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.

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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. 

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.

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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

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.

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REA

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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 . . .