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November 26 - November 27, 2020
Amazon had benefitted hugely from the coronavirus lockdowns, which had forced many competitors to close.
The result has been a huge surge in positive tests, which the media insists on calling “cases.” But using the word “case” implies someone has a clinically significant illness – that they are sick enough to need hospitalization or at least medical attention.
I notice that WSJ and Fox heva begun backing off from this position since the election.
But for now coronavirus deaths remain significantly lower than they were in the Northeast in March and April. And we have every reason to think that they will stay that way.
As of November we are seeing a rise in infections.
California has about 40 million people. Since the epidemic began almost five months ago, the state has had about 9,000 deaths from the virus, none in anyone under 18. That’s correct: Not one person under the age of 18 has died in the largest American state from Sars-Cov-2. Yet California’s economy and society remain crippled.
First, the media has hidden the reality that anyone who is not extremely elderly or sick has a miniscule risk of dying from the coronavirus. In Part 1, I offered the real numbers and risks, based on the best government data. And since Part 1 was published, even more studies have emerged. A new Swedish government report puts the risk of death from Sars-Cov-2 at 1 in 10,000 for everyone under 50 – including those who have chronic conditions. And in a talk on July 14, Dr. Robert Redfield, the director of the Centers for Disease Control, put the risk of deaths in children under 18 at 1 in 1
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What went all-but-unnoticed in the push for lockdowns was the fact that major public health organizations had for decades rejected them as a potential solution to epidemics.
Despite the lack of evidence for them, they have become uniquely important symbolically as a way for the media and politicians to shame people who challenge the official narrative that Sars-Cov-2 is an extraordinarily dangerous disease.)
when Sars-Cov-2 arrived in force in Europe and the United States in March, public health authorities ignored their own cautious advice.
A lockdown is a broader response, perhaps more accurately described as a “mass quarantine,” covering a community, state, or even country.
In contrast, the phrase “social distancing” generally refers to voluntary measures that governments encourage but don’t require, like working from home.
Of all those choices, mass lockdowns are the most powerful and disruptive.
They are also the most seductive for policymakers, at least at first, because they seem so certain to work.
Small differences in R can make huge differences to how quickly an epidemic spreads.
But R can change dramatically and quickly, and it does not depend solely on the virus itself.
The goal of a lockdown is to reduce R – to slow the transmission rate.
When policymakers use the phrase “flatten the curve,” that’s what they really mean. People will still be infected, and some will still die. But the disease will spread over a longer period. So hospitals will function more normally, including continuing to treat sick people who don’t have the virus.
Is this a unit curve (i.e., does flatening the curve change the number of infections or just the peak number?
Governors must instead rely on fear and public pressure.
When there’s nowhere to go except grocery stores and Wal-Mart, many people will decide leaving their houses is not worth the trouble.
Most infamously, the Imperial College London report of March 16 – written by researchers who were working with the World Health Organization – predicted more than 2 million American coronavirus deaths without immediate action.
The stunning impact of the Imperial College report made Ferguson arguably the most important public health expert in the world. Yet he was neither physician nor virologist.
But he and the other Imperial College researchers appeared to believe a handful of relatively simple equations would predict the coronavirus epidemic.
That's the problem with physisists (assuma a perfectly circular cow of uniform density).
Nonetheless, Ferguson’s model produced highly precise answers. Lockdowns could reduce coronavirus deaths 95 percent or more if they continued until a vaccine was developed. Ferguson and his team even offered different death projections based on the severity of the lockdowns and benchmarks used to lift and reinstate them. These details gave the Imperial College model an undeserved sense of certainty and reliability.
But for all the complexity of his equations, Ferguson really offered nothing more than an updated version of the original frightened rationale for the quarantines European city-states had imposed during the Black Death seven centuries earlier: Keep strangers away and we’ll be safe.
Based on the CDC’s scale, Sars-Cov-2 almost certainly should be classified as Category 2 epidemic, meaning it will cause between 90,000 and 450,000 deaths. For Category 2 or 3 epidemics, the CDC merely said governments should consider school closures of less than four weeks, along with moderate efforts to reduce contacts among adults, such as encouraging telecommuting.
Experience has shown that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted.
At best, “models should be viewed as aids to decision-making, rather than substitutes for decision-making,”
Compare this to the personal MBA on decision-making. (People make decisions, not systems).
But the most likely explanation is the simplest. Faced with a risk of hundreds of thousands or millions of deaths, the public health experts who for decades had counseled patience and caution flinched. They found they could not live with acknowledging how little control they or any of us had over the spread
of an easily transmissible respiratory virus. They had to do something – even if they had been warning for decades that what they were about to do would not work and might have terrible secondary consequences.
Following infection with Sars-Cov-2, the average time to develop symptoms like fever or cough is five days.
In all, in the tiny fraction of cases when the novel coronavirus kills, death comes at roughly 18 days after symptoms begin and 23 days after infection.
These doomsday projections proved far off. But Cuomo wasn’t making them on his own. The hospital center Weill Cornell Medicine, the consulting firm McKinsey & Company, and the CDC were all advising him.
It was failing not just to predict the future but accurately measure of what was happening in real time.
By mid-April, some Americans – mostly conservatives – had begun to demand an end to the lockdowns. But their protests made little difference. Media outlets like CNN and the Times, which fully supported the lockdowns, treated the protests as fringe events.
We are learning that hospitals might be the main Covid-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patients.
The more medicalized and centralized the society, the more widespread the virus.
In other words, panic itself drives vulnerable people to hospitals and thus increases transmission among them. And nothing causes panic to spike faster than the serious consideration of lockdowns.
Unfortunately, coronavirus spreads most efficiently inside, especially in households living in poorly ventilated apartments or small houses, their windows closed against winter cold or summer heat.
Chinese researchers published a paper that looked at 318 outbreaks with 1,245 Sars-Cov-2 infections. They found that 80 percent took place in homes or apartments. Another 34 percent occurred on public transportation (some outbreaks occurred in more than one place, or could not be placed at a single venue). All other venues, including stores and restaurants, accounted for less than 20 percent of infections combined.
Quebec reported fewer than 15 percent could be traced to workplaces, stores, or bars and restaurants. 35 percent were intra-familial. Another 25 percent were of health care workers, patients, or prison inmates, and a similar number could not be traced.
the people most vulnerable to that intra-familial transmission of coronavirus – the extremely elderly and people with severe health problems – rarely work and are the least likely to spend time outside. They are naturally somewhat protected, until lockdowns confine them with family members who have been infected elsewhere and bring the virus home.
broad lockdowns do not appear to make much difference to the spread of the virus in nursing homes. Long-term care facilities are uniquely vulnerable to the coronavirus because their patients are both medically fragile and live close together. Fewer than 0.5 percent of Americans live in nursing homes – fewer than 1 in 200 people. But in both the United States and Europe, nursing home residents have accounted for 40 to 50 percent of all Covid deaths, well over 100,000 in all.
the effort required to promote and manage lockdowns can distract governments from the crisis in nursing homes.
Six months into the epidemic, the data are clear: the overall number of people infected with Sars-Cov-2 is less relevant to the number of people who die than which people are infected. Only when nursing home and hospital outbreaks burn out do deaths decrease.
the most impressive country-level evidence in favor of lockdowns comes from New Zealand, which locked down very hard and very early, and now appears to have largely eliminated the coronavirus on its territory.
Some European leaders have publicly admitted lockdowns were a mistake. In July, Jean Castex, the French prime minister, said the country would never again “impose a lockdown like the one did last March, because we’ve learned… that the economic and human consequences from a total lockdown are disastrous.”
And yet they have done so again.
Experience has shown that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted.
