Covid vaccines may have saved 2,000,000 American lives

 How effective are the Covid vaccines? Here's some new data:

A team of epidemiologists and infectious disease specialists at the University of California, San Francisco (UCSF) and the California Department of Public health developed two different data-based models of the course of the Covid pandemic in California in the ten months after vaccines became available. They published their results in the April 22, 2022 edition of the prestigious Journal of the American Medical Association.

Projected Covid deaths without vaccination
(Image by Eric C. Schnieder, et al.)   Details   DMCA

Their first model estimated that during the ten months prior to October 16, 2021, Covid vaccinations in California averted 1.52 million infections, 72,930 hospitalizations and 19,430 deaths.

The second model estimated that during those same ten months, vaccinations prevented 1.4 million Covid cases, 84,330 hospitalizations and 22,620 deaths.

The researchers limited themselves to pointing out that these results "can be generalized across the United States." We can take a stab at doing that if we assume that the vaccines averted cases, hospitalizations and deaths at roughly the same rate across the country as they did in California. By the end of the study period, 23,800,846 Californians were fully vaccinated. At that same time 188,902,483 Americans had been fully vaccinated, or 7.94 times the number in California alone.

Multiplying by that factor, the vaccines conservatively averted 11,116,000 Covid cases, 579,064 hospitalizations and 154,036 deaths in the US in the first 10 months of their availability.

On February 25 of this year I posted an OpEdNews article providing a count--based on the actual differences between week-by-week death rates among unvaccinated and vaccinated people--of how many American lives the Covid vaccines had saved to that date.

My estimate was that 545,000 Americans were still alive because they had gotten vaccinated. It's important to note that those only represented lives saved directly by the vaccines, not infections, hospitalizations or deaths averted among the contacts of people who stayed healthy because they were vaccinated.

Similarly, the UCSF researchers note that their estimates only count people whose lives were saved because they were vaccinated--direct lives saved. They point out that many more Covid infections, hospitalizations and deaths were doubtlessly averted among the contacts of vaccinated people. "The true numbers are definitely significantly higher," says lead author Sophia Tan, at UCSF.

To get a sense of how just how much higher, we have a new study by the Commonwealth Fund, a century-old private foundation that promotes effective and equitable health care in the US. They used a highly detailed model that, along with many other factors, accounts for contagion, hospitalization and deaths within people's contact networks. Their study provides estimates through March, 2022.

Those researchers estimate that Covid vaccinations have probably prevented more than 66 million infections, more than 17 million hospitalizations and more than 2 million deaths in the United States.

Given the high cost of health care in the US, we shouldn't be surprised that, according to the Commonwealth study, averting those millions of infections, hospitalizations and deaths saved some $900 billion--that's nearly one trillion dollars--in healthcare costs.

As of April 25, 2022, the US has suffered just under one million Covid deaths. If the 219 million Americans who are fully vaccinated had chosen not to, the number of US Covid deaths would have been much higher, perhaps approaching a shocking 3 million.

The Covid pandemic is at low ebb right now, but it has not disappeared. The vaccines are readily available and free. If you're among the one-third of Americans who have not yet gotten vaccinated, it's not too late to protect yourself and the people you are close to.

STILL DEBATING A COVID VACCINE? HERE'S SOME CRYSTAL-CLEAR DATA FOR YOU

As of the end of August, 2021, 51 percent of the US population have been fully vaccinated for Covid-19. That means that 49 percent have not, despite the vaccine being widely available and free. Still, 61 percent have gotten at least one shot, so that leaves "only" 39 percent of the US population who have so far chosen not to seek or accept Covid-19 vaccination.

That means that more than 129 million Americans remain un-vaccinated, giving the SARS-CoV-2 virus, and especially the highly contagious delta mutant more than enough unprotected targets to continue to cause widespread illness, hospitalizations and death. Those 129 million unvaccinated people also comprise an enormous human petri dish in which the virus can continue to multiply and mutate.

Vaccination vs. hospitalization by state

Credit: NYT

Just in case some of those 129 million might be amenable to real-life, on-the-ground data about the life-saving benefits of the vaccine, here are some brand-new, nation-wide county-by-county research findings:

                                                                          Credit: Jeffrey Harris, MD

Jeffrey Harris, a physician and emeritus professor of economics at the Massachusetts Institute of Technology, gathered data on vaccination rates, Covid-19 case rates and Covid-related hospitalizations in the 112 most populated US counties, a total of 147 million people. He used vaccination data as of mid-July, 2020 and compared them to Covid cases and hospitalizations between July 30 and August 12. You can read a pre-print of the research report here.

The results are striking. 

In the 56 counties in the lower half of the vaccination range, there were 548 cases per 100,000 population during the two-week study period, but just 281 cases per 100,000 in the 56 counties in the upper half of the vaccination rates. 

People in the less-vaccinated counties suffered 1.95 times as many diagnosed Covid-19 cases than people in the more-vaccinated counties.

A ten percent increase in vaccination rate correlated with a 28.3 percent reduction in Covid-19 cases.

The difference in Covid-caused hospitalizations in less- compared to more-vaccinated counties was even more dramatic. In the 56 less-vaccinated counties there were 55.4 hospitalizations per 100,000 people during the two-week study period, compared to 20.5 per 100,000 in the more-vaccinated counties. 

That means that for every hospitalization in the more-vaccinated counties, there were 2.7 hospitalizations in the less-vaccinated ones.

A ten-percent increase in vaccination rate correlated with a whopping 44.9 percent decrease in Covid hospitalizations.

So what's the bottom line of this large, detailed nationwide study? Basically, any region that can get 10 percent more of its citizens to get vaccinated can expect to cut its Covid case rate by 28 percent and its Covid hospitalization rate by 45 percent.

Lets translate those reductions in Covid cases and hospitalizations into lives saved:

In the US to date, we've suffered 39,662,129 confirmed Covid-19 cases. Among those, 2,675,000 have been hospitalized and 654,668 people have died. 

That means that for every 100,000 US cases, we're likely to see 1650 deaths. 

Thanks to an incredibly quick learning curve within the medical profession, the percentage of Americans who survive after being hospitalized for Covid-19 increased from 78.9 percent in early 2021 to 93.5 percent in August. Still, that means that even now the death rate for hospitalized Covid patients is 6.5 percent, meaning that out of every 100,000 Americans hospitalized for Covid, 6500 are likely to die.

As of the end of August, 2021, the US is registering more than 140,000 new Covid cases per day, or 980,000 per week. We're seeing an average of 12,297 new hospitalization per day, or 86,079 per week, and 1163 deaths per day, or 8,141 deaths per week.

Looking just weeks into the future, this study tells us that if just 10 percent of the 129,000,000 un-vaccinated Americans were to get vaccinated, we could avoid approximately 275,000 new Covid-19 cases, prevent 38,650 hospitalizations, and save at least 2500 lives--every week!

Dr. Harris believes we can do this. He says that among his patients he has encountered many "reasons" for not getting vaccinated. He recognizes that some people are "encapsulated in a misinformation bubble from which there seems to be no escape." Others, however, may be reachable, especially if there are tangible, real-life consequences to not be being vaccinated, such as loss of a job or not being able to enter restaurants or other businesses. 

"I expect many will come around," he says. Let's hope he's right.

Worth getting the jabs? You decide.

-----

REA/8-29-21

Vaccination rates ranged from below 30 percent in three counties in Georgia to over 65 percent in several counties in Maryland, Massachusetts, California and Washington. 

VOTING FOR COVID

If we needed any proof that people's political beliefs shape their reality, this graph from the New York Times provides it:

Credit: NYT, 4/18/21

On the left, appropriately, are the states in which more people voted for Biden in 2020, and on the right, states with more Trump voters. Vaccine hesitancy rates range from less than 10% in true-blue Vermont and Massachusetts to over 30% in true-to-Trump Wyoming. The Times didn't provide a regression line or a correlation coefficient, but having dealt with lots of graphs of this kind, I can say that it's the kind of distribution any researcher would be thrilled to see. 

We're now seeing real-world data showing that fully vaccinated Americans have about one chance in 10,000 of contracting COVID-19, while their un-vaccinated fellow citizens have close to one chance in 10 of catching the virus, and among those who do, close to two percent will die. If the political beliefs reflected in this chart continue to determine vaccination rates, we're going to see two Americas. One that's highly vaccinated, where there's low risk of catching COVID, and where people can return to their normal personal, social and economic activities.  In the other, poorly vaccinated America, people may also be returning to their normal activities, but they'll be doing so with a continued high risk of illness and death from COVID.

Will that contrast wake people up or change many minds.? I doubt it.  As evidence, check this story of death-by-denial, although it's from Norway, not North Dakota.

HOW IS THE US DOING VS COVID-19 COMPARED TO THE REST OF THE WORLD?

 Just a quick note as of Sunday, October 11, 2020.

Credit: geralt/pixabay

The US has 4.25% of the world's population.

To date we've suffered 21.17% of the total recorded cases of Covid-19. That's 7,958,612 documented cases in the US.

But we have a great medical system, so our death rate is much lower, right?

Sorry, but our death rate is almost identical, 20.03% of the total deaths. That's 219,343 Americans who have died from the coronavirus in the nine months since the first documented case, January 20, 2020. That represents an average of 828 covid-19 deaths per day, or almost 5800 per week.

For another comparison, so far documented cases for the whole world equal 4,833 cases per million people. In the US we've chalked up 24,005 cases per million. We've had just under 5 times as many cases per million.

The world as a whole has incurred 139 documented covid-19 deaths per million. The US 662. The US has suffered 4.76 times as many deaths per million.

You can draw your own conclusions as to how we're doing and who's responsible.

Here's my nominee:

THE CORONAVIRUS AS A REALITY CHECK

To paraphrase a quote usually attributed to Abraham Lincoln:

You can fool all the people some of the time and some of the people all the time, but you cannot fool a virus.

                                                     The coronavirus--"It is what it is."

                        Credit: NIAID

As historian Yuval Noah Harari brilliantly explains in Sapiens: A Brief History of Humankind, it's our uniquely human capacity to believe in shared fictions such as the value of money or the necessity for daily prayers that sets humans apart, allows millions of strangers to cooperate, but that also divides us into adversarial and sometimes murderous tribes. 

As symbol-using animals, we are able to convince ourselves of all kinds of ideas, from bible stories to trickle-down economics and act by the millions or hundreds of millions as if they were real, sometimes defending them with our lives (or all too frequently the lives of others). 

It's belief in a shared narrative that lets you go to an ATM anywhere in the world and retrieve a handful of paper for which a merchant will hand you actual food or clothing. But that same propensity to accept and believe in pervasive, communal myths also means you may not be able to share a Thanksgiving meal with friends or relatives on the other side of a political or ideological fence. 

We humans swim in a sea of memes, concepts, ideas and narratives, and we're usually as unaware of it as fish are of the ocean. 

In stark contrast, the coronavirus is completely immune to the web of narratives that we clever, cognitive, symbol-using humans weave within and around and ourselves. It has no ears so it doesn't hear that it will surely be defeated next week, month or year.  It has no eyes so it isn't deflected or deterred by what we see on our screens or read on the signs so proudly displayed at political rallies. It can't be seduced, bribed, bullied, browbeaten, bargained with or bought off. 

All the virus has is a genetic code that equips it to infect one person, multiply, turn that victim into a vector, sicken or kill, and spread. To the coronavirus we are not republicans or democrats, billionaires or beggars, sentient, sophisticated, symbol-using beings; we're just meat. That's the truth, and as Ghandi said, " . . . truth overrides all our plans."

As President Trump so succinctly pointed out, the coronavirus is what it is. Precisely because of that it has the potential to serve as a painful and costly yet vital teacher to us. It can be the "whack on the side of the head" that awakens us to reality, to the ground truth behind the crazy-making swarm of buzzwords, memes, slogans and contradictory narratives that befuddles us. 

I doubt that Trump, now personally suffering from the virus, will get the message. More than anyone else I know of, he seems to believe that he can impose his will on reality. He's spent his life mastering an armamentarium of manipulations that have worked to get him what he wants and where he wants to be.  My guess is that he has travelled too far down the ever-narrowing tunnel of narcissism to turn back. If he survives his bout with Covid-19, my guess is that he will brag about his superior genes and tell us how his resilience and toughness let him beat the virus.

However, that doesn't mean that the rest of us can't benefit from the raw reality that the virus makes us face. Beyond taking the by-now-well-known steps to protect ourselves and others from the virus, it can and should prod us to question our assumptions and preconceptions, to search for and be open to facts, to remember that there's an actual reality that we can strive to know and have to respect. 

It's worth noting that we have access to a highly developed methodology for doing that. It's called science. Scientists have spent centuries honing tools to track fact to its lair by stripping away as many as possible of the myths, wishes and cognitive biases we project onto it. They too spin their theories, but they constantly check them against reality. We need to listen to them, not just about the coronavirus, but about the increasingly urgent threats of climate destabilization and ecological collapse.

Rather than groping and wandering in a fog of myths and memes or choking on the smog of outright lies, let's use this implacable virus to spur us to at least start the hard climb to where we can breathe the cold but bracing air of truth.

-----

REA

A SOURCE FOR ACCURATE AND UP-TO-THE-MINUTE CORONAVIRUS/COVID-19 STATISTICS

 If you want to keep track of how many Covid-19 cases and deaths have occurred worldwide, country-by-country or state-by-state in the US, the best source I've found is https://ncov2019.live/.

Credit: Avi Schiffmann

The site was created and is maintained by a remarkable high-school student named Avi Schiffmann. It's updated in real time, and provides an accurate, detailed basis for understanding how the pandemic is progressing and changing worldwide.

-----

REA

COVID-19 IN THE US--WHEN CAN WE STOP BEING EXCEPTIONAL?

The following statistics come from ncov2019.live/,  a great source for up-to-the-minute covid-19 data.

I'm just going to present some of the numbers as of September 4, 2020. You can come to your own conclusions.

The US represents 4.3 percent of the world population.

We've had 24 percent of the recorded Covid-19 cases in the world. 

We've had 2.2 million more cases than India, the next most impacted country, India's population is more than four times that of the US.

We've suffered 22 percent of the world's Covid-19 deaths; 191,221 as of 9/4/20.

Credit: Pixabay

Covid-19 deaths per million population as of 9/4/20


Peru                                            890
Belgium                                      853
Spain                                          629
United Kingdom                        611
Chile                                            600
Italy                                             588
Brazil                                           587

UNITED STATES                      578     

Sweden                                        577
...      
                                    
Japan                                           471
France                                         470
...

Netherlands                                364
Ireland                                         359
...

Norway                                        264
Canada                                        243
South Africa                                245
Switzerland                                 232
Argentina                                    209
...

Russia                                           121
Germany                                      112
Denmark                                      108


WORLD                                        113

...

India                                                 50
Norway                                             49
Australia                                           29
Hong Kong                                       13
Singapore                                           5
China                                                  3
Iceland                                                0

To save you the calculations, the US has suffered 5.12 times as many deaths per million than the world as a whole.

Given that we've lost 191,388 people to Covid-19 as of today, if we had managed to just be mediocre, to keep our death rate down to the global average, we would have saved nearly 150,000 lives. Wouldn't it be great just to be average?

In comparison, here are some statistics about US war casualties:

Persian Gulf War       2,586

Korean War               36,574

Vietnam                      58,220

World War I             116,516

World War II           405,399

--------

And I'll add 9/11         2,977     
-----

REA

GOING CORONAVIRAL-- A COMMENT ABOUT EXPONENTIAL GROWTH

We humans are pretty good at understanding linear change. It's all around us:

--eat more, gain some weight; eat less, lose some weight
--press on the gas pedal, speed up; press on the brake, slow down
--turn up the heat, feel warmer; turn down the heat, feel cooler
--someone can't hear you, talk louder; someone moves closer, talk more softly
--and thousands of other daily experiences in which a small change produces a small result and a larger change produces a larger result.

However, some events don't behave linearly. There are situations where a small change can quickly produce a big effect. We're living through at least two of them right now--climate change and the Covid-19 pandemic. We're failing miserably in understanding and dealing with both of them.

A sneeze--a few tiny droplets can cause massive disruption

Photo credit: CDC

Let's do a little math--please bear with me:

Step number     Linear growth (n x 2)     Exponential growth (2 to the n) 

         1                        2                                                    2                                       
         2                        4                                                    4                                         
         3                        6                                                    8                                         
         4                        8                                                   16                                       
         5                      10                                                   32                                       
         6                      12                                                   64                                       
         7                      14                                                 128                                       
         8                      16                                                 256                                         
         9                      18                                                 512                                         
       10                      20                                               1024 
       11                      22                                               2048                                     

Let's pretend that these numbers represent two different responses to the Covid-19 virus.

The steps might represent weeks. The first column might represent a situation where the virus is fairly well controlled (e.g. through some combination of social distancing, mask wearing, testing, tracing and isolating people likely to shed the virus). On average one infected person infects approximately one other person, with the result that the number of cases grows linearly. The third column represents exponential growth--where the virus truly is "going viral." All that takes is for one infected person to pass the virus on to more than one new victim.

Notice the enormous and rapidly expanding difference as the weeks tick by. At week three, exponential growth has infected just two more people than in the linear growth model, but at ten weeks the difference is more than 1,000, and one week later, more than 2,000.

So, our first takeaway is that when we're dealing with any situation involving exponential growth, at first it's hard to distinguish from a normal linear situation that we're used to, but sooner or later it takes off explosively.

Now let's examine that phrase "sooner or later."

      Week    Doubling stopped sooner           Doubling stopped later
         1                        2                                                    2                                     
         2                        4                                                    4                                       
         3                        8                                                    8                                       
         4                      16                                                   16                                       
         5                      18                                                   32                                       
         6                      20                                                   64                                       
         7                      22                                                 128                                       
         8                      24                                                 256                                         
         9                      26                                                 258                                         
       10                      28                                                 260 
       11                      30                                                 262
Total Cases:          198                                               1290

What a difference a delay makes.  This might represent two states, one of which sees the exponential handwriting on the wall after just four weeks, institutes effective controls and ends up with 198 cases, while the other delays control measures one month more and ends up with with 6.5 times as many cases. (Or these numbers could equally well represent deaths, in which case that one month delay would have caused over a thousand needless deaths.

Obviously the numbers above are meant to be an illustration; they don't match exactly with the real world. However, you can see this in the real world if you compare the impact of a one-week delay in responding to the pandemic in New York vs. California. Here's a zerospinzone.blogspot post from March 30:

In this comparison of coronavirus cases in New York vs California, you can see what difference even a few days lag in imposing strict stay-at-home orders makes. California--population 39.5 million, first state to impose strict controls: current # of cases 6358, deaths 132. New York--population 19.5 million, delayed a week before imposing controls: current # of cases 60,679, deaths 1063. The number of cases per population in NY is 19 times greater than in California, and the number of deaths per population 17 times greater. What a tragic difference a week's delay makes.

A lot has happened in New York and California in the subsequent three months, with start-and-stop openings and closings in both states. Through all that, however, California has managed to keep a tighter lid on the explosive potential of the coronavirus. As of today, June 28, New York has documented 416,769 cases and 31,483 deaths while Callifornia has had 215,575 cases and just 5,934 deaths. Adjusted for population, late-starting New York has suffered nearly four times as many cases and more than ten times as many deaths as California. Clamping down just one week earlier in California almost certainly saved tens of thousands of lives.

Our second takeaway, then, is that when dealing with the potential for exponential growth, getting control of the rate of growth as early as possible--before the number of cases explodes-- makes a huge difference.

It's pretty clear that we, as a species, aren't very good at dealing with things that have the potential for exponential growth, and so can blast out of control at any time.  We're seeing the results of this globally as we try to put a cap on the coronavirus. Similarly, experts have been warning us for decades that, because of a number of looming tipping points, climate change too has the potential to spin wildly out of control.

However, we don't have a good excuse for continued ignorance; it's not as though the potential for dangerous exponential growth has been a secret. Consider this old proverb, a version of which goes like this:

For want of a nail a horseshoe was lost,
for want of a horseshoe a horse went lame,
for want of a horse a rider never got through,
for want of a rider a message never arrived,
for want of a message an army was never sent,
for want of an army a battle was lost,
for want of a battle a war was lost,
for want of a war a kingdom fell,
and all for want of a nail.

Clearly we've had folk knowledge about exponentially large consequences from a small event for a lot time.

Even more ancient is a story from India about a chess-loving king who promised to reward a visitor with whatever he wanted. The visitor "modestly" asked for one grain of rice on the first square of a chessboard, 2 grains on the second square, 4 on the third, 8 on the fourth, etc. It didn't take the King many squares before he realized he'd taken on an impossible task. Sixty-four doublings would have required some 18,000,000,000,000,000,000 grains of rice, enough to cover all of India a meter deep.

That ancient king learned a striking and costly lesson about exponential growth. It seems as though we--and our current leaders--need to learn it all over again, and quickly. That is, if we don't want our kingdom to fall for want of an adequate response to this microscopic but immensely dangerous virus.

-----

REA

TO MASK OR NOT TO MASK, THAT IS THE QUESTION

Two new studies make this question much easier to answer than Hamlet's dilemma. If we all wear face masks in public, that alone will go a long way towards choking off the coronavirus pandemic.

Writing in the prestigious Proceedings of the Royal Academy A, epidemiologist Richard Stutt and colleagues at the UK's Cambridge and Greenwich universities modeled 18 months of the pandemic with different levels of mask-wearing effectiveness.

Students wearing face masks (and saving lives)

Credit: Gustavo Fring

Not surprisingly, the biggest impact on the virus came when 100 percent of the population wore masks that were highly effective both in keeping infected people from expelling virus-laden droplets and protecting healthy people from inhaling them. The models showed that that combination could push the infamous R-value--the number of infections an infected person passes on--below 1, and so snuff out the pandemic.

Even more encouragingly, even if the masks were just slightly more than 50 percent effective, or if only slightly more than 50 percent of the population wore them, that crucial R value could be pushed below the magic number 1.

Here's the striking bottom line of this study, assuming face masks that are 50 percent effective:

"We note that 100% facemask adoption without lock-down achieves a greater reduction in the final size of epidemic, a lower 'total removed' and a lower peak of active cases than lock-down without facemasks."

Let me repeat that. According to their models, if everyone wore face masks, that would be more effective in limiting the size and impact of the epidemic than a total lockdown. If we compare the social and economic impacts of universal face mask-wearing to a full-scale lockdown, there's no contest. Wearing a face mask is a significant nuisance, but it allows most activities to continue--as we see in many Asian countries where face masks are a normal part of life. Lockdowns, as we've seen, are immensely life-changing and economically devastating.

A second research team, reporting in the equally prestigious Proceedings of the National Academy of Sciences, analyzed the spread of the coronavirus in three of the worst-hit parts of the world, Wuhan, China, Italy and New York City. The researchers tracked the course of the epidemic in each location as different measures were put in place to try to control it.

Their conclusion was striking--mandated face covering was ". . . the determinant in shaping the trends of the pandemic." Renyi Zhang, at Texas A&M Univeristy, and colleagues, calculated that face masks alone prevented 78,000 COVID-19 cases in Italy between April 6 and May 9, and over 66,000 in New York between April 17 and May 9. Given the percentage of diagnosed COVID-19 patients who died in Italy and New York, wearing face masks likely saved more than 15,000 lives in Italy and New York City during those weeks.

This research team's bottom line:

"We conclude that wearing face masks in public corresponds to the most effective means to prevent interhuman transmission, and this inexpensive practice, in conjunction with simultaneous social distancing, quarantine and contact tracing represents the most likely fighting opportunity to stop the COVID-19 pandemic."

Again, note that wearing face masks in public, maintaining a safe distance from others, quarantining people who are infected and tracing their contacts, while challenging are still far less damaging to normal life and to the economy than lockdowns.


So, two separate studies using completely different methodologies came to essentially the same conclusion. Wearing face masks in public can be extremely effective in snuffing out this world-shaking pandemic.

I'm wearing my mask whenever I step out my front door. Please do all of the world a huge favor and wear yours too!

-----

Here's a link to another researcher who has reviewed the research literature and comes to the same conclusion. Jeremy Howard, a distinguished research scientist at the University of California, San Francisco, and his colleagues, clarify that masks work by keeping most virus-carrying droplets from being expelled into the environment. Again, the more people who wear them, the safer we all are.

REA

TWO MILLION U.S. CORONAVIRUS CASES, 114,000 DEATHS--WHERE DO WE GO FROM HERE?

On April 27, I posted a piece noting that the US had suffered its one millionth documented COVID-19 case, and more than 56,000 deaths from this deadly virus. Today, 43 days later, the toll has more than doubled. We've now had 2.044 million people diagnosed, of whom 114,118 have died.

The good news is that it took 43 days for the number of cases to double. That's far slower than at the start of the pandemic, when numbers were doubling every few days.

As discussed in a previous post, we've flattened the curve and slowed the advance of the SARS-CoV-2 virus through lockdowns, stay-at-home orders, social distancing, mask-wearing, hand washing and all the other life-changing steps that we've taken. Making those drastic changes works and has saved huge numbers of lives, although, as we know, at enormous economic cost.

The bad news is that the virus is still circulating almost everywhere in the world (enormous kudos to New Zealand for having defeated the virus, at least for now). In addition, with just 2 to 5 percent of us now possibly protected by antibodies, the SARS-CoV-2 virus still has hundreds of millions of potential victims in the US; all it takes is a bit of exposure.

All of which raises the question--where do we go from here? Do we fling open the doors of  the businesses and public spaces that have been closed, go back to work, and try to get back to something like our previous lives as quickly as possible? Or do we tiptoe back towards normalcy, cautiously opening up the economy and our lifestyles step by step, slowly enough and with enough testing and tracking to keep the virus contained? Or, more likely, stumble ahead with a confused and confusing state-by-state, city-by-city smorgasbord, with predictably mixed results?

We can be sure that Trump and his administration will push for a quick re-opening. Trump's eyes are fixated on the economy and its impact on his electability this November.

It's not hard to understand how vital it is for people to be able to have jobs to return to and to get  back to work.  Nor to feel the need to reclaim the freedoms and joys of our pre-coronavirus lives.

As these vital decisions are made, perhaps the most important thing to keep in mind is that once unleashed--as long as someone who has the virus is likely to pass it on to more than one other person--this virus can and will expand exponentially. This is a factor that is truly hard to grasp. We are used to things that change linearly. Push harder on the gas pedal and the car speeds up a bit, not by a factor of 10, 100 or 1000. Work more hours and you don't suddenly get rich. We're not used to things with the propensity to "go viral," where a small change can produce an enormous effect, or where a slight delay can mean the difference between 100 deaths and 100,000.

So step on the gas to get the economy moving again? It's a great idea, but not if we forget that the coronavirus is still there, still circulating, itching for another chance to explode.

REA

LOCKDOWNS HAVE WORKED TO CONTROL THE CORONAVIRUS--BUT ARE THEY WORTH IT?

If, as you've spent endless hours at home the last few months, you've wondered if the lockdowns and shelter-in-place policies that have upended lives around the world actually work, two major new research papers pretty much close the case.

Image credit: Prachatai/Flickr

Research teams at Imperial College, London and the University of California, Berkeley, used different methodologies to study the impact of the "non-pharmaceutical interventions" such as business closings, social distancing and home isolation that were put in place in different mixtures and different times in 11 European countries, and in China, South Korea, Iran and the United States.

The detailed findings are complex, but the bottom line is simple: lockdowns worked whenever and wherever they were applied. When implemented and followed consistently, within three weeks they successfully reduced the reproduction rate of the coronavirus below the critical number 1, flattened the curve of cases, and saved large numbers of lives.

The numbers that the two research teams calculated are impressive. The Imperial College team estimates that in Europe the lockdown and social distancing measures put in place in March prevented several hundred million Covid-19 cases and approximately 3.1 million deaths before the May 4 end of their data gathering.

The Berkeley group found that in the six countries they studied--including the US--the measures put in place prevented 62 million confirmed cases or an estimated 530 million actual cases.  
Assuming a case mortality rate of just one percent, that means that some 5.3 million lives were saved, again in the course of a few months.

"The lockdowns had a very large effect on cases and saving lives," says Solomon Hsiang, at the University of California, Berkeley.      "[Some people assert that] the lockdowns weren't necessary. This research nails that it was. Without them, we believe the toll would have been huge."

Researchers from both groups emphasize that some mixture of these life-changing but also life-saving measures needs to be continued, tailored to each country or region's population structure and economic needs. 

"We're just at the beginning of the pandemic," says Samir Bhatt, at Imperial College. "We're very far from herd immunity and the risk of more waves of the virus is very high. Care must be continued until a vaccine becomes available."

These two papers were published on June 8, at which point there have been more than 7 million confirmed cases of Covid-19 and 407,000 confirmed deaths worldwide. If most of the countries in the world had not taken the stringent steps they did to control the SARS-CoV2 virus, these two research papers show that those numbers would have been orders of magnitude higher.

Was it worth it? Clearly that's not a scientific question, nor should it be strictly an economic one. The answer depends on the value one places on human lives as well as on other important factors such as employment and economic well being. Both research teams are well aware of the huge economic impacts of lockdowns, social distancing, travel restrictions, business closures, and other measures taken to control the spread of the virus. But both of them emphasize that some mix of these measures will be needed for a long time. 

"There's no back to normal," says Hsiang. "It's a cost-benefit question--interventions of different kinds along with economic well-being. The longer you stay in lockdown, the fewer infections. If you undo lockdown, there's economic growth but more infections and death. Something still needs to be in place."

-----

You can download the full scientific papers from the journal Nature, here and also here.

100,000 COVID-19 DEATHS IN US--MORE THAN HALF COULD HAVE BEEN PREVENTED

The United States just suffered its 100,000th documented death from the coronavirus.

The true number of coronavirus caused or related deaths in the US is probably closer to 130,000.

As more states and localities "open up," this toll of loss and grief will keep rising, and almost certainly will speed up.

". . . while the worst are full of passionate intensity."
(from The Second Coming by W. B.Yeats)Photo credit: Michael Vadon

As reported in the New York Times, researchers at Columbia University modeled the dynamics of the pandemic and calculated that if the United States had taken decisive action to limit the spread of the virus by March 1, just two weeks earlier than we belatedly did, 54,000 lives would have been spared.

To start to understand what this means, look at the front page of the New York Times listing the names of 1000 people from across the nation who have died from COVID-19. Then picture 53 more pages like that, memorializing 53,000 Americans who didn't need to die in this pandemic.

Then remember that as late as March 10, the deluded narcissist who promised to Make America Great Again was still blathering, "It will go away. Just stay calm. It will go away."

Unfortunately, even amplified by Fox News and echoed by right-wing true believers, his magic words had no effect on this virulent, deadly virus. Reality inevitably trumps politics, polemics and magical thinking.

Please remember come November--54,000 needless deaths, and counting . . .

REA

Note: The US has 4.3% of the world's population. We've manged to produce 28.6% of COVID-19 deaths. This isn't the fault of China, the World Health Organization, Barack Obama or Joe Biden. The buck stops squarely on the desk in the oval office, no matter what the current resident of the White House would like us to believe.

Much more on how Trump made this pandemic far worse than it needed to be--Dan Benbow details 370 ways that Trump turned this into a man-made catastrophe. Read his piece here.

SPEEDING PAST ANOTHER TRAGIC COVID-19 MILESTONE

On April 27, just 11 days ago,  I posted a piece noting that the world had just passed the grim milestone of three million COVID-19 cases and 210,000 deaths. It took this highly contagious and dangerous virus just 11 more days to infect another million people and kill another 65,000.  In the US during those same 11 days, 320,000 more people caught the virus and more than 22,000 died. 

To try to remind ourselves that these are people, not statistics, that means that every minute of those 11 days four husbands, wives, fathers, mothers and children died miserable deaths from this pandemic disease.

Anti-quarantine demonstrators in Colombus, Ohio, 4/18/20

Credit: M/Creative Commons

Nonetheless, countries, states and cities around the world are "re-opening," loosening the restrictions that have, when applied with determination and followed in good faith, slowed and in a few places even stopped the virus. This is said to be necessary to get the economy moving again. 

What is not said nearly as loudly if at all is that this promised economic recovery will be purchased at the price of tens or hundreds of thousands of human lives. Nor should we forget that the majority of those lives cut short will not be those of the rich, nor or the well-educated, highly skilled occupants of the kinds of jobs that can be managed largely online. No. Most of those who die will be ordinary people whose jobs require face-to-face contact or working close to others, and who have no choice but to go back to work when they're told to. 

The boosters shout, "Liberate out state,"  or "Let's get the economy going again." Trump eggs them on, and so it is happening now. That despite the fact that few places in the US are in a condition to do so safely. 

Let's at least be honest about the price, and who will pay it. 

REA

Rhyme or Reason: Responses to the Pandemic

• 
  

Daniel Defoe's classic novel "Journal of the Plague Year" based on the experience of London in 1665 details the understandable but often irrational behavior of both leaders and citizens coming to terms with the deadly epidemic sweeping the City during that year in which London lost between 14 and 21 percent of its population.

Image from the Great London Plague of 1665

Credit: Science Source

First came the very human response of denial: surely this will pass swiftly; perhaps it is limited to very few people or certain regions of the city; perhaps it can be contained; perhaps when the weather warms it will magically vanish; perhaps prayer will help.


Then distortion of the data soon followed to support these theories. As bodies piled up or were carted away, records were altered to attribute the deaths to other, more usual, acceptable, or even invented causes. Naturally, those responsible for affected districts sought to avoid the blame or opprobrium of being associated with the disease, and thus reported these false accounts to their superiors.

As in every case we know of from ancient Rome, to Europe in the Middle Ages, to modern-day China, actual facts about a growing epidemic, no matter how tightly controlled by the authorities, will be leaked to the general public, with predictable responses. Spreading like wildfire, often blowing limited or incomplete bits of information completely out of context, rumors themselves contribute to the impact of the contagion.

One all-too-human tendency inevitably leads down the path of stigmatizing easy-to-identify 'others' as the source. Another is the search for quick cures: rituals, signs or amulets to ward off the illness; or in other cases the promotion of folk-medicines or sometimes dangerous potions claimed by others to heal the sick.

From the perspective of authorities anxious to avoid challenges to their power, the next step is often to portray the disease and disaster as emanating from foreign sources, both external and internal. During the Antonine smallpox plague in ancient Rome, Christians were portrayed as the disease's source since they refused to serve the Roman Gods. During the Middle Ages in Europe, popular fear and anger during the scourge of the Black Death was directed against the Jews who were charged with and often murdered for poisoning the wells regardless of the fact that they drank the same water and often suffered from the same diseases.

If all this sounds familiar in the age of Covid-19, it should. But in this twenty-first century, we all should know better. Plagues and pandemics, despite President Trump's declarations, do not "magically go away by April;" nor are they "hoaxes" concocted by political enemies; or malicious evils carried by immigrants or sent by rival powers; nor can they be cured by untested potions, wishes or by "injecting disinfectants."


"History does not repeat itself, But it does rhyme," Mark Twain is alleged to have said.

In an age defined by science and deep medical knowledge, not myth, mystery and ignorance, isn't it time for us to finally bring the rhyme scheme up to date? A few nations, including Australia, New Zealand and South Korea are applying science and expertise to defeat our current plague. Can we do the same?

-----

Les Adler

GOOD NEW AND BAD NEWS ABOUT COVID-19

Researchers are constantly trying to refine their understanding of the coronavirus pandemic in order to make meaningful recommendations and accurate predictions. To help with this, they have a suite of mathematical models that, for example, can predict the impact that interventions like social distancing, universal mask-wearing, or stay-at-home orders will have on the trajectory of the pandemic.

What are your chances of finding yourself in a situation like this?
Credit: U.S. Air Force/Staff Sgt. Kevin Linuma

However, as anyone who has ever tried to analyze data knows, the best model in the world is useless if it's fed inaccurate data. This is captured by an acronym that dates back at least to 1963, GIGO--garbage in, garbage out.

Probably the most garbage-laden information about the COVID-19 pandemic is the actual number of people in a given region who have been infected by the SARS-CoV-2 virus. This number is necessary in order to calculate how infectious the virus really is, how quickly it can spread through a population, what proportion of the population remains vulnerable, and, crucially, how deadly it is.

Unfortunately, in the absence of widespread testing and contact tracing, typically only severe cases get confirmed and counted. The trick is to get a handle on how many uncounted cases there are for each confirmed one.

That's the key number which is now providing us both good and bad news.

The bad news is that multiple signs point to there being many more people who have been or are currently infected than the official, confirmed case counts tell us. That's bad because it means that you're much more likely to run into someone carrying and potentially shedding the virus than you and public health authorities probably thought.

The good news is that if there are in fact many more COVID-19 cases than we thought, but if the count of  deaths is reasonably accurate, then the virus may be significantly less lethal than we thought in terms of the number people who die compared to the total number who catch the virus.

Here are some relevant data points:

--Out of 3,330 people tested for antibodies to the SARS-CoV-2 virus in Santa Clara County, California, 1.5 percent tested positive. That doesn't sound like much, but it implies that the actual number of cases in that county is 50 to 85 times greater than the confirmed case count.

--A similar study in Los Angeles County found an infection rate between 2.8 and 5.6 percent among adults. Compared to the 8,000 confirmed cases at that time, it implies a true incidence of infections between 27.5 and 55 times greater than the official count.

--New York State has turned out to be the unfortunate epicenter for the virus, with more than 288,000 confirmed cases and more than 22,000 deaths to date. When 3,000 people in 19 counties were tested for antibodies, 13.9 percent tested positive (and a remarkable 21.2 percent in New York City). Those numbers indicate that there have been at least 10 undocumented cases in the state for every confirmed case.

The picture is still blurry--we need much more testing, not only to make the models and their predictions more accurate, but, along with contact tracing and effective isolation, to be able to get our lives and the economy back to normal.

Critics tell us that the above numbers must be scrutinized with care. Statisticians point out that when the incidence of a disease is low, a less-than-perfect test can produce enough false positives to significantly blur the picture.  Others point out that it is hard to match these indicators of a more widespread but milder and much less lethal illness with well-documented clusters of cases and fatalities, as we saw on several cruise ships.

Still, if we squint, it looks as though there are probably ten times or  more actual cases of COVID-19 than confirmed cases.

So again, when you go out, someone comes to your door or you find yourself among a group of people, anyone you're close to is 10 times more likely to be contagious than you might have thought.

But that also implies that the SARS-CoV-2 virus may well be ten times less lethal than we've been told so far; it may kill just two out of a thousand cases rather than the more frequently cited estimates of from 7 to 34 out of a thousand. From the point of view of the population as a whole, that's definitely good news.

However, if you, like 92 million other Americans, are over 65 or have an underlying medical condition such as hypertension, diabetes or obesity,  you remain at high risk of serious illness or a miserable death from the virus. For those at high risk, the crucial, and potentially vital take-away is the fact that there may be 10 times more potential sources of contagion outside your door than you thought.

Please take care!

WHAT DIDN'T HE KNOW AND WHEN DIDN'T HE KNOW IT?

What didn't Trump know and when didn't he know it?

Concerning Trump in general and his handling of the COVID-19 pandemic in particular, the simple answer is that he knows nothing, always. Despite being "a very stable genius," perennial ignorance is his stock in trade. It lets him avoid responsibility across the board. Unlike President Truman, the buck never stops at Trump's desk (or if it does, like Macavity, Trump wasn't there. He never got the memo.)

Harry Truman, 1959--the buck stops here

Credit: Levan Ramishvili/flickr

Unfortunately for America, sometimes ignorance, especially arrogantly willful ignorance, has costs, real-world impacts that can't be erased by shifting blame to someone else (right now WHO's on first), smearing someone with a smarmy nickname, or filing a lawsuit.

MACAVITY'S NOT THERE

Credit: Pixabay

As I write this, 565,835 Americans have been sickened by the coronovirus, and 22,850 have died. That's more cases than the next three worst-hit countries combined, and more deaths than any other country. So much for MAGA and "we're number one."

Tragically, neither those deaths nor those yet to come will make a difference to Trump's core supporters; his approval ratings have ranged from 41 to 49 percent as the pandemic has raged.  Still, for those of us who at least try to live in the real world, it might be interesting to figure out what Trump could have known, and ought to have known, and when he chose to ignore it and go with his--also brilliant--gut.

We now know that multiple agencies were trying to alert Trump to the approaching tsunami starting in January. These included the National Security Council, Health and Human Services, the CDC, Homeland Security, the VA and the Pentagon--at least 10 high-level warnings between January 18 and February 25. Clearly enough of these early warnings got through to him to stimulate him to do what comes naturally to him--closing borders. On January 31 he banned most travelers coming from China. 

Domestically, however, Trump presented a very different face to the U.S. public. From January 20th through mid-March, Trump blatantly downplayed the seriousness of the pandemic. His consistent message was "no worries," "under control," and "it will disappear." Finally, in mid-March, and some six weeks too late, he began to take the pandemic seriously in terms of what should be done within the U.S.

What he could have known if he were capable of and willing to listen to experts, was that viruses like SARS-CoV-2 have the capacity to go viral--duh--for the number of people sickened or killed to increase exponentially.  If he had digested that bit of information, his native genius could have led him to the conclusion that days count. In a country the size of the US, putting effective control measures into place a week or two sooner could mean the difference between a few thousand deaths and a few hundred thousand deaths .

We can see this clearly if we compare New York and California. New York dithered while California took quick and serious steps to slow the spread of the virus.  As of 4/13/20, New York has registered 195,031 cases and suffered 10,056 deaths. California has just one-eighth as many cases, 23,428 and one-fifteenth as many deaths, 675. The contrast becomes even starker when you consider that California has twice the population of New York. So, per population, California has just one-sixteenth the number of cases and one-thirtieth he number of deaths. If California had failed to act as quickly and decisively as it did, 20,000 more people might have died.

What the experts tried to get across to Trump starting in January is that when you're dealing with the potentially exponential explosion of a fatal disease, there isn't room for half measures nor time for delay. Trump only heard what he wanted to hear, and reality steamrolled over all his magical thinking, political positioning and base-soothing blather to remind us that ignorance can be fatal. That makes Trump even more dangerous than we thought just a few months ago.

-----

REA

-----
6/28/20:  Just to add one more data point to the ongoing drama of what Trump didn't know and when didn't he know it, we now have the scandal of Russian intelligence paying a bounty to the Taliban for the murder of US soldiers. As usual, Trump missed the briefing, and the next briefing, and the one after that . . .