A reader responds to my follow up on the American withdrawal from the World Health Organization (WHO):
And in what way is it spreading around the globe? A few newly hit countries are still seeing rises, but in most of the world, just like the US, it’s done. Look at the current death rates from COVID for any European country, or the US for that matter. There is no US “surge.” We’re doing about half a million tests a day, and based on previous research it’s estimated that about 30% of the US population has already had COVID, so every “new” case is just a report of an old one. And that data is totally useless.
Did I miss something, or did the CDC not stop conflating infection tests with antibody tests? They admitted to that blunder something like a month ago, and I had assumed they fixed it. If they did, then the statement every new case is a report of an old one would seem to me to be false. Infection tests are for cases in which the virus is active in the body; antibody tests are for the antibodies which are generated by the body either during the infection, or after the infection has been resolved. Infections are expected to resolve within, as I understand it, at worst a couple of months; that’s an extreme. Most numbers I see are for positive infection tests, not labeled positive antibody tests.
Based on previous experiences with pandemics, mostly the 1917-1918 influenza, the statement that Covid-19 is done because we’re seeing a decline in cases in many countries is unsupportable. The double spike seen in that outbreak was not a data signal from the pathogen’s interaction with the human population. It was a signal from human psychology and how it interacted with the pathogen. In other words, the second spike came from human behavior. Given that and that our behaviors of today don’t seem to be that different from 100 years ago, a behavior inconsonant with good public health measures could easily reintroduce an incline in those numbers. Say, reopening bars or churches.
When we look at the US numbers, deaths, hospital beads [sic] in use, ICU beds in use, ventilators in use, are all flat or declining.
I put this current map from Global Epidemics to make the point that I think numbers taken at the granularity of the United States are worthless. We’re a nation of states that, by and large, formulate their responses to the pandemic without reference to the other states; attempting to summarize our current status on a national basis may be useful for predictions for unaffected parts of the nation about potential futures, but to suggest that it’s done when hospitals not coincidentally located in the states colored red in the above map are reporting nearing overflow conditions (Florida, Texas) strikes me as meaningless. Questions this sort of map provokes is whether the colors map faithfully to human behaviors, such as staying home in green Vermont while going to bars in red-colored Texas, as well as increasing usage of hospital beds, ICU beds, and deaths due to Covid-19 in the red and orange colored states.
The WHO was absolutely worthless during this event. The inaccurate numbers they reported and based models on, along with the inaccurate statements of everything from transmission methods, incubation periods, and even symptoms sparked inappropriate government responses around the world. We’re better off without them.
I’m baffled by this statement. The WHO is a front-line organization that serves to
The WHO’s broad mandate includes advocating for universal healthcare, monitoring public health risks, coordinating responses to health emergencies, and promoting human health and well being. It provides technical assistance to countries, sets international health standards and guidelines, and collects data on global health issues through the World Health Survey. [Wikipedia]
My bold. Given that such advice can only be given as deductions from information, which, by definition, is in short supply at the beginning of a pandemic, the quality of their recommendations is inevitably going to be worse early than later. They and their nation-partners are busy learning, and, in this case, studying a pathogen which seems to stimulate an unusually large variety of symptoms. Its reactions to medications are, of course, unknown at the beginning, and given the difficulties of designing and implementing medical studies, speedy improvements in advice are unlikely. And then add in the unreliability of those nation-partners’ data in some cases! I’d have difficulty supporting the reader’s conclusion, I’m afraid, especially in the face of the obvious political facets of the President’s announcement.
Finally, the reader remarks …
This is older now, but time has proven the data in it to be completely accurate.
Covid-19: What The Data Tells Us [by Josh Ketter]
Right off the bat, I’m not going to dispute this guy’s data or analysis. I’m a working dude, it’s not my area, and I don’t have time. But frankly I am skeptical of anyone who’s jumping up and down claiming the experts are wrong but he’s right – unless he has an interesting credential or work experience to throw into the mix. This could lead into a post about how non-experts should approach this sort of missive, but I’ll defer that to another day – and maybe I’ve written it already, I don’t recall.
But here’s just a couple of points (I’m having some physical problems with typing, so I’m limiting myself) that bother me.
The topic of immunity. Ketter’s just a dancer. That is, he spends a fair-sized paragraph trying to elide the current truth concerning the length of post-infection immunity, which is We don’t know. We just don’t know if you’re life-long immune to Covid-19 after surviving a bout, or only for 5 years – or only for 5 minutes. This is important because prescribing future human behaviors until a cure or vaccine is developed and distributed must pivot on the value discovered for the reinfection rate over time. There’s no choice or wiggle room. If immunity is non-existent, then we’ve got a problem, because we can’t just keep going to the hospital over and over again – or, for those who are primed to the economic side, missing work over and over. If immunity is 5 years, the problem is a lot less severe. But to suggest that the problem has passed, and that it wasn’t as severe as thought, without a value for the reinfection rate, is flat out nutty. I’ll also note the hidden contradiction in that paragraph: he references cousin coronaviruses to fake up some possible values for the immunity period, without noting that MERS had a case-fatality rate (that is, the ratio of known deaths from MERS to the number of known MERS cases) of .34, or 34%. There’s a really good reason epidemiologists became very worried about Covid-19 when it popped up – it’s bad enough losing 1% of the population for any country, but a 30% hit would cause absolute chaos.
The topic of collateral damage. Again, his coverage of the topic is incomplete. Here’s his visual aid, of which I’m properly envious:
Nowhere does he mention that these values are all affected by our response to the pandemic. Identification of specific problems is only half the battle, the other half is focusing on and tuning our response to the pandemic. For example, if suicide due to unemployment is forecast to be a problem, then cover the income problem for the duration of the emergency might be the initial response, followed by investigating how to support the businesses that provide the jobs until the pandemic has resolved.
The point is that these are not numbers written in stone by Mother Nature; what we do will affect them, so we should be mindful of these forecasts and let them guide our responses. Suggesting the vulnerable should just suck it up and die, and telling people in front line positions that, hey, thanks, and that’s it doesn’t really cut it, now does it?
Stopping now. It’s too nice out and the hands need a rest.
