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. 

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:

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."

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

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 . . .

ONE MILLION CASES AND GROWING FAST

The official count of coronavirus or COVID-19 cases passed one million worldwide early today (4/2/20).** But that number is already out of date, since the count is growing by at least 70,000 per day. As I write this in the late afternoon, 20,000 more people have been diagnosed, and 6,000 have died. That's just today.

Wall Street in lockdown

(along with Main Street)

Credit: Dan Nguyen/Flickr

Tragically, the US is number one among the nations on this statistic.  Despite having less than 5 percent of the world's population, we've incurred nearly 25 percent of the COVID-19 cases, and 11 percent of the deaths. (One day after this posting, the US sped past a grim milestone--1000 COVID-19 deaths in a day).

Many factors are contributing to our unfortunate leadership in this area. Our healthcare system is focused on providing top-quality care to people who are well off or well insured, but lacks a comparable commitment to public health, In response to a problem that requires a  quick, coordinated, disciplined response, and a response that requires personal sacrifice, our national love of individualism and our more recent Ayn Randian valuation of putting oneself first certainly contributed.

Still, if we're going to assign responsibility for where we are today, an awful lot needs to go to our tweeter-in-chief, Donald Trump. As anyone whose memory has not been wiped clean by the Ministry of Truth knows. Trump treated the looming pandemic as--take your choice--a hoax, a Democrat scheme to discredit him, just like impeachment; as a threat to his re-election; as something totally under control; as an ordinary, relatively trivial event, like the flu; as another reason to close borders; as something that could be cleared away by Easter, and, even if it risked thousands of deaths, should not be allowed to upset the economy. With his narcissistic, impulsive and erratic leadership, the US was ill prepared, slow to respond, and still extremely spotty in dealing with this grave crisis.

By the way, the fact that even as thousands of Americans die every day--deaths that could have been prevented by prompt and well-informed leadership, Trump's approval ratings are approaching 50 percent suggests that the Ministry of Truth* is doing a bang-up job.

The big question is how we proceed from here. The US is still at the beginning of the epidemic. Nothing that we've done so far in the US has "flattened the curve." Instead, COVID-19 cases in the US are on a steeply rising exponential trajectory.  Experts tell us that social distancing--staying at home and avoiding as many contacts with other people as possible-- is crucial. So is hand washing. If everyone, sick, possibly sick or well, wears a face mask in public, that may help.

A separate, perhaps more crucial factor is testing as many people as possible in order to isolate people who are shedding the virus, along with tracking and isolating their contacts. Where this has been done, for example in South Korea, it has controlled the spread of the virus without shutting down the country, businesses and the economy. Again, unfortunately, the US lags far, far behind on testing.

What lies ahead is in our hands. A swift, strong, coordinated, nationwide attack on the virus can still save thousands or perhaps even hundreds of thousands of live. The two key questions are:

Will enough Americans wake up and do what's needed, or will half of them remain in the dark and asleep even as the plague surges towards them?

Will government, starting with Trump, get its act together, and in time?

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* For another example of Trump's Ministry of Truth revising history as we speak, click here.

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** The number of cases worldwide passed two million on 4/15/20. In other words, the global doubling time for the virus is around 13 days. We'll see if the enormous sacrifices that nations and individuals are making are making a difference. When will we suffer 4,000,000 cases?

REA