This is an update to my post from March 21st,
http://zogprime.blogspot.com/2020/03/coronavirus-math-and-our-future.html
In the interest of not burying the lead, I’ll start by saying that we are still in a very bad place.
We are not doing enough to slow the rate of spread, and we are headed for a nightmare scenario.
If the United States can’t get the rate of new infections below 1% daily we will exceed a million deaths nationwide by January or February 2021.
The US now has over 1% of the total population with confirmed cases. The growth rate for new cases, or Daily Rate of Spread (DRS), is hovering around 2%. At 2% the time to double the number of cases is a fraction over 35 days. [1]
At that rate, we will hit roughly 5% of the population with confirmed cases by the end of September, 10% by early November, 20% by mid-December, and 40% by mid-late January. At that density of infection, the entire country will hit or exceed 100% of the available hospital capacity, with many areas over 200%.
https://projects.propublica.org/graphics/covid-hospitals
Phrased in the terms used in that article we will hit 20% within the first 9 months of the outbreak and 40% within the first 12 months.
When I published the original post the US was still under 25,000 confirmed cases, but the Daily Rate of Spread (DRS) in the US was over 40% and we were just days away from breaking 100,000 cases. I ran the numbers are various DRS to try to illustrate the severity of the situation. Any DRS in double digits would be disastrous. By early April the national DRS was below 10% and falling thanks largely to social distancing, quarantine, and mask orders. In spite of that, the US broke 1,000,000 confirmed cases in late April. By early May the DRS was below 2%, and in early June briefly dropped below 1%.
During the first week of June, many states (Particularly those with Trump loyalist governors) decided to declare victory and start re-opening. June 15th was the last day we saw a sub 1% DRS. Since then the DRS has slowly been climbing and broke through 2% on July 1st.
In March, starting under 25,000 cases had the US managed a DRS of 2% and a doubling rate of 35 days we would have had a realistic shot at containment. The US would still be under 250,000 cases with the 1,000,000 case mark over 4 months away and hospitals able to keep up.
From where we are now a DRS of 2% is a disaster. Right now the mortality rate when you compare deaths to new cases for the day is at an all-time low. July 10th saw 72,311 new confirmed cases and only 826 deaths or 1.1%. That is an artificially low number that reflects the case rate 2-3 weeks earlier, but as such, it can be considered a best-case scenario. If you combine a 40% infection rate with a 1.1% mortality rate and plug in a population of 330,000,000 you have 132 million people infected and 1.452 million deaths by mid to late January.
Let me restate that. At the current growth rate, and with the absolute, most optimistic, artificially deflated mortality rate I can come up with we lose almost a million and a half people by early next year. If you use the global mortality rate of 4% we are looking at over 5 million dead by January.
Most of the remaining news is also bad. The early spike in COVID-19 cases was centered around a few large outbreaks. Mostly in the New York/New Jersey area. When the northeastern US started to get its outbreak under control the numbers dropped rapidly. The current surge of cases is spread across the country with dozens of hotspots or potential hotspots. A concerted effort in Houston, Los Angeles, Miami, or Phoenix will not have the impact that the “all hands on deck” in New York had.
http://www.gregorybufithis.com/2020/07/03/the-trillion-dollar-question-why-are-covid-cases-increasing-in-the-us-while-deaths-are-decreasing-the-answer-is-simple-simpsons-paradox/
My conclusion remains largely unchanged from what I said in March…
Are we overreacting? No. If anything we are still underreacting. At the current DRS, even the current mortality rate will be devastating. As hospitals are stressed beyond capacity the mortality rate will only increase. If we don’t get out ahead of this and contain the spread millions will die. That’s not hype, that’s not alarmism, that’s math.
[1]
Doubling rate calculated using
log (2) / log (1+x) where x is the rate of increase.
E.g. for x = 2%:
log (2) / log (1+.02) = 35.003
Sunday, July 12, 2020
Tuesday, June 2, 2020
Say Their Names
Say their names. Say them out loud.
David McAtee. 6/1/2020
They were all human beings. They all had stories.
George Floyd. 5/25/2020
They all had dreams. They should all still be alive.
Michael Ramos. 4/24/2020
Some were heroes, working on the front lines of a Pandemic.
Breonna Taylor. 3/12/2020
Their lives were all cut short
Ahmaud Aubrey. 2/23/2020
because we exist in a society that places a higher value on some lives than others.
Atatiana Jefferson. 10/12/2019
Some of them were in their own homes
Botham Jean. 9/6/2018
minding their own business,
Andrew Finch. 12/28/2017
when their lives were taken. Say their names.
Bijan Ghaisar. 11/17/2017
Some of them had criminal records.
Armando Frank. 10/20/2017
Some of them could not hear what the police were saying.
Madgiel Sanchez 9/19/2017
That doesn’t mean they deserved to die.
Charles Kinsey. 7/18/2016
Some were in their cars.
Philando Castile. 7/6/2016
Some were in police custody or already in prison.
Sandra Bland. 7/13/2015
That doesn’t mean they did not deserve to live.
Freddie Gray. 4/19/2015
Some were playing in the park.
Tamir Rice. 11/22/2014
Say their names.
Laquan McDonald. 10/20/2014
Some were men of large stature.
Michael Brown. 8/9/2014
Is being big a capital crime?
Eric Garner. 7/17/2014
Some were children or teens. We will never know what they could have accomplished.
Trayvon Martin. 2/26/2012
Some had a history of mental illness.
Elliott Williams. 10/27/2011
That should not be punishable by death.
Say their names.
Many of their killers were acquitted or never charged.
Say their names.
In some cases their killers were charged and convicted.
It didn’t bring them back.
It didn’t stop the killing.
Say their names.
We have to remember and we have to do better. These names are only a drop in the bucket. For every name that we know how many more are there for whom there were no cameras, so they were quietly forgotten?
We have to keep saying their names so they are never forgotten. We have to keep saying their names so that we never think of them as statistics.
Even more, we have to keep saying their names until we can stop adding names. The only way that we can honor these people is by changing the culture that killed them. Say their names.
Tuesday, May 26, 2020
If You're going to be a Raging Asshole, Own that Shit
It will come as little to no surprise to those who know me that once again I am full of crap. For all of my talk about wanting to start conversations and promote rational dialog, after too much news and social media and a bad day out and about trying to do my grocery and pharmacy shopping in COVID-land I cut loose with a good old fashioned mouth foaming, obscenity spewing Facebook rant about… well, about pretty much everyone who doesn’t think like I do.
Like most self-indulgent rants it felt good at the time and to my amusement, I started seeing likes and other reactions to my rant.
Haha. Hey, that’s funny, I’m getting more reactions to this than I do to things I write seriously. Hey, maybe I should start writing all my posts as if I was going to have Samuel L. Jackson read them. Haha. Ha? Wait. I’m not sure that’s funny. Did I just get attention by going Def Comedy Jam? Is this really any different than the shock style media that I complain about so much?
Over the course of the next day, I watched my off the cuff rant get more traction and more re-distribution than everything else I have written put together. At last count, it was up to 12 shares (yeah, I know, not exactly viral, but it’s still more than anything else I’ve published), some of them from people that I not only don’t know but with whom I have no mutual friends. These are friends of friends of friends (or even more distant) who are reposting my rant. In some cases, people are apologizing for the language even as they share it.
Oh crap, maybe I should revise it. Maybe I should add a disclaimer. Maybe I should just take it down, would that remove all the shares? This is definitely going to come back to haunt me if I ever run for president. Or just maybe I should take this and figure out how I could have gotten the same reaction without the four “Fuck”s, two "Fucking"s, and one “Assholes”. Admittedly just removing the profanity wouldn’t stop it from being a self-indulgent rant, but it would be a start.
The main conclusion I have come to though is that I need to own it. One of the many things I lecture people about is being aware that there are no take-backs on the internet. If you say it, you’ve said it and you don’t get to un-say it. For better or worse I wrote this and I hit "post".
So for those of you who are not on Facebook or who missed it, here then, in all its glory, is my most popular piece of writing to date. Originally posted 5/25/2020
You know what? Fuck subtlety. Fuck eloquence. Fuck trying to find clear, non-accusatory ways of saying things.
What the fuck is wrong with people? Are Americans really so fucking stupid they won't even act to protect themselves if not others?
Now not only am I seeing macho young rednecks at the store without masks I'm seeing people who are either in or bordering on high-risk demographics walking around without masks looking vaguely defiant. It's like they are just waiting for someone to call them out on it so they can make their stand for the right to stupidity.
This is not that fucking complicated. It turns out that lots of countries figured it out in time to stop the spread at a few thousand cases and a few hundred deaths.
Yes, I know the argument that you can't compare the US to New Zealand or South Korea. The US has more people, it is more spread out, blah blah blah. So let's compare the US to China.
China has over 4 times the population of the US. When COVID-19 hit China absolutely nothing was known about it. They started with zero information and zero time to prepare.
In Mainland China there are fewer confirmed CASES, around 83,000, than there are confirmed DEATHS in the US, Over 98,000 and climbing. Let me repeat that in case it wasn't clear. In the United States more people have DIED of COVID-19 than all of Mainland China's cases put together, Active, Recovered, and Dead.
When China passed 1,000 dead in February people were horrified. "The Chinese government doesn't care about its people. How can they let this happen? Why don't they do more?"
When Italy passed 10,000 deaths in March people were horrified.
Sometime today or tomorrow the US is going to pass 100,000 confirmed dead from COVID-19. Where is the horror? Where is the shock? Where is the call for action? Why is it that all we are hearing is from the idiot fringe who want to pretend that everything is OK and we should go back to Business as usual?
Newsflash Assholes. This is not the Flu. Over the last 10 years Flu deaths in the US have ranged from 12,000-61,000 Per YEAR. Again, the worst death toll in the last 10 years was 61,000 in a year. We are approaching 100,000 dead in 3 months. What will it take for you to take this seriously? Do COVID-19 deaths have to exceed all other causes put together? Guess what? Keep it up and we will get there.
Your boredom and bad hair month are NOT more important than people's lives.
Tuesday, April 14, 2020
The Case Against Donald J Trump
The United States has, far and away, the largest COVID-19 outbreak in the world, now accounting for over a quarter of all confirmed cases globally. As of 4/11/2020 the US had exceeded 20,000 deaths from COVID-19 surpassing both Spain and Italy. The US death toll is now over 23,000 and rising. The vast majority of those deaths were entirely preventable. Those deaths are on the heads of Trump and all the lackeys who enabled him to delay an effective response.
Anyone with the least knowledge of history will tell you that the way to deal with an epidemic or pandemic is to identify it early and contain it before it gets established. The way the coronavirus outbreak in South Korea was handled proves that it was containable.
While I am not any kind of a fan of Bush the Younger, even he was able to see that "If we wait for a pandemic to appear, it will be too late to prepare. And one day many lives could be needlessly lost because we failed to act today."
In 2005 after reading an advance copy of John M. Barry's "The Great Influenza" about the 1918 Spanish Influenza pandemic George W. Bush set out to spend $7 billion building out his pandemic preparedness plan.
Not only did Trump fail to act, he actively dismantled the work done by the previous two administrations to try to prepare for the pandemic that they believed was inevitable.
The Trump administration disbanded The Global Health Security and Biodefense unit of the NSC in May 2018.
The USAID PREDICT program arose from the efforts Bush started and Obama continued. Over a 10 year period it identified some 1,200 viruses with the potential to cause human disease and pandemics, including over 160 novel coronaviruses. In 2019 the Trump administration defunded it. PREDICT ceased fieldwork in September of 2019.
Starting in January 2020 (if not earlier) Trump and other members of his administration have consistently misrepresented the severity of the coronavirus and the outlook for its spread in the US. Trump has wasted precious time arguing about reporting methodology and trying to downplay the numbers out of concern that the truth would make him look bad.
Trump’s dismantling of the institutions intended to combat this exact type of threat and his failure to act once the outbreak was in progress make him culpable for the thousands of deaths that we have already seen and the thousands still to come.
Friday, April 10, 2020
Yet Another Health Care Story
This is Health Care in the United States in a nutshell…
Over four months ago my doctor prescribed a new medication for me. This was a change in medication for a long-standing condition that my insurance company is well aware of.
The pharmacy where I get all my prescriptions (because it is the only one my plan allows) informed me that the insurance did not go through and was requiring prior approval. I advised the doctor’s office and they said they would take care of it.
Next call to the pharmacy the claim was still not going through pending prior approval.
Back to the doctor’s office. They assured me they had sent it in, but saw that it was not approved and would resubmit. This began a cycle of calls to the insurance company and the doctor’s office in which the insurance company said that they had sent the PA back as incomplete because it was missing information and the doctor’s office saying that they had entered everything.
Fast Forward to March. After hearing yet again from the insurance company that the doctor’s office wasn’t responding and the doctor’s office claiming that they had re-submitted the request two weeks more recently than the insurance company was claiming they had seen an update I finally set up a conference call with both at the same time. The results of this call were
Because it was late in the day when this conversation took place and because the rep said it took at least 24 hours to process the request once it came in I gave it a couple of days before I called the pharmacy and asked them to re-run the prescription.
Still not going through. Back on the phone with the insurance company. This time the automated system at the front end told me that I had a recent prior approval and that it had been rejected. The first rep I spoke to couldn’t explain why but offered to transfer me to the PA department. “Yes, Please”. Then after several beeps and static the call dropped.
A total of four calls (the first three were dropped when they tried to transfer me) to the company finally got me through to a PA representative who could look at the submission and the rejection. He read through it several times muttering to himself things like “ok, that’s the right diagnosis” before he found the issue. The doctor’s office had entered exactly the correct diagnosis code for this medication, but prior to doing that had answered NO to an earlier question that should have been yes. The question was “Does the patient have XXX”, where XXX is exactly what they had put in the code. At this point, we don’t know why the nurse answered no to that when that is exactly what the doctor said I had, but the upshot is that now that the PA has gone in, been reviewed and rejected the doctor’s office only gets one more try to re-submit before it is frozen and requires an appeal.
So over the course of 4+ months, there have been at least 3 or 4 re-submissions that apparently didn’t count due to the lack of an end date. Once the end date was added the form was rejected because the wrong box on line 1 was checked. The Caremark PA rep can’t update the form even though he could see that the diagnosis code was clearly correct. And if everything doesn’t go right next time the whole thing goes into an even more complicated appeals process.
Here’s the real kicker though. I have what is considered “good” insurance. This is coverage that would cost me upwards of $600/month if I was paying out of pocket. As health insurance in the US goes I am probably in the top 5-10% in terms of coverage and access, and I still can’t get a prescription filled because of clerical and procedural errors. That is the state of health care in the richest country in the world.
The only upside is that I can state with confidence that at least 4 different people have jobs just to tell people like me why we can't be treated.
Over four months ago my doctor prescribed a new medication for me. This was a change in medication for a long-standing condition that my insurance company is well aware of.
The pharmacy where I get all my prescriptions (because it is the only one my plan allows) informed me that the insurance did not go through and was requiring prior approval. I advised the doctor’s office and they said they would take care of it.
Next call to the pharmacy the claim was still not going through pending prior approval.
Back to the doctor’s office. They assured me they had sent it in, but saw that it was not approved and would resubmit. This began a cycle of calls to the insurance company and the doctor’s office in which the insurance company said that they had sent the PA back as incomplete because it was missing information and the doctor’s office saying that they had entered everything.
Fast Forward to March. After hearing yet again from the insurance company that the doctor’s office wasn’t responding and the doctor’s office claiming that they had re-submitted the request two weeks more recently than the insurance company was claiming they had seen an update I finally set up a conference call with both at the same time. The results of this call were
- The last person I talked to at the insurance company was wrong, they had received the recent submission.
- The recent submission had also been bounced due to missing information
- The piece of information that was causing the automatic kick out (turns out this is not the same as a rejection, the form was being auto processed out on the missing field with no human intervention) was an end date to the prior approval request.
- Apparently for a prescription prior approval to be considered it must have a start and end date.
- The insurance rep providing this information could not make the changes directly, the doctor’s office would have to re-submit.
- The insurance rep gave the nurse an 800 number to call for quicker processing and advised her not to use the online system
Because it was late in the day when this conversation took place and because the rep said it took at least 24 hours to process the request once it came in I gave it a couple of days before I called the pharmacy and asked them to re-run the prescription.
Still not going through. Back on the phone with the insurance company. This time the automated system at the front end told me that I had a recent prior approval and that it had been rejected. The first rep I spoke to couldn’t explain why but offered to transfer me to the PA department. “Yes, Please”. Then after several beeps and static the call dropped.
A total of four calls (the first three were dropped when they tried to transfer me) to the company finally got me through to a PA representative who could look at the submission and the rejection. He read through it several times muttering to himself things like “ok, that’s the right diagnosis” before he found the issue. The doctor’s office had entered exactly the correct diagnosis code for this medication, but prior to doing that had answered NO to an earlier question that should have been yes. The question was “Does the patient have XXX”, where XXX is exactly what they had put in the code. At this point, we don’t know why the nurse answered no to that when that is exactly what the doctor said I had, but the upshot is that now that the PA has gone in, been reviewed and rejected the doctor’s office only gets one more try to re-submit before it is frozen and requires an appeal.
So over the course of 4+ months, there have been at least 3 or 4 re-submissions that apparently didn’t count due to the lack of an end date. Once the end date was added the form was rejected because the wrong box on line 1 was checked. The Caremark PA rep can’t update the form even though he could see that the diagnosis code was clearly correct. And if everything doesn’t go right next time the whole thing goes into an even more complicated appeals process.
Here’s the real kicker though. I have what is considered “good” insurance. This is coverage that would cost me upwards of $600/month if I was paying out of pocket. As health insurance in the US goes I am probably in the top 5-10% in terms of coverage and access, and I still can’t get a prescription filled because of clerical and procedural errors. That is the state of health care in the richest country in the world.
The only upside is that I can state with confidence that at least 4 different people have jobs just to tell people like me why we can't be treated.
Saturday, March 21, 2020
Coronavirus Math and Our Future
Someone please tell me that my math is wrong…
Seriously, I really hope my math is wrong, because if it isn’t the plain truth is that the US is in worse shape than either China or Italy with regard to Coronavirus and COVID-19.
If you are among the people wondering if we are over-reacting to the Novel Coronavirus outbreak, the answer is resoundingly no.
I’m basing all my starting numbers on the current data in Wikipedia
(which seems to be pulling numbers from each state's health and human services sites)
The Daily Rate of Spread (DRS) in the US has been over 40% for the last three days (1). In contrast Italy is holding steady around 15% (2). If we extrapolate forward with a DRS of 40% in the US and 15% in Italy the total number of confirmed cases in the US will pass Italy on Thursday, 3/26. That will also be the day we break 100,000 cases. If the reports from China can be believed they have had no new cases in three days. They are holding steady at around 81,000 confirmed cases, we will pass that on 3/25 (3).
Now here’s the bad news. Even at 15% Italy is still in horrible shape. If Italy continues from where it is today with a DRS of 15% they will reach 10% of the total population infected in 34 days, 20% in 39 days, 30% in 42 days, 40% in 44 days, 50% in 46 days, 60% in 47 days and 100% in 51 days.
So what does that mean? Italy is already seeing it’s healthcare system badly overloaded with 53,578 cases nationally. Globally the mortality rate for COVID-19 is around 4.2%. In Italy the mortality rate is 9%. The disparity is at least partially due to the overloaded medical system.
At 10% infection they would have over 6,000,000 cases. With a 9% mortality rate that is over half a million fatalities. Even if they could get the mortality rate down to the 4.2% global average it is over 250,000 dead. That is just in the first month, and that assumes the mortality rate does not increase farther as the hospitals become more and more overloaded.
Now translate that to the United States. Currently the mortality rate in the US is around 1.2%. This reflects the availability of the level of medical care required in serious cases. As hospitals start to reach and exceed capacity we can expect to see the mortality rate rise toward the global average.
According to a study conducted by the Harvard Global Health Institute (4) and then modeled by ProPublica (5) if 20% of the US Adult population is infected within 6 months most of the country will hit or exceed 100% of hospital bed capacity and some areas will exceed 200%. At 40% infection within 6 months most areas of the country exceed 200% capacity. To have any chance of current hospital capacity being able to meet the COVID-19 load in addition to normal demand the total number of cases would have to stay below 20% for 12 months and below 40% for 18 months.
Even if the US miraculously dropped to a 10% DRS starting today we would still hit 10% of the population infected in 79-80 days, 20% in 87 days, 30% in 91 days, 40% in 94 days, 60% in 98-99 days, and 100% in 104 days. At the current 40% DRS we will hit 10% in 23 days, 40% in 27 Days, and 100% in 29 Days.
If you project that into human impact, at 10% infection there are over 33 million cases in the US. Even at the current US mortality rate of 1.2% that is almost 400,000 dead. At the global average of 4.2% it is 1.3 million dead. If we were to see a mortality spike like in Italy as hospitals can’t keep up you are looking at over 2.5 million people dead. That is almost 1% of the total population. If we do not get the spread under control 60% infection nation wide is a very real possibility. 60% of the US population is over 198 million people. Even at 1.2% mortality that is over 2.3 million people dead. At 4.2% it's over 8 million. At 9% almost 18 million people. That is roughly 5% of the population. 1 in 20. Think about your family, friends, coworkers. That is probably more than 20 people. Who's not going to make it?
To stay below 20% of the population infected in the first 6 months we would have to get the DRS down to 4%. To stay below 20% for 12 months we would need to get it to 2%. To stay below 40% in 18 months we need to get the DRS below 1%.
The window to do this is very small. If we stay at 40% DRS for two more days then the target to stay below 20% infection in 12 months drops to 3% DRS.
So are we overreacting? No. If anything we are still underacting. At the current DRS or even one quarter of the current DRS even the current mortality rate will be devastating. As hospitals are stressed beyond capacity the mortality rate will only increase. If we don’t get out ahead of this and contain the spread millions will die. The CDC guidance for Preventing the Spread of Coronavirus (6) is the bare minimum we should be doing.
That’s not hype, that’s not alarmist, that’s math.
Unless my math is wrong. Someone please tell me my math is wrong.
Sources
1. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_United_States
2. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy
3. https://en.wikipedia.org/wiki/2019%E2%80%9320_coronavirus_pandemic_in_mainland_China
4. https://globalepidemics.org/2020/03/17/caring-for-covid-19-patients/
5. https://projects.propublica.org/graphics/covid-hospitals
6. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html
Seriously, I really hope my math is wrong, because if it isn’t the plain truth is that the US is in worse shape than either China or Italy with regard to Coronavirus and COVID-19.
If you are among the people wondering if we are over-reacting to the Novel Coronavirus outbreak, the answer is resoundingly no.
I’m basing all my starting numbers on the current data in Wikipedia
(which seems to be pulling numbers from each state's health and human services sites)
The Daily Rate of Spread (DRS) in the US has been over 40% for the last three days (1). In contrast Italy is holding steady around 15% (2). If we extrapolate forward with a DRS of 40% in the US and 15% in Italy the total number of confirmed cases in the US will pass Italy on Thursday, 3/26. That will also be the day we break 100,000 cases. If the reports from China can be believed they have had no new cases in three days. They are holding steady at around 81,000 confirmed cases, we will pass that on 3/25 (3).
Now here’s the bad news. Even at 15% Italy is still in horrible shape. If Italy continues from where it is today with a DRS of 15% they will reach 10% of the total population infected in 34 days, 20% in 39 days, 30% in 42 days, 40% in 44 days, 50% in 46 days, 60% in 47 days and 100% in 51 days.
So what does that mean? Italy is already seeing it’s healthcare system badly overloaded with 53,578 cases nationally. Globally the mortality rate for COVID-19 is around 4.2%. In Italy the mortality rate is 9%. The disparity is at least partially due to the overloaded medical system.
At 10% infection they would have over 6,000,000 cases. With a 9% mortality rate that is over half a million fatalities. Even if they could get the mortality rate down to the 4.2% global average it is over 250,000 dead. That is just in the first month, and that assumes the mortality rate does not increase farther as the hospitals become more and more overloaded.
Now translate that to the United States. Currently the mortality rate in the US is around 1.2%. This reflects the availability of the level of medical care required in serious cases. As hospitals start to reach and exceed capacity we can expect to see the mortality rate rise toward the global average.
According to a study conducted by the Harvard Global Health Institute (4) and then modeled by ProPublica (5) if 20% of the US Adult population is infected within 6 months most of the country will hit or exceed 100% of hospital bed capacity and some areas will exceed 200%. At 40% infection within 6 months most areas of the country exceed 200% capacity. To have any chance of current hospital capacity being able to meet the COVID-19 load in addition to normal demand the total number of cases would have to stay below 20% for 12 months and below 40% for 18 months.
Even if the US miraculously dropped to a 10% DRS starting today we would still hit 10% of the population infected in 79-80 days, 20% in 87 days, 30% in 91 days, 40% in 94 days, 60% in 98-99 days, and 100% in 104 days. At the current 40% DRS we will hit 10% in 23 days, 40% in 27 Days, and 100% in 29 Days.
If you project that into human impact, at 10% infection there are over 33 million cases in the US. Even at the current US mortality rate of 1.2% that is almost 400,000 dead. At the global average of 4.2% it is 1.3 million dead. If we were to see a mortality spike like in Italy as hospitals can’t keep up you are looking at over 2.5 million people dead. That is almost 1% of the total population. If we do not get the spread under control 60% infection nation wide is a very real possibility. 60% of the US population is over 198 million people. Even at 1.2% mortality that is over 2.3 million people dead. At 4.2% it's over 8 million. At 9% almost 18 million people. That is roughly 5% of the population. 1 in 20. Think about your family, friends, coworkers. That is probably more than 20 people. Who's not going to make it?
To stay below 20% of the population infected in the first 6 months we would have to get the DRS down to 4%. To stay below 20% for 12 months we would need to get it to 2%. To stay below 40% in 18 months we need to get the DRS below 1%.
The window to do this is very small. If we stay at 40% DRS for two more days then the target to stay below 20% infection in 12 months drops to 3% DRS.
So are we overreacting? No. If anything we are still underacting. At the current DRS or even one quarter of the current DRS even the current mortality rate will be devastating. As hospitals are stressed beyond capacity the mortality rate will only increase. If we don’t get out ahead of this and contain the spread millions will die. The CDC guidance for Preventing the Spread of Coronavirus (6) is the bare minimum we should be doing.
That’s not hype, that’s not alarmist, that’s math.
Unless my math is wrong. Someone please tell me my math is wrong.
Sources
1. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_United_States
2. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy
3. https://en.wikipedia.org/wiki/2019%E2%80%9320_coronavirus_pandemic_in_mainland_China
4. https://globalepidemics.org/2020/03/17/caring-for-covid-19-patients/
5. https://projects.propublica.org/graphics/covid-hospitals
6. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html
Saturday, January 18, 2020
Has the Great American Experiment ever faced a greater challenge?
When asked what form of government we had ended up with Benjamin Franklin is famously quoted as responding
"A Republic, if you can keep it."
As far back as Plato there has been a fear that Democracies or Republics will naturally devolve toward demagogues and tyrants. A representative republic on the scale proposed for the new United States of America was a radical notion even without the expansion that would follow.
Now, as we stand with an unstable narcissist in the White House elected on a platform of racism, hatred and outright lies, it seems like the worst fears of the framers have come to pass. Every new piece of information that surfaces about this presidency highlights Trump's unfitness for the office he holds.
See the WaPo excerpt from “A Very Stable Genius: Donald J. Trump’s Testing of America"
The framers of the constitution were well aware of the historical tendencies of republics and tried to build in safeguards to protect the country they envisioned. Those safeguards have steadily eroded and are in jeopardy of collapsing entirely.
It has been over 230 years since the Constitution of the United States was ratified, and with the possible exception of the American Civil war in the 1860s I don't think we have ever been closer to seeing the Great Experiment Fail.
I don't know what it will take for the Great Experiment to survive this chapter. The mechanisms exist in the constitution to reclaim the government from the Oligarchs, but that requires winning elections. Democracy has always been predicated on the notion of an informed, engaged voting population.
Currently it appears that the elections in the Unites States are being won through manipulation of a highly malleable voter base. Professor Jonathan Metzl recently examined aspects of this in interviews with Boston University Today "Are White Americans Harming Themselves by Backing GOP Policies?" and the Tennessee Star "Vanderbilt Professor Says Racial Prejudice Keeps Rural Tennesseans From Embracing Obamacare".
In terms of the legitimacy of elections themselves it is hard to tell whether things are getting better or worse. With recent court decisions overturning heavily gerrymandered districting in Michigan and North Carolina it seems like there is progress on that front, but at the same time direct hacking of voting systems is on the rise. See Page 7 of the Worldwide Threat Assessment
The bottom line is that if we want to keep our Republic we will have to singularly and collectively commit to building voting coalitions that can defeat the bought and paid for servants of the oligarchs by large enough margins to make it impossible to steal the elections.
As far back as Plato there has been a fear that Democracies or Republics will naturally devolve toward demagogues and tyrants. A representative republic on the scale proposed for the new United States of America was a radical notion even without the expansion that would follow.
Now, as we stand with an unstable narcissist in the White House elected on a platform of racism, hatred and outright lies, it seems like the worst fears of the framers have come to pass. Every new piece of information that surfaces about this presidency highlights Trump's unfitness for the office he holds.
See the WaPo excerpt from “A Very Stable Genius: Donald J. Trump’s Testing of America"
The framers of the constitution were well aware of the historical tendencies of republics and tried to build in safeguards to protect the country they envisioned. Those safeguards have steadily eroded and are in jeopardy of collapsing entirely.
It has been over 230 years since the Constitution of the United States was ratified, and with the possible exception of the American Civil war in the 1860s I don't think we have ever been closer to seeing the Great Experiment Fail.
I don't know what it will take for the Great Experiment to survive this chapter. The mechanisms exist in the constitution to reclaim the government from the Oligarchs, but that requires winning elections. Democracy has always been predicated on the notion of an informed, engaged voting population.
Currently it appears that the elections in the Unites States are being won through manipulation of a highly malleable voter base. Professor Jonathan Metzl recently examined aspects of this in interviews with Boston University Today "Are White Americans Harming Themselves by Backing GOP Policies?" and the Tennessee Star "Vanderbilt Professor Says Racial Prejudice Keeps Rural Tennesseans From Embracing Obamacare".
In terms of the legitimacy of elections themselves it is hard to tell whether things are getting better or worse. With recent court decisions overturning heavily gerrymandered districting in Michigan and North Carolina it seems like there is progress on that front, but at the same time direct hacking of voting systems is on the rise. See Page 7 of the Worldwide Threat Assessment
The bottom line is that if we want to keep our Republic we will have to singularly and collectively commit to building voting coalitions that can defeat the bought and paid for servants of the oligarchs by large enough margins to make it impossible to steal the elections.
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