first "overloaded hospital" story I see with actual occupancy numbers compared to the same months in prior years will be the first.   In this case there really is no excuse for this, as the NHS apparently keeps pretty detailed daily hospital records and puts them all online here.  So I looked at the week including January 21, which looks like the peak of critical care at least in the death chart.  On 1/21/21, there were apparently 3 acute and emergency care diverts in the whole of England, and it is not even clear if these were due to capacity issues.  Other days that week were generally on 3 as well (I don't know how they count so I don't know if these are the same 3 people all week or different people each day).  Occupancy of acute and emergency beds was around 87%.  For comparison, the January 2019 report from the same site showed acute and critical care occupancy of 85%.  The site cautions that with the segregation of COVID and non-COVID patients, capacity is harder to manage (a basic tenant one learns in any operations course) but it is hard to gauge by how much.  But all this sort of discussion and outlining of facts that are so easy to find is missing from the article, as the whole point is to scare, not to inform.  After all, reciting statistical facts about vampire incidents is not the best way to tell a scary ghost story around the camp fire.

  • The article keeps saying that this variant is thought to be more transmissible and more deadly.  Towards the very end they get the most specific when they say:

The variant is believed to be about 60 percent more contagious and 67 percent deadlier than the original version of the virus. 

If you follow the link, you have to go through an Easter egg hunt of clicks, but eventually one gets to this metastudy looking at a number of results.   I am not even going to pretend to have expertise in reading and interpreting these results, but I would observe that a) the claimed 67% number seems at the high end of a lot of the results; b) 67% is awfully precise for studies who summarize their study results as this variant "may" and "probably" be more deadly; and c) the sample sizes here are really small and pretty skewed (most seem to be dealing with people already hospitalized or at least showing symptoms).    My personal bet is that we will see a story buried on page 34 in August saying that original relative death studies for this variant appear to have been exaggerated.  When the NY Times is hyping a scare story that increases the power of government, particularly in a Democratic administration, take the under.

  • My understanding is that most deadly viruses tend to mutate over time to be less rather than more deadly.   More transmissive but less deadly is the ideal for a virus trying to spam copies of itself across the globe.  I have yet to see any discussion in any article of this fact along with any hypothesis of why COVID might be behaving differently (since according to the media every damn variant is more scary than the last one).  There may be a reason, and it would be an interesting discussion -- as well as an obvious on of interest to readers -- but I have yet to see it.

I really should not get that worked up about all this -- after all, my blog certainly is not even-handed.  But my concern is

  1. The undercurrent of all these stories is essentially "so shut up and obey."
  2. No criticism or skepticism is being allowed by most of the major gatekeepers.  I can say this kind of stuff because I have a small audience, but once one gets any sort of prominence, such skepticism no matter how well-grounded in facts will be memory-holed.  Take this story.  The claim that children don't need masks is perfectly justifiable for a disease that is deadly for octogenarians but milder than the flu for kids.  We could have a discussion about this and people can disagree, but it is a totally reasonable topic for public discourse.  To ban this can't be due to science, it can only be a quasi-totalitarian deference to authority -- President Biden says we need masks so no one should publicly disagree with him.

Be warned -- totalitarians have not missed the significance of this nor that the government seems to be getting away with it.  You are going to see a spate of issues all reframed as public health issues -- guns, race, climate, immigration -- with folks claiming that newly established COVID-related dictatorial powers need to be applied to their pet issues as well,

I don't think in the history of this country the general populace** has been subjected to the sorts of limitations to individual freedoms that have been imposed over the last year, often by executive order without even involvement of the legislature.  Sometimes by public health officials who are not even elected.  Even in wartime I can't think of any affront to individual liberties that was as bad as the combination of lockdowns, school closures, and business closures.  To have all that happen is bad enough.  But to have the gatekeepers of the public discourse declare that not only are we going to do all these unprecedented authoritarian things, but we are not even going to allow public skepticism of them --that is really scary.  Historically, all the worst ideas have been accompanied by bans on public criticism.

** Clearly minority populations have been subjected to worse.  Enslavement of African-Americans, internment of Japanese-Americans, and near-genocidal actions taken against various native American groups come to mind.

No One In Power Has The Guts To Declare The Pandemic Over, So I Will: It's Over in Arizona

Half our politicians don't want to declare the pandemic over because they are wallowing in all their new power and having too much fun as petty dictators.  The other half are scared, living in fear that every death after they declare an end will be used as the basis for a Bush-esque "mission accomplished" critique.  Well, people will likely contract and perish from COVID forever.  Heck, people died last year in this country of the whooping cough.  My 25-year-old nephew died of regular old flu.

But if we define the pandemic as a time when a single disease drives excess mortality outside of normal bounds, then this pandemic is over, at least in AZ.   As of this morning, 27% of people in AZ had at least one dose of the Pfizer or similar vaccine, over half of those being in the vulnerable over-65 group.  We don't know how many have gotten the virus, but (non-random) anti-body tests were running over 50% positive last month.  If we assume a third of folks have antibodies from the virus itself, and that there is a 50% overlap between these folks and those vaccinated, this gets us to nearly 45% immunity, rising by several percentage points each week.  Immunity levels in the over-65 population may be over 80%.

As a result, cases have fallen sharply but due to the sensitivity of testing, I am not a fan of that metric.  We will probably always have people testing positive.  The question is whether people are getting seriously ill.  And here are the numbers for that, I use ICU bed occupancy as a proxy for serious illness (because case numbers are exaggerated and death numbers have a crazy lag to them):

I am not cherry-picking -- this is the most useful metric, I think, but all the others show the same thing.

My suspicion has always been that "COVID patients" means "Patients who test positive for COVID," so the number may be a bit exaggerated for true hospitalizations caused by COVID.  Also it is a lagging indicator -- 10 days to incubate and a week to end up in the hospital and perhaps a week stay in the hospital means these are likely folks exposed in early March.   But the result is clear.  Given the sensitivity of testing, these numbers will likely never go to zero.  What we see is a normal hospital load form a seasonal virus, in fact one currently far smaller than what we might get in a normal flu season.  In other words, we are back to normal.  AZ, by the way, last week opened vaccines to everyone over 18.

Postscript:  If you compare the ethnic data on COVID deaths vs. vaccines, it does appear Hispanic and native American groups are under-represented in the vaccine population vs. the population of COVID deaths, though the ethnic information on vaccine administration has a lot of gaps.  This is partly predictable for Hispanic groups as they skew much younger than whites in AZ so the prioritization to over-65 people first is going to skew the racial mix.

That fact may get reported on.  The fact that will not get reported on is the gender skew.  In AZ men were 58% of deaths but are only 43% of those who have been vaccinated.  I guess if I wanted to spend my life being aggrieved about my tribe I could be upset about this, but in fact it is entirely predictable from the vaccine priorities.  Vaccines first went to teachers, health care workers, and old people -- all three of which skew heavily female.

Postscript #2: One interesting thing that I have not seen reported -- I don't know any men, including myself, who had any substantial reactions from the vaccine.  My wife and daughter, however, were really knocked out for a day.  This is partly random, but also partly the inevitable result of having a singles-size dose for everyone.  The ladies in my family have much smaller body mass than I but got the same dose, which may explain why it hit them harder.

 

Credit Where It is Due -- Our County's Vaccination Effort is Pretty Impressive

Last week I volunteered, along with 100+ other people, for an 8-hour shift at the Phoenix area's largest vaccination station, located at State Farm Stadium (the oft-name-changing home of the Arizona Cardinals football team).  Someone really did it right.

I often criticize public efforts for their inefficiency and poor performance, but this one is certainly an exception.  Granted, it is being run as a public-private partnership and my gut feel is that the Blue Cross Blue Shield folks have a lot to do with the success, but partnering for expertise is a perfectly reasonable way to get a job done and the government seldom is willing to admit it needs help.

The entire operation uses one section of the stadium's massive flat parking lots.  They have created an assembly line for those being vaccinated to move through the process without ever leaving their car.  The whole setup has the feeling of a Disney ride or an assembly line.  Those being vaccinated are greeted at the first station and checked in against their reservation.  Their reservation number is written on grease pencil on their window.  They then proceed station by station to get their vaccine and to get checked for any negative reactions on the way out.  In between volunteers with ipads walk car to car in the queue for each station, asking screening questions, gathering data, or at the end making appointments for second vaccine.  The number on the windshield allows these volunteers (I was one) to quickly access the relevant portion of that visitor's records.  It is clear someone has load balanced the stations, because there might be 12 of one sort of station followed by 8 of another that cycle faster.  From front to back the process requires about 30 minutes, including the mandatory 15 minute wait for negative reactions.  Patients have an email waiting for them with their selected appointment time for a second shot before they even drive off the property.

The whole process never stops, running for 24 hours a day.  We volunteers get the training we need through a 15-30 minute overlap with the last person doing the job (most of us are on our feet with the iPads or with parking flags).  The biggest staffing bottleneck are the trained medical professionals needed at the vaccination station and at the end to monitor for negative reactions.  Thus all the rest of the process is designed to leverage these folks, to make sure they are doing only medical tasks -- a large force of volunteers without medical skills (eg me) do all the rest under the supervision of a surprisingly small permanent management team.  The medical folks for example at the actual vax station are not asking background questions or managing records -- this is all done with non-medical volunteers -- so they can focus on sticking needles in arms.  This is important because the medical professionals are the most limited resource and the hardest to keep deployed 24 hours a day.   I really have a lot of love for those folks because it is a long, long shift, rivaling any in a Chinese sweat shop.  Those of us non-medical volunteers just did it once or twice, these folks are doing it day after day.

The rest of the volunteers are frankly easy to get, despite it being a really long shift (especially the 10pm - 6am one), because folks who work a couple of shifts get the vaccine on the way out.  So soliciting volunteers mostly consists of running a sign up site and handling the deluge of traffic in the first 5 minutes after new spots open.  I will say it was a pretty amazing volunteering opportunity.  First, the number of well-organized volunteer efforts are, in my experience, really limited and these guys totally had their act together.   I worked at the end of the process, walking the line of cars waiting out their 15 minutes, scheduling appointments.  It was not unusual to have an older person crying and telling me they could finally go see their grandchildren after 12 months of isolation.

I thought a bit about whether to even bother, as I have never been very worried about COVID risk, but I have to travel a lot and I worry about whether the Biden Administration may put vaccine requirements on travel at some point.  Plus I work with about 800 folks over 60, so at the end of the day it made sense for me.  However, the second vaccine really has me in a quandy.  New reports have first dose effectiveness at 92+% vs two dose at 95%.  Are they really going to put this scarce resource in my arm for +03% effectiveness  (probably in the error bar of the studies)?  On the other hand, they have already scheduled me for x day and time for #2 and its part of the process that you agree to come back for the second.  I will think about it, but frankly I will be happy if the state decides to delay second doses for a while.

Every Service Organization Has Lost 20 Organizational IQ Points During COVID (Banks Have Lost 40)

Over the past year, I have spent a staggering amount of my time trying to get service providers who are supposed to be the leaders of their business to do their damn job.  I literally keep a list at my desk with a list of reminders I need to send out to service providers to do what they promised.  This list is never less than 30 names long.

More than the COVID life disruptions, more than the fear-mongering, more even than our merger, the most exhausting thing for me over the last year has been the utter inability to reliably delegate anything to a third party without constantly having to coach them through their job.

I see many reasons this is occurring.  These include:

  • Lack of employees due to either sickness or else difficulty in competing against high unemployment payments.
  • Closure and elimination of services that companies always wanted to eliminate but they can now blame on COVID.  For example
    • Hotels stopping maid services and room service
    • Banks closing tellers and branches
    • Airlines not serving meals or drinks
  • Unwillingness to adjust to the current reality.  Banks are high on this list, demanding things they have always demanded but that are impossible to do in the last year

But these do not encompass the whole problem.  There are a lot of companies in their core functionality that seem to have simply forgotten how to do what they do.  Even after 6 phone calls, Amerigas can't take and fulfill a simple order for bulk propane delivery;  Iron Mountain, who I like and invest in, can't reliably provide any of their core services accurately and on the first try; I don't think Intuit even picks up the phone anymore.

My hypothesis is that people are getting too far ahead of themselves in saying that COVID proves that the centralized workplace is dead.   I think we are going to find that this is not true at all, that there are networks in the office that spread both knowledge and accountability that are lost with all this home work.

I have run a company for 20 years where every employee works out of their home, or more accurately, where every employee moves their home (RV) to the workplace.  My employees work in over 400 spots.  And one thing I have learned vs. years of working in Fortune 50 offices is that you have to build a special process for this situation.   In particular, my constant focus is how how to centralize complexity.  I keep trying to take complexity out of field locations and managers and centralize it in a few office people where it is easier to train and build tools and create backups, etc.

My hypothesis is that companies did OK for the first month or two with work at home as well-trained employees carried the momentum of office work styles to their house.  But as time passes, and the staff turns over, the lack of traditional knowledge-sharing, support networks, and accountability systems are causing service functionality to degrade.

 

 

Media Fear-Mongering With Zero Education Value

For most of the past year I have been hammering on the media for their destructive COVID fear-mongering.  By always cherry-picking the most alarmist opinion on every topic, and filling articles with carefully calibrated fear-provoking language, they have made us all dumber.

Let me give you one example.  For literally months, day after day, our AZ papers have been screaming that emergency rooms are filling up and telling the public they may soon be lying untreated on some hallway floor or not allowed into a hospital at all.  The articles were in my email every morning -- maybe some day I need to piece together a supercut montage of them all but my guess is most of you have experienced something similar.

I know zero about hospital management but even I can look at ICU data and see that the narrative is substantially more complex than what is in the media.  Here is the AZ state tracking report on state ICU bed utilization -- dark gray is total and red is COVID-related in some way.

The implication in the media is always that a 80% full ICU plus the equivalent of 30% of the beds with new COVID patients = zero capacity and people dying with no treatment.  But that is clearly not what happens.  AZ ICU's have run at 80+% capacity utilization since June 1, while COVID bed use in that time has drifted from 10% to 60% but we were never out of capacity.

There is clearly some complex management process the goes on with the management of ICU capacity.  In fact, it seems like someone knows what they are doing here.  Why don't we ever, ever get to hear that story?   I can't think of one hospital administrator I have seen interviewed in our local papers discussing how this management process works.  The only people they ever interview seems to be that one nurse with PTSD screaming that her hospital is a dystopian nightmare.

Perhaps this capacity management is being done with little cost, deferring non-urgent cases.  Perhaps someone is missing out on care to defer to the COVID folks.  Perhaps this is entirely normal in every winter flu season.  We don't know because apparently the media has decided it is not interesting, or at least not as interesting as the reactions they get when they have everyone as scared as possible.

"Work From Home & Socialize via Zoom" Is the Height of Elite Priviledge

I have been pointing out since April that stay at home orders tend to be supported by folks who either a) are rich with lots of savings; b) have professional jobs and can work from home (eg journalists) or c) get paid even if they don't work (eg government workers and teachers).  A lot of folks on the Left that lecture the rest of us constantly on privilege have shown zero self-awareness in advocating for the most privilege-biased government order in my memory.

So it should not be shocking that the results of the COVID business lockdowns have disproportionately hit lower income and less educated workers.  From the WSJ:

A two-track recovery is emerging from the country’s pandemic-driven economic contraction. Some workers, companies and regions show signs of coming out fine or even stronger. The rest are mired in a deep decline with an uncertain path ahead.

Just months ago, economists were predicting a V-shaped recovery—a rapid rebound from a steep fall—or a U-shaped path—a prolonged downturn before healing began.

What has developed is more like a K. On the upper arm of the K are well-educated and well-off people, businesses tied to the digital economy or supplying domestic necessities, and regions such as tech-forward Western cities. By and large, they are prospering.

On the bottom arm are lower-wage workers with fewer credentials, old-line businesses and regions tied to tourism and public gatherings. They can expect to bear years-long scars from the crisis.

The divergence helps explain the striking disconnect of a stock market and household wealth near record highs, while lines stretch at food banks and applications for jobless benefits continue to grow.

These charts are telling:

     

One other observation -- I think the second part of the statement in the title to this post is important as well.  I am not an expert on ethnic and cultural variations and practices.  However, I have been lectured by the woke that cultural differences are important, including a memorable twitter argument about whether expecting workers to show up on time is racist.  It has been my observation that different cultures satisfy the human need for socialization differently.  In my world, you often see white families in parks gathered in small nuclear families, while other cultures might have 25-30 person extended multi-generational families with them.

I wish I had more background on this topic, but it is my hypothesis that the government's lockdown orders may well disproportionately harm ethnic minorities.  In general, we Westerners are more used to getting by individually or in small nuclear family groups (though remember that even for whites, solitary confinement is generally the ultimate societal punishment short of the death penalty).  I think there is a good chance other cultures more used to relying on larger networks and multi-generational extended families are having a particularly hard time with the order to limit social contact to zoom.

Why The Incentives Are Stacked to Overreact to COVID

Long-time readers will know that I am interested, to the point of obsession, in incentives.   One should always be suspicious of bad outcomes described as irrational or the nefarious actions of bad people.  In both cases, if one looks carefully, the outcomes usually turn out to be the perfectly rational outcomes of perfectly normal people responding to bad incentives, assumptions, and/or information.

I personally believe the COVID response in this country (and others) is exaggerated and counter-productive.  But for this post I am not going to ask you to agree or disagree with my skepticism.  Instead, I am going to focus on incentives, and show how media, academia, and government all have incentives, assumptions, and information asymmetries that push them towards exaggerated COVID responses.

The following list is not necessarily complete and the items here are not independent of each other.  Having completed this post, they now look a little random but this is sometimes the way I clarify my thinking on things -- to write and publish and get feedback and maybe be more structured the next time.

Incentives

  • Political incentives to "do something" about the issue of the moment.  We see this after every high-profile "bad thing" that happens.  There is immense pressure on politicians to do something -- pass some law (often with a person's name in it) or, if the legislative process is perceived as to slow, fire off some executive order.  In the heat of battle these actions are often taken without regard to efficacy, cost, or unintended consequences.  In the heat of these frenzies, a multi-dimensional decision is magically redefined as having only one dimension that matters.  Anyone who focuses on costs or unintended consequences or even efficacy problems of the proposed solution are cast as heartless and uncaring, potentially even evil and nefarious.
  • Politicians always legislate to first-order metrics, never second-order metrics.  Politicians know that the public and the media is looking at their country or state every day and publishing the number of COVID cases and deaths.  No one is publishing the number of additional suicides, or cancer deaths from people too scared to go to the hospital, or increased starvation and disease deaths in poorer countries as food prices rise and aid from rich countries dries up. These second order effects are real but hard to prove or measure.  They are what we call "unintended consequences" but should instead call "ignored but entirely predictable consequences."
  • Political incentives to expand power.  Every politician in every branch of government is always working to expand their own power (this is not unique to government, you can say the same thing of executives and functional departments in many large corporations).  When the public is scared and panicky, politicians are able to break through past limits and norms and establish new precedents.  The best example of this is that governments in Western democracies all expanded their power during the 20th century wars, expansions that largely stuck and were not reversed in peace time (except for a few fortunate examples like locking up whole ethnic groups in internment camps).  When the public is scared, power is to be had and it is the unusual politician that will say in such a situation that the right solution is to do nothing.
  • Political incentives not to admit error.  Politicians simply cannot admit error.  To some extent this is due to the personality and ego traits that the political process sorts for, and to some extent this is based on day to day political incentives.  But think about any President in your lifetime and try to think of even the smallest issue on which they said something like "I tried X, over time X has not worked and now I realize we should do something other than X."  We would actually hope this is the kind of person we have leading the country, but simultaneously our own behaviors don't allow it.  Presidents frequently admit past errors of others (eg, a current President saying the war in Afghanistan was a mistake) but they can never turn against any policy of their own.  So if, say, lockdowns were the response to wave 1 of the virus, lockdowns are damn well going to be the response in successive waves.  Because not doing so is essentially an admission that it was a mistake the first time.
  • If it bleeds, it leads.  This one takes little explanation, because I think most of us understand the strong incentives of news organizations to create and amplify emergencies to increase the attention and viewership they get.  Cable news had a huge spike in viewership after 9/11 and again in the early days of the Gulf War, and they are constantly jonesing for the same sort of hit.  Remember that the media has accurately called 11 of the last 2 pandemics, earlier predicting disaster from swine flu (dating myself here), bird flu, ebola, zika, mad cow, and probably several I can't remember.
  • Reference to personal circumstances when making national trade-offs.  I would say that the number 1 thing that drives me crazy about statists on the Left and Right and which makes me a libertarian is the tendency to impose solutions to tradeoffs on everyone in the country based on how you would personally make decisions for yourself.   If one-size-fits-all public policy decisions are going to be made, I want them to be made in a way that suits me.  For example, a politician in Chicago might say they would never feel comfortable letting thier kids walk to school on their own, so no parent should be allowed to let their kids walk to school alone.  Applying this to COVID, we know there is a large contingent in media, academia, and politics who will say that is is wrong to consider economic damage when evaluating COVID lockdowns.  What do all these folks have in common who tend to be advocating strongest for lockdowns?  They still have their jobs, are still getting paid, can still be productive over the Internet, and are comfortable getting their social interaction over zoom.  Note that these are the same folks that constantly tell us to check our privilege, but then tell us to ignore the economic hardships of lockdowns that they are too privileged to experience.  Only by the most extreme action do the voices of the less privileged who are suffering the most under lock-downs get heard (and even then, like the hair dresser in TX and later in SF, they get mocked by the elite).

Assumptions

  • Trump is so bad that no price is too high to get rid of him.  I have told folks for years that every generation thinks their current era is uniquely politically toxic.  I don't think we have yet risen even to 1968 levels of discord, but one exception is the hatred for Trump that exists in some quarters.  I personally have never seen anything like it.  The nadir was when Trump mentioned that HCQ looked like a promising COVID treatment and the governors of MI and NV immediately banned HCQ without evidence to make Trump look bad (a desire I assume stems from a perception that Tump is so dangerous and represents such an existential threat that any action to undermine him or make his re-election less likely should be pursued).  A prominent study was essentially made up out of whole cloth to prove HCQ was dangerous and thus Trump bad, a conclusion that should have made zero sense to everyone as HCQ is used by millions every day as a malaria prophylactic.   I find Trump distasteful but trust the American system to limit the damage of tyrants, but many are working from a very different assumption.
  • Humans have conquered nature.  I will confess to having an almost Victorian confidence in progress, but even I accept that sometimes nature throws things at us that are a) not our fault and b) we can't yet stop.  But throughout our COVID responses there seems to be, particularly in Western nations, an assumption that we should be able to prevent death from this thing -- ie that any death should be judged as a failure of our response.  But diseases still kill people.  Last year communicable diseases killed at least 15 million people in the world.  And many of our Western deaths have been among the very old in care facilities where the average life expectancy pre-COVID was numbered in months.

Information

  • Good cause skewing of data, or "fake but accurate."  Decades ago, there was a stat that there were a million homeless people in the US.  Everyone repeated it as gospel.  Someone tracked it down, and eventually discovered that it was just made up by a homeless advocate who just picked a round large number.  When this was presented to a well-respected reporter on NPR, that the "fact" she was quoting was no such thing, she just shrugged.  She said homelessness was clearly a problem and if the number she was quoting (as a reporter!) was exaggerated, then it was in the good cause of increasing attention to homelessness.  This was the first example I can remember of something that was considered fake but accurate, but there have been many more since.   During COVID, this has caused outlets like Goggle and Facebook to actually censor opinions the tend to be skeptical of the severity of the disease or efficacy of mitigation steps like lockdowns.  They claim to be doing so for a good cause, believing it is better to err on the side of having the public too cautious rather than insufficiently cautious.
  • Asymmetric public exposure to experts.  Throughout COVID we have been told that the experts all say X, that there is a consensus for X.  And sure enough, we mostly only hear X on the news.  But anyone in academia can tell you that this sort of homogeneity of opinion can't possibly be true.  As in other science, on issues such as mask or lockdown effectiveness or herd immunity thresholds, academics hold a wide range of opinions and there are a wide range of findings in the literature.  But this heterodoxy in opinions never really gets full public view due to media incentives, political incentives, and good cause skewing.  The most extreme voices on the end of the academic scale that support the media's and politicians' desire to create fear are selected for public exposure.  Then, these selected academics are retroactively crafted into leading experts.  Any of you folks every heard of Anthony Fauci before this started?  How about whatever expert your governor is using?  No, you had not -- these are prominent people in their field but just one of ten or twenty equally qualified persons who could have been selected and presented as experts.  They are then retroactively reinvented not as one of ten folks with a wide variety of opinions but as the one leading true unassailable expert.
  • Social media amplification of tail-of-the-distribution events.  One of the features of social media independent of these incentives is that it tends to spread and amplify tail of the distribution events/risks.  The problem is that there seems to be two personality types in people -- one, and I would include myself in this -- who are knee-jerk skeptical of such stories.  Did it really happen?  Did A really cause B?  Is this really anything more than one bizarre outlier?  But there is a second type of person, and I would say that they are WAY more prevalent than I would have believed a year ago, who sees a story that someone's gynecologist's hairdresser's uncle claimed to have had heart issues after getting COVID and suddenly "everyone who gets COVID has permanent heart damage!"  Even before the Internet, Americans were very bad at parsing relative risks and now they just seem terrible at it.

The COVID Rorschach Test and the Split in Thinking That Divides America (the Sweden tribe vs. the Whitmer tribe)

If you want to get right down to the core of the disagreement on responses to COVID, this post by Kevin Drum illustrates it perfectly.  Start with this:

My usual daily look at COVID-19 deaths was posted a few minutes ago, but I thought it might be worthwhile to also give you a quick look at COVID-19 cases. As you can see, they’re going up all over the place. Spain, France, and the Netherlands are skyrocketing. The United States skyrocketed back in July and looks like it’s now turning upward for a third time. The UK is going up, and so was Switzerland until a week ago, when it suddenly slammed the brakes on. Even Germany is rising a bit.

If we weed out exaggerated language like "skyrocketing" and ignore things like testing sensitivity and frequency, this statement is largely true.  The difference is how people interpret it, and the world splits into the Whitmer clan and the Sweden clan.  Drum speaks for the Whitmer tribe:

it sure looks as if even a modest re-opening quickly causes cases to boil over. ... Still, it’s obvious that we shouldn’t let up. The only way to keep cases and deaths down is to rigorously maintain social distancing precautions. If only we could get our president to agree.

For Drum and the Whitmer tribe, evidence that loosening of harsh lockdowns is followed by increasing COVID cases is proof that we should never stop lockdowns, at least until everyone is vaccinated with a vaccine that does not exist, may not exist, and will not exist for most of us until well into next year.

For those of us in the Sweden tribe, we come to exactly the opposite conclusion from the same evidence:  that lockdowns only pointlessly drag out the pandemic and artificially increase its costs, since no matter how long we hide, the disease is still there to infect us when we come out.  As I wrote last week:

All lockdowns do is delay the onset of the disease, not avoid it, and thus add severe economic dislocation, increased poverty, domestic violence, alcoholism, suicide and any number of other negative lockdown effects to the inevitable toll of the disease.  If we are doing anything at all to affect the course of the disease, we are stretching out the misery.

I go on to write that lockdowns make protection of the vulnerable harder.  I have two examples -- my 85+ year old mother-in-law and a bunch of immune compromised kids we support via Care Camps.  In both cases it's easy to keep them locked away for a few months.  But what happens when that stretches to 7 months?  Does my mother-in-law want to spend her all too precious remaining days locked inside?  Are we helping sick kids by essentially imprisoning them alone?

This may sound over-the-top, but I could argue that it is the duty of all of us who are under 60 and in good health to go out and risk exposure to the disease and get our society to herd immunity so the vulnerable can be safe and stop self-incarcerating.  I say this knowing the Mr. Drum may be among the immune compromised and particularly vulnerable.

My Now-Standard COVID Postscript:  I am not a fan of "check your privilege" retorts, but if one accepts that framework for a moment, one might notice just how privileged the exhortation to "Lock down, work from home, and stay in touch with friends over Zoom" really is.  Listen to the folks rooting for lockdowns and you will find that the vast majority

  • have professional jobs that can be done from home
  • continue to get paid even when they don't work at all (e.g. teachers and politicians)
  • have a lot of savings

A large number also tend to ignore the rules they foist on everyone else.

Update:  I am still working on data, but the declaration of second and third waves is often BS.  In most cases, these so-called second waves are the first waves in areas that were not affected earlier.  New York has had one wave.  Arizona has had one wave, just later.  Louisiana has had two waves, but it is a unique case due to the timing of Mardi Gras.

A Framework for Thinking About Lockdowns and Why They Are Counter-Productive

Warning:  I am not a trained expert on infectious diseases, just a well-informed person with scientific training and a bias towards skepticism.   If you are a scientific Catholic (meaning your science can only come from officially-designated authorities) rather than a scientific Protestant (which allows you to take responsibility for your own understanding of the universe) then you might as well skip to the next article.

Hypothesis 1:  It is impossible for a large population in a modern society to hide from the disease.  It might be possible to delay or slow the onset of the disease in the larger group, but until some sort of herd immunity exists, reservoirs of the disease will still remain and spark new infections.   For God sakes we still have whooping cough outbreaks in this country.  Look at COVID disease curve shapes for states and counties -- Some locked down early, some late, some hard, some not at all.  Some required masks and some didn't.  But all the curves look the same shape.

Corollary 1:  All lockdowns do is delay the onset of the disease, not avoid it, and thus add severe economic dislocation, increased poverty, domestic violence, alcoholism, suicide and any number of other negative lockdown effects to the inevitable toll of the disease.  If we are doing anything at all to affect the course of the disease, we are stretching out the misery.

Hypothesis 2:  Individuals can, with some decent probability of success, hide from the disease.  There are those who see a conflict between hypotheses 1 and 2, so let me address that.  There is a very old joke about two men who are camping and are awakened by a very large, angry, hungry bear.  One man starts putting on his tennis shoes.  The other says to him, "you can't outrun that bear" and the first man responds, "I don't have to outrun the bear, I just have to outrun you."  In this story, no matter how much running or hiding is done, its likely unavoidable that 50% of the men will get chomped, but individual action can influence who that 50% is.

Corollary 2:  While we cannot do much about ultimate COVID case counts, because the disease is so selective in who it tends to kill we CAN do a lot to limit the death toll.  We should be protecting seniors and other vulnerable people.  Everyone nods their heads to this.  But logically we should also be encouraging everyone else to get the disease and get us to herd immunity.  I don't want to overstretch the bear analogy, but imagine now that one of the two men were wearing a Kevlar suit.  That person needs to face the bear while the other runs -- the experience may not be pleasant for him, but he will probably survive and thus the total bear death toll will be reduced 100%.

A while back when I was active on Twitter, I wrote that instead of closing colleges, we should have opened them for 8 weeks this summer with no teachers and administrators -- Just leave them alone with a few truckloads of alcohol and condoms.  Soon an entire generation would be immune.  The death rate from COVID in healthy 20-year-olds is microscopic (it appears to be lower than the flu, which killed my 25-year-old nephew btw).  Instead we sent them all home from infection hotspots of NY and Boston to potentially infect grandma.

The best way to test a series of hypotheses that are crafted from historic data is to see if they continue to make sense going forward.  So I bring you this recent story on COVID and Hawaii:

After initially defying fears that its proximity to Japan and popularity with tourists might lead to a massive outbreak, Hawaii is finally facing its very own COVID-19 reckoning.

The state is now struggling with a genuine surge in the month of August after remaining at or near the bottom of the US league tables for the first four months of the pandemic.

For a small state with just 1.4 million residents, Hawaii has a total of 7,260 confirmed cases, 5,549 of which were confirmed within the last month, according to Johns Hopkins data. The state has gone from last or near last to No. 19 in terms of new cases reported daily over the past few weeks.

From mid-March to mid-June, the state saw an average of just 7.9 new cases reported per day. Last week, that average number climbed to 219.

This is terrible news for a state that, at the end of July, had the highest unemployment rate in the US (more than 13%) due to its reliance on tourism.

For me, given my hypotheses about virus responses, this is the least surprising story ever.  But apparently the "experts" are scratching their heads

One infectious disease specialist says the surge is surprising given Hawaii's geography, and the plunge in tourism-related traffic.

"As a public health professional, I expect this to look like New Zealand," he said, referring to the Pacific island nation that isolated itself and had few Covid-19 cases.

Postscript:  I am not a fan of "check your privilege" retorts, but if one accepts that framework for a moment, one might notice just how privileged the exhortation to "Lock down, work from home, and stay in touch with friends over Zoom" really is.  Listen to the folks rooting for lockdowns and you will find that the vast majority

  • have professional jobs that can be done from home
  • continue to get paid even when they don't work at all (e.g. teachers and politicians)
  • have a lot of savings

A large number also tend to ignore the rules they foist on everyone else.

Update:  Relevent to my sort of tongue in cheek college suggestion above

Good News on COVID No One Will Likely Report

  • Arizona ICU beds in use for COVID patients fell to 16%, the lowest number of beds in use for COVID since April 10.
  • COVID patients, even at the nationally ballyhooed Arizona peak, never reached 60% of ICU beds.   Total ICU capacity utilization never exceeded 91%  (note that these likely overstate the numbers, as a shooting victim who tests positive for COVID can be listed as a COVID patient).

Source

There is something weird about the COVID test and/or test process we are using in AZ.  We are still testing a lot of people every day and the test positive rate for the state is still high, like 5-8% each day.  But the number of new cases is falling rapidly to levels we last saw in May, and the number of hospitalizations have fallen into early April levels.  So what gives?

One anecdotal data point is an employee of ours who tested positive without symptoms (he has other medical issues that brought him into the hospital).  Weeks and weeks later he continues to test positive on followup tests and continues to be entirely asymptomatic.   My hypothesis is that we are retesting the hell out of people and using a test that is overly sensitive and does not really indicate disease activity.

One other note on this same fellow -- he and we are in somewhat of a bind on his employment.  We are working under contract to a division of the Federal government and they require that employees test negative before they return to work.  Many corporations have the same internal policy.  So what do folks in this situation do?  They are likely perfectly safe to everyone but can't get a negative test.  Do they ever get to work again?

AZ Finally Comes Up With A Better Way to Show COVID-Related Hospital Capacity

Now that the COVID wave in Arizona is receding, the ADHS Data Dashboard finally has come up with a better way to show COVID-related hospital bed use.  Had this been in use at the peak, I think the general panic about overwhelmed hospitals might have been reduced.  I would consider this serious but not disastrous, with some squeezing out of less urgent or delay-able procedures but still with substantial non-COVID capacity remaining.

 

Postscript:  I have an acquaintance, a man in his late 70's, who passed away this week.  He had a long history of heart issues and had something go wrong again.  The ICU in his area of California was apparently full -- could have been COVID, could have been the fires in the area, but he had to be flown to another.  He passed away at the new location, and I don't know if the ICU shuffle was the cause or a contributor but it certainly did not help.  So I am not arguing ICU loads are not important -- this is why we all were mostly OK with "flatten the curve" (but not necessarily with "hide for months or years until the disease completely goes away").  But the situation has been grossly exaggerated to scare people and that makes me angry.

Well, So Much for Medical Privacy

I got this in my email today from the state of New Mexico:

Dear Employer,

As of Wednesday, August 5, 2020, the New Mexico Environment Department (NMED) filed an emergency rule that requires employers to report positive COVID-19 cases to NMED within four hours of being notified of the case. The employer must notify NMED by email at:

Email: NMENV-OSHA@state.nm.us

This kind of thing actually makes it harder for us to keep our workplace safe.  We depend on our employees completing a daily health self-assessment each day and the only way we could coax a number of them into being honest on this survey was to promise them that a) we would take care of them financially through any quarantine and b) their self-assessment would remain confidential.  But now it can't remain confidential in NM.  This is going to make it much harder for us to get honest information from our employees on potential infection, as they are all worried about  -- as they put it -- getting into some government system.  Arguing that this fear is irrational (and I am not sure it is entirely in a world where mayors are turning off power and water to homes they don't obey them) is beside the point, as it is a fear they have and will prevent an honest discussion with some.

Wait, You Mean That the Economic Damage From COVID Lockdowns DOES Matter?

As I mentioned last week on twitter, I have retreated from that platform for a variety of reasons and will focus again on long-form blogging of the style this site has been pursuing for 16 years.

For the last several months, I have been a lockdown skeptic, at least for the healthy population under 55 or 60 years old.  I will confess my early tendency toward skepticism was driven as much by the behavior of lockdown hawks as any data or knowledge on my part.  Whenever I hear appeals to authority, use of non-transparent computer model results as facts, politicization of scientific positions, and restrictions on dissent in any scientific issue, I immediately get skeptical of the orthodox position.  As I have watched things unfold, I am increasingly convinced that this virus is (like most new viruses in history) going to run its course until large sections of the population have gained immunity.  Lockdowns, while they may have salutary effects in preventing hospitals from being overwhelmed, just seem to be delaying the inevitable -- when we come out of hiding, reservoirs of the disease are still there and infections mount again.  "Flatten the curve" made sense to me, but that seems as far in the past of political rationals as does the Tiger King mania.

But to some extent my opinion on lockdowns does not matter.  The one thing I AM sure of is that, whether lockdowns are effective or not, it is perfectly reasonable to balance the costs of such interventions against their benefits.  But I remember clearly when this commitment to making thoughtful tradeoffs marked one as practically Hitler.  Many of our intelligentsia, particularly on the Left, argued that it was immoral even to consider effects on the economy of COVID interventions.  I always thought this was ironic, because the worst economic effects were sure to hit lower income folks first -- they had jobs you had to, you know, show up for and they had less savings to weather the storm.   Paraphrasing one of my commenters, "Stay at home, work remotely by computer, and keep up with your family on Zoom" has to be one of the most white privilege government orders ever.  But nevertheless there was the Left self-righteously advising exactly this, with pundit after pundit who had portable jobs writing on a computer criticizing any hair dresser who wanted to actually be able to ply their trade as well.

So I was floored when I saw these charts on Kevin Drum's site as part of a criticism of the Republican reluctance to extend rich unemployment benefits:

You know what my reaction to these charts is?  No sh*t, Sherlock.  Many of us warned of EXACTLY this when the lockdowns began.  And folks on the Left treated our warning as not just irrelevant but evil. They would say, "How can you be so callous as to suggest jobs are more important that lives?"

But wait, now the economic impact of the lockdowns IS a problem?  I refuse to defend the Republican morons in Congress or the White House, but I can say that many of them warned of exactly this problem with the lockdowns while the Democrats were full steam ahead on economic shutdown.  I could accept Drum's post as self-criticism of the sort like "Wow, I really underestimated this when I was advocating for lockdowns" but now, he uses this as a platform to blame other people for the problem.

Libertarians have often highlighted how the government tends to create problems by their actions and then gains more power by saying that it needs to fix the problem its own actions created.   I can't imagine we will ever have a better example of this effect -- here is Drum advocating that the government simply must send more money to help people who were willing, even eager, to work but were not allowed to do so by the government.  COVID has been a socialist dream, converting payment for productive work to payment for breathing.

And let's discuss the exact program he is advocating.  He wants an extension of the Federal unemployment supplement of $600 a week which takes most state benefits to $1000 to $1200 a week.    Realize that is $50,000 to $60,000 a year we are paying people to not work (one only qualifies for these benefits if one does not work -- take a job and they are gone).  Look at the former income levels in his chart -- who is going back to work with this kind of government payment?  We are training people that they should be paid this much for not working and encouraging them not to seek actual employment -- this is a terrible message (and one reason a UBI makes far more sense if we are going to transfer this much money).   I think this is contributing somewhat to the position of the teachers' unions.  The public game now is to get paid and not work.

We have 13+% unemployment and our company has to struggle to hire anyone in these conditions.   I posted this on twitter as a comment on a Paul Krugman post, and his followers dutifully lined up to tell me that it was because I did not pay a fair wage.  People are making $25-$30 an hour on unemployment.  I thought $15 was our idea of "fair" -- are we really going to set $30 as our minimum wage?  Will anyone be employed?

Postscript:  I have one other rant related to employment and COVID.   Every blue check mark and Hollywood star bends over backwards on every occasion to thank health care workers during the pandemic.  Good, I agree, health care work is particularly fraught right now.  But you know who else worked through the pandemic?  I will give you a hint:  I bet you never had problems filling your car with gas, that you always had gas and electricity at home, and that (with a few brief exceptions) you always had plenty of food choices.  There are a lot of folks out there who showed a lot of commitment during COVID on whom we rely, and a lot of them are in industries (oil, manufacturing, farming) the elite of the Left tends to look down its nose at as backwards and inferior.

Postscript #2:  I am well aware that Drum has had significant medical issues that make him likely particularly vulnerable to this virus.  I am thrilled that he has a career he can pursue without endangering himself via public contact.  Our family made certain choices we might not have to protect my 85 year old mother in law.  But I am exhausted with people applying their own personal preferences and risk trade-offs to others who may be in very different situations.

Another Climate-COVID Computer Modelling Similarity

In this post, I wrote about parallels between climate and COVID alarm and related issues of computer modelling.  I realized I left out at least one parallel.

In the world of climate, computer model results are often used as the counterfactual case.  Let me give you an example.  The world has warmed over the last 100 years at the same time atmospheric CO2 concentration has increased.  Obviously, to truly judge the effect of CO2 on temperatures, we would like to know what the temperatures would have been over the last 100 years without rising CO2 concentrations.  But we don't have thermometers that read "with" and "without" CO2.

I remember I got caught up in this years ago when I published an analysis that showed that estimates of temperature sensitivity to CO2 concentrations used in projections going forward greatly over-predicted the amount of warming we have seen already.  In other words, there had not been enough warming historically to justify such high sensitivity numbers.  In response, I was told that alarmists considered the base case without CO2 increases to be a cooling world, because that is what some models showed.  Compared to this cooling counterfactual, they argued that the warming from CO2 historically had been much higher.

By the way, this argument always gets to be very circular.  When you really dig into the assumptions of the counter-factual models, they are based on assumptions that temperature sensitivity to CO2 is high.  Thus models predicated on high sensitivity are used to justify the assumption of high sensitivity.

I thought of all this today when I saw this post on COVID models and interventions from Kevin Drum.  I read Drum because, though I don't love his politics, he is more likely than most team-politics writers from either the Coke or Pepsi party to do a reasonable job of data analysis and interpretation.  But I have to fault him for this post, which I think is just terrible.  You can click through to see the chart but here is the text:

At the end of March, the highest estimate for [NY State] hospitalizations was 136,000+. Today the peak is estimated at about 30,000. That’s a difference of 5x. Did the modelers screw up?

Not really. Remember the Imperial College projections for the United States? They estimated about 2 million deaths if nothing was done; 1 million deaths if some countermeasures were taken; and 200,000 deaths if stringent countermeasures were taken. That’s a range of 10x. If you figure that we’ve taken fairly stringent countermeasures but not the maximum possible, then a reduction of 5x is about what you’d expect. Alternatively, if you ignore the Columbia University projection as an outlier, the IHME estimate has only gone down by about 2x. That’s what you’d expect if we took countermeasures that were just a little more stringent than their model assumed.

At the end of March it was still not clear how stringent and how effective the coronavirus countermeasures would be. In the event, it looks like they worked pretty well, cutting cases by at least 2x and possibly more. This is why the model estimates have gone down: because we followed expert advice and locked ourselves down. Just as we hoped.

Treating the early model estimates as if they are accurate representations of the "no intervention" counter-factual is just absurd.   It is particularly absurd in this case as he actually quotes a model -- the early Imperial College model -- that is demonstrably grossly flawed.  He is positing that we are in the Imperial College  middle intervention case, which estimated a million deaths in the US and is likely to be off by more than an order of magnitude.  Given this clear model/estimate miss, why in the world does he treat early Columbia and McKinsey models as accurate representations of the counter-factual?  Isn't it at least as likely that these models were just as flawed as the Imperial College models (and for many of the same reasons)?

The way he uses the IHME model results is also  flawed.  He acts like the reductions in the IHME estimates are due to countermeasures, but IHME has always assumed full counter-measures so it is impossible to use the numbers the way he wants to use them.

Parallels Between COVID-19 Alarm and Global Warming Alarm

So I finally had a day or two of downtime from trying to keep my business afloat (it's weird reading all the internet memes of people at home bored when I have never been busier).  I wondered why I was initially, and remain, skeptical of apocalyptic COVID-19 projections.

I have been skeptical about extreme global warming and climate change forecasts, but those were informed by my knowledge of physics and dynamic systems (e.g. feedback mechanics).  I have been immensely skeptical of Elon Musk, but again that skepticism has been informed by domain knowledge (e.g. engineering in the case of the hyperloop and business strategy in the case of SolarCity and Tesla).  But I have no domain knowledge that is at all relevant to disease transfer and pathology.  So why was I immediately skeptical when, for example, the governor of Texas was told by "experts" that a million persons would die in Texas if a lock-down order was not issued?

I think the reason for my skepticism was pattern recognition -- I saw a lot of elements in COVID-19 modelling and responses that appeared really similar to what I thought were the most questionable aspects of climate science.  For example:

  • We seem to have a sorting process of "experts" that selects for only the most extreme.  We start any such question, such as forecasting disease death rates or global temperature increases, with a wide range of opinion among people with domain knowledge.  When presented with a range of possible outcomes, the media's incentives generally push it to present the most extreme.  So if five folks say 100,000 might die and one person says a million, the media will feature the latter person as their "expert" and tell the public "up to a million expected to die."  After this new "expert" is repetitively featured in the media, that person becomes the go-to expert for politicians, as politicians want to be seen by the public to be using "experts" the public recognizes as "experts."
  • Computer models are converted from tools to project out the implications of a certain set of starting hypotheses and assumptions into "facts" in and of themselves.   They are treated as having a reality, and a certainty, that actually exceeds that of their inputs (a scientific absurdity but a media reality I have observed so many times I gave it the name "data-washing").  Never are the key assumptions that drive the model's behavior ever disclosed along with the model results.  Rather than go on forever on this topic, I will refer you to my earlier article.
  • Defenders of alarmist projections cloak themselves in a mantle of being pro-science.  Their discussions of the topic tend to by science-y without being scientific.  They tend to understand one aspect of the science -- exponential growth in viruses or tipping points in systems dominated by positive feedback.  But they don't really understand it -- for example, what is interesting about exponential growth is not the math of its growth, but what stops the growth from being infinite.  Why doesn't a bacteria culture grow to the mass of the Earth, or nuclear fission continue until all the fuel is used up?  We are going to have a lot of problem with this after COVID-19.  People will want to attribute the end of the exponential growth to lock-downs and distancing, but it's hard to really make this analysis without understanding at what point -- and there is a point -- the virus's growth would have turned down anyway.
  • Alarmists who claim to be anti-science have a tendency to insist on "solutions" that have absolutely no basis in science, or even ones that science has proven to be utterly bankrupt.  Ethanol and wind power likely do little to reduce CO2 emissions and may make them worse, yet we spend billions on them as taxpayers.  And don't get me started on plastic bag and straw bans.   I am willing to cut COVID-19 responses a little more slack because we don't have the time to do elaborate studies.  But just don't tell me lockdown orders are science -- they are guesses as to the correct response.  I live in Phoenix where it was sunny and 80F this weekend.  We are on lockdown in our houses.  I could argue that ordering everyone out into the natural disinfectant of heat and sunlight for 2 hours a day is as effective a response as forcing families into their houses (initial data, though it is sketchy, of limited transfer of the virus in summertime Australia is interesting -- only a small portion of cases are from community transferBy comparison less than a half percent of US cases from travel).
  • In both cases, advocates of the precautionary principle seem to rule the day.  I would argue that in practice, the precautionary principle means that any steps that might conceivably limit something bad should be pursued irregardless of cost.  You see a form of this all over social media, which folks arguing that it is wrong to balance deaths against money, and any life spared is worth the cost.  But this is absurd two at least two reasons
    • First, unemployment and economic recession have real, proven effects on mortality.  Shut down the economy to reduce CO2 or virus spread, and people will die
    • Second, if we really followed this principle for everything we would be back in the stone age.  Take the flu.  15,000-20,000 people will die of the flu every year in the US -- my healthy 25-year-old nephew died of the flu.  Are we going to shut down the economy next year in flu season?  It would reduce flu deaths.  Or take the 37,000 people killed each year in the US in motor vehicle accidents.  With the lockdowns, that figure is certainly reduced right now.  Should we just shut down the economy forever, it sure would reduce car fatalities?
  • And of course there is the political polarization of what should be scientific opinion.  The Nevada and Michigan governors initially banned chloroquine treatment strategies for no good reason other than the fact that Trump publicly highlighted them as promising.

Update:  Prediction from climate applied to COVID-19:  No one will go back and call out widely-used models for failing to accurately model the disease or attempt to learn from their mistakes.  If it is ever mentioned that these models grossly over-estimated deaths, it will be forgiven as being exaggeration in a good cause.  (Somewhat related, Bryan Caplan on Social Desirability Bias)

Please Honor Social Distancing Rules, Even if You Are Skeptical of the Risk

I write this because I have been publicly skeptical of some of the COVID-19 responses.  But be that as it may, the decision has been made to go all-in on social distancing.  I am fully participating, whatever my personal beliefs are about risk.  Our family is staying isolated and wearing masks and gloves when we need to go into a store -- not because we are scared but because we are participating.  These sorts of things are much easier to do when everyone else is doing them, and more effective as well.

In places like Phoenix that is lightly hit by the virus and in rural areas where my company operates that have been hit not at all (e.g. zero cases in the county), a lot of folks are not playing along.  It would be heartbreaking to crash the economy and double the government debt only to have this thing still drag out because folks couldn't put neighborhood barbecues on hold for a few weeks (yes, I have seen several).

Update from a long-time reader:

The claimed purpose of quarantine is to create a gap in a long line of transmission. While it can be quite effective, the quarantine time does not really start until EVERYONE stops moving around. As long as even a few still move between isolated groups, those groups are not actually isolated at all. This means that failure to self quarantine lengthens the required quarantine period of all who actually comply. I would like this to be over, the sooner the better.