The Coronavirus

[pbrower2a]

Donald Trump: Handling of COVID-19:

In your opinion, has President Trump handled the coronavirus crisis well? (yes - no - don't know/no response)

Arizona  40-51-9
North Carolina 40-49-11
Florida 41-49-10
Pennsylvania 37-53-10
Michigan 37-53-10
Wisconsin 35-55-10

https://redfieldandwiltonstrategies.com/...ng-states/

This is a British pollster.

Because the Plague of 2010 is the big story of the Trump Administration, performance on COVID-19, this is a good proxy for overall approval. Even the erratic foreign policy, the President's expressions of bigotry, and "the economy"  are now on the back burner due to COVID-19.  If the economy stays in the tank, then such will have an indelible link to COVID-19.

This may be worse than the colors look because Trump approval in every one of these states is under 42%. The true tragedy of the Plague of 2020 has yet to hit many of us because unless we are medical personnel we rarely see people dying of it. People die of COVID-19  in private, unlike the case with something non-contagious such as cirrhosis, cancer, Parkinsonism, Alzheimer's, or congestive heart failure. In the last eight years I have seen seven people on the second-to-last or last days of their lives in knowledge that those people were dying. But all of those cases did not involve any contagious disease.

The full impact of COVID-19 will not affect people's thoughts until many of the funeral services delayed due to limited numbers of participants are held without such constraints. People will be asking to see death certificates

What is so bad about 41% approval? Late in May it is next to impossible to win re-election as an incumbent unless one already has 45% support by then. Trump might have gotten away with numbers like these in December or January, but as the season warms up, opinions typically fossilize in a contest of vision. Things can go terribly wrong with an incumbent -- a breaking scandal or an inept response to a natural disaster. COVID-19 is a natural disaster. Trump has been lucky until COVID-19 struck.

But high disapproval numbers are themselves trouble. 51% disapproval is the highest that I saw for Barack Obama in any state in 2011 or 2012 by a reputable pollster in any state that he eventually won in 2012. But even in that one (Quinnipiac, and I forget the details other than that it was still fairly close at 45-51 and rather early) was for Ohio, which was one of Obama's barest wins. Obama won a spirited and competent campaign, and (I forget the timing) he may have won Ohio over the dead body of Osama bin Laden.

I will spare the obvious metaphor about Donald Trump.

[Bob Butler 54]

The virus has a R0 around 2, the average number of people infected by one person, the basic number showing how contagious the bug is.  This is only an average.  There are super spreaders, people who spread to a lot more.  You get one person in a meat packing plant, one going to a church service, one person going into a prison.  Such people often center a hotspot.

CNN reports on one such pair, a couple of hairdressers who opened with the economy lately.  Most take the precautions and stay safe, but if you ignore the precautions...

[Warren Dew]

CBS reports on a study that estimates the shutdown will cause about 75,000 suicides and similar deaths:

https://www.cbsnews.com/news/coronavirus...mic-75000/

Unfortunately they don't link to the original study, but it supports the fact that those opposing all reopening are just rooting for more deaths.

[Mikebert]

Here is a plot of the death rate per day per million pop in what I call the "Hot Zone" (NY, NJ, MA, MI, PA, IL & CT) and the rest of the country. As a point of comparison, the 2009 flu (a bad flu year) saw 61000 deaths over six months, which works out to 1.1 deaths/million/day.

Three observations:

(1) the death rate in the 2 regions is very different (the hot zone scale is 10X that for the rest of the country)

(2) the profile shapes are different. In the Hot Zone the death rate rose to a peak and then has fallen off dramatically. In the rest of the country, death rates rose to a plateau about a tenth of the size of the Hot Zone peak and has stayed there.

(3) Even after the large drop in the Hot Zone, the death rates there are still much higher than in the rest of the country.

Discuss.

[

[sbarrera]

(05-24-2020, 12:46 PM)Mikebert Wrote: Here is a plot of the death rate per day per million pop in what I call the "Hot Zone" (NY, NJ, MA, MI, PA, IL & CT) and the rest of the country. As a point of comparison, the 2009 flu (a bad flu year) saw 61000 deaths over six months, which works out to 1.1 deaths/million/day.

Three observations:

(1) the death rate in the 2 regions is very different (the hot zone scale is 10X that for the rest of the country)

(2) the profile shapes are different. In the Hot Zone the death rate rose to a peak and then has fallen off dramatically. In the rest of the country, death rates rose to a plateau about a tenth of the size of the Hot Zone peak and has stayed there.

(3) Even after the large drop in the Hot Zone, the death rates there are still much higher than in the rest of the country.

Discuss.

[

Seems the lockdown measure are more neccessary in the hot zone, and should be continued. They could be lessened in the 'rest zone'. The state where I live, Pennsylvania, basically has this, by color coding the counties as either red for 'stay at home' or yellow for 'aggressive mitigation.' The red counties cluster around Philly and the yellow counties are pretty much the rest of the state. Although the latest news is that we are all going to be yellow by June 5 and some will go green, where there are still restrictions but business could return in basically reduced form.

[Eric the Green]

(05-24-2020, 12:46 PM)Mikebert Wrote: Here is a plot of the death rate per day per million pop in what I call the "Hot Zone" (NY, NJ, MA, MI, PA, IL & CT) and the rest of the country. As a point of comparison, the 2009 flu (a bad flu year) saw 61000 deaths over six months, which works out to 1.1 deaths/million/day.

Three observations:

(1) the death rate in the 2 regions is very different (the hot zone scale is 10X that for the rest of the country)

(2) the profile shapes are different. In the Hot Zone the death rate rose to a peak and then has fallen off dramatically. In the rest of the country, death rates rose to a plateau about a tenth of the size of the Hot Zone peak and has stayed there.

(3) Even after the large drop in the Hot Zone, the death rates there are still much higher than in the rest of the country.

Discuss.

[

The graph compared the two zones, showing the rest of US now has a higher rate than the hot zone, but you say one trend line is 10X the other. The graph might be less confusing if it compared the two lines on the same scale.

Another observation from my daily observation of the stats: MD, VA and DC are also part of the hot zone.

[Eric the Green]

(05-24-2020, 11:39 AM)Warren Dew Wrote: CBS reports on a study that estimates the shutdown will cause about 75,000 suicides and similar deaths:

https://www.cbsnews.com/news/coronavirus...mic-75000/

Unfortunately they don't link to the original study, but it supports the fact that those opposing all reopening are just rooting for more deaths.

We're screwed either way then, because without the shutdown we'd have 10 times more covid deaths.

We got screwed because Trump (and Cuomo too) delayed the shutdown too long. Now the shutdown has to go on much longer than it otherwise would have.

[Bob Butler 54]

(05-24-2020, 12:46 PM)Mikebert Wrote: Here is a plot of the death rate per day per million pop in what I call the "Hot Zone" (NY, NJ, MA, MI, PA, IL & CT) and the rest of the country. As a point of comparison, the 2009 flu (a bad flu year) saw 61000 deaths over six months, which works out to 1.1 deaths/million/day...

The Hot Zone states are highly populated states in the northeast, with the exception of the addition of Illinois.  Most got caught looking at China while the infections came in from Europe.  They didn’t react as quickly as the west coast states, and thus the high peak.  They did react, while much of the country did not, thus the rest of the US is still going up.

The big thing is that they have the high population density and thus the high R0 so had to react.  Many other states have the lower R0, thus not as difficult a problem, but their policies are nowhere near as stringent.  A more moderate isolation might be enough to turn things to an exponential decay, but so far the politics have not let it happen.

Not sure how much more can be said with only two lines to look at.  Breaking it up into more groups by response policy might be useful.

[Eric the Green]

(05-24-2020, 01:12 PM)Bob Butler 54 Wrote:

(05-24-2020, 12:46 PM)Mikebert Wrote: Here is a plot of the death rate per day per million pop in what I call the "Hot Zone" (NY, NJ, MA, MI, PA, IL & CT) and the rest of the country. As a point of comparison, the 2009 flu (a bad flu year) saw 61000 deaths over six months, which works out to 1.1 deaths/million/day...

The Hot Zone states are highly populated states in the northeast, with the exception of the addition of Illinois.  Most got caught looking at China while the infections came in from Europe.  They didn’t react as quickly as the west coast states, and thus the high peak.  They did react, while much of the country did not, thus the rest of the US is still going up.

The big thing is that they have the high population density and thus the high R0 so had to react.  Many other states have the lower R0, thus not as difficult a problem, but their policies are nowhere near as stringent.  A more moderate isolation might be enough to turn things to an exponential decay, but so far the politics have not let it happen.

Not sure how much more can be said with only two lines to look at.  Breaking it up into more groups by response policy might be useful.

What is "R0"?

[sbarrera]

Using this sort of nuanced data to take intelligent, coordinated action is exactly what strong national leadership should/would be doing. But alas, we have a dumpster fire of a Federal government presided over by a criminal lunatic.

[Bob Butler 54]

(05-24-2020, 01:11 PM)Eric the Green Wrote:

(05-24-2020, 11:39 AM)Warren Dew Wrote: CBS reports on a study that estimates the shutdown will cause about 75,000 suicides and similar deaths:

https://www.cbsnews.com/news/coronavirus...mic-75000/

Unfortunately they don't link to the original study, but it supports the fact that those opposing all reopening are just rooting for more deaths.

We're screwed either way then, because without the shutdown we'd have 10 times more covid deaths.

We got screwed because Trump (and Cuomo too) delayed the shutdown too long. Now the shutdown has to go on much longer than it otherwise would have.

Questionable logic as the more you open up, the more deaths before there is finally a response, thus the longer the shutdown has to be, the more deaths of despair there will be.

[Bob Butler 54]

(05-24-2020, 01:17 PM)Eric the Green Wrote: What is "R0"?

A medical term for how many people an infected person infects on average.  If above one, you get an exponential growth of the disease.  If below one, you get exponential containment.  The further from one, the greater the speed of growth or containment.  Isolation in the form of social distancing, masks, gloves, etc, is one way to lower R0.  The population level of the environment is also a large factor.  If you are a farmer who is well away from everyone, it is better than being in a prison, nursing home or meat processing plant with infected coworkers.

Sorry.  I thought defining the term every time I used it seemed tiring.  Still, it is one of the defining terms of the pandemic, along with the chance of death among those infected.

[Eric the Green]

(05-24-2020, 01:20 PM)sbarrera Wrote: Using this sort of nuanced data to take intelligent, coordinated action is exactly what strong national leadership should/would be doing. But alas, we have a dumpster fire of a Federal government presided over by a criminal lunatic.

That's exactly right.

[Eric the Green]

(05-24-2020, 01:28 PM)Bob Butler 54 Wrote:

(05-24-2020, 01:17 PM)Eric the Green Wrote: What is "R0"?

A medical term for how many people an infected person infects on average.  If above one, you get an exponential growth of the disease.  If below one, you get exponential containment.  The further from one, the greater the speed of growth or containment.  Isolation in the form of social distancing, masks, gloves, etc, is one way to lower R0.  The population level of the environment is also a large factor.  If you are a farmer who is well away from everyone, it is better than being in a prison, nursing home or meat processing plant with infected coworkers.

Sorry.  I thought defining the term every time I used it seemed tiring.  Still, it is one of the defining terms of the pandemic, along with the chance of death among those infected.

Thanks. I didn't think such a small acronym would be google-able. But I found it, and it means "Reproduction number." R stands for Reproduction. The "0" is often a subtext, and I guess it just means a number.

[Bob Butler 54]

(05-24-2020, 02:47 PM)Eric the Green Wrote:

(05-24-2020, 01:20 PM)sbarrera Wrote: Using this sort of nuanced data to take intelligent, coordinated action is exactly what strong national leadership should/would be doing. But alas, we have a dumpster fire of a Federal government presided over by a criminal lunatic.

That's exactly right.

Well, it is close enough.  You could say they value money over people.  You could say they prefer to ignore problems rather than confront them if confrontation costs money.  But at this point I'm tired of making excuses and think Sbarrera's evaluation more honest and pertinent.

[Warren Dew]

(05-24-2020, 01:05 PM)sbarrera Wrote: Seems the lockdown measure are more neccessary in the hot zone, and should be continued.

I don't think it's obvious that the measures that are currently failing to control the number of cases in the "hot zone" are the ones that should be continued.

I live in an urban suburb of Boston, a hot area of a hot zone.  We had a fairly severe shutdown with people basically going to grocery and drug stores and nowhere else.  This reduced travel and should have reduced the viral reproduction rate R by a factor of 10, but the actual result of a new case reduction that's extremely gradual showed a reduction in R by a factor of 3 at most.  Something is going on beyond the shutdown.

Possibilities include a very high R on the subway system, which remained open, or transmission by some other vector, like food or something, or an external driver, like people travelling from New York.  We don't know what it was, but we need to find out, because we need for the interventions to become more effective, rather than just resorting to the ones that are most draconian but are of limited effectiveness.

I'm hoping masks will help, but masks will only address the same tranmission vectors that we thought we were already addressing.

[Bob Butler 54]

(05-24-2020, 09:35 PM)Warren Dew Wrote:

(05-24-2020, 01:05 PM)sbarrera Wrote: Seems the lockdown measure are more neccessary in the hot zone, and should be continued.

I don't think it's obvious that the measures that are currently failing to control the number of cases in the "hot zone" are the ones that should be continued.

I live in an urban suburb of Boston, a hot area of a hot zone.  We had a fairly severe shutdown with people basically going to grocery and drug stores and nowhere else.  This reduced travel and should have reduced the viral reproduction rate R by a factor of 10, but the actual result of a new case reduction that's extremely gradual showed a reduction in R by a factor of 3 at most.  Something is going on beyond the shutdown.

Possibilities include a very high R on the subway system, which remained open, or transmission by some other vector, like food or something, or an external driver, like people travelling from New York.  We don't know what it was, but we need to find out, because we need for the interventions to become more effective, rather than just resorting to the ones that are most draconian but are of limited effectiveness.

I'm hoping masks will help, but masks will only address the same tranmission vectors that we thought we were already addressing.

I suspect a lot of it is individuals failing to take the precautions seriously enough.  Mothers holding sleepovers, or dropping kids off at shut down malls to socialize might be examples.  Too many people are stuck in the unraveling mindset, putting their own convenience ahead of the community's need. Trump is keeping up his open up do not take this seriously narrative in opposition to the hot zone governors position.  As a result many are extending the lockdown and hitting themselves in the economy.

But the result is to bring us below an R0 of one.  We are not quite blowing the health care system away.

[Mikebert]

(05-24-2020, 01:05 PM)Eric the Green Wrote: The graph compared the two zones, showing the rest of US now has a higher rate than the hot zone, but you say one trend line is 10X the other. The graph might be less confusing if it compared the two lines on the same scale.

Another observation from my daily observation of the stats: MD, VA and DC are also part of the hot zone.

The scale on the left is 1/10 the scale on the right. If both were plotted on the same axis it would make it hard to see the shape of the rest of the country.

I chose the top 7 states in terms of total deaths as the Hot Zone, when I started to track these. CA has since bumped CT to 8th place, but because CA is so large, its per capita death rates are very small, so I wouldn't include them any way. The next two states in the total death ranking are LA and MD, so if I chose to expand the Hot State category they would be next. Next after them would be FL, which I would exclude based on size, like CA. Then comes OH, IN, and GA, followed by TX (which I would exclude like CA and FL). Then comes CO and only then VA.  So VA is not really part of the hot zone.

DC is hot in terms of per capita deaths, but has a small number of total deaths, like RI. Consider how this graph is constructed. The Hot Zone is the sum of dealths in seven states with the highest deaths. Adding in more states with small numbers of death will not significantly change the plot, they will only serve to divide the total deaths by a bigger population and water down the finding. 

A key thing to remember is NY accounts for 29% of the deaths in the whole country and 45% of the deaths in the hot zone. I chose the other six states partly to reduce the dominance of NY in the data set, while removing their dynamics from the national data. When you plot the national data you see a peak and decline afterward. But this is misleading. It is an artifact of including NY and a handful of other states in the total. Take those out (i.e. the Hot Zone) and you get the profile in a majority of the country. There was no peak, no "first wave".  It's just a steady progression.  As states open up, the state and local health departments will be working to isolate infected people since we now have MUCH more testing that we did in March. There will probably be no "second wave".  The flat trend may be replaced by a slowly rising trend, but that is a lot less scary.

I would point out that the shape of the hot zone profile is also shown by 4 hot zone state that are not NY. Two are adjacent to NYC (NJ, CT) and so are really part of the NYC outbreak.  Another state (MA) may are may not have its own outbreak. Then there is my state (MI) which likely got its own innoculum from Europe or maybe even Wuhan because of the links between the auto industry and suppliers there. So I consider MI to be a separate outbreak, like the early ones in WA and CA. These outbreaks were crushed by the authorities, keeping these states from becoming part of the hot zone.

LA may have had its own outbreak too, I am not very familiar with their experience.

[Mikebert]

(05-24-2020, 09:35 PM)Warren Dew Wrote: I don't think it's obvious that the measures that are currently failing to control the number of cases in the "hot zone" are the ones that should be continued.

I live in an urban suburb of Boston, a hot area of a hot zone.  We had a fairly severe shutdown with people basically going to grocery and drug stores and nowhere else.  This reduced travel and should have reduced the viral reproduction rate R by a factor of 10,

I don't understand how it is obvious that the measures being used to control the number of cases in the "hot zone" are failing. Over the last month, the daily death rate has fallen by 75%. Over the same period of time in the rest of the country the death rate has been slightly up (6%).

Also, where did you get that factor of 10 from?

[Mikebert]

(05-24-2020, 09:46 PM)Bob Butler 54 Wrote:

(05-24-2020, 09:35 PM)Warren Dew Wrote:

(05-24-2020, 01:05 PM)sbarrera Wrote: Seems the lockdown measure are more neccessary in the hot zone, and should be continued.

I don't think it's obvious that the measures that are currently failing to control the number of cases in the "hot zone" are the ones that should be continued.

I live in an urban suburb of Boston, a hot area of a hot zone.  We had a fairly severe shutdown with people basically going to grocery and drug stores and nowhere else.  This reduced travel and should have reduced the viral reproduction rate R by a factor of 10, but the actual result of a new case reduction that's extremely gradual showed a reduction in R by a factor of 3 at most.  Something is going on beyond the shutdown.

Possibilities include a very high R on the subway system, which remained open, or transmission by some other vector, like food or something, or an external driver, like people travelling from New York.  We don't know what it was, but we need to find out, because we need for the interventions to become more effective, rather than just resorting to the ones that are most draconian but are of limited effectiveness.

I'm hoping masks will help, but masks will only address the same tranmission vectors that we thought we were already addressing.

I suspect a lot of it is individuals failing to take the precautions seriously enough.  Mothers holding sleepovers, or dropping kids off at shut down malls to socialize might be examples.  Too many people are stuck in the unraveling mindset, putting their own convenience ahead of the community's need.  Trump is keeping up his open up do not take this seriously narrative in opposition to the hot zone governors position.  As a result many are extending the lockdown and hitting themselves in the economy.

But the result is to bring us below an R0 of one.  We are not quite blowing the health care system away.

It's not the R0, its the R. R is the observed infection rate. R0 is the infection rate under natural conditions, typically at the beginning of an outbreak. That is, it is the base case, hence the subscript 0.

For Warren, R0 is a first order rate constant for infection kinetics.  R is the rate constant after you take into account various inhibitors like social distancing, mask-wearing and weather, plus mass-action effects like isolation & contact tracing or brute-force actions like shutdowns.