Wednesday, September 30, 2020

 I have long been a proud member of the Palo Alto Fellowship Forum, a group that meets weekly for lunch with outstanding speakers.   When I moved from the Bay area a few years ago, I had to go "inactive" but with the Covid pandemic, they are now meeting via Zoom (who isn't?)  which has allowed me to attend once again on a semi-regular basis.

One of our members is Robert Brooks, who yesterday gave a brief talk about the status of vaccine research and testing.   Here is the summary statement from the program chairman:

Our own Robert Brooks updated us on current status of COVID-19 and progress on vaccinations in development. The good news is that it is very highly probable that at least one or more vaccines will prove to be safe and effective. His view on general availability, in line with those of Doctors Gottlieb, Redfield, and Fauci, is before the middle of 2021. The bad news is that the World is not doing well with containing the disease at this time. The United States and Sweden are not doing well at all.


He discussed three general types of vaccines in development: Messenger RNA types (Moderna, Pfizer); Inactivated viral (some Chinese); and Adenoviral (Oxford/AstraZeneca, J&J, Merck, some Russian). Disadvantages of the first type are that they have not been used before, their autoimmunity may be too high (resulting in allergic reaction), and low temperature storage is critical. They are easily scaled up in production. The disadvantages of the second type are that they are expensive and slow to manufacture. The third type uses a “trojan horse” common virus (such as rhinovirus) to enter the cell with codes for making proteins of the COVID-19 virus to build immunity. They may be somewhat less effective if the host (you-me) already has the trojan horse virus and resists, and side effects may result from the specific trojan horse virus used.  


Brooks' bio is solid: He is adjunct professor in the Stanford School of Medicine, and founder and CEO of Virobay, which IPO'd in 2014, but died in 2018.   I found to my surprise that there are over 6,000 failed bio-tech companies listed in https://biopharmguy.com/links/company-by-name-defunct.php     This compares not too favorably with US automobile manufacturers (only around 1,100), and computer PC makers (less than 500)...   


Here's some of the slides that he used:

His first point was that this pandemic hasn't gone away, and in some key countries, is again rising




















His second point was that most of the states in the USA are 'again in trouble' to a degree





















His third point was that people have been intimidated by the conflicting claims re vaccines





        



































He then took us through a series of possible vaccine types, and closed with this somber calendar prediction




Wednesday, September 16, 2020

A reader responds

 Dan Thomas has long been one of the nation's top business strategists.   I have referenced him in earlier blog-posts, notably "Yes, Matilda, the ship has sailed" on August 19.   He was the leader for the Aug 4 post about "Some say the ship has sailed" as well.   And we all know too well that the bulk of colleges that have tried to open in recent weeks have experienced nearly all of the ills that his team described.

Unsolicited, I got this message from Dan this morning.   Blew me away . . . and I thought it is worth sharing with more folk.

Hi Chuck-

 

I have been remiss in not sharing my thoughts with you about the Covid-19 work you have done. It is, in short, stunning.

 

In many ways it is the highest and best use of the visual presentation of data. It shows us things we cannot see by looking at the numbers. It unlocks insights that are profound.

 

I know that you, Scott and Art did a lot of work to get the visuals to where they are today. That was a great public service by all of you.

 

I only wish more people, especially those in leadership positions would look at it and USE it.

 

Best regards,

 

Dan

 

Dan Thomas

Focus, Inc.

Palo Alto, CA

Thursday, September 3, 2020

TRUST--whom do YOU trust these days?

Remember the 'trusted handshake"?   

Trust--it used to be that a "man kept his word."   And then it became, "HE is a man who keeps his word" which implies that such an example had become more of an exception than the rule.  Women weren't 'in the parable" which may say something all by itself.

A great Forbes article recently caught my attention.  Let me show some extracts:

 https://www.forbes.com/sites/keldjensen/2018/04/15/women-trust-and-the-business-world/#6a27e3411b78

In the U.S., trust is a hard thing to come by. Recent studies have shown that only 1/3 of Americans trust other people – the lowest level recorded since the General Social Survey first began tracking it in 1972. 

A 50-year decline in trust continues. Most Americans say they don’t trust any branch of government. Non-governmental institutions have shed credibility, too. The media is widely scorned and distrusted. Organized religion continues its long decline. Even the police and military — revered by most of the public for decades — have seen some erosion in their numbers as well. We are a country with few establishment heroes.

As a rule, women tend to be more trusting than men. The most successful business negotiators have traditionally been women – likely due to their tendency to display higher levels of trust and empathy than their male counterparts.

Here are some fascinating (and disturbing) graphs about Trust in our institutions


These are stunning numbers if we really stop and consider them.   Organized religion, down from 68% to 38% in fifty years.   Banks, down from 60% to 30%.  Congress, never a favorite, down from 40% to a shocking 10%.    Our news sources, either television or the departing newspapers, down from 40% by nearly half.    

And the metrics re the presidency started a free-fall in 2004 or so, and while they show modest recovery of late, it is at the expense of a much more polarized citizenry than any in US history.

Trust, in our little rural county, has seriously eroded in the eight years we've lived here.  I'm in Kevin McCarthy/Devon Nunes land, a very conservative 'red county' in a very blue state (CA).  

Today, folk we know who are liberal, or as in our case, moderate (self-described), are afraid to speak out--not true until Trump was elected.   This divisiveness is shocking, appalling, and certainly guaranteed to make it harder to 'govern' responsibly for anyone crazy enough to get in the political arena.   But the 'political arena' is extending into Kiwanis, the local churches, and the schools, plus hair salons, bars, and gyms struggling with pandemic restrictions.   

And our town is 89% Hispanic, with the lowest county per capita income in California's 58 counties.   Trust, for many (most?) of these hardworking parents about what the state or federal government will do for them during the Covid pandemic and its terrible economic overlay, is (to put it mildly) modest.   And agricultural people, like them, in our county and the adjacent two (Fresno and Kern), produce half of California's food, which itself is by a factor of two the largest food producing state in America.   

Not surprisingly, perhaps, those three counties are the leaders for Covid deaths in CA counties on a per capita basis.  Trust?   In what?   Fairness?  Empathy?    Equal opportunity?

How might we imagine a future where trust is rekindled?

Who will lead such a re-kindling?  How?   When?


Tuesday, September 1, 2020

What're the odds you know (or knew) someone?

 I still hear, in too many Covid conversations, something like this: "Well, I don't know if this is real or not.   I don't know anyone who's had it."   Some go on to say, "I don't know anyone who knows anyone who..."

Others, fixated on denial, latch onto the President's words, such as yesterday: "Only 6% of the Covid deaths 'really count'--all the rest had underlying conditions"   So, instead of 180,000 dead Americans, the number is maybe 10,000 'real deaths'--all the rest would have died by now of indigestion or cancer or severe asthma.    Not even counting car accidents (which, not incidentally, are way down because no one is driving now).

So I thought it might be worth asking "How many does it take, and how close to your home, to make you a believer?"    And the answer comes out, usually, to be something like "in our block, or in our extended family" or "in my xxxx group (e.g. Kiwanis, church, workplace).    

And, if you think about it, that says there is probably a number that matters--a different number for each person, to be sure, but a number for which you say, "Hummn" or something like that.

I'm going to assert that the number is somewhere between 1 in 20 and 1 in 30.    If 5% of the people in your town/county have it, odds are good that one of them is known to, and maybe even close to, you.

Which says that more than 5,000 Confirmed Cases per 100,000 population might begin to wake folk up.

Where are we finding such numbers?   Well, for starters, there are 3,142 counties in America, and only 61 of them as of this morning--a mere 2% of them--have such a number.   

Original HOTSPOTS--Connecticut, Illinois , Maryland, Massachusetts, Michigan, Pennsylvania and Delaware--not only don't have any counties with 1 in 20--they don't even have any counties with 1 in 30 people confirmed.  

The leaders early--New York and New Jersey--have one county with 1 in 25, and 4 counties with 1 in 30 between them.   The most populous state--California--once seemingly immune, has struggled of late, but it has only one county out of 58 with 1 in 20 (and one with 1 in 25, and one more with 1 in 30).  

So the point is--if I go chatting about 'how awful it is" in nearly all of my home state, it mostly elicits statements like the opening to this post, certainly for folk who aren't busy studying all these details. 

If we broaden the 'search' to 1 person per 25, it adds another 63 counties.   Move the marker to 1 in 30, adds another 118 counties.   So, all told, 8% of America's counties have at least 1 in 30 confirmed cases.  And in the 92% who don't, it can seem 'far away' perhaps--even ridiculous to worry about.

By contrast, the 1918 flu pandemic seemed 'up close and personal'     It killed 675,000 Americans in a year and a half (which, not incidentally, Covid could easily match at current rates), but the country was not quite one-third as populous, and at some point, estimates are that 28,000,000 Americans were infected (again, a number that Covid might conceivably reach).   That means that 1 out of 4 people got the virus, and at that level, you HAD to know someone closely who was a victim.

Such absolute numbers today would still be only 1 in 12 that 'get it' and only 1 in 400 odds of dying.

The other thing that was different was that the 1918 pandemic was agnostic about its victims--it tackled everyone of all ages, whereas Covid to date is still mainly a killer for oldsters.   Indeed, setting aside the asinine arguments about 'kids don't get it' and 'kids don't transmit it' so let's open the schools willy-nilly kinds of statements, the fact is pretty clear that Covid is a great culling device for oldsters.  

How so?   Well, when the numbers began, something like 1.1% were aged 0-17; and all told, from 0-44 was 47% of the total.   Today, that number has increased to 62%.   Ages 45-64 were 28%, which has hardly changed at 27%.  Folk over 65 were 22.5% of the total then; they are now 11% of the total.    Here is a picture of the current distribution by age.



But note what happens when we compute the ratios for the oldsters.   Oldsters are 30% of the deaths, but the rate of death, should they contract Covid, is that it kills more than half of them.    This has largely gone UNREPORTED, but it is the basis on which much of the administration's argument rests.

Another nuance here is that 40% of the Covid deaths in the US to date are said to have been in the 1% of the population living in 'old folks homes' such as assisted living or nursing homes.    I cannot find supporting statistics for this--if true, it would say that every person over 85 who died, plus half of those over 75, were living in a nursing home, which is just clearly bullshit.

But that is the sorry fact with which we are dealing.  Hard numbers are difficult to come by; some claim that morticians are cheating the system, labelling deaths as Covid because of back-room payments while others insist that many deaths (more than 200,000 over "normal") were actually undiagnosed Covid.  

To dig deeper, into ethnic or economic impacts, or to do contact tracing, is fraught with more issues.

However we slice the onion, though, the odds are getting better that you will know someone affected by this terrible pandemic, if not now, certainly in the not too distant future. 




Sunday, August 23, 2020

How'd that work out?

 We get questions 'all the time' about this, that, and the other.   And sometimes the replies may not seem timely, but 'hey, I'm doing the best that I can'

One topic that has raged this month is RE-OPENING SCHOOLS.   

We've commented in two earlier posts about the prospects and initial reality for universities.   See August 4, "Some say, 'the ship has sailed'?" and August 19, "Yes, Matilda, the ship has sailed"

And we're very concerned for our grand-daughter who is an eighth grade science teacher in Shreveport Louisiana.   She reports that her principal is one of those who still believes (fervently) that Covid is a hoax

So it might be worth looking back a bit at a couple of 'leading states' whose governors think (or at least thought) this was a hoax--Texas and Florida.

Here's the news clips for those two states at the end of April

Trump followed on May 4 on Fox News, reported out on May 5:

So, let's look at the choropleths (the geo-spatial maps) for Florida and Texas, up until these bold decisions, and what happened over the next three months.  First, the Confirmed Cases data:

And, GASP, did it 'stay in the cities' or did it spread across the entire state?  Recall that ORANGE is bad.  These maps are of Cases per capita.

I'd call that a 'clean sweep' -- on May 1, only 4 counties out of 67 had more than 300 cases/100,000.  By August 5, every county in Florida had more than 1,000 cases per 100,000 residents.  Whew!

How about Texas and its 254 counties?

Wow!.  On May 1, nine counties out of 254 had more than 300 cases/100K; only 1 had 1,000+.   Fast forward after "we're safe to re-open" and only 5 counties have less than 100 cases/100K, and 10 more are less than 300.   A whopping 130 counties have more than 1000 cases per 100K residents.  

HOW'D THAT WORK OUT?

Pretty hard to defend the 'hoax' idea when the fires are starting to burn in 'your town'


Friday, August 21, 2020

Lord Kelvin got it right

 William Thomson, in later life dubbed Lord Kelvin, was perhaps the most noted scientist of his time.  True, he did say "X-rays are a hoax" and that both radio and aircraft will be impossibilities, but he was known as a physicist, not a futurist.   What he did say about measurement became the motto for the Hewlett-Packard Company for four decades, before it really thought much about computers.

Some notable and pertinent Lord Kelvin quotes:


As I was graduating from college, I needed a job (with two kids, I couldn't figure out why they called it a Bachelor's Degree).  My advisor, Carver Mead, said, "You're good in the lab, you ought to consider a small company named Hewlett-Packard.   They build instruments for engineers, and that's pretty neat because an instrument has to be three times faster or more accurate than the thing you're working on in order to get a valid measurement.  Thus, instrument designers get to be not only at the 'state of the art' but well ahead of it."

Turns out he was right.   Turns out it was yet a small company--I was their 98th engineer in 1962.  In 1982, as Corporate Engineering Director, I had 15,000 engineers reporting either directly or indirectly to me.   We'd grown some in 20 years.   In fact, from 1962 through 1998, HP was in fact the fastest growing US corporation in the Fortune 2000, hard as that might be to believe.

But it still, mostly, operated as a small company, or rather, a cluster of small companies each organized with their own Profit and Loss statement, replete with their own R&D, marketing, and manufacturing teams.   And, yes, in order to be a good or great instrumentation designer, you had to know a lot of things that no university teaches.   There are no degrees in instrumentation design.   What mattered was a generalist's view of science and engineering, and then domain specialization in medical or chemical or aeronautical or astronomical fields in order to understand and design appropriate solutions.

Which is why it is so distressing to watch the charade about Covid-19 testing.   What farcical actions by a host of groups--the CDC, the Feds, many of the States, and certainly the 'test manufacturers'.  Mygawd, amateur hour.   And because of it, we've probably endured three times as many deaths as would otherwise have been expected.

If you cannot measure, you cannot improve.   Simple


Testing, testing--one, two, three

Testing for Covid19--what's the story?   

Do we need more tests?  The U.S. needs to improve its coronavirus testing to deliver results within two days, said Anthony Fauci, the top U.S. infectious disease official.  “We need to do better,” Fauci, head of the National Institute of Allergy and Infectious Diseases, said Wednesday about testing in an interview with Bloomberg Television’s David Westin. “No excuses. It needs to be done.”

Do we need fewer tests?  Trump praised testing in the U.S.: “50% of the country is short-term testing.  ...you have to remember, we did 61 million tests. The next country is -- like Germany is at three. India with 1.5 billion people is at 11. We’re at 61. Nobody’s even close to us in testing.”“Our testing is the best ever, the best in the world....” 

What are the nuances?

This is one of those "both are right" situations.  Here's the world-wide graph for testing per capita, courtesy of Johns Hopkins Center for Disease Control:

Indeed, the US leads the world in both number of tests, and tests per capita.   Are the counts accurate?And are they effective?

Fauci said the U.S. still has too many instances where testing results take days or a week to come back. “I can’t credibly defend that and say it’s a good thing, because it’s not,” he said. He said the goal is to have at least 95% of test results returned with a week.  Fauci and other public health officials have said that faster test results are needed to prevent the spread of the virus. Waiting days for results means many people may unwittingly spread the virus before learning that they’re positive and take precautions.  If the tests take longer than two days for results, contact tracing becomes  impractical.   And estimates are that less than 10% of US testing meets that criteria.

Other 'flies in the ointment' exist.   Nearly all of these have been unique to the US, although Brazil and some European nations have endured similar situations.

A. Many states have been conflating infection tests with anti-body testing, notably high-incidence states such as Florida and Georgia.

B. The number of tests counted may not equal the number of people tested.   Especially in the early months, it took three tests per person to obtain a clear answer, so the test counts were only one-third of the assumed total.'

C. The number of sequential tests given to preferential individuals may not be considered--Trump and his cabinet have each experienced dozens of tests per person; same for professional sports figures and many prominent national figures.   And suspected individuals are often tested multiple times.  Some states--Ohio and North Carolina, for example--have insisted that they only count 'the individual' rather than the actual number of tests given to a person.
 
D. Reliability of the "Confirmation"tests.   Mike DeVine, the Ohio governor, this month experienced first positive, then negative, tests for COVID-19, providing fuel for skeptics of government pandemic mandates ....  “I’m sure the internet is lighting up with ‘Well, you can’t believe any test,’ ” Mike DeWine said in a WCOL radio interview Friday, after a whirlwind of events the day before when the initial positive showing forced the Republican to scrub a planned meeting with President Donald Trump. And on Sunday, he told CNN’s “State of the Union” that “people should not take away from my experience that testing is not reliable or doesn’t work.”

Instead of seeing Trump at the Cleveland airport, DeWine returned to this state capital for new testing with his wife, Fran, through Ohio State University’s medical center. They then went to their southwestern Ohio farm in Cedarville, where DeWine said he planned to quarantine for 14 days. But within hours, he had received Columbus test results that were negative. The first test, part of protocol for people meeting with the president, was a rapid-result antigen test, while the Columbus testing was a genetic, laboratory test whose results are considered more reliable. 

https://www.detroitnews.com/story/news/nation/coronavirus/2020/08/09/ohio-governors-positive-then-negative-covid-19-tests-spark-controversy/3330703001/

E. Reliability of the Antibody tests.   This is also nuanced: the early flux of commercial, quick-to-market COVID-19 antibody tests were highly error-prone.   And even after reputable manufacturers took time to develop reliable antibody tests, they can still provide inaccurate results--especially false positives.   Additionally, recent data shows that COVID antibodies don't always last in people's bodies.  Some who test positive on an antibody test may later test negative--even within 10-12 weeks.  Source for these statements: https://www.sharp.com/health-news/the-truth-about-antibody-testing.cfm

***********  

My personal experience was (and is) complicated.   When I and my doctors first were concerned, on March 6, the day that Trump said at the CDC that the US had "a million tests ready', our county hospital claimed that there were no test kits available in the county.  I was the first person in our county to be 'suspected'--the first validation would happen two days later.  After first putting me in an isolation room, and asking a bunch of questions, they tested for pneumonia and sent me home.

A week later, the hospital story (since I was back again) was that "Yes, they now had two kits in the county, but they were reserved for 'important people'--which made me feel a bit second-class."  Two weeks after that, they said the kits they now had were unreliable, in fact unusable, for lack of a key component.   The LA Times reported on this, noting that only 1,138 people had been tested in the state, a week after Trump's boast--because of a re-agent that was missing.  The governor called it -- "shipping a printer without the ink"  https://www.latimes.com/california/story/2020-03-11/coronavirus-testing-kits-lack-key-ingredient-causing-confusion

After a month of this charade, five visits to ER and the hospital, the docs said, "Look, we've tested for everything else, including Valley Fever, echocardiograms, pleurisy, cardiac angiograms, COPD tests, etc., but just stay at home and self-quarantine" which I'd been doing all along.  "We just don't think it is worth testing for COVID with the kits we have, and besides, you're past the 'infectious stage'.   The antibody tests were just arriving--I even bought a few shares of Abbott Labs, excited by their new test, only to have it turn out to be only 50% reliable.

By the time antibody testing was deemed 'accurate', the docs all said, "No point in it--you'll test negative now because it will have worn off."

The next day, the President again told the nation: "Anyone who wants a test can get one--no problem"

I chagned the channel.