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. 

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'

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.

Yes, Matilda, the SHIP HAS SAILED

 August 4, I posted a glum assessment from a workshop held with the AnywhereAnytime team, led by Dan Thomas, one of America's premier strategic thinkers.   Dan spent some 36 years teaching in the Executive Education section of Stanford's Business School, along with time at Harvard and others.

His succinct wrap-up was that "kids will not follow the rules" so if the decision on re-opening a school is dependent on the health impact for students, teachers, staff and the community, it is a lost cause.   The report generated some 'hate mail' from some of my erstwhile friends, who apparently still believe in Santa Claus and the Easter Bunny.

What we didn't expect was such sudden vindication.   Here's nine major universities (including private Colorado College in my 'old home town') that have just found out that students did not follow the rules:

https://www.cnn.com/2020/08/18/health/colleges-return-coronavirus-cases-wellness/index.html

So, Matilda, did the ship sail?   How will this play out across the country, not just in colleges but in elementary and secondary schools as well?   

Thoughts?

Reflelcting on a multi-cultural mixed bag

Although I've lived in California most of my life, and I am one of those oddities today in California--a native son born before World War II (only 2 people in 1,000 in California today fit that description)--and I have been here non-stop for the past fourteen years, I had no insight or perspective about Kamala Harris when she became the Vice Presidential nominee for the Democratic party.

And I just read a story about her and her husband, which was eminently readable no matter your party persuasion.   It is at https://www.washingtonpost.com/lifestyle/relationships/doug-emhoff-kamala-harris-husband/2020/08/18/a6c64db6-e15c-11ea-8181-606e603bb1c4_story.html?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most

What appealed to me?   Simple.   The lines about the backgrounds of she and her 'new' husband sounded sort of just like my wife and me.   

"a pairing that reflects the country’s diversity. Emhoff is White and Jewish. Harris is Black and Indian — she identifies as Baptist, like her father, but her mother also introduced her to Hindu customs. “They showcase America as it is, as it is becoming and as it will be . . . .”   

"It’s Harris’s first marriage and Emhoff’s second — he has two children from his previous one. According to the Pew Research Center, remarriage is on the rise — as are unions of two people of differing faiths and races."

How, you might ask, is that "just like my wife and me"?    Well, we are 're-married'--each of us for the third time.   We estimate that we have had a thousand people 'tsk-tsk' when they hear that.   The fact that we are now together for 35 years is some testament that it worked, but each of our deceased parents would doubtless still be surprised.

Re people of differing faiths and races uniting, Jenny is Catholic, my first wife was Mormon, and the second Episcopalian, while I was raised as a Protestant Methodist.   Moreover, Jenny's second husband was Jewish, so we've covered the waterfront on mixing differing faiths.

As for ethnic mixing, our offspring and our nieces and nephews have brought Asians and Hispanics into the family, not to mention Southerners from Alabama and Louisiana.   Not wildly diverse, but enough to challenge some family old-timers with Archie Bunker views.

Both of us are from the 'high-tech' world, so we've become acquainted with, and good friends with, Indians, Blacks, and Asians from a wide variety of countries and faiths and beliefs.  And we have consistently been impressed by their humanity as well as their intelligence and hard work and dedication.   

I've been on the Computer History Museum Board of Trustees for a while now, and it began as a bunch of computer nerds (almost all old white guys, usually ex-IBM or DEC folk).   Today, both on the staff and the Board, the heterogeneity is both gratifying and amazing--and the advice provided is much richer and more nuanced than it ever was in the pasts.

So, whatever else may play out in this election campaign, it is refreshing to see someone who isn't 'just another old white guy' on at least one ticket.  America has long since become a very multi-cultural country, and I for one think that is our greatest strength as a nation.

Los Angeles County

Treated as a nation, Los Angeles County has some interesting comparative statistics.

In terms of population, it is bigger than Switzerland, Israel, or Austria, and about the same as Portugal or Greece, at 10,110,000 folk.   Compared to American states, only six states are much larger--Texas, Florida, New York, Illinois, Pennsylvania, and Ohio--while North Carolina, Georgia, and Michigan are roughly equivalent.    It has as many residents as South Carolina and Alabama combined.

And California, without Los Angeles County, still has more people than any other state.

In terms of land area, Los Angeles County is not so large.  it is about the same as Vanautu, which by the way has not yet had a single case of Covid19 (quick, can you point out Vanautu on a map?).   Peru is one hundred times larger; France is fifty times and Spain is forty times larger.  Actually, our county, Tulare with 446,000 folk, is 80 square miles bigger.   Next door Kern County (Bakersfield) is almost twice as big, and San Bernardino County (America's largest) is four times larger than LA County.

In economic terms, it is America's largest GDP county at $711 Billion, 4% of the USA.   It would tie for the 20th richest GDP nation with Switzerland, well ahead of Taiwan from which so much of American electronics has emanated.

California today with 11% of America's population, has 619,000 Confirmed Covid19 Cases, 12% of America's total and 11,700 Deaths, 7% of the USA total.   LA County, with 25% of California's population, has 36% of its confirmed cases and 47% of its deaths.  

.As a Covid19 hotspot, it is America's leading county, with 221,000 Confirmed Cases at this writing.   Granted, NYC's five boroughs exceed this number slightly, but only Miami-Dade County in Florida is within shouting distance, with 70% of LA County's cases.  Cook County (Chicago) has half as many.  

So LA County is 'the biggest deal' in the biggest state, with the leading Covid19 statistics.

What might we learn from it?

First, some demographics

LA County is 27% White, 47% Hispanic, 14% Asian, 9% African-American

LA County's Confirmed Cases (where known) are 15% White, 71% Hispanic, 7% Asian, 6% Black

Deaths are 24% White, 50% Hispanic, 15% Asian, and 10% Black

Thus in lockstep with California, Hispanics have borne the brunt of Confirmed Cases.   However, in sharp contrast with much of California, their death-rate is substantially lower in proportion to every other ethnic group.   Whites have one fifth as many cases, and half the deaths.  Worth understanding.

Second, some deeper analysis

LA County has 88 incorporated towns, some pretty large besides LA City itself (at 4 million).  Long Beach has 460,000; Glendale 201,000; and Pasadena 162,000.   Fourteen cities are larger than 100,000.

Seventeen have more than 3,000 Cases per 100,000 folk, which is enough that you'd likely know someone who has been infected.   Twenty-eight have less than 1,000 Cases per 100,000--relatively safe communities.    

Ditto for the 140 Districts within LA City, and the 133 Unincorporated areas.

So, a mixed bag, to be sure.   Mull these now, and we can return to this example later, comparing it to other big cities/counties in America, and also to the other California urban centers.