Flattening The Curve

Guest Post by Willis Eschenbach

I’ve been following the many changes in the IHME coronavirus model used by our very own most incompetent Dr. Fauci. (In passing, let me note that he’s been wrong about most everything from the start—from first saying it was not a problem, to predicting 200,000 deaths in the US (based on an earlier version of this model), to advising people to NOT wear masks, to opposing chloroquine. But I digress …)

The IHME model is here, and it’s well worth a look, although not worth too much trust—it’s been wrong too many times. To their credit they’ve put the results online here.

Another problem with it is that the presentation of the data is so good. It’s good enough that it’s hard not to take it as fact.

The model historically has predicted numbers that were too high. The latest incarnation of the model is predicting 81,766 COVID-19 deaths in the US by August 4, 2020. That’s down from 93,000 in the previous incarnation of the model. Are they finally right? History makes one cautious. There’s a discussion of the upgrade of the model here.

However, despite their past high estimates in absolute numbers, I figured that their estimates of the shapes of the responses is likely pretty close to realistic. So I thought I’d take a look at the projected daily deaths, to see what I could learn. In particular, I wanted to investigate this idea of “flattening the curve”.

What does “flattening the curve” mean? It is based on the hope that our interventions will slow the progress of the disease. By doing so, we won’t get as many deaths on any given day. And this means less strain on a city or a country’s medical system.

Be clear, however, that this is just a delaying tactic. Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period. Valuable indeed, critical at times, but keep in mind that these delaying interventions do not reduce the reach of the infection. Unless your health system is so overloaded that people are needlessly dying, the final numbers stay the same.

Now, the model lists three kind of interventions on a state-by-state basis. The interventions are:

• Stay at home order

Educational facilities closed

Non-essential services closed

I figured I could take a look to see if imposing those restrictions would make a difference to how flat the curve is. Of course, to do that, I had to figure out a variable that would represent the “flatness” of the curve. After some experimentation, I settled on using the highest daily death number as a percentage of the total number of deaths. For convenience I’ve called this number the “peak factor”, and the larger it is, the more peaked the curve is.

So to start with, here are a couple of states with very different peak factors from two ends of the scale. The graph shows the shapes of the curves, but not the actual sizes, of the daily death counts in the two states.

Figure 1. The shapes of the curves of daily deaths for West Virginia and Missouri. Both have been scaled to a mean of 0 and a standard deviation of 1, and then aligned to zero. Both datasets slightly smoothed (Gaussian filter, FWHM = 3 days). For purposes of illustration of curve flattening, I’ve adjusted them so the total number of deaths are the same in both states.

Note that the area outside the blue line but still under the yellow line (bottom center) is equal to the amount of the peak above the yellow line. It’s the same total amount, just spread out over time.

Now, that looks like interventions are working … except for one detail. West Virginia imposed all three restrictions. Missouri only imposed two. And for those two, Missouri imposed them both later than did West Virginia.

So that pair certainly doesn’t say much for the effectiveness of our interventions. Why are they so different? Unknown, but presumably because of things including the density and distribution of the population.

So that’s what the effect of the interventions should look like. It should take a peaked curve and transform them, stretch them out over a longer time with a lower peak. And more interventions should flatten the peak even more.

Intrigued by all of this, I returned to the IHME model. One interesting discovery that I made was that for all of the states, the number of deaths before the peak is very close to the number of deaths after the peak. This was true for states with a high peak factor as well as a low peak factor, across the board. This should allow us a rough-and-ready rule of thumb to estimate the total deaths once the peak is passed. 

Note that this rule of thumb is true no matter when the lockdowns are removed—all that will do is change the date of the deaths, not the total number calculated by the rule of thumb.

For example, Italy. Let me go look it up at Worldometer … OK, the peak was on March 28th, at about 10,000 deaths. That would make me think that total deaths in Italy will be on the order of 20,000 deaths. 

To check that prediction, I just now looked for the first time at the IHME model country page for Italy. Until this latest update, they didn’t cover other countries, just the US. OK, the IHME model says 20,300 deaths projected for Italy. So my rule of thumb appears to work quite well. Let me test it with Spain. First, Worldometer. It says there had been 9,400 deaths by the time of the peak daily death in Spain. Rule of thumb says that the total should be on the order of 18,800 deaths. Turns out when I got there that the IHME model page for Spain says 19,200 deaths. So it seems that the rule of thumb works well, at least according to the model. Whether it works in the real world remains to be seen …

Next I looked at the peak factor for all the states versus the number of interventions, to see if the interventions tended to lower the peaks and flatten the curve. Figure 3 shows that result.

Figure 2. Scatterplot, “peak factor” showing how peaked the curve is, versus the number of interventions imposed on the populace. Red “whisker” lines show one sigma uncertainty of the median. Since there are only two states with zero intervention, no uncertainty calculation is possible.

As you can see, the total number of interventions makes no statistically significant difference in the flattening of the curve. 

So I thought, well, let me look at the dates of each of the three types of interventions—stay at home, close schools, close businesses. Maybe there is relationship there. First, here are peak factors of the various states versus the timing of their “stay-at-home” order. Over time, the intervention should lead to lower peak factors, with early adopters getting greater benefit. Here’s that result.

Figure 3. Scatterplot, peak factors of the states versus the date on which they imposed the “stay-at-home” order. The yellow line is a “robust” trend, one which downweights any outliers. The trend is not statistically significant.

What that says is the opposite of what we’d expect—in this case, the later the intervention happened, the flatter the curve. Should be the other way around, earlier interventions should lead to more effect on the outcome.

Next I looked at the closing of non-essential services. Here’s that result.

Figure 4. Scatterplot, peak factor versus the date of closing of all inessential services. Again, the yellow line is a “robust” trend, one which downweights any outliers. This time the trend is statistically significant (p-value = .028)

However, despite the statistical significance of the trend line, it’s going the wrong way. The early adopters should be less peaked by now, not more peaked. Finally, here is the school closure data.

Figure 5. Scatterplot, peak factor versus the date of closing of all schools. Trend is not statistically significant.

It’s sloped the wrong way again, but I saw that graph and I thought “Hang on … that one data point is influencing all the rest”. So removed that point, which happened to be Iowa, and took another look.

Figure 6. Scatterplot, peak factor versus the date of closing of all schools. Trend is not statistically significant. 

At least this one is going slightly the right way, although the trend is still not significant. That lack of a clear result may be a result of the bluntness of the instrument and the small size of the data sample.

Despite the lack of significance, I suspect that of all of the actions taken in the Western world to slow the spread of this illness, closing the schools could be the only one to have an actual measurable effect. Don’t get me wrong, any intervention has some effect however small. But I mean a real significant effect.

I say closing schools could have this effect because schools, particularly grade schools, could have been designed to be a very effective way to spread an infection. Consider. You not only have the kids packed in close together indoors for five days out of the week. Worse, it’s the same kids every day, so they have multiple chances to infect each other. Worse yet, they all go back home at the end of the day to infect the rest of the family, or to bring in new fun illnesses for “show-and-tell-time” at school to start the process over.

And finally, as all kids do, they wrestle and kick and cough and grab each other and sneeze and spit on the ground and trade clothing and eat bits of each others’ lunches … it’s a perfect petri dish.

So if you want to slow an infection, closing the schools at least makes logical sense.

On the other hand, stay-at-home orders where people still go out for groceries as well as to either work in “essential” jobs or purchase other essentials (and non-), that seems like a joke to me. The virus is sneaky. The Fed-Ex driver just dropped off a couple of packages here … there are still loads of people out and about. It’s all around. It can live on surfaces. It is transported by coughing, sneezing, or even talking. Yes, if you do a full-on surveillance state detecting, tracking, and contact tracing like South Korea has done, that will work. But you need to give your phone GPS data to the government to make that work. There’s no way Americans, or most westerners in general, would do that.

The western style style of quarantine leaks virus like a “closed” Senate hearing leaks classified information, and then the virus is transported everywhere. There’s really no attempt being made to track contacts. I suspect it would be futile at this point.

Overall? I see little evidence that the various measures adopted by the western nations have had much effect. And with the exception of closing schools, I would not expect them to do so given the laxness of the lockdown and the vague nature of “essential business”. I’ve mentioned before, here in Sonoma Country California, the local cannabis retailer is considered an essential business … strange but absolutely true.

Finally, I want to talk about that most mundane of things, the humble cost/benefit analysis. Draw a vertical line down a sheet of paper, label one side “Costs” and the other “Benefits”. Write them down on the appropriate side, add them up. We’ve all done some variation of that, even if just mentally.

Unfortunately, it seems Dr. Fauci doesn’t do cost/benefit analyses. It seems he only looks at or cares about the benefits. He called millions of people being thrown out of work “unfortunate” … unfortunate? It is a huge cost that he doesn’t want to think about. He’s not going to lose his job. His friends won’t lose their jobs. Meanwhile, at the same time that he’s saying “unfortunate”, the mental health hotlines and the suicide hotlines are ringing off the wall. People are going off the rails. Domestic violence calls are through the roof, and understandably. Forcibly take the jobs away from a wife and a husband, tell them that they are under house arrest, that’s stress enough … and meanwhile there’s no money coming in, rent and electricity bills are piling up, can’t put gas in the car, kids bouncing off the walls from being cooped up … of course domestic violence and suicides and mental health problems are off the charts.

Which brings me to California where I live. If California were a country it would have the fifth-largest economy in the world. Fifth. Just California. The annual GDP (Gross Domestic Product, the total value of everything we produce) of California in round numbers is three trillion per year. We have no hard figures, but it would not surprise me if 2020 was only seventy percent of normal, not from the virus, but from the government pulling the wheels off of the economy. That’s a loss of Nine. Hundred. Billion. Dollars. That’s bigger than the GDP of most countries, up in smoke.

And that’s not counting the cost of partially offseting the governmental destruction. First, the government pulled the wheels off of the economy. And now, they’re pumping out taxpayers’ dollars like water to try to ease the pain that they’ve just inflicted. That $1,200 check people are talking about? That a cost, not a benefit as the chatterati would have us believe. It comes out of our pockets. And there are all kinds of other associated expenses, lost wages, the list goes on and on.

So overall, here in California alone we’ve lost pushing a trillion dollars of value, with millions out of work, tens of thousands of businesses shuttered forever, discord and dismay abounding … and for what? For what?

Well, it’s for the following. Here is the IHME model projection for coronavirus deaths in the fifth largest economy in the world …

Figure 7. Projected coronavirus deaths, California.

That’s it? That’s all? Eighteen hundred dead? That’s less than California murders. It’s less than California gun deaths. It’s a third of our drug overdose deaths, for heaven’s sake, and guess what?

The trillion dollars we lost from the government shutting down the California economy?

It won’t save one of those 1,783 people. Not one.

It will just delay their deaths by a week or two.

A trillion in losses are on the cost side of the cost/benefit analysis. And on the benefits side, all we have is a two-week delay in eighteen hundred unavoidable deaths? That’s it? That’s all that a trillion dollars buys you these days?

Ah, you say, but more people might die if the medical system is overwhelmed. Are there enough beds and ventilators?

Well, glad you asked. Here are the figures, again from the IHME model. Unfortunately, as with the number of deaths, all the previous incarnations of the model have overestimated the need for hospital resources … but with that caveat, here are their California numbers.

No bed shortage. No ICU bed shortage. And we just shipped some ventilators to New York. We should peak in a week.

And while we’re waiting for the peak, we’ve just spent about a trillion dollars to delay 1,783 deaths by a few weeks. Not to save anyone’s life, I say again. Just to delay a couple thousand deaths by a couple weeks … look, it still wouldn’t be worth a trillion dollars even if we could actually save that many lives and not just delay their deaths. If it helps your conscience you could give the family of each person who could have been saved a million dollars, that’s only 0.2% of your trillion dollars, and the economy could keep humming along.

But it’s simply not worth totally wrecking the lives of 30 million Californians just to save eighteen hundred lives. That’s madness, that’s a terrible deal.

I have opposed this from the start. I don’t do a one-sided “benefits” analysis like Dr. Fauci does. I do a COST/benefit analysis, and we’ve just looked at it. Here’s the conclusion of that analysis:

Even if your hospital system is going to get overloaded, even if more people are going to die, put the trillion dollars into making the medical system the strongest and most resilient imaginable. Spend it on field hospitals and stocks of disposables, buy ventilators, buy hospitals, buy medical schools, buy beds and gowns, that’s what will save lives. I don’t care, shut down the grade schools if you have to although with a solid medical system you likely won’t have to … but whatever you do …

DO NOT SHUT DOWN THE ECONOMY, STUPID!! The costs are far, far too great.

Just the human costs are beyond measure. Lives ripped apart, suicides, endless worry and concern, running out of money to feed the kids, there’s no end to it, lying in bed at night wondering when they’ll let you out of jail. 

And that’s all before we even get to the economic costs and the ripple-effect costs and the loss of productive capacity and the canceled contracts and the lawyers’ fees and finally, the start-up capital required, and the businesses that will have gone elsewhere, and the need to rehire or replace people and overhaul idled machinery, etc. etc. once this monumental stupidity is over.

So this is a plea for all you women and men at the top, the ones deciding when to call off the madness, I implore you—get up out of your offices, look around you, go to a small town and talk to some unemployed businesswoman whose local enterprise is now belly-up, understand what the loss of that business means to that small town, and GET AMERICA WORKING AGAIN TODAY! Not tomorrow. Today. Every day is endless pain and worry for far too many.

Here’s how crazy this lockdown is. You folks who decide on this for California? You are costing us trillions of dollars, and you are literally killing people through increased suicide and depression and domestic violence, and it’s all in the name of delaying a couple of thousand deaths. Not preventing the deaths, you understand. Delaying the deaths.

Killing people to delay death, that sounds like a charmingly Aztec plan, it comes complete with real human sacrifices …

Sheesh … it’s not rocket science. Further delay at this point won’t help. End the American lockdown today, leave the schools closed, let’s get back to business.

And yes, of course I’d include all the usual actions and recommendations in addition to leaving the schools closed—the at-risk population, who are those with underlying conditions, particularly the elderly, should avoid crowds. And of course continue to follow the usual precautions—wash your hands; wear a mask at normal functions and not, as in your past, just at bank robberies; only skype or facetime with pangolins, no hootchie cootchie IRL; refrain from touching your face; sanitize hard surfaces; y’all know the drill by now … the reality is we’ll all be exposed to to coronavirus sooner or later. And like the Spanish Flu and Hong Kong Flu and a host of diseases before and after them, after a couple of years the once-novel coronavirus will no longer be novel. It will simply become part of the background of diseases inhabiting our world like the Swine flu and the Bird Flu, all dressed disreputably and hanging out on every street corner in every town waiting for someone to mug …

My regards to all, and my profound thanks to the medical troops who are on the front lines of this war. The wave is about to break in the US, dawn is approaching, it will be over in a month. And hopefully, long before then. these insane regulations will go into the trash, we can stop paying trillions to delay a few deaths a few weeks, and we can get America up and working again.

w.

A REQUEST: If you know someone who makes the decisions on one of the lockdowns, or if you know somebody who knows one or more of the women and men making that decision, please send them a link to this document and ask them to read it and pass it up the chain so that we can all get back to work sooner rather than later.

To facilitate this, I’ve put a copy of this post for anyone to download as a Word document here, and as a downloadable PDF document here. Send a copy to someone who might make a difference.

MY USUAL REQUEST: When you comment, please quote the exact words that you are referring to. Only in that way can we be clear about what you are discussing.

469 thoughts on “Flattening The Curve

  1. This study just published in Lancet says school closures have only a minimal effect:

    https://www.thelancet.com/pdfs/journals/lanchi/PIIS2352-4642(20)30095-X.pdf

    Systematic reviews of influenza outbreaks suggest that school closures are likely to have the greatest effect if the virus has low transmissibility (R<2), particularly if attack rates and transmission are
    higher in children than in adults. Although our information on SARS-CoV-2 remains incomplete, this appears not to be the case with COVID-19 outbreaks. Reported R values for COVID-19 are high (≥2·5). Although children appear to contract infection at the same rate as adults, they largely have mild or asymptomatic forms of the disease and appear to be less likely to spread the virus through coughing or sneezing

    • Thanks. Gotta say, their claim that kids are “less likely to spread the virus through coughing or sneezing” is cold comfort, and seems offset by the fact that they are more likely to be asymptomatic.

      w.

      • Asymptomatic for Covid-19 perhaps, yet sneezing coughing and drooling from other causes and spreading the virus regardless.

      • Plus they are far less likely to be conscientious about the fact that there we got this a’here virus dealio goin’ around.

      • Kids and middle agers mostly get it, give it, and get over it. This is the best way to build that ‘herd immunity’. Of course the elderly and frail need to be protected. All retirement homes must be closed for this 3-4 wks of nastier virus season. All these other measures are truly flattening the curve but at some point we need to get back to living – then with only ?50% of the herd immunized – here comes the next bump this fall.

        • The following confirm Rick’s point.
          https://www.doh.wa.gov/Emergencies/Coronavirus 93% of deaths w/ C19 in WA state occurred amongst those age 60 & older.
          https://digg.com/2020/coronavirus-death-rate-italy-spain-elderly The results are similar in Italy, Spain & S. Korea.

          Changing perspective helps support the results of Willis’ analysis. Healthy people 59 & younger have less chance of dying with C19 than of winning a $100+ million lottery. So, preventing such people from carrying on their normal daily routines will NOT significantly affect deaths with C19. Worse, ordering these people to stay home WILL INCREASE deaths from anxiety related causes (suicides, overdoses, heart attacks … _) and by murders.

          The consequences for hospitalizations are similar. 50+% of those 59 & younger w/o complicating health conditions are asymptomatic when infected, or they feel only slightly subpar. So, they will NOT seek hospital care. The others can be sent home because they do NOT need hospital care.

          Willis, another point you make is worth emphasizing. Flattening the curve FAILS to reduce the # of deaths with C19, unless it reduces deaths caused by rationing health care services. I will add: A more effective way to allocate health care service is to give priority to those KNOWN to be most vulnerable to dying with C19.

          Time to wrap up: The KEY public health issue is how to better protect the most vulnerable to dying with C19. Another key issue is how to minimize the adverse consequences such measures have for the rest of society.

      • The more I learn, the more I am convinced that it is co-infections that are responsible for making COVID-19 deadly for a tiny minority of the infected. It has very high rates of asymptomatic and mild infection. Is it not plausible that besides “pre-existing” health conditions, a determinant of deadliness is another common and sometimes-deadly pathogen?

        Kids spreading COVID-19 and the other pathogen or pathogens, would be a plausible explanation for your finding.

        But the thing I am most convinced about is the “housing and environment” factor. New Zealand is an outlier; it had to have had COVID-19 spreading as early as anyone else did because China is a major trading partner and source of tourists, immigrants and arrivals. Lockdown only started after the first death in late March. Testing has been slow and late, quarantining based on tracing contacts (like Singapore) is non-existent, and border triaging extremely lax even now.

        The fact that there is one death and 14 hospitalized in total so far is NOT due to any inherent POLICY superiority. Lockdown can’t be the reason that there is no sign of previously infected people still ending up in intensive care during the early days of lockdown!!! (Like there is in every other country).

        Confirmed cases of “community transmission” is “two”! The other 1100 total confirmed infected, only 14 of whom are in largely-empty hospitals, are explained by known contact with infected people from overseas. The experts need to be excited about studying New Zealand to discover what factors make its people so “immune”. Plenty of experts are pointing out that COVID-19 is an infection with a high rate, 40 to 60%, of asymptomatic cases, and of the rest, most are mild illnesses only. The true rate of infection on average everywhere is around 100 times “confirmed infections”. New Zealand obviously has the highest rate of asymptomatic or mild infection anywhere in the world!

        I say it is obvious, self-evident, that the factors are low urban density, clean air, the elderly being predominantly in good suburban housing, the fact that it is not flu season in the Southern Hemisphere (hence absence of the co-infections that actually result in deaths “with” rather than “of” COVID-19), and NZ’s climate itself (ambient humidity, temperature etc at this time of year). See this paper for guidance on environmental and seasonal factors:

        https://www.annualreviews.org/doi/pdf/10.1146/annurev-virology-012420-022445

        Obviously there can be quite different environmental conditions from region to region even within States and countries. All else being equal, one would expect rural regions to have lower death rates and yet there are exceptions, suggesting that their environmental and housing conditions should be investigated.

        • My bet is that countries with these very low rates have already “had it” and so have some immunity. There’s no reason why South Korea, Taiwan and Japan should be so lightly hit. I note Japan had a very early flu season and Korea and bad flu season. Could easily have been COVID.

      • Actually, from what I recall regarding the study on the Princess cruise ship,when testing positive for the “dreaded virus,” the older you were the more asymptomatic you were by percentage: obviously, the older you were and symptomatic, the worse it was for you. Thought I had read another study on http://www.swprs.org/a-swiss-doctor-on-covid-19 (which was linked from WUWT awhile back) which stated that children with the “dreaded virus” were more symptomatic.

        Regards
        ak

    • No surprise there is little effect from closing schools. Most students are not in any high-risk categories.

    • The way I see it, schools are germ factories…really efficient ones.
      And kids are germ fountains…not like a gently flowing kind of fountain, but the kind that sends out high pressures jets in every direction…willy-nilly-like.

    • Willis Eschenbach how do a very high R0 and high asymptomatic fraction affect the analysis?
      High SARS-CoV2 Infection rate
      CDC has calculated each person’s R0 reproductive number at very high 5.7 of new persons infected per newly infected person. This China Virus has a very rapid spread of 20%-31%/day or doubling every 2.3 to 3.3 days. The Communist Party’s refusal to quarantine Wuhan before the annual Spring Festival New Years celebration caused this pandemic to very rapidly seed cross China and thence to the world.
      If asymptomatic cases are 2-3 times those with symptoms, that causes it to spread unannounced very rapidly. That suggests what some thought was the “flu” could have been COVId-19.
      High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2

      the threshold for combined vaccine efficacy and herd immunity needed for disease extinction is calculated as 1 – 1/R0. At R0 = 2.2, this threshold is only 55%. But at R0 = 5.7, this threshold rises to 82% (i.e., >82% of the population has to be immune, through either vaccination or prior infection, to achieve herd immunity to stop transmission)….
      we estimated the growth rate of the early outbreak in Wuhan to be 0.21–0.30 per day (a doubling time of 2.3–3.3 days), suggesting a much faster rate of spread than initially measured.

      https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article
      https://twitter.com/QTRResearch/status/1247873179391012864/photo/1

      • David L Hagen April 8, 2020 at 1:02 pm

        Willis Eschenbach how do a very high R0 and high asymptomatic fraction affect the analysis?

        Those are the very reasons that the “quarantine” doesn’t work in western countries … it’s very sneaky. If you want to quarantine against it you have to do it Chinese style—lock people in their apartment buildings and deliver food to them.

        Anything less the virus just laughs at.

        w.

        • This is true. And reading this paper in more detail is somewhat laughable. There was a study in Oregon where a serum tested positive had the disease in December. Their 5.7 R0 is based on the assumption that only 4,000 people in Wuhan had in on Jan. 18th. That doesn’t jive.

          Again, the CDC, Imperial College and and initially IHME were all using IFR north of 1% and high R0, that they do not adjust. This throws out millions of dead even though the majority of evidence suggested otherwise. A highly transmissible virus floating around in China since Nov/Dec and only 4,100 Wuhan residents have it? Just that modeling alone should show the fallibility of those projections. It was more likely in the millions or 10 of millions, where the majority of people that have little ability to pay or access healthcare are low/no symptom patients.

          Case counts are super irrelevant because they are biased and CFR is then rendered meaningless until testing is random and large – please ignore case counts on TV and Worldometers for your own good. IFR can be estimated other ways until large scale serum testing is done (Diamond Princess was a perfect example).

      • This is a good link, though a bit primitive. I have seen several private models and public ones. First thing:

        1. NYC has easily the highest R0 outside Wuhan. Probably 4.0 or something. Europe 2.5-3.0, rest of US 2.0-2.2. Its very density driven
        2. Once people are aware of a virus R0 drops, so NYC drops from 4.0 to 2.0 quickly
        3. Distancing drops is further. Lockdown maybe is 0.5
        4. R (which is R0 adjusted for the amount of people immune) drops very quickly as people are infected, especially if R0 is high.

        By definition the higher the R0 the lower the IFR – the chances you die if you get it. If both were high the death toll globally would already be millions and maybe 10’s of millions. Oxford has the IFR at 0.1%-0.25% which is 1-2.5x a bad influenza year. Those numbers feel right to me, even a little high.

        A friend of mine who does modeling for COVID has been saying NYC is already >50% infected and recovered by next week – almost herd immune. It all happened before the lockdown. As of now its the safest place to be if you are high risk. There will be no second peak.

        • There are 2 things affecting Kung flu spread.
          1) Population density
          2) Density of that population….

          • You left out the obvious connection to the prevalence of people with the Flu Manchu style of facial hair.

  2. Absolutely what I have been saying re the lockdown here in UK. Well said Willis. I dont have your analytical skills but common sense says that wrecking an entire economy so that a relatively small number of people very sick with this virus are not turned away to die somewhere else. Tragic but necessary.
    There will be far more deaths and suffering as a result of wrecking the economy than would occur from the virus – and the economic effects will last a much time.

  3. Can we rely on the total number of virus deaths given by the government? I don’t believe we can. As noted in other articles posted on WUWT, a large number of patients in Italy and other countiies were old or very old. Many had serious underlying health conditions. Some had more than one serious underlying condition. According to one of the doctors on the Federal task force, if a person with the virus dies, their death is counted as a virus death. The presence of virus may have been a contributing factor however, we should not just assume that all deaths were caused by the virus. A person may have died of a heart attack, cancer, or some other pre-existing or unknown condition however, that death is counted as a virus death. Do we really know how many people actually died of the virus and not some other cause?

    • There is a scenario not many are mentioning: the next wave. In 1918, the mortality rate in the first wave of the Spanish Flu from (6/29–7/27) was one fifth the mortality rate of the second wave that started in October. There are reasons to be optimistic about a second wave because warmer temperatures will likely reduce the spread, but come fall we’d better have effective treatments and health care capacity for the most serious cases or we’ll be right back where we are now. It is hard to imagine going through another period of self-induced economic destruction later this year.

      Some hopeful news about a possible broad-spectrum vaccine:

      https://medicalxpress.com/news/2020-04-successful-mers-vaccine-mice-covid-.html

      And a potentially effective treatment for the most severe cases:

      https://medicalxpress.com/news/2020-04-coronavirus-patients-benefit-blood-recovered.html

      • re: ” in the first wave of the Spanish Flu from (6/29–7/27) was one fifth the mortality rate of the second wave that started in October.”

        Case sample of one; are there other examples where the flu (etc) has come in ‘waves’?

        • This one. Social distancing and school closures are credited – at least in part – with causing 2 additional waves, the third one being the worst.

          “Social distancing and school closures can create multiple outbreaks… when examined in detail, the “waves” result from the aggregation cases occurring non-uniformly with respect to location and time (Fig. 8). In addition, the multiple “waves” do not occur because of differences in the recovery time or susceptibility to infection due to geographical factors. These results provide strong support to the hypothesis that a combined effect of local transportation, social distancing, and school closures can produce multiple macroscopic (whole-country) “waves” for the same epidemic; as observed in Mexico during 2009 (Fig. 2)…

          The “waves” in the cases considered here occur because the implementation of social distancing and school closure measures pause, but not stop, the spread of the disease.

          https://www.aimspress.com/fileOther/PDF/MBE/1551-0018_2011_1_21.pdf

          https://www.ncbi.nlm.nih.gov/pubmed/21361398

      • “There is a scenario not many are mentioning: the next wave. ”

        Doh!
        I knew I was forgettin’ sumptin’!

  4. Well done. But, despite continued exodus of citizens, there are 40 million Californians, with an unknown number of illegal aliens.

  5. I have noticed for some time that the death rate of coronavirus in both Hong Kong and Singapore is about 0.5%. These places are more densely populated than New York, have closer tie to China and their outbreak was earlier. Also, the death and infected numbers are quite reliable and believable. How come that their death rates are so low and different from those in Europe and USA? They seem to test suspected cases only.

  6. Thank you for doing the maths.
    I have been arguing this very point for days, but now the numbers are showing.

  7. The UK’s curve is far from flattening but there is an encouraging deviation downwards of about 35% from the longest persistent trend line. In the absolute numbers the divergence is some 3800 cases from 10905 (trend line) to 7097 actual recorded deaths as shown here

  8. Are there “Unintended Consequences (a la polio)” of flattening the curve?

    a charmingly Aztec plan, it comes complete with real human sacrifices

    One-child? That is so Pro-C… I guess it depends on how you define “human”, “sacrifice”, and “real”.

  9. Not only is Fauci wrong, he’s dangerous and at the very least, he’s allowing politics to cloud his judgement’s. In the extreme, he’s acting as a Chinese operative. That video recently posted by kenji, is eye raising.

    https://youtu.be/eglF0BFkkrQ

  10. Willis, thanks for putting forth a clear and understandable explanation of the need to consider the unintended consequences of actions that are often taken to address the symptoms without understanding fully the benefits, let alone the costs. Your point about the constancy of the total deaths is a very important one. You also nailed the need not to overload our healthcare facilities as that could lead to an increase in fatalities. It does no good when the Governor of New York demands 37,000 ventilators, when the actual number they apparently will need is less than 10,000. My only caution is that the data is really not very good, particularly given the large number of asymptomatic infections as well as the possible undercounting of COVID-19 deaths given the shortage of test kits over the past two months. That said, you have done this as well as possible at the moment, and I certainly hope your analysis is considered by our decision makers.

    • I haven’t seen any mention that the malaria meds are prophylactic and curative. Isn’t that the real deal – we took malaria pills in VN – give the quinines to medical staff and the +60 crowd with underlying morbidities – tell old folks to shelter as much as possible – and have everyone else get back to work?

      • re: “I haven’t seen any mention that the malaria meds are prophylactic and curative. ”

        You must have missed the postings in previous threads; I think the group has ‘moved on’ …

  11. Flattening the curve does reduce the death count. If there is a high peak there are no ventilators available at all and clearly more people will die.

  12. Flattening the curve does not reduce the total number of cases or deaths. … Unless your health system is so overloaded that people are needlessly dying, the final numbers stay the same.

    The whole rationale for flattening the curve is to keep the health system from becoming overloaded. The poster child for an overwhelmed system is probably Ecuador. They can’t even pick up the dead bodies fast enough.

    You may think America has the best medical system that has ever existed anywhere, and it probably does, but the bottleneck is ICU beds. How many of those are available in your community? The probable answer is probably, not enough … unless you can sufficiently flatten the curve.

    You can ask the Ecuadorians about the wisdom of partying hardy in the face of a pandemic.

    • Except Willis shows the number of ICU beds in his neighborhood against the projections. There are plenty

      • So, suppose that you have two cities in 1950. How do you know how many long distance phone circuits to run between them? Ultimately, you have to decide how much of the time you are willing to have all the circuits filled with the result that some customers won’t be able to make a connection. You can’t afford to have one long distance circuit per subscriber. Not only that, but most of the time most of the circuits will be unoccupied which seems like a waste. Your boss’s boss’s boss will lay down policy on how much of the time you’re willing to put up with all the circuits being full. You will then tell him how big the cable has to be. erlangs

        The ICU bed problem is similar. In 2005, the national ICU bed occupancy was 68%. link That means that a distressing amount of the time there was an ICU bed shortage in some communities even without any sort of emergency.

        • Even in NYC they haven’t run out of ICU beds or Ventilators, that’s per Governor Cuomo just yesterday.

          • It’s not nearly as clear cut as you think.

            As hospitals have teetered on the brink of being overwhelmed, they have sent home people whom they would have admitted just a few weeks earlier, several New York doctors said in interviews. link

            Has NY peaked? When will it peak? Anyway, it sounds like things aren’t that rosy as it is, and people aren’t getting the care they need.

    • +++I appreciate this comment.

      For most of the posts across the internet I see the same, fundamental assumption. I do not understand how this point can be overlooked. I am starting to think that it is purposeful oversight as I see it so often and as often refudiated.

      If there are more people requiring medical assistance than the system can accommodate at that time it is very likely that their prognosis will be *significantly* worse.

      • Jabre do you think people are refusing to go see a Dr?

        I know I am…I am assume a physical will not be scheduled, because they are fighting Corona

    • The whole rationale for flattening the curve is to keep the health system from becoming overloaded.

      And when a vaccine comes along then those yet to be exposed won’t die either. Of course if the vaccine is say a year away then it would seem irrelevant.

    • Thanks to the bobs. I understand that the rationale is to keep the peak lower than the health system can help at one time. I discussed that. Let me summarize.

      • I’ve been to Ecuador, I have friends there, and the situation there breaks my heart.

      • The issue is, as you say, the medical system can’t cope.

      • Ecuador has about half the hospital beds per capita that the US has. In general its medical system is quite poor. There is not a whole lot that their medical system CAN cope with.

      • In other than heavy surveillance states like Korea and China, the various measures taken to “lower the curve” have not been shown to be effective, including in this study.

      • Ecuador is poor, in many parts desperately poor. Shutting down their economy would impoverish, injure, and even kill untold people.

      • Should they “party hardy”? I never said that. I said take all the appropriate steps we know of, avoid crowds, close the schools, wash hands, the usual, and DON’T SHUT DOWN THE ECONOMY, DUH! And put the money saved into the medical system as fast as you can, even this very day.

      I hold that that is just as true for Ecuador as the US. They already have a big disease problem. Adding a gigantic, huge economic problem on top of that in the hopes of sparing a few is madness.

      Regards,

      w.

      • Willis writes

        In other than heavy surveillance states like Korea and China, the various measures taken to “lower the curve” have not been shown to be effective

        I’d say its being effective in Australia. Infection rates have stayed low and so far each Australian State appears to be on top of tracking the infections.

        Personally I think that’s an excellent initial strategy but without a vaccine, leaves the country in an even more difficult position going forward.

      • Should they “party hardy”? I never said that.

        You did not and I apologize if I left that impression.

        From the reports I have read, ‘party hardy’ pretty much describes what the people did. Perhaps I exceeded my poetic license. It might be more technically correct to say that they displayed a cavalier attitude to the looming threat.

        There are two things about the situation in Ecuador.
        1 – It seems to be the worst case scenario and, IMHO, an object lesson.
        2 – Although much of Ecuador has malaria, the city with the coronavirus doesn’t have it. That accords with Roy Spencer’s observation that places with malaria don’t have coronavirus and vice versa. link

        • This is the greatest epidemic that we have seen in a long time and even in NY city the hospital system is keeping up. Yes its a strain and yes we should learn from this and yes we need to be more prepared, but no we don’t need to bankrupted the entire country over this.

    • There was a comment from a poster that actually lived in the city that generated that information about bodies laying in the street. He actually said it had to do with the way they deal with the dead and the government had closed down most of the mortuaries as being non-essential. Place on top of that the shuttering of wood mills which supplied wood for the coffin building and all the people could do is put the bodies out in the streets. Many of the bodies were from the average daily death rate and not primarily from covid-19.

    • Yes their medical system is overloaded, but it probably always is. Life expectancy there is likely lower all the time.

      But Ecuador’s covid “reported” death toll is currently a mere 20 per million population. Much, much, lower than half the states in America.

      Italy, Spain 300, NYC 500+ Whereas CA is 15. I doubt many dispute that mitigation buys time and spreads the case load across a limited resource base. Nowhere in America It also simultaneously allows better medical practice outcomes to circulate. The question is at what cost to the rest of everything else.

      We have a luxuriated population because of modern healthcare access. We have “cheated” our way around natural selection. Taking for granted that we are owed, that we have a right to x years on the planet is the default presumption in our policy. The presumption needs challenging.

      If we reduce US productivity to Ecuadorian levels we’re going to have an Ecuadorian level health system.

  13. So it seems that the rule of thumb works well, at least according to the model. Whether it works in the real world remains to be seen …

    It’s the standard feature of the logistic curve which does work rather well in the real world.
    You focussed on grade school closures, one thing that concerned my university was that all our students would leave campus during spring break and disperse all over the country for a week (many by air) mix with many others then return to campus and spread any infections around campus. Consequently we decided to close campus for the rest of the semester and go to virtual classes. Several years ago we instituted a fall flu vaccination program free to all students and faculty and it has definitely had a good effect on the usual outbreak in flu after the fall break.

    • Indeed, Phil. My surprise was that I’d expected that the disease would ramp up more quickly than it would taper off. The models says no … now we’ll have to see if that is borne out in the real world. Fascinating stuff.

      Regarding schools, I didn’t mean just close grade schools for the duration. On my planet, it’s appropriate to close any school that can reasonably be expected to pose a problem, as you have done. Shutting down the economy does little compared to shutting schools.

      I lived for some years in Solomon Islands north of Australia, where malaria rules supreme. They have the British boarding school system where the grade school kids go away, sometimes to another island, for the duration of the semester.

      And when they came home from boarding school, they were always accompanies by a wave of malaria …

      Thanks for the comment,

      w.

      • Willis, thank you.

        “.. I’d expected that the disease would ramp up more quickly than it would taper off…”

        Seems the NYC numbers agree more to that then IMHE projections of two weeks back.

        New hopsitaliztions are lower than peak,
        but not dramatically so. Perhaps midpoint is much farther to the right.

        Spain Italy similar.

      • He’s wrong. He doesn’t even understand the basic problem, which is the data is useless. Thus using data to prove your argument immediately fails.

        We have some basic data, totally all-cause deaths, and that’s about it. Look at that and nothing shows up. There’s now a great deal of argument about the resource claim, with doctors saying that ventilation is a mistake both medically and ethically, and simply putting everyone in ICU and on a ventilator is a mistake.

        • Phoenix44: “We have some basic data, totally all-cause deaths, and that’s about it. Look at that and nothing shows up.”

          WR: The basic data: totally all-cause deaths in the Netherlands in week 13 showed that there were1300-1600 more deaths than ‘normal’. Normal in a week: 2700-3000 deaths in this time of the year.

          Official Corona count for week 13: 592. Missing (!) 700 to 1000 extra deaths: probably Corona. Which means that the general number of all-cause deaths shows that the situation is two to two and a half times as serious as the official numbers show.

          The Netherlands only show tested cases and in nurseries and at home people dying people are not tested and so not counted as corona deaths. The same in Flanders (Belgium) until recently and in France (until recently). The situation in many countries is more serious than official numbers show – that is what shows up when you look at basic data.

    • It’s not just the NYC metro area. In most states, it’s concentrated in a few urban and suburban counties.

    • Although the NYC mayor and health commissioner did pursue especially idiotic policies, as did the mayor of New Orleans and governor of LA.

  14. Willis
    You said, “Of course, to do that, I had to figure out a variable that would represent the “flatness” of the curve.”
    Kurtosis?

    • Good question, Clyde. I looked at using that, but eventually concluded a) the death rates are not necessarily perfectly normal in distribution, and b) kurtosis measures non-normality, not “Peakiness. As an example, both of the distributions in Figure 1 are relatively normal … just very different. So kurtosis doesn’t measure the quantity of interest.

      So I chose height divided by area (actually the sum of the deaths, which represents the area) as the measure of how tall and skinny the distribution is. Seems to work and is sensitive (wide range), as Figure 1 shows.

      Best regards,

      w.

  15. “That $1,200 check people are talking about? That[‘s] a cost, not a benefit as the chatterati would have us believe. It comes out of our pockets.”

    No brief for the bailout here, but that doesn’t seem quite right. No, I don’t like the way they did it it, but in principle it could be done in a way that makes some sense. Consider the following hypothetical:

    Suppose the treasury issued everyone $3000 in income taxable at 100%: the $3K they get this year would be added to everyone’s tax bill next April. Politically impossible, of course, but what if it weren’t? Administrative friction and tax non-compliance would probably end up costing us something, of course. But a lot of folks will get income shifted from next year, which they can plan for, to now, when they really need it.

    Does that make us poorer? Maybe, but not by nearly $3K x population.

    • They are gonna have to monetize it this time.
      Some are calling for a period of very high inflation, something we have not seen in many decades, coming to a theater near you this Fall. Or so.

    • Thanks, Joe. As I mentioned, I do a cost/benefit analysis. My only point was that people want to count that on the benefit side of the page. It doesn’t belong there. Best case is that in some hypothetical friction free sense where everyone paid the same amount of taxes, it would be neutral.

      But it’s not that world, so some people will win and some will lose. I call that a cost as well. If I come to you and say “Joe, I’m gonna throw you in jail if you don’t take $3,000 out of your pocket and give it to your neer-do-well couch-sitting brother-in-law because he is poor boo-hoo,” that does NOT net out to no cost to society. It may be a cost we are willing to pay, but it is indeed a cost.

      My point was that you can’t get richer by redistributiong money from person to person. You can only get poorer. How much can be debated … but it is NOT a benefit as claimed by the chatterati.

      Which is what I said.

      w.

  16. “Flattening the curve does not reduce the total number of cases or deaths”

    Everybody repeats this; few can backup that statement. Is it true?

    I’m skeptical. I can think of situations where it is true and I can think of situations where it is not.
    For example, a theoretical (impossible?) case where the whole world goes on a total perfect lockdown and the virus dies out in 14 days and the world goes back to what it was last year as far as the virus is concerned, which is billions of people with no immunity but no virus.

    • Toto: The virus will not disappear because we no longer have carriers. Without eventual immunity it will go on infecting. Consider polio, the plague, ebola, etc. …. once thought eradicated but still pop up on the radar.

      • If there are no human carriers, the virus is gone from humans, no? So this problem would be solved until next time. There will be other viruses and more pandemics.

        You mention polio. Polio is a good example. Once common, now mostly gone. And any herd immunity is gone with it. There is a vaccine for polio or else it would still be a pandemic.

        One thing that flattening the curve does is give more time to develop vaccines, antibody tests, and other things that could limit the contagion and the issues of lockdowns. Like we do for malaria — there is a pill to prevent getting it. More time to do research on what works and what doesn’t. Meanwhile, take more zinc.

        If flattening the curve could get us back into the initial stages where we had few carriers, we could do it better for the second wave. More testing, more contact tracing.

        A lockdown done poorly is one that needs to go on forever because it doesn’t get the job done.

    • Yes, there are situations where it would reduce cases and deaths (e.g., vaccine or treatment discovery).

      But most experts seem to assume this is going to stick-around and eventually become seasonal (albeit not nearly so destructive).

      From my experience, “everybody repeats” that flattening the curve will bring things back to normal sooner, too. Sometimes the curves are right there in front of their eyes to tell them that is not the case…and sometimes the curves are truncated (seemingly intentionally) so that you can’t see that to be the case.

    • I like Willis’ in depth look at the effect when measures are introduced etc. Once our expectation of what seems “obvious” turns out not to be the case at all. We need a lot more fact checking examining whether our assumptions are correct.

      However, I think Toto, like another person above has put his finger on a flaw in Willis’ logic which explains why this all looks pointless.

      He deftly demonstrates that flattening the curve in California , where according to current models it is already flat enough it TOTALLY pointless. The whole point of flattening is to avoid health service saturation. If that is not likely, it makes no sense and is doing immense harm for nothing.

      However, he stops there and seems to make an unsubstantiated jump to concluding this is automatically can be generalised to the whole USA and pleads “End the American lockdown today”

      I’m generally in agreement and I’m sure most states should not be in this insane shutdown. Europe should get out of it as quickly as possible.

      It is not clear from this article that would apply to NY.

      • You bring up a good point. If the US borders were closed on New Years day, there would be few if any cases in the US. But they weren’t. So cases popped up in the big cities with international airports. And then it spread to smaller areas and so on. If only there was a way to set up green zones and red zones.

        So we are left with keeping distant from others. Is it working? If not, try something else.
        BTW, there is police type enforcement and there is social pressure type enforcement.
        The former generates backlash. The second is more effective.

      • Thirty of the fifty US states are predicted to have NO shortfall in ICU beds. As to NY, they have a huge ICU bed shortage. Yes, IF the listed interventions actually flattened the curve in a significant manner, they MIGHT save a few hundred deaths in NY, maybe as many as a thousand although that seems unlikely.

        So then we have to ask, given that shutting down the economy doesn’t seem to have helped in the states to date, and given that if it works it MIGHT save as many as 1,000 deaths, and given that a number of those would die from many comorbidities regardless of COVID-19, and given than only 1% of the NY deaths have no comorbidities … should we shut down the world’s biggest financial center and throw millions out of work on the off chance that we might save 500 or 1,000 lives?

        You’re making Fauci’s mistake. You have to balance the HUGE costs of shutting down any modern economy against the chance, not a guarantee but a chance, that doing so might save a thousand lives.

        Me? I say absolutely not worth it. That’s a third of the annual overdose deaths in NY.

        w.

        • Why do you say NY has a huge ICU shortage when admissions have been stable for the past 14 days and the hospitals are still managing? They are now well into their peak and don’t seem to be overrun. The plateau has also happened too soon to put it down to the lockdown.

        • “I don’t do a one-sided “benefits” analysis like Dr. Fauci does.”

          Thats exactly what you are doing. On the one hand you are railing against the economic cost for the saving of a disproportionately small number of lives but ignore the fact that without the economic cost many more would have succumbed. You say “not a guarantee but a chance” but that is plainly incorrect. Not just from Fauci but senior epidemiologists worldwide. In countries where shuttering was done early the death toll has been insignificant. In Australia and NZ for example community spread has been neglible as a result of EARLY shuttering, testing, social distancing, etc,.

          • We are outliers. Both Oz and NZ have very spread out population centres. Even our capital cities are very small and sparsely populated compared to most other countries. My town has no significant nearby towns for 500km.

          • as a result of EARLY shuttering, testing, social distancing, etc,.

            You are making the same fallacy as Monckton. Spurious temporally coincident change is not correlation and is no reason for jumping to your conclusion of attribution.

            You start from expecting a certain effect and then jump to confimation bias to claim it’s happening.

            Global CO2 has increased since the 14th March , that must be the cause of the reductions in new COVID cases. You seem to think it causes every other change on Earth, why not this one?

            The danger is with the shutdown CO2 may begin to drop and we’ll have a “second wave” of COVID.

            Stop the shutdown ! We must act now!

          • Loydo, I live in a state where the count of cases is very low. Even in my medium sized city only 5% of those who think they are sick have been positive for the virus. You are assuming that after some period of shutdown we will all be just fine.

            Will we? We still live in a very mobile society. Seems to me this will just allow the virus to gain entrance again and up jumps another curve. Only this time there’s no way to shutdown the economy. All that happened was the problem was delayed.

            That’s why the only hope is for a miracle treatment or vaccine. Otherwise, we are damaging our economy for almost no benefit.

            China is loving it.

          • Coronavirus lockdown has led to increase in suicides, police chiefs say as fears grow that domestic violence and sex abuse are also on the up
            Police Federation’s Simon Kempton said ‘early indications’ of a rise in suicides
            There is concerns about a possible rise in crimes such as domestic violence

            SOURCE

            Coronavirus: Mental health incidents rising during UK lockdown, police say
             
            Increasing numbers of mental health incidents are being reported to police during the coronavirus lockdown, senior officers have said.

            SOURCE

            Chillingly, Scariest Coronavirus Death Toll May Not Come from COVID-19
            A great deal of scientific research indicates the coronavirus containment strategy will cause more deaths than COVID-19 would have.
             
            The link between unemployment and suicides will be a concern that has to be addressed while the majority of the population stays-in to duck the coronavirus pandemic. | Source: REUTERS/Carlo Allegri
             
            While many countries are in lock down to prevent COVID-19 deaths, the reaction to coronavirus is likely to kill more people than the disease itself.
            That’s because coronavirus layoffs have already surged across the US. And unemployment projections are already as high as 4.6 million.
            Meanwhile, there’s a firm body of scientific literature establishing a strong link between unemployment and higher suicide rates.

            SOURCE

            L.A. suicide hotline sees rise in coronavirus-related calls. Counselors feel the pain

            SOURCE

            In Portland, Police Chief Jami Resch said Tuesday suicide threats or attempts are up 41 percent from this time last year and have jumped 23 percent since 10 days before a declared state of emergency, according to local Oregon news outlet KATU.

            Allysen Efferson, a therapist in east Tennessee told The Federalist that the link between suicide and financial hardship has been well established and that policymakers should be taking the current epidemic over suicide already at play into account when crafting measures to counter the virus.

            SOURCE

            I’m just posting these to show that as I’ve been saying, the lockdown itself is killing people …

            My point is that in this cost/benefit analysis of the economic shutdown, there’s blood on both paths.

            w.

          • ZZW, I agree to a point that we are generally spread out but cities of 1-5 million with avid travellers, international airports and cruise ship ports are at equal risk world-wide. The only US states to have a higher population than Australia California and Texas. You have to run down the list of US states to Minnesota before you find one with fewer deaths than the entire country of Australia. If New Zealand was a US state it would rank 25th in population behind Alabama, but only Wyoming would rank lower in deaths. It’s a lot more than just population density.

            “you start from expecting a certain effect and then jump to confimation bias to claim it’s happening.”
            Fair enough Greg, what strategies/circumstances/timing would you say have made such a huge difference in outcomes between certain countries?

        • Just yesterday Cuomo stated that the situation is stable and there are enough ICU beds and ventilators.

    • Thanks, Joe. Actually, it is technically true. Flattening the curve just spreads out the disease. Whether that reduces deaths or not is a function of the medical system, not of the flattening. It is the shortcomings of the medical system that is causing the deaths, not the shape of the curve.

      If we have a medical system like California’s you can flatten all you want and not reduce deaths. And if you have no medical system at all, none, then everyone badly afflicted will die regardless of flattening. Death numbers are a function of the medical system, and as such, it makes MUCH more sense to improve the medical system than to shut down the economy and throw millions out of work.

      It will cost NY millions of dollars from their shutdown. Think of how many ICU beds and ventilators that would have bought since February when we could see the problem coming. Then consider that there’s no evidence I’ve seen that shutting down the economy makes any significant reduction in the curve … bad deal all around.

      w.

      • Ventilators cost about the same as a small car and have about the same useful life. Imagine asking the car companies too tool up production to double the total number of cars on the road in the next few months. Its laughably impossible. Its the same for the few companies making ventilators.

      • Pro tip: just saying it’s technically true doesn’t make it so.

        For the benefit of any lurkers, I’ll mention that I did the math and plotted the results at the Twitter link above. The math shows that flattening can indeed reduce deaths even if we have all the ventilators and ICU beds we need.

      • Pro tip: Just saying that something is technically true doesn’t make it so; the oh-yeah-so’s-your-old-man response is not compelling. Please try to tighten up your game.

        For the benefit of any lurkers, I’ll mention that I did the math; it shows that flattening the curve can indeed reduce the number of deaths even if we have enough ventilators and ICU beds and even if we come up with no improvements in treatment. The Twitter link above gives plots the results. And I’m not the only one who came up with that result.

        • Joe Born April 8, 2020 at 5:45 pm

          Pro tip: Just saying that something is technically true doesn’t make it so; the oh-yeah-so’s-your-old-man response is not compelling. Please try to tighten up your game.

          Pro-tip. You were the one who flatly claimed it was not technically true, which doesn’t make it so. Please try to up your game, blah blah blah …

          Damn, Joe, you’re better than this. You understand my point. Delaying deaths does NOT necessarily reduce deaths. Here was my statement about flattening the curve:

          “Valuable indeed, critical at times, but keep in mind that these delaying interventions do not reduce the reach of the infection.”

          Are you denying that what I said is 100% true, and if so, where and why?

          w.

          • Look, I admire your facility with data sets, and I find your “thermostat” hypothesis quite insightful and the data you’ve marshaled in support compelling. I freely admit that I wouldn’t have had the capacity to come up with it myself. So please don’t take this the wrong way.

            But we all have our limitations, and your failure to recognize yours has led you consistently to reject help with math from the half dozen or so of us at this site who can provide it and have attempted to do so.

            I explained on Twitter why I disagree with your statement that “Delaying deaths does NOT necessarily reduce deaths.” I’ve done the math and plotted the results for you. I’ll even comment the script I used and send it to you. If you can provide a reasoned explanation as to why you disagree with it, fine.

            But you haven’t so far, and, frankly, nothing in my experience suggests that you can. That’s okay. We all have our limitations; I certainly have mine.

            Just try to entertain the possibility that maybe, just maybe, some of us actually know what we’re talking about.

        • Sorry Joe. That twatter link’s mess, I see 1/5 and 2/5 then a load of junk.
          I gained nothing from reading what was there.

          Twatter is an awful media for anything but the plus banal in life.

          • Sorry about that; you’re among the few who probably could have understood the concept (although I see above that you haven’t yet).

            I don’t know what to tell you except to try using Twitter’s search feature with my name and clicking on “Tweets & replies.” There should be five of my tweets on this subject, with two plots.

            Unfortunately, I have no way of sending you what I’ve sent Mr. Eschenbach: the underlying scripts with extensive comments. (His other gifts notwithstanding, my sending it to him is no doubt casting pearls before . . . someone who wouldn’t appreciate them. But, hey, I tried.)

  17. “put the trillion dollars into making the medical system the strongest and most resilient imaginable”

    Too late, the pandemic is already here. Might have worked if you did it last year.

    “wrecking the lives of 30 million Californians just to save eighteen hundred lives. ”

    So, are you saying that $1,000,000,000,000 / 1800 is your dollar value on a human life?

    • Yes, in fact my value is a lot less. Just fricking stupid, if you found out that you could save ten lives for 100 trillion dollars would you spend it? Those dollars your dismissing are people’s lives, many many peoples lives.

    • Henry,
      Strawman argument. What he is saying, if I may Willis, is that wrecking the lives of 30 million people will cause far more loss of life than the 1800 the virus is predicted to take. If you disagree with that, fine, then state your case. As distasteful as you may personally find it, our elected leaders must make these kind of calculations all the time. Resources are always limited are almost always less than the perceived need. So sometimes, yes a human life is reduced to a value of some kind to help make a particular decision. It can’t be avoided, and you are naive if you think it can be.

      • “wrecking the lives of 30 million people will cause far more loss of life than the 1800 the virus is predicted to take”

        Sorry, there is no evidence that this is the case, it’ just you assuming so. PS, my argument is not a “strawman” it is derived by the implicit dollar valuation that Willis has placed on a human life.

        • Henry,

          I don’t have data for the US, but in Italy, 85% have been over 70 years of age. Assume US is similar. Ballpark figures here.

          We are going to spend far more than two trillion dollars to compensate for Wuhan virus economic losses. Assume, wildly unrealistically, that the economic catastrophe from shutdown will save 100,000 lives (probably ten times too high). That’s $20 million per life, or at a minimum two million per year of remaining life. The real figure could easily be ten times that high.

          Weigh end of life expense vs. cost of early in life enjoyment and productivity. All is not absolute, but relative. Many great grandparents would willingly give up a year of bedridden, painful, drugged life for more time for their young descendants.

          I know I gladly would, although that’s easy for me to say, lacking great grandkids.

        • Henry,
          No assumptions necessary. Just look at Venezuela or any poor third world country for that matter. Need something more concrete? In the state I live in there has been a spike in motor vehicle deaths since the shut-down because people are driving a lot faster since there are not as many vehicles on the road. Stupidity? Of course, but still a consequence of the shut-down. Also trending up are suicides, robberies, and assaults. Which will all get worse as time goes on.

    • Henry, are you saying that spending one half of a billion dollars of someone else’s money to buy an extra 5-10 years, on average, for a person is a reasonable idea?

      The real problem here is some people’s demand for “safety”. Safety, like dry land, is a myth. It does not exist in and of itself, only as a relative comparator between two or more things. What we have is risk. And risk is different for each and every individual.

      Let’s use COVID-19 as an example. I’m in my mid 40s and due to health issues am in the high risk group, I probably have 1 chance in 5 of dying if I get this. My kid sister is in her upper 20’s and in perfect health. Her chance of dying is much less than 1%. In economics, I make a comfortable living, have decent savings, own my home, have a job in an “essential” industry, and can work from home/in isolation. She makes less than half what I do, is currently laid off due to the lockdown, can’t work from home, has little savings, and rents. While my risk from the shutdown is very low, it is putting serious risk on her.
      My example is essentially the statistical pattern you will find in the general public as well. While the older are at higher risk for COVID, the younger are at higher risk from the economic shutdown. This leads us back to the $1/2 billion dollar question: Why is it okay/a good idea to transfer so much risk from the older population unto the younger? More importantly, why would anyone be for taking away one’s choice on which risks they are willing to accept? Is it just to eliminate the responsibility on people to mitigate their own risk?

      Every day we all make decisions that risk our life and limb based on what we perceive the risks to be, whether we are good at calculating them or not. Now instead of giving people guidance on what their risks are and methods to reduce them, then allow them to make their choices and live with the consequences, we are taking the decision out of their hands and imposing a different set of risks to reduce this one particular risk. But, I suppose it’s an easy decision to make when the risk isn’t yours to bear.

      • You are free to make decisions that risk your life and limb based on what you perceive the risks to be, whether you are good at calculating them or not. You are not free to make those decisions for me, or for anyone other than yourself.

        • Henry

          its your job to make the decisions for you to protect your self, but its you that thinks you should have the power to alter everyone else’s life to protect yours.
          If you are high risk you can self isolate.

        • That’s a rather poor argument.
          Every decision in this involves making decisions for other people. And they can be life and death decisions on both sides of the equation. It’s not simply suicides. Wealth of a society by itself is highly correlated to lower mortality rates. Destroy trillions in wealth and more people will die earlier. Destroy enough and the number will be rather high.

        • C’mon guys, credit virtue when it’s due. Henry is signaling, admittedly indirectly, that he sufficiently feels for human life that he would welcome deductions from his own savings in the effort to extend lives even for some months. I respect his generous decision to devote his own hard won resources instead of further burdening generations to follow with a soaring indebtedness to effect his wishes.

  18. Looking at the virus maps, it’s blindingly obvious that population density is *everything*. No other risk factor even comes close. And New York City is, unfortunately, is the outcome of a “perfect storm” of risk factors (27,000 people per square mile!) and absolutely criminal policy decisions. Is anyone really surprised what happened there?

    This pandemic is not even close to homogeneous. Federal and statewide one-size-fits-all lockdowns are idiotic policy. Some states still only have case counts in the low double digits. Many, many counties in the U.S. have not recorded a *single* case. Zero point zero zero. Why can’t people living there go back to work?

    This is outrageous.

    • Yep! Respiratory disease transmission requires 2 people, the infector and the infectee to be in some relatively close proximity. Thus it is analogous to a “2nd order” chemical reaction for which the rate varies as the square of concentration. So the disease transmission models should have rates that vary as the square of the population density! Do they? I don’t think so and if this is the case, no amount of curve fitting and “updating with better data” will allow them to make better “predictions”! So yes, most of the country is not in any danger of local outbreaks that would overwhelm their normal health systems… and we are finding this to be the case!

    • Large cities with high populations densities also have mass transit systems. They also have tall buildings with lots of elevators. Both of these are excellent vehicles for disease transmission. As a result the virus moves quickly through these area. The disease was already well up the curve before mitigation policies could have an effect.

      Smaller population densities are not as easily infected. However, I think they will eventually go through a curve because of schools and other public transmission areas. They just look flat now because the mitigation took place before the disease got a good foothold.

      I fully expect less populated areas to see a large increase in infections once the shutdowns end.

  19. A great start, Willis. I like your approach of trying to fingerprint the effects of particular policies. You in the US have a great advantage over us Europeans; you have 50 laboratories trying different cures! Here, we have only 12 or so, with the French (at least) having screwed up their data. And if the EU had its way, we’d have only one…

    In Europe, things are looking up with regard to new cases. (Though not in the UK, yet). Unclear (to me at least) whether it’s the result of lockdowns, or of herd immunity starting to kick in. The latter would require that the virus has been around a lot longer than anyone has told us. We shall see.

    • At what point would you expect herd immunity to “start” to kick in?

      I’ve seen 60-70% figures suggested as needed to it stop the virus, not for it to “kick in”.

      Herd immunity maybe starting to have an effect as is the attrition of the supply of vulnerable octogenarians in poor quality care homes and those on ACE inhibitors.

      What we have seen in Europe seems like the normal progression of any epidemic. I can not see the slightest effect of confinement. If it helped it is not slapping us in the face ( unlike the costs of doing it ).

      https://climategrog.files.wordpress.com/2020/04/2019-ncov-log-fit-france.png

    • ‘And if the EU had its way, we’d have only one…’

      You are gone from the EU, Neil, but yet still continue complaining about it! You can have all the curved bananas and laboratories you want now – but the tooth fairy ain’t going to pay for them….

  20. One would wonder that the societal permeation factor would be associated with one infection transfer. How exponential would that be over a 1 week period in an uncontrolled environment. Let’s say with an R0 of 3 per day as an example. I get the possibility of 2,187 infections in one week generated from such. Just pretending to be a model 🙂

  21. Very interesting discussion Willis. You do a great service by introducing aspects of the response that need attention. I am a practicing infectious disease physician and have similar concerns but would not state some of the conclusions as forcefully, as much is still not known. I agree the decisions about how to respond should rightly be cost-benefit. They appear however to be CYA decisions (i.e. cover your ass by doing anything possible to reduce infections) – all “benefit” no cost. That is they are focused on one benefit that is of primary interest to decision-makers who will later crow loudly about how they saved everyone. This is contrary to the medical dictum of “first do no harm”. Even if cost benefit is calculated purely on lives lost or saved the idea that the precautions taken don’t cause loss of life is negated repeatedly by many examples such as increased violence, increased suicides, and decreased access to appropriate care for other serious conditions.

    The one conclusion I am more uncertain of is that flattening the curve is just delaying but not preventing cases. It may well be true, but there is at least theoretical potential for measures to actually reduce the long term burden of infections if effective. That is the issue at the center of this discussion. Are the measures actually reducing the number of people who will ultimately get infected – we don’t know, but we should get a much better idea towards the end of this outbreak by doing comparisons similar to those undertaken by Willis.

    Delaying deaths is a much more reasonable goal than preventing them since immortality is not an option. That is to say the death rate is always 100% if you do long enough follow-up. While the elderly and chronically ill are much more at risk of dying from or with CoVID, they were at more immediate risk of death even without CoVID. We will need more refined analysis to determine how much COVID contributed to an increased rate of early death. Seasonal increased mortality such as is tracked yearly during the flu season may give a better indication.

    If, as Willis suggests, the measures we are taking are in error and have much higher costs than benefits, then faulty modeling based on incorrect assumptions is likely a major contributor to that outcome. Sounds a lot like global warming to me all over again.

    With respect to the negative correlation of measures taken versus steepness of the curve there is an alternate possible explanation. Those jurisdictions starting off with the steepest case increase may be more persuaded to adopt coercive measures because of the steepness – i.e. the causation is reverse of what was theorized. One day we will have a much better understanding but it is critical that these contrary discussion points get a hearing and that honest analysis take place so that any mistakes made today need not be repeated in future.

    • I was thinking something very similar…the places that took steps first were the places that were getting impacted harder at the outset. IOW…people were reacting to what was being seen, not what they thought might be coming.

    • Andy’s excellent comments made me think. We need a metric that, estimated by a doctor, for each person whose death was claimed to be caused by COVID19 would have lived if the person had not been infected.

      • Correction:
        I meant to ask how much longer they would have lived if they had not been infected.

        • Yes that is exactly the point. A better metric for “cause of death” is attributable years of life lost. That is the amount of life lost due to a particular contributor. For CoVID it would be how much longer and individual would have lived on average had they not contracted CoVID. A few hours doesn’t count for much, a few days?, but many months to years would be more impactful.

    • re: “Delaying deaths is a much more reasonable goal than preventing them since immortality is not an option.”

      AS I wrote on FreeRepublic on this subject, the number of deaths has been “front loaded” for this year due to the deaths of the ‘weak and infirm’ to date, and the stats for the rest of the year should reflect this.

    • “The one conclusion I am more uncertain of is that flattening the curve is just delaying but not preventing cases.”

      I think that is a valid question. I do know that flattening the curve was sold as having the same area under each curve but the flattened curve spread it out. That is the same number of infections are presumed in either curve while the flattened one reduced the stress on the medical system. So I’m not going to fault Willis for arguing based on the model assumptions sold to us.

  22. 1. It’s not feasible to spend a trillion dollars beefing up the healthcare system in just one month.
    2. In Wuhan and in Italy the hospitals did get overloaded and the mortality rate increased. London has got very close to that point, and so has New York.

  23. I am completely mystified as to how locking up people in small houses for weeks, passing the virus from one person to another is a good idea. I am also baffled as to why the enormous repercussions in terms of people’s physical, mental and financial health seem to be ignored, not forgetting the impact on personal relations. Or on our freedoms.

    Panic of the first order. The madness of crowds forcing the politicans to do ‘something’ whether or not that ‘something’ is at all logical.

    • In most nursing homes, residents are being forced to stay in their rooms. They can’t leave even to go outside for a little fresh air and sunshine. They can’t see family, friends or enjoy any outside pleasures. The resulting grief will kill some.

  24. The problem is that all your analysis uses absolute date… but those states that were hardest hit will have the earliest intervention dates, which completely messes up your ability to tell if interventions work. Preferably, you would use “intervention date RELATIVE to the date at which deaths exceeded X” (where X might be 5/million inhabitants, or something like that).

    I also think it is fairly evident that if New York had NOT shut things down hard, they’d be hiring refrigerated trucks just for the excess dead… oh, wait, they already are. It would have been EVEN WORSE THAN THAT.

    And all of these curves assume continued actions to halt spread. If we hadn’t locked down at all, California wouldn’t have peaked earlier but had the same number of deaths… instead, that curve would have skyrocketed up, and kept on going. If we assume a 0.5% mortality rate, we’d be looking at 150,000 deaths for California, not 1800. (likely the mortality rate would be much higher since hospitals would be overwhelmed, but probably some percentage of the population wouldn’t get infected even under no-lockdown, so I’m assuming those cancel out).

    -Marc

  25. Check out the numbers for New York to see an example of a shortage of beds and ventilators. Then throw in the concerns that ventilators may not be the best solution: https://blogs.webmd.com/public-health/20200407/coronavirus-in-context-do-covid-19-vent-protocols-need-a-second-look and we are floundering for answers.

    I have been thinking that I have not heard any politicians offer a plan to end this and I am leaning to an approach such as the one you proposed. Unfortunately, you offer a nuanced solution in a sound-bite society that views things in politicized black and white so it would be headlined as a plan to let people die.

  26. The more I read and witness the more I believe herd immunity is the answer. More months of lock down would destroy the world’s economy to the point it would cause more deaths than the virus. The fact that overall flu deaths are below normal doesn’t seem to get traction with the scaremongers.

  27. Hi Willis, I’m a fan of your work but I find this post lacking in your trademark critical thinking.

    1) You say: “Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.”

    Is it not possible that flattening the curve could indeed reduce the total number of deaths, in that a less stressed health system may lead to better outcomes for some fraction of serious cases? If not why even put people in hospital or ICU.

    2) In this post (and previous) you use count of the number of interventions as a metric, but this treats all interventions as equally effective in their design and implementation. Intervention is not a standard unit of measure so a poor choice for things like Figure 3.

    3) Also related to Figure 3, you seem to be missing the possible (likely?) correlation between number of interventions deployed and prior severity and risk factors for the local situation.

    4) Figures 4 (typo: labelled as 3), 5, and 6 are by calendar date so confounded by date of local onset, which appears to have varied significantly across the country. Should this not be normalized to some factor (time since: first case, first death, first 100 cases, etc) to have any comparability? For example 2 jurisdictions may have closed schools on the same calendar day but one was a late adopter having 1000+ cases already, and the other was an early adopter having no reported cases. Date of adoption relative to the progression of the local outbreak could significantly influence effectiveness of the adoption.

    MJB

    • Figure numbers seem to have been corrected. In the above comment point 2) and 3) should refer to Figure 2, and point 4) should refer to Figures 3, 4, and 5. Thanks. MJB

  28. At last some real common sense. Dr Knut Wittkowsky a top coronavirus epidemiologist posted this yesterday a must see totally concurs 100% with this posting and explains why flattening the curve prolongs the viral problem plus the trillions lost suicides ect Thank you. This is the link first posted by H/T to Robert yesterday https://www.youtube.com/watch?v=QO1fvhksSoI BTW Sweden has not lockdowned and has same incidence a low rate countries with extreme lockdowns

  29. it still wouldn’t be worth a trillion dollars even if we could actually save that many lives

    So at each life valued at about $0.5 Billion ($1T/1800), and with the death toll now greater than 14,000, we have lost $7 Trillion in value, and the death toll keeps rising.

    • And more and more people are losing their jobs, their friends and family members are losing their jobs added to the fear of losing their jobs. People won’t go to the doctors for fear of getting the virus too 🙁

    • I’m sorry, but no human life is worth $500,000,000 at least from an economic perspective. The range is about $130,000 (will insurance provide coverage for a new procedure?) to $9,000,000 according to the US EPA. So at $9 million a pop, CA shouldn’t be employing measures costing more than $16.2 billion. For the US, that’s $126 billion. We are so screwed.

        • “Some people will argue putting a dollar value on human life is immoral”
          RealLy so how much will you spend to “save” a life? $1, $10, $100, $1000, how about a trillion dollars? The money your are willing to spend is people’s lives, it’s their life savings from all their years of work and sacrifice. How many family businesses should we flush down the toilet? How many people that worked their whole lives scrimping and saving and fight to get ahead should we force back to square one? How much earlier will they die because they can’t enjoy the fruits of their life’s work? And how much will you spend to extend their lives?

          • What dollar figure do you place on a human life? Is a teenager’s life worth more than a 50-year old? Is a male worth more than a female? Is an Asian worth more than a Spainard? What is your life worth?

        • Henry, I know that you frame this in religious terms, but consider that every action (including the refusal to act) has multiple effects. Surely the decision to take an action motivated by profit should not be considered licit because the cost of deaths caused that might need to be compensated is less than the profit made. Any action that directly causes another person’s death is illicit, regardless of how lucrative. But that gets muddied if the deaths are not predictably and directly caused and everyone enjoys the benefits while everyone remains at a slight risk. For a small group to benefit while a large group only risks death is clearly immoral. But when burning fossil fuel for example, society as a whole benefits greatly and many more lives are extended than may be lost from pollution effects. In a just society we may still wish to compensate those who are negatively impacted, even though they also benefited from the positive effects. In such a case we must set a value for fair compensation. It is not the value of a life, it is a value of a compensation for a reduction in lifespan.

          When we compare the harmful effects of overspending on mitigation of one problem, we can’t just look at the lives putatively saved by the mitigation. We have to look at costs and benefits of all the effects of our action. If in avoiding one death we unintentionally cause another person to die, then no cost can be justified.

          • Rich, can you explain in your framing of this discussing, why do we execute death row inmates, when it is less expensive to keep them incarcerated for the rest of their natural lives? This is an illicit action motivated by the opposite of profit.

          • Henry,
            The death penalty is a question of justice and of deterrence and also not as you assert the unjust taking of innocent life. Personally, I hold as a matter of faith that human life has an intrinsic value and would prefer to see the death penalty minimized or eliminated, because in my judgment, there is not much deterrent value. On the other hand, some heinous crimes cry out for justice. Reasonable people may disagree on this, and we obviously do.

            It doesn’t enter into my calculus at all as to which choice costs less. Having said that, the cost of incarceration or execution is largely a matter of policy. I am sure that China’s extensive use of the death penalty is far cheaper under their policy choices than incarceration would be. Indeed they may profit greatly from organ harvesting. If we sink to that level of indifference to the value of human life, we can certainly make slaughter pay.

            Again that is not validly a question of cost, but of justice.

          • OK Mr. Davis, you argue that you cannot place a dollar value on a life because of “justice.” I’m arguing that you cannot place a dollar value on a life because of “morality.”

        • The Court system is forced to value lives in wrongful death cases all the time. Expert witnesses are called by both sides to testify to various aspects of the person’s life, the loss, pain and suffering to the widow, etc… And the jury comes to a verdict on the valuation of that life.

          Whether it’s “moral” to do so or not misses the point, IMO. If it’s “immoral” to value a life, then would you take the position that when a life is lost due to wrongful death, the widow should receive no compensation because it would be immoral to calculate the compensation?

          It’s not something anyone WANTS to do. But it has to be done anyway.

          And as to your question, “Is a teenager’s life worth more than a 50-year old?”

          It depends. Here are some of the factors used to determine it:

          “Placing a monetary value on a life is incredibly difficult. There are, however several factors which may be considered to help reach a amount. These include:

          The age of the deceased person
          The deceased’s earning capacity
          The deceased’s state of health
          The deceased’s income at the time of death
          The age and circumstances of the deceased’s dependents
          The deceased’s education and training
          Medical bills and other expenses incurred for the deceased
          Funeral expenses
          Value of lost benefits (e.g. pension, health insurance)

          The damages amount must not be merely a ballpark estimate, but must be supported by objective evidence. Economists and other expert witnesses can look at the deceased person and their circumstances and consider the various circumstances to determine an amount.”

          https://www.askadamskutner.com/wrongful-death/calculating-wrongful-death-settlements/

          Point being… whether it’s “moral” or not, sometimes you’re forced to give a life a valuation. And when you do that, you have to have a metric to do so. Most metrics value lives at no more than $25 million dollars, and often a lot less than that.

        • Obviously never had to make healthcare funding decisions then. Bill Gates pays $15,000 pcm premium for the best available healthcare. Do you see the problem?

        • In a world of limited resources and infinite wants, valuation is imperative. Not doing so is immoral, as every compensation paid means funds not available to clean the water and air and render medical care to those less fortunate. At any point in time, there’s only so much cash available.

      • Are you implying that if my uncle was on death row in CA, I could free him for $10 million?

        • No, but if your uncle accidentally killed someone, it might be considered to be a just compensation to the family.

  30. The “expected” flu (s, several varieties) for which we vaccinated and prepared, should be just as slowed from social distancing and masks as any other contagion. The US CDC measures annual effectiveness of the seasonal vaccine against each season’s flu to find vaccination is rarely much more that 50% effective. Before the Covid crunch, this season was typical, and there was a modest rise in “Influenza Like Illnesses” (ILI). Possibly some unspecified ILIs were CV-19.

    Is there a data source pooling and segmenting ILIs, seasonal flu, and CV-19 incidence and fatalities, over time, such that we can see the effects of various measures? The “pool” should show all such contagions flatten. The seasonal stuff should flatten less, because the vaccine provides the herd immunity we are looking for. And the mysterious ILIs may, or may not, be or include CV-19 but if the curve — flattened or otherwise — parallels CV-19 that would be indicative. Of something.

  31. Until we know what percentage of the population is naturally immune and what percentage simply shows no symptoms, all models are shots in the dark – that’s why graphs with uncertainty ranges bear a depressing similarity to IPCC models.

    Given how little we know, whatever approach we take is playing a roulette. Of course, we will put a scientific veneer on the approach taken. In four weeks or so we may compare results from Sweden and Denmark and other countries. Then we can evaluate approaches in hindsight.

    I am not blaming anybody for the lack of knowledge, but I blame officials who ban potential treatments for questionable reasons.

  32. Excellent insight as always Willis …

    The IHME Model has seen a major revision yet again … just a few days after the last one. Yesterday’s projection update:

    Total Projected US Deaths:
    60,415 COVID-19 deaths projected by August 4, 2020

    Last week:
    93,000 COVID-19 deaths projected by August 4, 2020

    Last Sunday:
    81,766 COVID-19 deaths projected by August 4, 2020

    California projected deaths down also – now:

    1,611 COVID-19 deaths projected by August 4, 2020

    https://covid19.healthdata.org/united-states-of-america

    • Scott Gates
      The 30x disparity between NY known rates and CA assumed is what strikes me as odd in the IMHE. Avocado toast?

      Also, Willis accepting the peak death day as being the halfway point may be off. Seems more likely that halfway will be farther along on the downslope with the tail long and fat. If NY, Spain and Italy aren’t at halfway yet then just doubling the 300 deaths per million now may be optimistic. That said, even .0008 or .001
      is still quite low against other existing morbidities, which it will also lower.

  33. “Here’s how crazy this lockdown is.” Human costs, economic costs, all too true.

    It’s a war and the generals are incompetent.

    “The western style style of quarantine leaks virus like a “closed” Senate hearing leaks classified information, and then the virus is transported everywhere. There’s really no attempt being made being made to track contacts.”

    Incompetent and inexcusable.

    To fight the virus, “we” have decided on social distancing, and “we” decided until recently that masks don’t work. Look at the photos from China yesterday as their big lockdown was ended. The photos show massive crowds, tightly packed, living outdoors and in the streets again — wearing masks. Clearly the Chinese people (as opposed to their government) think that masks are enough. They may be right. We will see.

    And “we” decided that some malaria drug (and don’t forget to take zinc with it) doesn’t work and might kill somebody’, just because Trump mentioned it. Good thing Trump didn’t mention tonic water!

    And “we” decided not to do aggressive contact tracing? That would be a worthwhile job creation program.

    Let’s not do anything that works, let’s just do the symbolic (but damaging) stuff. /sarc

    I don’t know who “we” is, but it doesn’t include me.

  34. Willis, the problem with what you propose is summed up as follows….. The economy will recover from this, but the dead people won’t.

    • You’re assuming the lock down will make a difference and you’re assuming no one loses a life due to suicide. Sadly, economic despair and isolation have a human cost as well. Many people, young healthy people, may choose to end their lives because of the bleak future they perceive.

    • Hmm… Henry, are you one of the “if it saves just one life” crowd? Is one life worth a multi-trillion dollar hit to the economy? Or ten lives? A hundred? Just where is your cutoff point?

      And hey, since we’re playing this game already, why not outlaw private ownership of automobiles? Use of alcohol? Air travel? Backyard swimming pools? Think of all the lives it would save. We’d get used to it, I’m sure. Freedom is highly overrated.

      • Cranch, you choose to ride in an automobile. You choose to drink alcohol. You choose to board an aircraft. You also choose to swim in a pool. You don’t choose to be infected.

        • You do not choose to be run over by a speeding car. You don’t choose to be beaten up by a rowdy drunk. You don’t choose to have an airplane crash into your neighborhood. An infant crawling into a pool doesn’t make a choice. If you carelessly go around risking infection maybe you are making a choice.

          But Henry, how is it that you refuse to acknowledge that every action has multiple effects? Multiple effects that must be balanced.

    • Henry

      The money lost is very much other people’s lives! The economy may recover but how many small business won’t and how many people does that equate to? All the people losing their jobs and there lively hoods has a direct effect on their life spans, so how are you to give those people their life span back? Life stress is the number 1 contributer and indicator of early death.

      • Bob you can resuscitate a failed business, you can’t do so with a dead person. People lost their jobs during the Great Recession, they got new ones. Dead people can’t get a new life. Stress is a part of life, it’s been here before the virus showed up. Business and economic endeavors are transient, they come and go, but death is final.

        • Henry

          So since it’s clear that less people will die from the flu because of the shut down, should we just stay shut down for ever to save those lives?
          Being someone who lost his business during the 2008 recession and most of his life’s savings and has spent the last 12 years trying to get back some of those saving I can say without a doubt you have no fracking clue what your talking about. I lost 30 years of sweat and sacrifice, I don’t have another 30 years to get back that let alone what you think is so easily sacrificed now and there are many others that depend on me as well. People die, that’s part of life and matter how much of other people’s lives you are willing to sacrifice people are still going to die. Cars kill let’s get rid of them. Trains kill let’s get rid of them. plains kill let’s get rid of them. Peanut butter kills let’s out law that. Going to work is dangerous let’s out law that. Fighting wars against evil people takes lives let’s never do that again.

    • So are you claiming that it would be worth it to shut down the entire economy to save one person from death?

      Didn’t think so … and at that point, we’re back to the cost-benefit question. The virus looks like it will kill maybe 80,000 people in the US. The interventions we’ve made MIGHT save a few percent of them, but we have no real evidence how effective they are. My investigation shows that they’re not doing a whole lot …

      So … is it worth shutting down the entire economy to save say 2,000 people? Again, I say absolutely not. Sure, shut the schools, that’s low cost and high probability it might save some … although again my analysis didn’t show a significant effect from that.

      But shut down the economy and throw millions out of work to save a couple of thousand? Sorry, but that’s what we used to call “Stepping on a dollar to pick up a dime”.

      w.

      • “So are you claiming that it would be worth it to shut down the entire economy to save one person from death?” No, I didn’t say that, I said you cannot place a dollar amount on the value of a human life because it is immoral to do so. The problem you have in doing so is that you create a “market” for human life. You are in effect enabling trafficking and exploitation of people when you do so. Answer the question I posed: “if my uncle was on death row in CA, could I free him for $10 million?” $500 million? $20 billion?

        • Insurance companies value human life all the time. Its literally one of the largest industries on earth. You can estimate that value by the premiums on life insurance. Its hardly immoral. Its also not very high, especially when you are older.

          On a pure cost/benefit check here, its better to due minor distancing measure not lock downs. And its not particularly close.

      • Willis (forgive the informality) I think a lot of people are forgetting the undeniable fact that people in rich countries are healthier and live longer than people in poor countries, generally speaking. The US has been intentionally making herself a poor country for about a month now. That will yield the cost in lives that you’re speaking of, I believe.

        The potential deaths now can be seen on the news, whereas the potential deaths later may never be connected to their cause: lack of societal resources and personal resources brought on by panic and shortsightedness (not to mention love of power). Our children’s and grandchildren’s lives will be diminished in quantity and quality, but they’re not on the radar of the “compassionate” elite who only care about some deaths, not all deaths.

        Thank you for your efforts.

    • Henry, people die. Most of those in every country that died of COVID-19 are the old and infirm. COVID-19 is just one of many that visit every year to do the job and we really can’t change it very much. These viruses are opportunistic and ubiquitous and have been around since humans have.

      The best we all can do is try to eat healthy and keep our weight down. Exercise and don’t smoke. We all have some personal responsibility in this. And even if we all do our best, sometimes nature has other ideas.

      • Do you have either elderly parents, or grandparents? If you do, do you consider them expendable for the economy? How about if your wife is old and diabetic? Oh, another “issue” you have is that you used the word “most” which of course we all know means that young people are also susceptible to this virus. I agree every year the flu takes out a lot of folks, but consider this….right now in NYC they are using refrigerated trailers to hold the dead bodies that have overflowed from the mortuaries. They are even going to temporarily inter them in a park.

        • Where did I post I consider anyone “expendable”? People just don’t live forever and the Flu and other diseases kill tens of thousands of people in the US every year, most of them old and infirm. We don’t shut the place down for them.

          Please explain what makes this one different?

          BTW I don’t have elderly parents. They have passed on. I’m a 69 yr old male. But I can say this. I have a resting heartbeat of 48, bike 15+ miles almost every day and have been in great shape all my life. I might get CV-19 and not make it through, but more than likely will because I chose a healthy lifestyle. There will come a day as I age where I will be old and probably infirm. It’s inevitable. But when it’s time to go, I will have no regrets.

        • Henry

          Neither my elderly father or mother would ever want someone to sacrifice their future for them. They know that their lives are their responsibility, they would make what ever sacrifice they would need to make to safe guard themselves and if that wasn’t possible then they would accept that outcome. They would never put the burden on others. As would almost anyone from their generation.

        • “Do you have either elderly parents, or grandparents? If you do, do you consider them expendable for the economy?”

          My parents are 67 and 70. I don’t consider them expendable.

          On the other hand, I value the (estimated) 60-70 years of life that my children have left more than the (estimated) 5-15 years of life that my parents have left. And the quality of life for those 60-70 years of life my children have left is important.

          You can say “the economy will recover” but you don’t know that to be a fact (especially the “when” part). We could be headed for a great depression that will result in lots more deaths than this virus will cause due to a variety of factors. And that would certainly make life much less pleasant than it was before this virus or even is now.

          Your idea that this is a “lives vs. economy” situation is incorrect. It is a “lives vs. lives” situation. GDP has a direct correlation with lifespan and overall health.

          As to my parents, what I would do is encourage my parents to self-isolate/social distance while the virus is around in order to protect the remainder of their lives. If they refuse to listen to reason, then there are consequences for bad choices.

          But I do not think shutting down the economy to “save my parents” is either wise or necessary. They can be reasonably protected without shutting down the economy.

    • Again Henry, you are unfortunately blind to some of the corpses. The ones who lose their jobs, despair and die of substance abuse, who commit suicide, who through stress develop diseases and succumb to them. The ones k!lled in domestic violence. Why do you avert your gaze from them?

      There is a balance which imho neither you nor Willis have gotten correctly. Just as rash to take no action and hope for the best.

  35. Stay at home orders are not as important, it seems to me, as how people are voluntarily modifying their own behavior.
    Look at pictures of the roadways and interstates, of the sidewalks in downtown.
    People are not doing much more than going to work (if they have to, but many are working from home), or to a store.
    These modifications in behavior started long before any edicts directed it to be so.
    The NBA cancelled their season when one player tested positive.
    Major League Baseball did the same shortly thereafter.
    Concerts were cancelled.
    Theme parks were closed.
    Movie theaters were first almost empty, then just closed up.
    Schools closed, and University’s closed and told everyone to go home, even though many people lived on campus.
    Businesses told people to work from home if they could, then told everyone to work from home unless it was some sort of essential business.

    I think the stay at home orders came after most people were already doing that, and a few people who were flagrantly defying what had become the norm. And in a short span of time the norm came to be do not congregate in crowds or even large groups.

    I for one am not focused on modelling or analyzing a comparison of different locales.
    What it seems like to me is a more or less haphazard convergence towards a large segment of the populace deciding they did not feel like getting this particular disease, and taking person steps to protect themselves.
    And a large component of that is the most obvious one: Do not go near anyone who might have the virus if it can be avoided. And since basically anyone could possibly have the virus, that winds up at the logical conclusion of self imposed isolation. As much as possible.

    Look at it this way: If tomorrow morning some official who you trust says all the movie theaters and ball games and concerts and theme parks and airports and vacation spots and everything else is going to open and everyone needs to pretend this virus is not a thing…would that still be someone you trust?
    I for one would not do anything different than I have been doing: Not worrying about it, but also not doing anything I absolutely do not have to do that could or would cause me to spin the COVID 19 roulette wheel.
    Here is the layout of the roulette wheel, as I see it: About 80 of the 100 slots on the wheel are either nothing at all happens, or the spinner of the wheel gets a dry cough for a few days, perhaps a fever, and a few that are like being sick like in a usual bad cold or case of the flu; 10 to 20 of the slots though, say “Get really darn sick, so sick you go to the hospital for the first time in your life because of a virus”; about 5 to 10 of those 10 or 20 say “Get really really REALLY sick, so darn sick they put you in the intensive care unit at the hospital, where you will remain for as much as FOUR TO FIVE WEEKS! Thanks for playing!; and somewhere between one and three of the slots say “Go to the cemetery. Go directly to the cemetery. Do not pass Go, do not collect $1200”.

    Even without knowing that many of the people who do not get a cemetery slot on the wheel, will nonetheless having somewhere between long term organ damage to the lungs, and never being anything like healthy ever again…even without knowing that…I for one have no desire to spin that wheel and play that particular game of chance.
    Heck…I am not even anywhere close the stage of hating this that I make myself pretend I am stuck in a mountain cabin in the Arctic in November… with no chance of rescue until Spring.

    Instead, I am at the “Dang! This sucks, and I wonder how it is gonna end?” stage, personally.
    As soon as I see some solid scientifical evimadence of a treatment with a very high rate of promising a good outcome, I will be at the “Who the hell cares about corona virus!” stage.

    • Unfortunately for you, you’re spinning the wheel whether you want to or not. Statistically, sooner or later, your spin is coming regardless of your behavior, since you’re still connected to everyone else through at least the need to acquire food you don’t produce yourself from time to time.

      • But fortunately for me, I am far more informed, equipped, resourceful, fastidious, and careful than everyone else (everyone else in the collective sense, not EACH everyone else).
        IOW…I know how to protect myself, and intend to.
        Can I get it anyway?
        Yup.
        Will I get it from fomites on a box delivered by Amazon or Walmart? Nope…not unless they can survive being sprayed with Lysol, sitting in the direct Florida Sun, and/or the type of hand washing I am doing.
        I have N-95 masks and a whole bunch of cheaper ones, I have and know how to use eye protection, disposable gloves, Hibiclens, povidone iodine, 93% isopropyl alcohol, every cleaning product known to man, 50 pounds of calcium hypochlorite (a few ounces makes a gallon of extra strong bleach), and all sorts of other stuff, plus I know a lot about nutrition, have been a lifelong swimmer and biker, have never smoked, take no drugs, do not drink even a little bit EVER, and all sort of other stuff that I figure maybe just might give me a slight edge.
        By the way none of that stuff did I purchase this year.

        And…if I do become infected anyway, I am angling for a low infectious dose.
        Luck and fate favor the well prepared.

        In the end, my not wanting to get it will not necessarily prevent me from getting it, but it does not have to.
        All that has to happen is I do not get it before whichever of the treatments that work, are well understood so I do not get some crap that will not help if I have an unlucky spin, or a vaccine comes along, or whatever.
        And if I do get it and get real sick, oh well, I did everything I could think of.
        No point in worrying about anything out of your hands.
        I can tell you I do know what hospitals where are having clinical trials, and I know these places have a far higher level of patient care than some other places.
        I aint gonna just go wherever.
        And doctors tend to like me…I speak their lingo.
        At this point, I think the virus has infected somewhere in the single digits percentage of the population…so just giving yourself an edge will go a long way.
        Fortunately.

  36. Willis,
    I agree with you in general – but I think New York and its neighbors are clearly a different story.
    California nCOV deaths are low – presently under 100 per 10M pop – but New York just passed 3000 per 10M pop.
    New Jersey, Louisiana, Michigan also appear to be a different story: 1669, 1393 and 850 respectively.

  37. Seems to me that the IHME model was originally tuned for the west coast states, had to be updated to take NY/NJ into account (NJ was way under counted in first model), and further tweaked when hospitalizations were nowhere near forecast. I was also amused at the projections for Wyoming, which has yet to report a COVID related death and my eyeballs estimating a 2 week doubling time for confirmed cases.

    One thing missing from the model was the fraction of people taking mass transit as that would have a huge impact on the effectiveness of stay at home policies.

    Based on the drastic changes between updates, the models should not be used for policy decisions more than a week in advance. (Sounds a bit like long term weather forecasting) Based on the experience of the last two months, for next winters repeat of the pandemic the US should implement closing of ski areas, and a ban on travel from high risk areas.

  38. Emotionally the decision makers need a cure.

    Hydroxy Chloroquine and some mixers looked like a possibility it need do only help 80% of people well and it would be fine.
    Problem is political BS has hit it and that is sad. politics and ego, big problem.

    good article thanks again.

  39. If the proportion of all infections that reach the serious (i.e. ventilation required) ICU stage is very low, but the proportion of those that subsequently die is very high, then it is definitely a waste of time, as resources overwhelmed or not, the number of deaths will be little different. Also as it tends to take the infirm, the death rate from all other causes after it has passed will drop for a while.

    https://ichef.bbci.co.uk/news/624/cpsprodpb/E96A/production/_111545795_optimised-mortality_rates-nc.png

    ‘That does not mean there will be no extra deaths – but, Sir David says, there will be “a substantial overlap”.
    “Many people who die of Covid would have died anyway within a short period,” he says.’

    https://www.bbc.co.uk/news/health-51979654

    The important data no one knows is the total number of infections – millions of which have probably had negligible symptoms.

    It would be ‘scary’ if the media did a running count/commentary in any average flu season of people that died from any cause that happened to also have flu. e.g. If the worst hit area in Italy is notorious for atrocious winter air quality and normally has 100,000 excess winter deaths, then suddenly things look very different.

    • I don’t see people like Willis saying that won’t be a problem and won’t happen they are just placing a higher value on the Economy. It’s the classic problem how much is one human life worth and there are multiple answers to that and who gets to decide?

  40. I have a son, an engineer, who has a keen interest in Mathematics, Statistics and Computer Modeling. From the first reports, he has closely followed details of the spread of the virus. He has been frustrated that crucial questions should have been asked ages ago but were not. To make matters worse the media and politicians keep fanning the flames of alarmism with their ignorant assertions. The consequences of their foolhardy responses will cause considerable economic damage. Will there be any accountability?

  41. I strongly agree that COVID-19 mitigation methods must be based on a realistic assessment of costs as well as benefits, However, the assertion that flattening the curve can not reduce overall mortality is almost certainly wrong. This would only be correct if access to health care and the efficacy of COVID-19 treatments don’t matter, or will not improve over time.

    There is plenty of anecdotal evidence that overloading of hospitals in some areas (e.g., northern Italy) degraded standards of care and contributed to increased mortality, particularly among groups that were de-prioritized for treatment. Buying time to increase hospital, ICU, and critical equipment capacity can save lives. This is very hard to quantify in real time, but we should ultimately be able to make estimates of the case fatality rate and infection fatality rate over time and by group.

    While the media and authorities have made much of the capacity issue, the more significant factor is the likelihood of improving treatment effectiveness over time. If any of the drugs current being assessed are shown to be effective in reducing the severity of the infection, or if protocols for supportive treatment can be improved, this could substantially reduce the number of deaths as well as the number of patients who are permanently impaired. Delaying COVID-19 infections by even a month or two could make a big difference.

    • Given that New York has passed both Italy and Spain – and continues to display a much higher rate of death curve – is hospital overload really the main concern? Are NY hospitals worse than the eponymous Italian ones? Because now the NY outcomes are worse…

      • C1ue,

        I don’t understand your comment that New York continues to display a much higher rate of death curve then Italy or Spain.

        The number of reported COVID-19 cases in New York state (150697) is comparable to Italy (135586) and Spain (140511). However the number of reported deaths in New York state (6268) is substantially less than Italy (17669) or Spain (14673) – at least so far.

        I also do not think this is the relevant question when assessing the utility of mitigation measures or whether flattening the curve can save lives even if the total number of infections is not reduced. New York City where many hospitals are said to be nearing or at capacity is reporting 55% of the cases in New York state, but 73% of the deaths. The situation in Lombardy where hospitals were overwhelmed. The reported case fatality rate in Lombardy is 18.2% according to this source:
        https://github.com/pcm-dpc/COVID-19/blob/master/schede-riepilogative/regioni/dpc-covid19-ita-scheda-regioni-20200408.pdf

        • You can’t compare absolute numbers – Italy has a population of 60.8 million people while New York State has a population of 19.4 million.
          Spain’s population is 46.4 million.
          What matters from an epidemiological perspective is the number of deaths per unit of population.
          The numbers above are for 10M population – a typical flu season might see 1000 to 2000 flu deaths per 10M – which is what Willis has noted in the wattsupwiththat COVID-19 graphs page.
          However, Spain, Italy and New York have long since exceeded the 2000 deaths per 10M point – and they’re still increasing. New York, in particular, is increasing a lot faster than Spain and Italy.
          So: if the nCOV mortality rate is so bad in Italy and Spain because the hospitals are overwhelmed – what then do you say about New York where the mortality rate is higher and increasing faster than either Spain or Italy?

    • Excellent point. It is now increasingly clear that hydroxychloroquine and zinc is a safe and effective treatment. Supplies have been deployed widely. We are at most approaching the top of the bell curve. We could hope that 80-90% of the remaining projected deaths could now be avoided. At this moment the US is at 14,668 deaths with a model projection of 61,000 deaths. If 80% of the projected remaining deaths were avoided, the US would end up with under 25,000 deaths.

      I hope that Trump Derangement Syndrome doesn’t sentence 36,000 people to a needless death. Come on media, you can pretend that Biden told Trump about HCQ and Trump stole the idea.

      • “I hope that Trump Derangement Syndrome doesn’t sentence 36,000 people to a needless death. Come on media, you can pretend that Biden told Trump about HCQ and Trump stole the idea.”

        You know, I saw something that I would consider strange on Fox News Channel this morning and it is possibly related to your question.

        Two nights ago, Tucker Carlson was interviewing Dr Seigel on Fox News Channel and at the end of the conversation, Dr. Seigel mentioned that his 96-year-old father had been infected with the Wuhan virus and had gotten to the point where he thought he was on Death’s Door, and asked Dr. Seigel to get him some hydroxychloroquine, which he did, and Dr. Seigel said in a very short time his father had recovered. So, naturally, I thought this was significant. Not only because it is another example of people being very ill with Wuhan virus, and taking hydroxychloroquine, and being back to normal in a matter of hours or days, but also because it happened to a high-profile doctor who is a contributor to Fox News about the Wuhan virus pandemic.

        So now the strange part: I was watching Fox & Friends this morning and they interviewed Dr. Seigel about the Wuhan virus situation, but they never even mentioned his father, or the fact that he had such a good experience with hydroxychloroquine!!! Not one word.

        And I thought to myself: Is the leftwing smear campaign against hydroxychloroquine affecting even how Fox News Hosts are addressing, or in this case, not addressing the promise of hydroxychloroquine?

        Not one word about it. Unbelievable.

        • re: “And I thought to myself: Is the leftwing smear campaign against hydroxychloroquine affecting even how Fox News Hosts are addressing, or in this case, not addressing the promise of hydroxychloroquine?
          Not one word about it. Unbelievable.”

          Almost as bad as mentioning Dr. Mills and Hydrinos on various forums; “not done in polite company” eh?

          • Since that interview on Fox & Friends yesterday, I saw Dr. Seigel interviewed three more times on Fox by various hosts and again, not one mention of hydroxychloroquine or what it did for his father.

            You would think the hosts would at least be congratulating Dr. Seigel on his father’s good fortune, but no, not one mention.

            I’m beginning to wonder if corporate at Fox has put out a message to their hosts to stay away from the subject. They do seem to be pushing Fox to the Left a little. They focus on the meme’s the Leftwing media create and treat them like they are legitimate instead of being skeptical about everything coming out of the Leftwing media. That’s my biggest problem with Fox. If it appears in the New York Times, then Fox has to talk about it, giving the Fake News legitimacy.

        • What I found dumbfounding was that at yesterday’s WH press briefing, there was no mention of the American Thoracic Society’s guidance. Not surprising that there was no question from the Democrat political activists (assembled in the guise of reporters), but usually Trump would be crowing about such a development. Why the silence?

          https://www.thoracic.org/about/newsroom/press-releases/journal/2020/ats-publishes-new-guidance-on-covid-19-management.php

          I’m not so naive as to believe HCQ-Zn is a cure for every case, but the anecdotes are sure building up.

  42. I’m still holding to the view that without having a parallel universe in which to run experiments, you do not have a control and it is unknowable what would have happened absent mitigation attempts.

    It’s not valid to compare the actual shape of one state’s curve to the actual shape of any other state’s curve. They are not equivalent test subjects receiving different treatments. Each state has different population density, demographics, etc.

    Then there are randomly different initial conditions. I suppose more people travelled between Wuhan and Chinatown in NYC than travelled between Wuhan and West Virginia. But it’s also unpredictably possible that somebody from WV took a trip to NYC to observe Chinese New Year festivities and then returned home asymptomatic and infected a great many people. Another state might have had a patient zero who didn’t interact with many people and who was quickly diagnosed. Every state is different.

    As we all acknowledge, there has been nothing approaching a true lockdown. It has been very porous. The degree of compliance is also different for each state. Many people in states with no formal government interventions may be behaving almost the same as in states with the strictest mandates.

    I am not willing to criticize Trump or the Governors for attempting to take steps to affect a pandemic in a situation where we do not have adequate information and millions of lives MAY be at stake. After this event provides lessons learned, if the inevitable errors being made now (which can only be confirmed after the fact) are repeated then I will be happy to criticize.

  43. The reduction in numbers of new cases and the reduction in the need for ventilators and ICU beds might have something to do with how well the population is maintaining their distance from one another, and, although I’m not sure how you would do it right now, the number of patients receivng hydroxychloroquine and other treatments for the Wuhan virus ought to be figured into the mix, too, assuming they are actually having a beneficial effect on the disease.

    I heard this morning that the virus models are predicated on using an estimation that 50 percent of the population would abide by the social distancing request, and some are saying that the reduction in numbers of new cases in the lastest estimates is a result of Americans doing better than 50 percent.

    So there are two things that are not being taken into consideration when doing these calculations.

    I’m curious: Does anyone contend that the 2.2 million dead figure is wildly inaccurate if we had done nothing to slow the spread of the Wuhan virus? I wonder what infection rate they were using to get that figure. You know, we still don’t know the real infection rate.

    There are a lot of things we don’t know about this virus. People should keep that in mind.

    • At the very least, 2.2 million is a phantasy number, because it assumes people will go on, business as usual, stepping over the corpses. Long before 200k deaths, people, especially vulnerable people, would certainly modify their behaviors.

      • “At the very least, 2.2 million is a phantasy number, because it assumes people will go on, business as usual, stepping over the corpses. Long before 200k deaths, people, especially vulnerable people, would certainly modify their behaviors.”

        Yup.

        The problem is nobody knows how long it would take people to voluntarily figure out
        that social distancing was what they needed to do.

        https://www.theweek.co.uk/76088/what-was-black-death-and-how-did-it-end

    • Here is what I was wondering: Let us suppose that everyone in the entire USA reads this article, becomes convinced that the number of deaths and even who exactly will die is chiseled into stone and nothing can change that.
      Convinced as in a mathematical certainty…and so everyone just tosses up hands, says “oh, well…what the hey!” and trudges on back to doing exactly what we were all doing last year at this time…just put it out of our minds.
      I have a hard time believing that there are not a whole bunch of more people this virus would just love to infect, sicken, and kill…whenever it can swing it.
      How many is a whole bunch of more people?
      Well, everyone in the country except people who are already exposed…assuming this is like most diseases and no one can get it again anytime soon after getting it and recovering. A fair assumption I think.
      Some people no doubt have a strong enough immune system and general constitution that this virus cannot do jack to ’em.
      Right now a cruise ship off the coast of Uruguay has 60% of people on board testing positive.
      Might that be an approximation of how many people will contract the virus?
      It was in the case of the people on that ship.
      If so many people get sick that all our hospitals are overwhelmed, it is not just people with COVID who will die but that would have lived with proper care…it is a large number of the people that normally inhabit our hospitals on an ongoing base…in addition to the excess COVID dead.

      Or so it seems to me.

      • Nicholas McGinley April 8, 2020 at 2:29 pm

        Here is what I was wondering: Let us suppose that everyone in the entire USA reads this article, becomes convinced that the number of deaths and even who exactly will die is chiseled into stone and nothing can change that.
        Convinced as in a mathematical certainty…and so everyone just tosses up hands, says “oh, well…what the hey!” and trudges on back to doing exactly what we were all doing last year at this time…just put it out of our minds.

        That is a devious and unprincipled misrepresentation of what I actually said, which was:

        “End the American lockdown today, leave the schools closed, let’s get back to business.

        And yes, of course I’d include all the usual actions and recommendations in addition to leaving the schools closed—the at-risk population, who are those with underlying conditions, particularly the elderly, should avoid crowds. And of course continue to follow the usual precautions—wash your hands; wear a mask at normal functions and not, as in your past, just at bank robberies; only skype or facetime with pangolins, no hootchie cootchie IRL; refrain from touching your face; sanitize hard surfaces; y’all know the drill by now …”

        People may indeed go back to doing what they did last July, but your foolish and failed attempt to blame it on me is most ugly.

        w.

        • I was not trying to be devious, and I am nothing like unprincipled.
          I did not say that that conclusion, if it were reached by everyone in the country, is what you have said.
          Clearly you did not say that.
          But people can misinterpret.
          What I did was, and I think I said so, just wonder what would happen IF everyone decided to just forget about the virus…as many people, but not you i do not think, have suggested we ought to do.
          If everyone just woke up this morning and forgot about the whole series of events and went back to business as usual…what would happen?
          Thought experiment.
          I did not say you advocated this.
          I am just going to ignore that you have put words in my mouth and accused me of blaming the whole thing on you.
          I think you just do not like me, at all, and are not really reading only what I have said.

          • Thanks, Nicholas. Let me clarify.

            You said:

            Let us suppose that everyone in the entire USA reads this article, becomes convinced that the number of deaths and even who exactly will die is chiseled into stone and nothing can change that.

            Some people may indeed believe that “the number of deaths and even who exactly will die is chiseled into stone and nothing can change that.” But that’s nothing to do with me.

            I didn’t say that, or anything like it. You’re pinning a belief on me without a single quote of what I’ve said. I said nothing of the sort.

            Instead, I said of flattening the curve, that it was:

            Valuable indeed, critical at times, but keep in mind that these delaying interventions do not reduce the reach of the infection. Unless your health system is so overloaded that people are needlessly dying, the final numbers stay the same.

            And yes, I get grumpy when, after hosts of requests, you imply that your total misrepresentation is actually my message without quoting one word of mine. I am touchy about being blamed for something I never said, and I never said that.

            I’ll let this go. Not productive.

            With best wishes to stay well,

            w.

          • Hi Willis,
            I am just getting back to this thread after all this time because for some reason my browser was unable to see any threads on WUWT older than two days old, for a while, but that seems to have been resolved.
            So, regarding this:
            “And yes, I get grumpy when, after hosts of requests, you imply that your total misrepresentation is actually my message without quoting one word of mine. I am touchy about being blamed for something I never said, and I never said that.””

            In retrospect, I could have and should have made my point without including this small snippet, ” in the entire USA reads this article” in the first sentence.
            This would have left you out of it.
            I was thoughtless and careless to include this in my comment.
            If I could erase it I would.
            You did not say any of the things I mentioned.
            I caused you angst by dint of my carelessness, and I want to tell anyone who reads this that I should never have said or implied any such thing.
            I was wrong, and I regret it.
            I am very sorry for my carelessness and the implications of that carelessness.
            It is not my intention to have antagonized you in any way, but this is beside the point that I did, and it was not a result of anything you said.
            I apologize to you unconditionally.

        • I am still trying to figure out what it is that made you say these things, Willis?

          Or how on Earth you came to some conclusion I was “blaming” anyone for anything?

          I was pretty clear in what I said in my direct comment that was not a reply to anyone.
          I said, basically, that it is my view that this whole mess was not ordered from the top at it’s origin, but was at the beginning a series of reactions from various individuals.

          I also said I do not think at this point that anyone is waiting for someone to tell them they can go back outside.
          I may be wrong about that, but it is what I think.
          I am not at all clear of even any theoretical basis anyone could possible credibly blame any of this on anyone!
          So for you to make the statements you made, I think you must just have some deeply simmering anger at anyone you perceive as contradicting you.
          I have not contradicted you…I do not even accept that what is happening can be modeled.
          And all I was even thinking about when I asked the thought experiment question was the idea that once a peak was reached, the ultimate number of deaths is somehow predetermined.
          I am not disputing the math, or even saying it is not true.
          I am saying that my understanding of how many people get sick and die is completely dependent on how 320 million individuals behave.
          And I am no where close to egotistical enough to think I or anyone else, including you, have much influence on how 320 million American citizens conduct themselves.
          I think people are focused on not getting sick with something that may turn out to be really incredibly unpleasant.
          I have said very little about orders or whether they should be lifted.
          What I have done is express surprise at the whole thing.
          But more than anything else, what has occurred in my view is that a large number of personal decisions, many of the most consequential and almost all of the early ones, were made by people in charge of various businesses, like the NBA, Baseball, Disney, the big tech companies and banks and such…when they closed their gates and/or told people to work from home.
          I said in another comment here, very clearly, that IMO not too many people are waiting for an all clear from anyone to be issued by edict.
          I could be wrong, but that is what it looks like to me.
          Frankly I do not know whether to be amused or offended at your anger.
          Amused that you somehow think you are so influential that this essay, or anyone’s opinion of it, could be construed as determination of what happens next.
          You must be very egotistical.
          I for one am not even remotely thinking of anything relating to blame or fault, so how could I deviously be trying to pin this whole thing on you?
          That s about the most nonsensical thing I have ever heard you say. Clearly you are really mad at me for my comments. Maybe you could tell me why?

          And offended…because you have, from where I am sitting, pulled some complete BS out of nowhere and pinned it on me.

          Here is what I was responding to:
          “I’m curious: Does anyone contend that the 2.2 million dead figure is wildly inaccurate if we had done nothing to slow the spread of the Wuhan virus? I wonder what infection rate they were using to get that figure. You know, we still don’t know the real infection rate.

          There are a lot of things we don’t know about this virus. People should keep that in mind.”
          Tom said that, and it seems like a sensible question to me.

          And I was responding to this:
          “At the very least, 2.2 million is a phantasy number, because it assumes people will go on, business as usual, stepping over the corpses. Long before 200k deaths, people, especially vulnerable people, would certainly modify their behaviors.”
          Which is what Rich said in response.
          I was following up on that and using the result you found, that by some confluence of factors, once the curve has peaked, the final number of deaths can be closely approximated to be double what occurred at the time of the peak. I specifically did not comment on this directly, because it is baffling to me, and yet you cited some stats that seem to confirm it.

          So, I agree with what Rich says in his response…people react to what is happening, not to what some politicians are saying.
          No one is going to do what I asked in my thought experiment. Or, rather, everyone collectively will not forget and just act like nothing happened.
          It was a rhetorical question…is that happened, everyone would have to have either went insanely fatalistic, or else developed a case of TV show amnesia.
          It was an IF hypothetical question!
          If they did, lots more people would die because the virus does not care what people think or believe…it just infects.
          Everyone knows that, and we know we need to protect ourselves.
          The world has changed forever, and the Genie will not go back in the bottle.
          Pandora’s box is opened, and this is the world we now have, incredible as it is.

          Look, I never directly disagreed with you about the Japan cruise ship statistical analysis you did on another article. Like other people have said, I do not know how to do what you do in that regard.
          But I was not entirely convinced it was a worst case scenario. It seemed to me some people probably did a very good job of not getting themselves infected. Some might have been dumb and got infected by not being careful. Or maybe no one was dumb, and the virus was spread to them through the air vents, or the food deliveries, etc.
          Unknowable, in my opinion.

          But now we have this ship off the coast of Urugauy.
          New development. New information. Reports are that 60% of the people on the ship are infected. 60%!
          Damn!
          I am not shocked, and I am not nodding my head saying “of course” either.
          I am absorbing it as new information…because I FOR ONE AM TRYING NOT TO THINK I KNOW WHAT WILL HAPPEN NEXT.
          Maybe I could guess, but I do not see the point. I would get no satisfaction by being a good guesser at something like that.
          Other people want to, fine with me.
          I am sitting here figuring I will have more surprises just like I have had plenty already.

          But that 60% ship is really something.
          It may be a BS stat.
          It may be true, or the number may be higher.
          I do not know.
          Why are 40% not testing positive?
          I do not know.
          Maybe they are locked up in their cabins.
          Maybe they are immune somehow.
          Maybe they just have no virus in their nose.

          And maybe there is something unusual about that group.
          But without assuming anything, we now have an examples which suggests that if left to it’s own course, this virus will infect as many as 60% of humanity.
          What is the death rate if that happens?
          I do not know.
          I know one thing…it is not my fault, it is not your fault, and I am not blaming anything on anybody!
          I just erased a final thought that I am sure would have got be banned for life, so that is all I have to say.

          tistical thinned skinned buttmunch.

    • “Does anyone contend that the 2.2 million dead figure is wildly inaccurate if we had done nothing to slow the spread of the Wuhan virus?”

      Yes. For example:

      Dr. Paul Offit (UPenn Virologist, Vaccinologist, Pediatrician, co-developer of Rotavirus vaccine).

      Dr. Knut Wittkowski (epidemiologist, 35 years of modeling epidemics).

      The Oxford team that created their own model of the virus.

  44. this whole flattening of the curve stuff got me to thinking about the annual flu cure, which flattens all on it own … my assumption is a combination of herd immunity building up and just plain old geographic friction eventually stops the spread of the virus …

    the geographic friction would be roughly the same for flu vs covid … now with the lock downs the travel during covid19 will eventually be felt more than with the flu but it takes weeks and geographic friction is never enough to stop a virus, that takes the herb immunity kicking in …

    so as far as herd immunity … it starts building the first day a virus presents itself to the country … and builds over time until its big enough to severly reduce the spread … and the big enough number must be some % of the population …

    so if covid19 is so much more infectious than the flu as we are told, then the population will build up herd immunity much faster than the flu … and its herd immunity that peaks a viral spread … the goegraphic friction is constant but never enough to stop the growth by itself … its the herd immunity reaching a certain threshold that nails a virus (thus the bell curves with sharp peaks) …

    So the flu peaks in about 3 months … covid19 should peak in less time … we are at about 2 months right now …

  45. I reached the same conclusions as above weeks ago. All of the curves a Gaussian. And normally shaped Gaussian curves have equal numbers on either side of the peak. The curve showing total deaths is the Gompertz curve or Gompertz function, which is simply the integral of the area under the curve showing the peak. All that “Slowing” the problem does is decrease the slope of the two curves. The only benefit is that it reduces the impact on unprepared medical facilities, and thus can, possibly, lower the deaths.

    It has been 55 years since I got my degree in Applied Mathematics and went on to joining the Navy and becoming a Nuclear Engineer, SO, some of my conclusions and assumptions may be incorrect.

    • “The only benefit is that it reduces the impact on unprepared medical facilities, and thus can, possibly, lower the deaths.”

      It also gives us more time to develop treatments and vaccines. Medical supply shortages will soon be a thing of the past, and there lots of promising treatments being tested along with new vaccines, and new, much faster methods of mass testing are coming online. All these things, plus lessons learned will help us deal with the Wuhan virus and viruses that come along in the future.

      We’ll be ahead of the next pandemic. Now, we just need to get this current Wuhan virus pandemic behind us, and as the president said, there is a little light at the end of the tunnel.

      Supposedly, the rescue package Trump and Congress have passed will keep most people and businesses solvent for the next eight weeks, which is about June 1. Maybe by May 1, we can start opening things up. So everyone relax for a couple of more weeks and maybe we’ll get lucky and work ourselves out of this mess. Lots of testing, like in every building can get us back to work, and if drugs like hydroxychloroquine can prevent people from dying if they get the disease, then we should be good to go. Even better would be if hydroxychloroquine can serve as a preventative, which it looks like it does. We’ll know soon, there are several trials going on right now.

      Wouldn’t it be nice if you could tell people that if they catch the Wuhan virus, they can take hydroxychloroquine, or something similar, and it will prevent them from dying, in most cases. Then people could walk around with confidence and not worry about being infected.

      Of course, we have to guard against wishful thinking, but this looks like the direction we are heading to me. There’s no doubt we can produce enough testing equipment and tests to do everyone in the U.S. And I have heard nothing but good things about hydroxychloroquine. Trump says there are no bad reports he’s seen. Every day we see more positive results from hydroxychloroquine.

      Dr. Oz is asking anyone who is taking hydroxychloroquine to treat their lupus to email him at DrOz.xxx if you have contracted Wuhan virus while taking this medication. He is trying to find out if hydroxychloroquine will prevent a person from being infected by Wuhan virus.

      Dr. Oz and several federal agencies are looking into the medical databases and are trying to find the number of people who are currently taking hydroxychloroquine, and then looking to see if any of them have contracted the Wuhan virus.

      One New York Hospital Director said his hospital was giving hydroxychloroquine to every patient that tested positive for Wuhan virus. I’ll bet you all those hospitals are doing that, especially when they are hearing about the good results, and there are a lot of medical people who are taking it in hopes it will prevent them from being infected. There’s a lot of hydroxychloroquine going around!

      It couldn’t be that easy, could it? Maybe. Let’s hope so. We’ll know before too long.

    • Why is such optimism about the economy acceptable while any optimism about this virus is treated like heresy?

  46. Willis-

    I certainly agree that we should end the lock down, and you have done a good job of showing why.

    However, I think you are being too hard on doctors. A doctor’s measure of success is lives saved, period. Years ago when I was in college, my machine design prof said “We can teach anyone to design [here insert any machine you want designed], an engineer’s job is to design it within a budget. Doctor’s aren’t taught this. They are taught save lives at any cost. Thus you are right, because of his training, Dr. Fauci only looks at the benefit (save lives) side, he is hardly aware that there is “cost” side.

    Our politicians make the mistake of listening to the wrong people. They listen to the doctors. So their actions are designed to save lives at any cost. They should be listening to economists.

  47. Just an observation:. The high population density cities of NY and Milan have death counts of about 600 per million residents. In places outside of these the count is about 125 per million residents.

    A counter to this:. Japan is has very high population density cities but has not experienced high death counts. Japan has done much better than S Korea so far and with little testing.

    I could use some help in understanding these observations.

    • Just a thought, but although densely populated, Japanese culture tends to be very formal compared with more high touch cultures. Also extremely conformist. If masks are prescribed, masks WILL be worn. They have a saying that the nail that sticks up will be pounded down. Western cultures are far less conformist or compliant. Cleanliness is also highly valued. My thought is that culture will be the main differentiator.

      Korea is far more like Japan than China in these respects.

  48. If this had happened 40 years ago you would not even know there was a virus. The internet is 100% responsible for this. Forty years ago headlines would have been >severe flu in some european countries this winter season> Again I reiterate that about 170000 people die per day mostly old and half with cardiorespiratory, influenza and flu problems apart from traffic accidents. Willis is 100% correct. This is just a normal flu virus pumped up by the internet to a terrible pandemic and multiplied by human ignorance/stupidity as affirmed by Einstein. BTW this virus will infect everybody as it is airborne transmitted probably by birds animals insects and humans all over the world. By flattening the curve you are not allowing natural immunity to take place which is actually the purpose of theses viruses to protect our lungs from future disease! Death rates are complete within the range of normal coronavirus flu viruses every year. In fact if you look at general mortality rates they probably have fallen for this year as there are no more accidents ect.

    • “This” happened about 100 years ago without the Internet. They called it the “Spanish Flu.” The death toll was pretty high.

      • This is thank God, nothing at all compared to the Spanish Flu. Orders of magnitude less death now.

        But to be fair, with 1917-18 medical standards, who can be sure.

  49. I’m very surprised that there has been no analysis of the benefits of contact tracing. Those countries, South Korea, Singapore, and Taiwan that put a lot of effort into this exercise seem to have better results and returned to normality much sooner.

      • re: “cases of pneumonia haven’t changed much and have simply been given a new name – COVID-19.”

        That’s the point.

    • 2020 worldwide todate as of about 20 minutes ago. To put things in perspective:

      3,509,758 Communicable disease deaths this year
      88,100 Deaths from COVID-19
      3,509,758 Seasonal flu deaths this year
      2,055,033 Deaths of children under 5 this year
      11,492,188 Abortions this year
      83,566 Deaths of mothers during birth this year
      41,698,340 HIV/AIDS infected people
      454,495 Deaths caused by HIV/AIDS this year
      2,220,459 Deaths caused by cancer this year
      265,193 Deaths caused by malaria
      1,351,547 Deaths caused by smoking this year
      676,200 Deaths caused by alcohol this year
      289,922 Suicides this year
      364,960 Road traffic accident fatalities this year

      Source; https://www.worldometers.info/

      • re: “2020 worldwide todate as of ”

        Really, just looking for year after year pneumonia stats, and icisil nailed it with his graph. You should take a look at it above … it shows quite a “nose dive” for pneumonia this year, leading credence to the hypothesis that ‘simple’ pneumonia causes of death are now being classified as Covid-19.

        • I see that as a new apex predator invading the habitat of vulnerable prey. The lion supplants the hyenas. The hyenas have a bad sales quarter.

          It doesn’t mean that nothing is different Even if total deaths are comparable to prior years, it doesn’t tell us everything because the mitigation could be suppressing deaths of vulnerable patients.

          My nod to your argument though would be that we know that under appropriate conditions (just 2 yrs ago), the vulnerable population could easily be 80k or more. We’re thankfully not seeing that yet.

  50. I think the points you are making are the same as those advising the Swedish government on how to deal with this virus. I think we could have contained this virus if like New Zealand we had stopped all travel to and from the rest of the world but now it is in the UK we cannot now contain the spread of the virus perhaps we can slow it down so that the NHS is not overwhelmed but it does raise the question why we cannot provide the resources to treat everyone as I believe Sweden is proposing to do. I received a letter from 10 Downing Street a few days ago saying that we must slow the spread of the virus to stop the NHS being overwhelmed by the number of cases.

  51. The UK NHS can’t cope with a normal winter far less a virulent Flu or CV19. Seriously ill people being treated in corridors or waiting in A&E for hours. So flattening the curve is vital to prevent total collapse and to maintain the myth of how good the NHS is. It also hides the lack of investment in modernisation.

    In France, as of this morning, the French government had raised 650 million € in fines for breaking the lock down by individuals. The fine for being out without an attestation is 135€. Anew attestation is needed for each foray.

  52. I just think this is a case of being caught with your pants down around your ankles.

    As noted, flattening the curve does not decrease deaths, it just spreads them out. The answer “was” to have a plan and supplies ready for such a pandemic. Even ol GWB warned about it. The “Savior” depleted what was stored and didn’t bother to change the toilet paper roll. The current admin didn’t even have time to think much about it, as about all it could focus on was defending itself against a laundry list of false accusations.

    The sociopath in me says, just let nature take its toll. Put out the warning, let everyone know what’s coming, and then step back and let it unfold as it will eventually unfold anyway. Sure, there will be a lot of people who weren’t long for leaving anyway take a “relatively” early exit. Then, there will be the stupid who need to be culled from the gene pool. What will remain is the resistant population, making the virus less of a threat from any second wave. At that point, we take the 2 Trillion in economic aid and refill the supply closet for the next time.

    • Yes, we were caught unprepared. Some countries more than others. That is why many actions were taken with an abundance of caution that begin to look to most of us like they won’t have been cost-effective. But I believe that those possibly mistaken actions were taken in good faith and were prudent.

      Also, if you look to any country like Italy, Spain, or the UK, or a state like New York, it doesn’t seem reasonable to me to say that there have not been some deaths due to overloading the system or that those deaths would not have been more numerous had there been even higher numbers of patients. It’s unknowable, but a reasonable assumption. Those are not deaths delayed a few weeks. They are early deaths potentially robbing people of years.

      If deaths from all causes end up looking very comparable to previous years, even that won’t be a strong proof that lockdowns were unnecessary. Greater awareness, less interactions by vulnerable people may well have limited what could otherwise have been a much higher toll.

      Unfortunately our society often acts on the basis of precedents. To the extent that this event has included wild overreaction oblivious to cost-benefit, we may be locking in to a new normal. Much like in the climate wars, it is impossible to prove a negative. Despite Willis’ attempts, he won’t be able to prove definitively that we don’t need to lockdown as the new standard response to any epidemic.

      If we let this event lead to a national identity card required to obtain a mobile phone, and mandatory tracking “for our own good” as in Korea, I fear that the potential for a creeping panopticon police state will be very real. I certainly do not trust our politicians with that power.

    • “As noted, flattening the curve does not decrease deaths, it just spreads them out.” That depends. If in the absence of interventions, hospitals would get overwhelmed (in terms of beds, or ICU beds, or–most likely–respirators), then flattening the curve would definitely have decreased deaths, because there would not be enough beds/ ICU beds/ respirators for those who need them. This has played out in other countries, and it might play out in some US states. Whether it actually would happen in any particular area is hard to predict; it depends on numbers that are hard to quantify. (To this day, we probably don’t know how many people in China were actually infected/ got symptoms/ got severe symptoms/ were hospitalized/ died, and that’s about the only country where this has been going on long enough to get past the peak.)

      At a guess–and this is only a guess–without social distancing and other preventative measures, US hospitals would run out of resources in areas that are densely populated, like New York City, but not in areas that are predominately rural, like Nevada or West Virginia. (If you haven’t spent time in West Virginia, you probably don’t realize how much the geography imposes distancing all by itself.) But don’t quote me on that, it’s only a guess.

  53. In countries that are proud of their healthcare, the virus feels great. In countries where healthcare is weak, people don’t leave the house.

  54. This historical factoid springs up in my convoluted mind: Drs Ancel Keys/Fauci, both bullies, never responsible. Keys for the “food pyramid” via Sen McGovern’s Ag Dept condemnation of the good fat, causing the current diabesity syndrome. Fauci for HIV/AIDS tunnel vision and ignoring other duties, and now being under Bill Gates’ thrall (‘Global Vaccine Action Plan’ ).

  55. I think you have to be a little careful in how you are discussing the number of projected deaths in California and the cost impact of the shutdown on the economy. The IMHE death projections are what will occur with mitigation of spread measures in place. I searched long and hard to find anything regarding what they projected without those measures. The only place you can find any reference to that is in the technical paper under the publications tab. There they only reference in the introductory paragraphs that millions of deaths were projected without mitigation of spread measures. They should be specific about what they project in the absence of mitigation. But presumably whatever the economic cost is for a state or the country as a whole, would need to be taken as the cost of the saved lives, not the ones that would still be lost in any events. And as you point out, I don’t think people understand that the mitigation measures aren’t saving lives, they are only deferring spread and deaths, in the absence of overwhelmed health resources.

    This, in my judgment is the biggest flaw in the use of the models. People can make up any number of lives lost without mitigation and then claim they saved the difference between that number and whatever the actual number does turn out to be. In Minnesota for example, the Governor justified his shutdown by saying the model they used said 74,000 deaths would occur in Minnesota without the order. Of course it later turned out that 50,000 would occur with it. Either number is simply absurd.

    It is also important to realize that IMHE is only forecasting first wave and by first wave they mean only 3% of the population is infected. To find that information you have to look in the FAQs. So you would have to keep the social distancing measures in place indefinitely to maintain low death rates. I think their model is defective in a variety of ways, but their communication is even worse, making it hard for people to understand what the value of mitigation is in terms of saved lives and not creating a model that runs out til we reach stability. It has given people the impression that 60,000 lives or whatever the current number is, are all that will be attributed to the virus, when 97% of the population is still susceptible in the model. I have blogged about these issues pretty extensively on my website.

  56. Ignorance is a great excuse to use massive stimulus to combat ……other policy in the name of saving lives. Hey, at least they didn’t weaken social security finances or Medicare yet. Well they did but not directly in the stimulus bill this time.

  57. All of the mitigation steps listed influence the spread of the virus through the population and changes the rate of the wave of infection. The consequence of that infection is then so many hospitalizations, so many ventilators and so many deaths as a percentage of that total.

    The factor that I have not seen discussed regarding the model’s poor performance is the effectiveness of an established treatment protocol in reducing the percentages of the infected population that require the steps to the hospital or ventilator or death. An effective early treatment that reduces the progress of the disease and restricts the severity of the disease in a significant percentage of the patients would be expected to reduce the number of hospitalizations necessary. Is that part of what we are seeing in the IMHE model updates? Is it accounting for an effective treatment? Isn’t this the change to trend you would expect if a treatment is effective?

    Could the advent of the wider use of Hydrochloroquine with zinc be a key part of this change to the modeled trends?

    • What is interesting is that no post treatment studies have been presented. With and without Hydrochloroquine . Seems simple enough if one has access to the admittance and discharge files and the treatment. This would require real work that could save lives with no endangerment other than spending very little money to see some direct results.

    • “An effective early treatment that reduces the progress of the disease and restricts the severity of the disease in a significant percentage of the patients would be expected to reduce the number of hospitalizations necessary. Is that part of what we are seeing in the IMHE model updates? Is it accounting for an effective treatment? Isn’t this the change to trend you would expect if a treatment is effective?”

      We don’t yet have enough information to know if we have an effective treatment. It looks like treatments are having some effect but we don’t have any numbers yet. The official trails only started this week, and I doubt there has been a survey of all the medical people who have been taking hydroxychloroquine or of all the doctors outside of hospitals that are prescribing these drugs. It only takes about 10 days for these drugs to be effective in appears, so there should be plenty of anecdotal evidence out there, but it just has not been brought together in one place yet.

      And it is possible that social distancing alone is bringing down the numbers. I think the computer models were based on 50 percent of Americans abiding by the social distancing rules, so if more than 50 percent are following the rules, that should bring the initial numbers down.

      One good thing about it is we are going to have a whole lot more information about all of this in a few weeks.

      • re: “We don’t yet have enough information to know if we have an effective treatment. ”

        I give you the “European trial” here, the cumulative numbers ‘rolling forward’ underscore the effectiveness of Dr./Prof. Raoult’s hcq et al treatment regimen:

        https://www.mediterranee-infection.com/covid-19/

        It has gone beyond the point of being ridiculous now, on this date, to state “We don’t yet have enough information to know if we have an effective treatment.

        Also overlooked are the so-called “anecdotal” reports of the hcq regimen used by a number of physicians in this country.

        IF you’re looking for ontological certitude in this matter there are TOO MANY unique factors that affect ANY ONE INDIVIDUAL PATIENT for a ‘trial’ to be absolutely 100% certain of the efficacy of hcq et al, yet, the desired result, patient recovery, DOES seem to occur AND at a level (of certainty) far exceeding the odds of a simple ‘coin flip’ …

        • “It has gone beyond the point of being ridiculous now, on this date, to state “We don’t yet have enough information to know if we have an effective treatment.”

          I think so, too, but a lot of people won’t be convinced (Dr. Fauci) without some numbers. Fortunately, we should be getting these numbers soon.

          If I learned I was infected, I would be looking for the nearest supply of hydroxychloroquine, ASAP. 🙂

          • re: ” think so, too, but a lot of people won’t be convinced (Dr. Fauci) …”

            Dr Fauci’s job (and other CDC/FDA/NIH etc “lifers”) is to say “no” (and usually some amount of “prejudice”, IOW, with no possibility for appeal (See W.C. Fields as in “Go away boy, ya bother me …”)) Otherwise, one could simply “hard wire” the input he makes (the decisions he makes) to the input of the decision-allowing ‘AND’ gate to a logic “high” (or True state) and bypass the need for him to make a decision; a bureaucrat’s job is to say “no” on the first go-round (and usually thereafter) until the ‘evidence’ (literally) threatens (overwhelms) his (the bureaucrat’s) job, pension and/or appearance (technical competency) in public.

  58. But you need to give your phone GPS data to the government to make that work.

    Israel has deployed an app that gets around this. Download app to your phone, tracks your movements, but data stays on your phone. Someone gets infected. Data from THEIR phone is anonymized, uploaded to the cloud, then downloaded to all other phones. The app on your phone then figures out if you have been in contact with someone infected, where and when. But neither you nor the government knows who.

    • re: “Israel has deployed an app that gets around this. Download app to your phone, tracks your movements, but data stays on your phone. ”

      Doesn’t bypass “periodic registration” (NEEDED to update the HLR with what cell site your phone is ‘camped’ on so a ‘call attempt’ (ringing) can be made) which is a transparent (to the subscriber) function ; a CDR (call detail record: a reg attempt, which is “metadata”) is created for these actions.

  59. Thanks Willis.

    I wish I knew a way of getting Jay Inslee, Governor of Washington State, to read this.
    The Life Care Center of Kirkland – in Jay’s backyard (so to speak) – was past tragic before anyone noticed. A state of indecisive agitation, dithering, followed. Then this deadly abnormal situation became the template for the local “model” of what was happening in the State, or what was about to happen.
    The official response has “flattened” the economy.
    The officials, however, still get paid.

    Have they never known folks on the margin, poor folks?

  60. “Be clear, however, that this is just a delaying tactic. Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period. ”

    No, no, and no… I do not understand why perfectly smart people have so much trouble with this one simple point.

    Flattening the curve *WILL* reduce deaths. If the number of infected that require critical care exceeds the capacity of the health system to provide it, then you will get excess deaths that *could* have been prevented. If you have enough data you can even project the excess or prevented deaths. It’s basic statistics.

    By flattening the curve you allow more of the patients that require critical care to actually receive it (assuming the critical care capacity would have been exceeded). You also, as you mentioned, allow more time to study the disease and prepare treatments for it.

    While it is likely true that roughly the same number of people will contract the disease, you reduce it’s mortality.

    In the case of a disease like Cov-ID19 where it is possible and even likely for it to have trouble spreading in warmer weather, it is actually possible that flattening the curve will reduce the number of people that catch the disease, at least in this current pandemic. If it declines over the Summer, it will likely re-emerge next Fall – but again we have bought time so there is at least a chance we can better fight the disease and reduce deaths even further.

    NOTE: I am not arguing with you over the effectiveness of the measures taken, only over the principle of flattening the curve. I do think measures have helped, but I don’t have data to back up my hunch and neither does anyone else. We intervened which means there is no good baseline to compare the current numbers to. You can compare them against other countries, but then just like using proxies you risk many variables being intermingled with the data you are using.

    • Robert of Texas April 8, 2020 at 12:30 pm

      “Be clear, however, that this is just a delaying tactic. Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period. ”

      No, no, and no… I do not understand why perfectly smart people have so much trouble with this one simple point.

      Flattening the curve *WILL* reduce deaths. If the number of infected that require critical care exceeds the capacity of the health system to provide it, then you will get excess deaths that *could* have been prevented.

      I agree with your “IF” … but in many cases, your IF is not true. Take California, the example I provided. No amount of flattening is needed.

      And even when it is, the number of people saved is minuscule compared to the cost. You’re making Fauci’s mistake, thinking that any amount of intervention to save a few lives is always worth it. Consider that according to the statistics used in the model, over half (30) of the US states are like California—the will have NO shortage of ICU beds. So in those thirty states, your claim is wrong—flattening the curve will do nothing more than delay the deaths.

      And where this is not the case? It is still a COST/benefit analysis. New York is the worst. Given that a) we have little evidence that western style self-quarantine actually flattens the curve, and b) if it flattens it by say 10% it MIGHT save a few hundred lives, or it might not, they might die anyway … we have to make a difficult decision—is it worth shutting down the entire New York economy including Wall Street on the CHANCE that it might save a few hundred lives?

      I say no way.

      w.

      • Willis, one aspect of “flattening” is that it should give some time to get new therapies in place that may have an affect on total deaths in the “First Wave”, and, hopefully more so in the “Second Wave”. I just noticed that the latest IHME projection for US deaths has been reduced to about 60K. Both Drs. Fauci and Birx have commented that the model estimates vary as new data is input but how accurate any of the outcomes are, yours, the models, the CDC, the White House Task Force, FEMA or anyone else, will only be judged when the dust has settled.

    • Please explain how, other than COMPLETE isolation, Complete LOCKDOWN, the multi-various self quarantine, with myriads of “Essential” workers this can lower the TOTAL numbers?
      Both of my sons are Essential Employees, Both of my Daughter-in-laws are also. Fire, police, paramedics, medical service drivers, cab drivers, Gas stations, drive throughs, drug stores, clinics, doctors offices, banks, auto-parts, buses, subways, restaurant pickup, maintenance service, ad infinitum. Eventually someone is going to touch someone who has it – it just takes longer. Just which of the above are you going to lockup in their house.

  61. And hopefully, long before then. these insane regulations will go into the trash, we can stop paying trillions to delay a few deaths a few weeks, and we can get America up and working again.

    I fear that you are missing the point . This engineered crisis is a 2008 all over again. It’s a bank bailout in disguise.

  62. Three observations.

    1. Flattening the curve saves lives IF it prevents the health care system from getting overloaded. All the extraordinary capacity additions for NYC would not be possible to repeat everywhere. And we already saw what happened in northern Italy when it did get overloaded.

    2. The related debate about dying with or because of COVID-19 isn’t very useful, because in most cases those deaths would have come years later rather than now. The new NY analysis yesterday says 63% of deaths are over 70, and 55% had hypertension and 35% had diabetes. Most people over 70 don’t die from hypertension or diabetes.

    3. Your analysis of the cost to the California economy is in my opinion far too simplistic. I looked up the composition of the California GDP by sector. Wiki has a nice chart from the BEA. biggest sector is Finance, Insurance and Realestate. Stuff deferred, not lost. Government, not lost at all. Manufacturing, maybe deferred, but not lost. Agriculture, not lost. And so on.
    There are only two sectors that will not bounce back with only minimal net losses (e.g. pent up demand) after say a one quarter closure. Those are “Entertainment, recreation, hospitality, and food service (restaurants)” at about $120 billion, and some portion of “Professional and business services” at about $660 billion, for example beauty salons and barbershops but not tax preparation (just delayed a quarter), or legal. Say half is vulnerable (probably too high).
    Then the cost math is 0.25 (at worst one quarter lost) * (120 + 660/2) $112.5 billion, not $900 billion. If the President suggests reopening May 1, then the hit is 45 days rather than 90 and the cost is ‘only’ $61 billion compared to lives saved.
    But that is still far too high because the CARES act is exactly intended to bridge these vulnerable sectors over this period via stuff like PPP and SBA grants, further reducing the potential cost hit.

    I think the President has got the optics just about right. Piles of bodybags in refrigerated trucks outside NYC hospitals (happening) while not doing anything would be a political nightmare. He chose to bend the curve while invoking the DPA to increase medical equipment supplies, which takes time to produce. And, by end of April we will know much more about remdesivir and chloroquine/zinc therapies. My thinking is the country will be opening May 1 for two reasons: curve sufficiently bent, and the therapies work (Dr. Zelenko’s letter about his 200 at risk positive patients–0 hospitalizations, 0 deaths– is pretty convincing, albeit not to Fauci).

    • Rud Istvan April 8, 2020 at 12:41 pm Edit

      The new NY analysis yesterday says 63% of deaths are over 70, and 55% had hypertension and 35% had diabetes. Most people over 70 don’t die from hypertension or diabetes.

      Diabetes is actually the third leading cause of death in the US … and old people are not different.

      3. Your analysis of the cost to the California economy is in my opinion far too simplistic. I looked up the composition of the California GDP by sector. Wiki has a nice chart from the BEA. biggest sector is Finance, Insurance and Realestate. Stuff deferred, not lost. Government, not lost at all. Manufacturing, maybe deferred, but not lost. Agriculture, not lost. And so on.

      So you’d be OK if we simply deferred your and everyone else’s salary for a year? That’s merely “deferred, not lost”, no big deal as you claim … but I doubt if the majority of folks would sign on for the plan.

      As to “Government, not lost at all”, we are currently paying every government employee who is not working their full salary for doing nothing. How is that not money flushed down a rathole and lost forever? Paying money and receiving nothing of value in return is not a loss on your planet? Really?

      w.

      • Willis, I projected 45 days, at worse 90 days. NOT a year, as you now posit.

        And you apparently agree with my sarcastic comment about Cali Government economic consequences, NONE, by your agreed definition of paid money flushed down the toilet for nothing in return. BUT. that was also true before C0vid-19, not just after. Much the same as my comment observation–useless keep getting paid, an ongoing cost without a benefit.

        I think we shall continue to disagree. BTW, you shoulda produced the BEA Cali GDP analysis if you wanted a credible fact rebuttal of my economic critique, none of which you addressed by segueing to a fictional ‘year’ of salary loss.

        • I totally agree with your analysis Rud and it would be how most of us in the middle ground view it. I am also pragmatic that these are Emergency Power laws in most countries and you could not change those powers while in effect. Post lockdown I suspect most will take a look at how the powers were used and if they were appropriate and at that time Willis and those who believe this is all wrong should then invest energy to progress the argument.

          • “Post lockdown I suspect most will take a look at how the powers were used and if they were appropriate and at that time Willis and those who believe this is all wrong should then invest energy to progress the argument.”

            I hope those who vigorously question the current virus computer models, will, after this is all over, use their expertise, and spend as much energy in debunking the computer models that gave us the bogus, bastardized global surface temperature record.

            In the past, some of our posters just meekly accepted the global temperature charts as being legitimate. They make their comparisons using these bastardized charts as though they represent reality. Maybe the controversy over the virus computer models will light a fire under some of these complacent people and make them take a second look at the bastardized global surface temperature record.

            They could start out by asking why unmodified, regional temperature charts don’t resemble the bastardized global surface temperature record at all. The regional charts show we are not experiencing unprecedented warming. The bastardized global surface temperature charts show we are experiencing the hottest temperatures in human history. It’s time to throw the bogus global surface temperature record in the trash. Silence from people who know better, is not helpful.

            And this isn’t aimed at any particular person. A lot of people could fill this bill. And a lot of people could do some pretty good debunking if they were so inclined.

    • Those who claim the economy will “bounce back” are ignoring the time value/factor of money.

      The economy flows like a river in time. Stopping the flow then starting it again does NOT replace the volume lost when the river was plugged. Production lost is production lost.

      Regarding the Decision Makers and their motivations, it might be useful to point out to them that their Public Retirement Funds just took an enormous hit. If the mandates were unfunded before, then they are deeply unfunded now with zero chance of ever being fully funded no matter how high future taxes are jacked.

      Dear Goobers, teachers, SEIU drones, etc.: you just lost your retirement. No soup for you in your post-work life. You’re busted flat. Sorry Charlies. And there’s nothing you can do about it now. Printing funny money won’t save you. You plugged the river, and your future dried up. Nice going, dummies.

      • Dear Mr. Eschenbach,

        I love your essay but have some questions. Does California print its own money? How are the tax receipts going? Will there be enough $$ by May to pay the state employees? Will they be paid in script, again? What about bullet trains to nowhere? How many CA municipalities will be doing a Stockton (or a PG&E) in the coming months? Are their mayors aware in the slightest? Are the sheeple?

  63. I want to quote Henry Pool – April 8, 2020 at 11:21 am – above: “Willis, the problem with what you propose is summed up as follows….. The economy will recover from this, but the dead people won’t.”

    With the extreme infectivity of this brand new virus, and many severe infections and deaths up front — more than medical care could handle in hot spots — immediate actions to halt the spread is very wise – and humane to all oldsters and grandparents and great grandparents. Slowing that curve bought time.

    Also we now have a cure – hydoxycholoroquine+zinc+azrthomycin and some other candidates (sheep dip for one, I think). We also are finding out that ventilators might not be wise. Better to concentrate oxygen. We couldn’t have found out this vital information — along with saving many lives — without stopping non-essential functions for a limited time.

    I think we could/should be up and ready to work around May 1 — and we may be a stronger country for the way we — through leadership from the current administration — have carefully gone about the task. I hope there’s lots of “you’re fired” for those “experts” who were (gleefully) so wrong (either university types or long-term govt employees). They thought they had us where they wanted us.

  64. Hi Willis and all.

    I posted this hypothesis on 21Mar2020; coincidentally, it is similar to Willis’ proposal. While I am less certain than Willis that we are correct, I am not seeing much evidence that we are wrong.

    I am certain that Willis is correct about contagion in schools – ask anyone about when their kids started going to playschool – or the plague ward, as I used to call it.

    Some interesting questions:

    1. Why are TOTAL WINTER DEATHS ‘way down this winter? See https://www.euromomo.eu/index.html
    Shouldn’t this very-scary coronavirus have increased total winter deaths?

    2. How is it that ~one hundred thousand deaths from coronavirus are scary, but millions of Excess Winter Deaths every year, caused in part by green hysteria and fuel poverty, are not?
    COLD WEATHER KILLS 20 TIMES AS MANY PEOPLE AS HOT WEATHER
    by Joseph D’Aleo and Allan MacRae, September 4, 2015
    https://friendsofsciencecalgary.files.wordpress.com/2015/09/cold-weather-kills-macrae-daleo-4sept2015-final.pdf

    FEARLESS CONCLUSION: TOTAL WINTER DEATHS DO NOT MATTER, BUT COVID-19 DEATHS ARE MUCH MORE IMPORTANT. (sarc/off)

    Regards, Allan

    https://wattsupwiththat.com/2020/03/21/to-save-our-economy-roll-out-antibody-testing-alongside-the-active-virus-testing/#comment-2943724

    This brief data analysis is far from comprehensive, but here are my preliminary conclusions:
    CORONAVIRUS – STRONG CONTAINMENT (3% INFECTED IN S. KOREA) VS POOR CONTAINMENT (21% INFECTED ON THE CRUISE SHIP).
    1% FATALITIES OF THOSE INFECTED IN BOTH CASES. (Note: Both 1% figures are moving targets.)
    ON THE CRUISE SHIP, ALL DEATHS WERE PEOPLE OVER 70 YEARS OF AGE.
    REPORTEDLY DEATHS TYPICALLY OCCURRED TO PATIENTS WITH POOR HEALTH AND POOR IMMUNE SYSTEMS.
    REPORTEDLY YOUNGER INFECTED PEOPLE OFTEN HAVE MILD OR NO SYMPTOMS.

    LET’S CONSIDER AN ALTERNATIVE APPROACH, SUBJECT TO VERIFICATION OF THE ABOVE CONCLUSIONS:
    Isolate people over sixty-five and those with poor immune systems and return to business-as-usual for people under sixty-five.
    This will allow “herd immunity” to develop much sooner and older people will thus be more protected AND THE ECONOMY WON’T CRASH.
    If tests prove positive, use chloroquine and remdesivir or other cheap available drugs ASAP as appropriate.

    Best, Allan

    https://wattsupwiththat.com/2020/04/05/how-to-analyze-and-not-analyze-coronavirus-deaths/#comment-2957322

    CONCLUSION: TOTAL WINTER DEATHS DO NOT MATTER, BUT COVID-19 DEATHS ARE MUCH MORE IMPORTANT. (sarc/off)

    Update of my previous post:

    Data for Europe is now up to end of week 13 – to ~31Mar2020.
    Note the downturn in deaths for under-65’s. and the upturn for over-65’s.

    Not only has this year’s total winter mortality declined substantially for all ages, it has even declined substantially for those over 65 when compared to previous years. Repeating, TOTAL WINTER DEATHS ARE FAR LOWER THAN IN RECENT YEARS. We will learn from this full-scale experiment.

    It seems ironic that when we wrote about HUNDREDS OF THOUSANDS OF EXCESS WINTER DEATHS due in part to high energy costs caused by false green climate hysteria, nobody listened, but now we are now prepared to shut down our economies due to A FEW THOUSAND DEATHS allegedly due to Covid-19, WHEN TOTAL WINTER DEATHS ARE ‘WAY DOWN.
    CONCLUSION: TOTAL WINTER DEATHS DO NOT MATTER, BUT COVID-19 DEATHS ARE MUCH MORE IMPORTANT.

    This data now extends to the end of Week 13, which corresponds to March 31, the end-date for the calculation of Winter Mortality and Excess Winter Mortality. We should also recognize that the Covid-19 flu is not over yet, and mortality figures are continuing to increase.
    https://www.euromomo.eu/index.html

    More data here:
    https://www.worldometers.info/coronavirus/#countries
    https://covid19.healthdata.org/projections

    Regards, Allan

    • https://www.stuff.co.nz/world/europe/120664672/coronavirus-swedens-unique-approach-to-fighting-the-pandemic?rm=m

      Reportedly, Sweden is not following the full lock-down model and has only moderate precautions for Covid-19. It will be interesting to see how Sweden’s full-country-scale test compares to the full lock-down, kill-the-economy model of the USA, Canada, etc.

      I think we will learn much about the greater picture of contagion with this exercise. We will also see some changes is social practices.

      Customary greetings like face-kissing and even handshakes will probably become much less commonplace after Covid-19 has passed.

      It is interesting to me that Total Winter Deaths are ‘way down this year, despite the alleged Covid-19 pandemic.

      It is also interesting that here in Calgary hospitals have deferred elective surgery to make way for the anticipated flood of Covid-19 patients, and as a result hospitals and staff are not at all busy – yet.

      The big questions remain:

      Is Covid-19 is really a catastrophic pandemic, or a huge over-reaction to one-more-seasonal-virus.

      Was the full lock-down that has harmed our economy and financially destroyed so many young people and small businesses really necessary, or was it like swatting a fly on a glass table… with a sledgehammer?

      We should know much more in a month or two. Fasten your seatbelts. Faites vos jeux.

    • Are Covid-19 deaths being exaggerated? How widespread is this practice?

      Are deaths from other causes being attributed to Covid-19?

      Is this why Total Winter Deaths have not increased this year?

      https://www.bizpacreview.com/2020/04/09/physician-state-sen-claims-feds-pressuring-doctors-to-inflate-covid-19-cases-reveals-7-page-doc-906488?

      PHYSICIAN/STATE SENATOR CLAIMS FEDS PRESSURING DOCTORS TO INFLATE COVID-19 CASES, REVEALS 7-PAGE DOC

      A physician from Minnesota claimed this week that federal officials are encouraging medical officials to incorrectly attribute all related deaths to COVID-19, even in cases where the coronavirus clearly played a minimal (if any) role in the deceased’s passage.

      As evidence, Dr. Scott Jensen, MD, who also happens to be a Republican member of the Minnesota Senate, cited a “guidance” issued by the Centers for Disease Control and Prevention’s National Vital Statistics System (NVSS).

      “Last Friday I received a 7-page document that told me if I had an 86-year-old patient that had pneumonia but was never tested for COVID-19, but some time after she came down with pneumonia we learned that she had been exposed to her son who had no symptoms but later on was identified with COVID-19, then it would be appropriate to diagnose on the death certificate COVID-19,” he explained in an interview with station KXJB.

  65. A dangerous virus can be controlled when there are still small numbers of infected people. Like happened with SARS and MERS. But in the present situation when there is already a general spread but still in relatively low numbers (less than one percent of total population) you can try to bring back the total number to zero or to near zero. And what will be happening in that case is that ‘the curve will be flattened’. But the goal is not flattening but the goal is that the curve has to be averted from rising to the highest possible top!

    The final goal is even to eradicate the virus, like China nearly completely did before it started re-importing the virus from elsewhere. And if a total eradication cannot be realized for the full 100% a new massive spread can be prevented if the number of cases is reduced to very low numbers. And if all means are used. As the Spanish Flu showed, a second spontaneous wave can even be more devastating than the first one.

    The result of ‘not flattening’ is an explosive rise of the curve until 60 or 70% of the 330 million people in the US have been infected. With not only as result a mortality of several percents of the whole population (and a higher percentage when the medical system becomes overwhelmed) but probably also resulting in a total disruption of society as well. At least, that is what normally happened in the past when there was a full blown epidemic.

    THAT is what governments are trying to avoid: a full blown epidemic with an equal or bigger damage to the economy. It is not just about flattening a curve at high cost.

    Reaching a spontaneous super high ‘peak infection’ is another experiment which did not work out well in the past. I see no possibility that in our modern interconnected societies a full blown epidemic can happen without causing a massive economic damage as well and without also resulting in a severe societal disruption. But perhaps I am wrong.

    For now I prefer to try to control and some countries already were showing us how to do so. If we would have been much better prepared for a virus like this one, the price of control would have been way lower. So most of the present damage has already been caused in the past. The Green Madness attracted all attention and directed all money to possible dangers that ‘could may might’ happen ‘if and when’ etc. in the year 2100. Never thinking about preparing for a virus which could be a real and direct worldwide threat to societies and economies. The Green Madness also led to the Green Blindness. At high cost.

    • kind of unlikely that a respiratory virus will be eradicated. The original SARS and MERS petered out because in the one case it wasn’t that transmissible and in the other it was too lethal, also apparently did not have the capability of this one to persist in environmental niches. This strain is a very nice, from its perspective, combination of transmissibility and lethality. It transmits easily and it doesn’t kill that many of its hosts. Hard to imagine why it would disappear from every human and animal host on earth. H1N1 is still around after all these years, most people just have antibodies and they continue to put them in the vaccine. We are just going to have to adapt to it, as we have with flu. This is the first year of the virus, the first year will always be the worst for a new strain, because of lack of immunity. In succeeding years it will become much less severe.

  66. Willis you say
    “Be clear, however, that this is just a delaying tactic. Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.”

    This is wrong unless you are saying that everyone dies someday

    the idea about flattening is to keep hospital from being overloaded so that everyone can have access to the best treatment. Overload the hospitals and medical staff have to choose who gets the best treatment and whom gets thrown onto the scrap pile.

    flattening the curve does indeed not lower total cases … unless you flatten it wide enough to get to allow the introduction of vaccination or other new medication.

    • Please read carefully before commenting… just a little further down IN THE SAME PARAGRAPH YOU QUOTED, Willis said:

      “Unless your health system is so overloaded that people are needlessly dying, the final numbers stay the same.”

      How could you miss that and correct his view to a view he already plainly stated?

      • you are correct
        “Flattening the curve does NOT reduce”
        was what I read together with the emphasis. It is a strange writing style!! Flattening the curve after all is about reducing the hospital overload to save staff having to decide who to treat and who to let die.

  67. You ask “Ah, you say, but more people might die if the medical system is overwhelmed. Are there enough beds and ventilators?”
    But you never answer the question.
    To what extent would we have overwhelmed the medical system and how many dying patients would not have been saved that ultimately were treated and recovered. 2000? 4000? 6000?
    You seem to suggest that we just let it rage and let us medical folks deal with watching people die that we know could have been saved. What the hell, you don’t have to do it.
    Is the almighty dollar that important to you.

    • “ Is the almighty dollar that important to you.”

      Do you not care about losing your job? Your friends losing their job? A family member? Do you care about the stress of losing a job? Do you care about those people?

      • Surely your government can provide aid to those out of work and no funds? Even the already unemployed can be helped from a rich government?

        The UK seems to be trying to do this despite being in hock before this virus.

        It is the homo spent thing to do.

    • “Is the almighty dollar that important to you.”

      Have you ever demanded that we abolish the automobile? Tens of thousands of people die EVERY YEAR in the United States alone from automobile accidents that never would have happened if we were not allowed to drive.

      Is the almighty desire to move quickly that important to you? TENS OF THOUSANDS of deaths every year and you do nothing.

      (Or, your argument is bad)

      • Your argument doesn’t work you make a choice to drive or not to drive … you don’t get a choice to get infected or not 🙂

  68. I think your argument would have beeb a lot more pwerful if you had considered only deaths in a section of your article. I hope you will use this to make another article. Suppose only deaths count. Many DO that that is the only thing that really matters.
    Well, unemployment KILLS. Refusal to hug the elderly KILLS–social life is a big predictor of well-being in seniors. What are the statistics for these? If you add in these estimates, how many people are we losing for every one we are saving, however briefly?
    Anti-constitutionalists are not merely traitors, they are DEADLY.

    • +100 my gran is healthy and active, she suffers the most atm from being shut off from her social interactions and from the constant bombardement of Covid 19 “news”. I’m in Germany and the thing that scares me the most is how willingly and happily people give up their individual right to freedom. I have friends who positively revel in the new restrictions without questioning any of these draconian measures. Brings darker times to mind.

      Stay healthy xx

  69. Be clear, however, that this is just a delaying tactic. Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.

    Love your stuff, Willis. But I have a major quibble here.

    We agree that “flattening the curve” can delay the rate of infection. The primary benefit is to buy time to establish treatments that will lower the “cost” of each infection. It is not that we will reduce the number of infections or spread the same number of infections over a longer time; it is to make the severity of each infection much less. This assumes that medical research and experience CAN learn to treat a virus more effectively with time.

    • “Cost of each infection” in the above could be measured in “man-days lost to illness.”

      A1. Hospitalizations would not only cost the day in the hospital, but include convalescence, the man-days of the hospital staff taking care of you, plus the materials you use. Each infection could run from 100 man-days to a thousand if there is permanent lung damage.

      A2. Deaths due to COVID-19 triggered related cause of death could be hundreds to tens of thousands of man-days depending upon the patient’s age and health prior to the virus.

      A3. On the other hand, asymptomatic infections have a handful of man-days loss by definition.

      A4. Finally, We WILL discover and utilize a treatments that mitigates a future hospitalization to that of a common cold or flu, then each infection has a cost of about 10 man days. This proportion of the population must increase with the number of lockdown days. Categories 1 and 2 would correspondingly drop. (A4) must be a function of LockDownDays to a negative exponent. (A4) must be lower for a 40 day lockdown than a 20 day lockdown, or there is no point in having a lockdown at all.

      The CostofInfections must be treated as the total cost of an entire population. Eventually, everyone will be infected, everyone will fall into one of the four infection cost categories. Furthermore the partial derivative d(CostofInfections)/d(LockdownDays) must be negative.

      There is also a cost of the lockdown, also in man-days.

      LockdownCost would be something like
      = Population * (Productivity Loss Factor) * LockdownDays^alpha

      Population are the people affected by the lockdown.

      (Productivity Loss Factor) is a value that recognizes that even under lockdown, some work is getting done, even if it only cleaning the house. Others are “essential workers”. This factor is between 0 and 1, but I think a good estimate is about 0.8-0.9. a person in 10 days of lockdown, will have lost 8 -9 man-days of productive life. (Conceivably, it is >1 if you have to eat your seed corn).

      LockdownDays are days under lockdown.

      alpha is an exponent of the LockdownDays which is almost certainly greater than 1, probably in the range 1.05-1.3. This is to recognize that 30 days under lockdown is almost certainly more costly than twice the cost of a 15 day lockdown. It will take longer to restart the economy, to restart supply lines, to get things back to ‘Normal”

      We are left then with an optimization problem:

      Minimize Total Man-Days Lost = LockdownCost + CostOfInfections.

      The partial Derivatives:
      d(lockdownCost)/d(LockdownDays) is positive and increasing (2nd derivative positive)
      d(CostOfInfections)/d(LockdownDays) MUST BE NEGATIVE (else optimum LockdownDays == 0) and has a positive 2nd derivative.

      Under these circumstances, the optimum LockdownDays is when
      Per day marginal LockdownCost + marginal CostofInfections = 0

  70. JoeShaw
    All those who do not catch COVID-19 during this phase, will lack immunity. They will therefore be at risk of catching it during subsequent outbreaks, which will surely happen unless an effective vaccine is developed quickly (unlikely), or a large enough percentage of the population acquires immunity through infection as to inhibit transmission. Those who are dying now, typically have comorbidities. A year from now, if they haven’t died from the comorbidities, they will be even more susceptible to this or other infections. So, looked at from the viewpoint of a closed system, any particular region that gets infected may suffer a large loss of life from the infection burning through the most susceptible before it wanes. However, given a longer period of time and random exposures, almost everyone will eventually be exposed, and if one is in the high-risk group, may well die. I suspect that one of the consequences of the social distancing will not only be delaying the peak, but to increase the length of the tail into the future. More formally, social distancing will affect both the kurtosis and skewness of the distribution curve. Places like NYC will probably have an excess of deaths from inadequate resources, regardless of what is done, while cities in Ohio will probably not face the same challenges regardless of mitigation strategies.

    • If we could some how segregate those under 40 that are healthy and then put no quarantine rules on them and no social distancing rules on them, this would produce a good deal of herd immunity quickly with low amount of deaths.

      • Stevek
        Any rational person in the high-risk category would self-isolate and doesn’t need to be compelled to do so under threat of punishment.

    • Clyde, I completely agree that in the absence of an effective vaccine a significant fraction of the population will eventually get infected. In the absence of mitigation measures we were on track to have a large fraction of the population get infected in the next few months while we are still grossly unprepared and lack effective treatments. The value of the measures is in potentially buying time to get those treatments, and hopefully get a working vaccine. Depending on how the current clinical trials go we could have treatments that significantly reduce mortality within months.

      As a guy with a couple of unhelpful co-morbidities it irks me that there is a widespread misunderstanding of the risk factors, and lack of useful data to calculate conditional probabilities of illness or death. At my age my likelihood of dying from one of the co-morbidities in the next year is about 1%, so yes, I plan to still be around next year. Available data suggests that my chances of dying in the next month if I get infected with COVID-19 rise to about 10%. The good news is that the available data is a biased sample of patients that got sick enough to get tested / hospitalized. It does not account for mild or asymptomatic cases so the actual risk is probably lower. We don’t know today. We also don’t know whether the increased mortality is due to the underlying conditions, or their treatment with ACE inhibitors and ARBs. Hopefully we will know these things before COVID 19 has infected most of the population.

      Cheers

  71. Mr. Eschenbach:

    I’ve been following the many changes in the IHME coronavirus model . . .

    Brilliant, thank you! I’ve been hoping a competent someone would.

    Would you consider doing another article at the end of all this that, if possible, comprehensively evaluates the IHME model’s predictive ability from start to finish?

  72. Spain, Italy, France, UK are running about 10% dead per known case, and they are weeks ahead of you gus, and you have almost half a million known cases.

    And we havent even peaked.

    And then you have the waves of infections this thing will cause till you are either dead or immune.

    As much as you can knock models, you guys are in for a rough ride. We all are, but expect in the long term anywhere up to 1% of the population to die.

    OK, that is a max, a ceiling. But it is there. Just give it a year and you will see. This thing is a killer, particularly of the type 2 diabetic and fat people. If you are fat and 30, you are in trouble. If you arent you wont even have symptoms. And you guys in the US have plenty of those, be honest eh.

  73. What we are seeing here it could be the Darwin’s law of natural selection in action this time enforced by the CV-16 epidemic. Without government’s interference mainly old, genetically or immunity inferior would (but not always) die, while predominantly younger and immunity stronger would survive. Eliminating all those who are unable to naturally overcome the infection would reduce country’s overall average age and to a degree make the country genetically stronger and healthier.
    Governments are charged to look after economic well-being of the country and its population, while the parliaments and religious leaders (wherever applicable) should have responsibility to resolve the moral quandary of how much society should do or sacrifice either in monetary or human life terms to prevent the onslaught of the disease whatever its origins were.
    In the UK, Chancellor of the Exchequer on behalf of the current government has presented to the parliament fiscal measures of action, which I believe were passed into legislation by both houses. Progression and the outcome of the conflict between the law of natural selection and a scientifically advanced, economically strong, mature parliamentary democracy may leave a generation long-lasting effect on the psyche of the nation.

    • re: “Darwin’s law of natural selection in action ”

      By “front-loading” the deaths of a ‘weak and infirm’ demographic (due to Covid-19) early in the year versus ‘spread out’ a little more evenly throughout the year …

    • Since the vast majority of those who have been swept away by the ChiCom virus were past reproductive age, the Darwin effect would be minimal.

  74. I would feel more confident in our leaders if they would establish some criteria for reducing and/or ending the lockdown, preferably based on a Willis-like cost/benefit analysis.

    My fear is they have no idea, and they’re simply huddled around the ouiga-board models, waiting for the other guy to make a decision. A lockdown-deadlock, if you will.

  75. ” Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.”

    This is only the true if everything else remains the same –which it won’t. We will get smarter about treating the disease. As more treatments come on line we will lower the fatality rate. Lessen the pressure on hospitals will result in better care which will also lower the fatality rate. Finding out what works and what doesn’t requires time. Flattening the curve buys time. So flatten the curve should reduce deaths.

    • Maybe, but that’s asking for a lot better treatment outcomes for the those unlucky 65+ unhealthy folk being cutdown by covid. Who, as Willis doesn’t point out had pre existing conditions that will mostly be lowering death stats elsewhere.

      NY 380 deaths per million population
      CA 11
      Worldometer stats as of April 7th

      IMEH sees CA peak surge in couple days. With a CA total death rate though early August 20x lower than NY when population adjusted. How?

      Do those numbers hold when we undo the social distance, go back to work and school? What then?

      Do we wait another month, three months, a year for those cures and treatments? How long do early adopters of mitigation need to wait till the above disparity is something more useful than just evidence of delay.

  76. Very interesting viewpoint. Some contrasts, using unproven ventilation protocols while suggesting Chloroquine should not be used. Issuing unproven stay at home orders with only a time push result expected. Best of all hide the results. Thank you Willis for the thoughtful presentation.

  77. A reason why you are seeing a spike in early adopters of restrictions versus slow adopters could be the percentage of their populations that are being tested. If you don’t test your population you have no idea how widespread the infection is across your population.
    The very large differences in testing numbers across countries and states make the majority of these estimates unreliable.

    • I saw a news item this morning saying the U.S. Senate wants to talk to Dr. Tedros.

      I wonder if he will show up? If he doesn’t, it will put his money in jeopardy. Maybe he thinks he can safely fall back on China’s leadership and will defy the United States. He didn’t help himself by threatening the United States in his last public statement. That’s probably one thing the U.S. Senate wants to talk to him about. 🙂

      He looks like a Chinese puppet to me. At a minimum, the United States should demand his resignation.

  78. Flattening the curve allows to gain time which can be used to improve or find new therapies for the disease. In the end, it does help to save lives. I do agree that a cost/benefit analysis should be mandatory. Otherwise it’s like shooting your house down to get a fly on the wall…

    • Otherwise it’s like shooting your house down to get a fly on the wall…

      That would be crazy.

      For a spider, though…

  79. “Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.”

    But flattening the curve buys time for the production and distribution of protective gear and drugs (like hydroxychloroquine, remesivir, ivermectin and antivirals) to ramp up. Some of those drugs provide not just a degree of treatment but a degree of protection as well. Therefore, THIS current lockdown should pay off in a lower overall case count and death count.

    (BTW, the argument that some make, that the “excess death count” is down, is irrelevant. It wouldn’t be if there were no quarantines in place. I.e., deaths from regular flu would be higher, as would deaths from auto and workplace accidents.)

  80. Willis,
    You appear to be confusing the best and worst case scenarios. The IHME model
    represents the best case scenario involving social distancing and good public health
    measures. If the USA follows the best approach then the IHME model predicts that
    roughly 80000 people will die in the first wave. Again this is the best case scenario.

    The worse case scenario is that the USA does nothing and goes about life as norma. In
    this case the predictions are truely dire with roughly 2 million people dying. So the question
    needs to be asked is how do you quantify the cost of the worse case and how much should you
    spend to prevent it. According to various economists and actuaries the “value” of a human
    life in the US is about 10 million dollars. So the cost to society in the worst case is between
    10 and 20 trillion dollars (ballpark figures given the large uncertainties in the values). See
    https://medium.com/@tomaspueyo/coronavirus-out-of-many-one-36b886af37e9
    for an overview of the calculations.

    Now the proposition is how much money should the government spend to avoid a potential
    loss of 10 trillion dollars? Congress has so far allocated 2 trillion or about 20% of the potential
    worse case scenario.

    If you want to claim that 2 trillion dollars is too much then you need to state:
    1) What your estimate is of the number of deaths in the worst case scenario (i.e.
    everyone goes about their usual business and no social distancing)?
    2) What value you place on a human life? And so what is the cost to society from
    doing nothing?

    Neither of which you have done. Until you are upfront about your calculations we have
    no reason to accept your conclusions.

    • Nowhere does the IHME team make any actual projection of deaths without any mitigation spread measures or with alternative mitigation spread strategies, as I pointed out in a comment above. They just make a general reference to other models, presumably the laughable original Imperial college one, which projected huge numbers of deaths. So again, people can, and have been, making up any number of lost lives, and then of course when the actual number comes in lower you can claim your shutdown saved the full difference.

      And Willis is absolutely right in his calculation of the economic impact. The US economy was originally projected to be over $22 trillion in 2020. Current consensus, assuming removal of the shutdown in the near future, is for a decline of 25% to 30%, which is in itself an unfathomable event. California is a large percent of the US economy, so a trillion dollar hit to its economy is certainly possible.

      • Kevin,
        the Imperial college predictions do not seem that widely inaccurate as a worse
        case scenario. Currently both the UK and Italy for example have a case fatality rate
        of over 10% while globally currently about 5% of those reported infections die while
        in the best cases it seems to be about 1 or 2%. Assuming that 20% of the US population (roughly 300 million) gets infected a 5% fatality rate rate would give 3 million deaths
        in the US. In contrast the Imperial College model predicted 2.2 million deaths.

        Of course the number who actually die is likely to be considerably less than 2.2 million
        for the simple reason that people will look at that number and immediately start behaving differently so as to reduce the chance of that happening. Which is why once people started practising social distancing the predictions from the Imperial College team came down so dramatically.

        • too early to talk about case fatality rates, since we don’t know how many infections there are, we only know positive test results and there is widespread agreement that infections are multiples of positive tests. Deaths per million is a little more sensible, but rises with every death, and we are early in the epidemic. Still gives you a little basis for comparison across countries and with other causes of death

          • Kevin,
            You have to talk about case fatality rates now if you want to predict what
            people should do to keep the fatalities down. And what is even worse you
            have to make an educated guess really early on in the epidemic and decide
            whether to go into lockdown or let the virus run its course. So I am not sure
            what you are suggesting here? Just wait until everybody who might die has died and then decide retrospectively what the best course of action was?

          • Not sure what your point is by quoting case fatality rate. Early in epidemic no one knows what the case fatality rate is because you don’t know the infection rate. So acting like 10% or 5% of the “cases” are going to die is meaningless. Pretty standard epidemiology that you won’t know the actual case fatality rate until you know the actual number of infections. Go back to the early stuff from Birx and Fauci and you will hear them say that. Only the really sick people show up at first and go to hospitals and they are the most likely to die. So the case fatality rate is meaningless. Once the epidemic is pretty much done, people calculate it to compare lethality of the infectious agent. It always drops as the true scope of an epidemic becomes clear. Think of it this way, if you only took flu deaths as a proportion of people who needed to be hospitalized, you would get a far higher number than if you take it of everybody who got the flu. What may be informative about how serious an outbreak is just the raw number of people who die early on. But you have to remember the most susceptible get sick first so it is very skewed. Bad sampling of the whole population of cases–which is all infections. So people throw around things like case fatality rates without thinking about how they are actually used.

          • Kevin,
            The point about case fatality rates is that you have to use something to estimate how
            serious the threat is. Do you have a better way to estimate the maximum number of
            possible deaths for a worse case scenario?

          • That is the problem, using estimates without a factual basis for the estimate. We don’t know infection rates, so we don’t know cases. It has been obvious for a long time that we need a randomized large scale study with testing for both infection and antibodies. Wouldn’t cost that much and could be done quickly. These studies are just now being started. That will tell us a lot, give us a better estimate of how many mild and asymptomatic cases there may have been. If, as most people suspect, the number of infections (cases) is multiples of positive test results, you can see that the case fatality rate immediately drops by the inverse of that multiple. So if you think the CFR is 2.5% today, based on positive test results, but the multiple is ten, all of sudden your CFR is .25%. This is exactly what happens to CFR calculations in every epidemic, because the sickest people always present first and there is not widespread population testing. Until you have some basis for a good CFR number, you are better off just using raw deaths. I mean, if only 50 people in the country died, you would be a lot less concerned than 10,000 have. So the raw number is pretty informative on how serious a problem you have.

    • The IHME model represents the best case scenario involving social distancing and good public health
      measures.

      Odd how that “best case scenario” continues to change case.

      • Of course it changes because people’s behaviour changes. The model updates
        with the actual numbers and then predicts what will happen.

        • Of course it changes because people’s behaviour changes.

          In my neck of the woods, people’s behavior hasn’t changed in over a month. We’ve been shut down. It’s a good assumption that the same is true for the majority of jurisdictions in the US. If I understand you correctly, your argument seems to be that behavior alone is the mitigating factor in the model’s predictive output. But if that’s true then how could this also be true:

          The model updates with the actual numbers and then predicts what will happen.

          Given most people’s behavior hasn’t changed in some time, but the model’s numbers appear to change from week to week, how do you explain the apparent discrepancy in predictive output?

    • Izaak
      William Ward brought the following interview to my attention. You (and others) might find it interesting.

      • Hi Clyde,
        Professor Wittkowski appears to have his own take on COVID-19 which is not one that is shared
        by most health experts. I am nowhere near knowledgable enough to make any judgement about
        who might be true. My only comment would be that the approach he seems to advocating (leaving
        the schools open, let the health get immunity) was the original strategy adopted by the UK
        which they quickly changed when they realised the scale of the crisis. And now the death rate in
        the UK is over 10% and it is on track to have the worse outcomes of any country in Europe. So
        unless I am not understanding the strategy it would appear to have been tried and it failed.

        • Isaak
          Nor am I in a position to decide who is right. I don’t have the background and experience he has. Although, I have asked a number of questions about the global response because something doesn’t smell right.

          However, inasmuch as Professor Wittkowski is obviously in the high-risk category, I have to give him points for having the courage of his convictions for his recommendations.

  81. ====>Is there a DOCTOR in the House?…Regarding the Chi-Com Kung Fluey Manchuey Chop Fluey Baloney Bio-Warfare Attack <====

    It just occurred to me that, like every other Vietnam war veteran, I spent a YEAR taking the anti-malaria medication QUININE, over a year, actually, as we were phased off of it so as not to have some kind of withdrawal or something.

    Is it possible that taking QUININE has provided some level of immunity to this dreaded PANIC-DEMIC, or is it DEM-PANIC, Chi-Com biological weapon attack on the world? Nationally Enquiring minds want to know. If so, you could be a hero by writing an Op-Ed to the world and get a Pulitzer Prize, too

  82. “Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.”

    But deferring new cases into the future buys time for the production and distribution of protective supplies and drugs to ramp up. Drugs include hydroxychloroquine, remesivir, ivermectin, and antivirals. Some of the have protective features that will lower the total number of new cases, or spread them out at low cost far down the road. All will reduce the severity of cases and the death count.

  83. It’s all very cute to say 1,800 deaths in Calif., and to show the health system isn’t stressed. It’s somewhat disingenusus to then not include New York in your examples (13,307 predicted deaths; 5, 173 ICU bed shortfall and 9,617 hospital bed shortfall). New Jersey is the same (5,277, 2,10 and 5,520 respectively).

    • So a one size fits all health care response is appropriate for all 50 states. That does not make sense to me.

    • The NY metro area is the epicenter of WuFlu in the US because of the criminally insane policies of its Social Democrat regime. Louisiana, ditto.

      Why should everywhere in US and our national economy suffer because of these raving lunatic whacko nut cases?

      I’m sorry for all the families in Democrat misgoverned jurisdictions who have lost loved ones, sacrificed on the pagan altars of the PC religion. But please spare the rational rest of the country the scourge of such (at best) misguided idiocy.

  84. –Be clear, however, that this is just a delaying tactic. Flattening the curve does not reduce the total number of cases or deaths. —

    Yes does not reduce cases, roughly speaking.

    Though perhaps a joke, but “just a delaying tactic” is what life is.

    I could spend a lot time on significant of flattening the curve.
    But flattening the curve is what one does with any virus, and particularly a new virus.
    And the total cost of flattening the curve is a more significant thing.
    But I am not going spend time talking about total cost, either.
    But one thing about cost is vacation time. And one discuss the political matter of
    having more vacation time.

    –So if you want to slow an infection, closing the schools at least makes logical sense.–
    What is important about “schools” is what you talking about really, is day schools.
    And these day schools are said or do act as day care.
    So you have a political problem with day care- parents are working and need the day care.
    If you had boarding schools, it’s a different “problem”- in terms spread of virus and the political problem.
    And also “political problems” are part of total costs.
    Considering we shut down travel and hotels, if not for “political problems”, the day care students could returned “home” to hotels. Or have camping adventures in stadiums or wherever.
    What you got is a day care problem. And having parent not work is one solution {a crude/dull solution} to day care.

    “Overall? I see little evidence that the various measures adopted by the western nations have had much effect.
    And with the exception of closing schools, I would not expect them to do so given the laxness of the lockdown and the vague nature of “essential business”. I’ve mentioned before, here in Sonoma Country California, the local cannabis retailer is considered an essential business … strange but absolutely true.”

    Well the cheapest and best thing done was shutting down air travel to China, and later {since Eureapean failed to do this, worst than US failing to do this} shutting down air travel to Europe to US.

    And WHO was utterly AWOL, in this regard, and why we are in the mess we are in.

    • Good points!
      I never realized, that driving at a non-insane person rate of speed on the highway is just a delaying tactic!

      It’s comin’ for us man…dead center, right down the tracks it is coming and there is not a damn thing anyone can do about it…except run down them tracks t’other way…real fast-like.

    • At best WHO was AWOL. At worst, it was a Fifth Column. Time will tell how much of either it really was. But as constituted, WHO is not to be believed.

  85. The analysis of the model curve shapes is wrong, especially because conclusions have been drawn after normalisation of the area under the line.

    Firstly to put some context into the IHME models. They are only modelling the first phase of the epidemic, from the outbreak to the point where there are no cases left. In this first phase, only a limited number of people catch the disease, and no significant herd immunity has developed, so the the whole thing can kick off again if someone infected arrives from elsewhere, or we missed someone exiting from the measures. The purpose of the containment measures is to 1) ensure critical care ICU capabilities (beds, staff, ventilators) are not exceeded and 2) buy time to build up the medical resources and 3) protect those that are vulnerable (over 70s plus those with certain conditions irrespective of age) 4) buy time to investigate treatments and ultimately to develop a vaccine.

    Now, on to the model. Think about just one US state, instead of two. Assume we do not have too many cases right now, but can see what is coming. We run two models with the same starting conditions. In both, we take measures which reduce the underlying R (number of infections caused directly in others by a single infected patient). An R above 1 means the numbers of infections and deaths in the epidemic are still increasing. Below 1 means the numbers are reducing, eventually to zero. Infections drive the epidemic, and deaths follow 2 to 3 weeks afterwards, as it takes something like 20 days after infection – the longer you are on a ventilator, the less chance you have.

    In one model we assume a stay at home order, close schools and college, and close essential services. Let’s assume these actions would reduce R to 1/3. In the other model we do not close essential services, but do take the other actions, R now increases to 2/3, but still below one.

    Because no action has been taken to protect members of the same household from each other, infections per day will continue to rise for a week or two after the measures are put in place.

    However, after that, in the first case, with R=1/3, the infections curve starts decelerating quite quickly, and once it peaks, it comes down quickly too. The deaths curve follows 2 to 3 weeks later. Because Willis is normalising the death curves to have the same area, it will look like West Virginia – narrow with a high peak.

    In the second model with R=2/3, it takes more time to “flatten the curve”. More people are infected because R is higher, and it takes more time to reach the peak of deaths, as these follow 2-3 weeks after infections. Further, the peak of deaths is higher, and the total number of deaths is higher. But because we now normalise the curve, it looks flatter and more spread out.

    The number of people dying is very different. In the first case, R=1/3, the epidemic is nipped in the bud more quickly, so fewer people die. On the date of the peak for the first case the number of people dying in the second case, R=2/3 is higher, and we still haven’t reached the second case peak. Without doing any very complicated (because of the delays) maths, perhaps more than four times as many people will die in case 2, R=2/3, without shutting down essential services – the later peak deaths per day will be more than twice as high, and the number of days at each level maybe is approximately doubled.

    The number of deaths before each peak can still roughly equal the number of deaths after each peak for each individual case, but we still have four times as many deaths from the second case with R=2/3. We haven’t just moved deaths backwards or forwards within this period, we have actually seen more people die in the second case with R=2/3.

    But when you normalise both death curves it looks as if the first case with R=1/3 is worse, when it isn’t. It is much better.

    When we have reduced the number of infections to zero with these measures, there is no immunity in most of the population, and no herd immunity. The number of actual cases is probably a lot higher than the figures for positive tests, maybe by a factor of 2 to 4 (for asymptomatic infections and low level infections not tested). We are taking measures to minimise the number of deaths in this phase in the hope there will be more ICU facilities, maybe a successful treatment from a doubled blind trial, and maybe a vaccine by the end of the year.

    Once the infections gets to zero and the measures are relaxed some people now have immunity, including a lot of medical staff. There will be more tests, with a better accuracy, including an antibody test to tell someone they have had it and developed immunity, so are safe from either catching COVID-19 again or infecting someone else. This helps in planning measures for the next round, in which the elderly and those with existing conditions still need to be protected.

    Deaths would only be deferred rather than avoided if most people (60-80%) are going to catch COVID-19 anyway. But this is not the plan.

    China is starting to open up Wuhan again, though it took immediate action to close one district which had a case. All entrants to the country automatically go into a 14 day quarantine. We will have to see how well this works.

    • Peter:

      Good insight; you may be the only other person on the site to recognize that flattening the curve can save lives even without any change in the quality of medical care. But I disagree with the following statement:

      “Deaths would only be deferred rather than avoided if most people (60-80%) are going to catch COVID-19 anyway.”

      We need to take “inertia” into account.

      Suppose a single infection is introduced into a large, perfectly mixed population so practicing social distancing that with zero immunity a single infected person would on average directly infect only 1.5 others: R0=1.5. Since R initially exceeds unity, the disease will spread despite the distancing, and, with no change in behavior, the resultant epidemic would not die out until 58% of the population had been infected and thereby become immune.

      This is true even though increasing immunity would already have reduced R to below unity when the immunity exceeded 33-1/3 %. The epidemic would blow through that level because a large number of people are infected at the time R falls below unity, so there’s some “inertia”: the epidemic continues while their infection chains die out.

      Now suppose that when the epidemic has thus subsided the population so relaxes its behavior that if immunity were zero a single person would directly infect four others: R0 =4. If a single person gets infected now, the disease will spread despite the acquired immunity, because R=(1-0.58)x4=1.68 exceeds unity. And, “inertia” being what it is, this second wave won’t die out in the absence of a behavior change until immunity reaches 87%.

      That’s greater than the 75% value at which R falls below unity, but it’s less than the 98% that “inertia” would have caused if the contagion had been introduced into a zero-immunity population whose behavior was at the R0=4 level initially and no behavior change had occurred.

      If you take “inertia” into account, that is, social distancing or other measures can prevent some deaths rather than merely delay them even if the majority of the population eventually gets the disease and even if the quality of medical care doesn’t change.

      • re: ” you may be the only other person on the site to recognize that flattening the curve can save lives even without any change in the quality of medical care.”

        Anybody familiar with ‘process flow’ would have to agree, as I do, but w/o having said so until now; an “orderly flow” of product in the manufacturing process, w/o bottlenecks, w/o product backing-up (choking) at any particular process station makes maximum use of process equipment (and in a timely manner) and doesn’t require the step-in of additional personnel (and/or equipment) to relieve, to ‘solve’ the problem. In a medical, patient-treatment environ I can’t help but think that this (the orderly handling of patients in ‘work flow’) saves lives.

  86. Are New York hospitals overrun? I read they are not, and admissions have been stable for the past 14 days. If this isn’t true I’d be grateful to know.

    • Will
      Initial model projections for the state of Ohio were that we would run out of resources. As of today, during the governor’s daily addresses, the thinking is now that we won’t even come close to saturating the capacity of individual hospitals, and if we do, there are plans to utilize other hospitals that have capacity. So, at least in the state of Ohio, the worst-case-scenario looks very improbable and those excess deaths will not occur.

  87. Re: “Are there enough beds and ventilators?”

    It’s not the total number of hospital beds you need to consider, it’s the number isolation unit beds.

    Sorry, I don’t know that number. I googled, but didn’t find it.

    From this paper about High-Level Isolation Units, it sounds like the number is probably small, but perhaps they don’t need to employ HLIUs for COVID-19.
     

    Re: “Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period. Valuable indeed, critical at times, but keep in mind that these delaying interventions do not reduce the reach of the infection. Unless your health system is so overloaded that people are needlessly dying, the final numbers stay the same.”

    You alluded to the fact that an overloaded healthcare system can increase the fatality rate. But it’s not binary. It is not the case that if the number of COVID-19 cases goes from 30% of the number of available isolation unit beds to 90% of the number of isolation unit beds that the fatality rate won’t increase. As the load on the healthcare system increases, local overloads occur with increasing frequency. Available isolation unit beds in Sheboygan, WI won’t help patients in New York City.

    The fatality rate is highly dependent on how severely stressed the healthcare system is, by the number of cases. Right now, less than 1/3 of 1% of the US population is infected, and most of them aren’t hospitalized. So far, U.S. hospitals are not having to triage or deny care to those most at risk. If the infection rate rises dramatically, as it has in parts of Europe, the US fatality rate will be much higher, even if many hospitals still have unoccupied isolation unit beds.

    Moreover, there are many parallel, intensive efforts to find effective treatments and vaccines for this disease. Delaying the exposure of someone from before the success of those efforts until after the success of those efforts will obviously improve that person’s chances of survival.

    Development of a vaccine would enable the achievement of effective herd immunity without most of the country getting sick.

    However, the ability to quickly and inexpensively test for the disease potentially changes the epidemiological dynamics, completely. We no longer need to rely on herd immunity to stop the spread of airborne diseases. If we can simply test the population, and identify most of the carriers of the disease, we can quarantine them, drive the infection rate below 1.0, and end the spread of the disease.

    Of course, that means we need vastly increased testing capacity. But that’s doable.

    It will be relatively cheap, too. The current medicare reimbursement price of a COVID-19 test is $36-$51. Even if tests cost more than that, testing everyone would be relatively cheap. If tests cost $66 each, then we could test everyone in the entire United States ten times each, for just 1/10 of the cost of the $2.2 Trillion coronavirus bailout/stimulus package.

    There might be as many as one million unidentified carriers of the disease in the United States, currently. If we could test everyone, right now, then even if each test were only 70% accurate (meaning that 30% of the positives are missed), testing everyone in America ten times could be expected to reduce the number of unidentified carriers from 1 million to about 6. The use of contact-tracing to better target the tests could easily improve that to less than 1, and the use of testing at ports of entry could prevent recurrent outbreaks.

  88. In the US, about 8,ooo people die every day on average over the course of a year. Today, it’s reported that there were 2,000 Covid 19 deaths. So is that in addition to the 8k avg., or would some of the 2k CV 19 reported deaths have died anyway???

    • re: “In the US, about 8,ooo people die every day on average over the course of a year. Today, it’s reported that there were 2,000 Covid 19 deaths. So is that in addition to the 8k avg., or would some of the 2k CV 19 reported deaths have died anyway???”

      Embrace the term, the concept of “front loading” (of deaths for the year). The weak and infirm were ‘taken out’ early this year …

      .
      .
      front-load: distribute or allocate (costs, effort, etc.) unevenly, with the greater proportion at the beginning of the enterprise or process.

      • re:

        “In the US, about 8,ooo people die every day on average over the course of a year. Today, it’s reported that there were 2,000 Covid 19 deaths. So is that in addition to the 8k avg., or would some of the 2k CV 19 reported deaths have died anyway???

        Scott Adams does pretty good job explaining it:
        I am still listening to rest of it {or you should get your answer in first 5 mins or so- I have not searched for graph he refers to, yet} ”

        MAYBE this graph explains it:

        https://pbs.twimg.com/media/EUyBMdvWAAEZAwX?format=jpg

        (Courtesy poster icisil.)

        • oh, that seems about right. But not sure it’s same as Scott’s thing which was suppose to be “better” at easily seeing it- Or better graphic display so people can see it easily.

          I have a bit problem with the weeks way counting things, but roughly it seems to confirms the US “shutdown” was needed.

          Though starting from now, have my doubts about how effective the measures we going take, or are going to be- I think we should end the “shutdown” quicker than what is publicly been said about it.
          And the biggest “insurance policy” to reduce possible potential deaths, to find out what our current “herd immunity” is at.
          Or we need random tests of US population of antibodies, and I start and focus on New York city- where I am guessing has highest percentage of herd immunity of US.
          But maybe California is pretty close to New York State.

          • Weeks ago: Mar 17, 2020 :
            https://www.postbulletin.com/life/health/mayo-clinic-working-on-antibody-test/article_31df2fb8-68ad-11ea-b5cd-e305c4d9bd7e.html

            “This makes the news all the more meaningful that Mayo Clinic has announced it is just weeks away from delivering an antibody test for coronavirus. Only Singapore has developed such a test, and it has yet to be validated.”

            So, instead search of ” random tests of US population of antibodies”
            I should search “random tests of Singapore of antibodies”
            and if done yet and results- I suspect Singapore has herd immunity which on the low side, or New York city has been and will be a higher herd immunity.

            But need both tests mentioned in above link, ” PCR tests”
            and “serology test” and good {and a lot} random surveys

    • John Brodman asked, “In the US, about 8,ooo people die every day on average over the course of a year. Today, it’s reported that there were 2,000 Covid 19 deaths. So is that in addition to the 8k avg., or would some of the 2k CV 19 reported deaths have died anyway???”

      If 1/3 of 1% of the American population is infected with COVID-19 right now (a reasonable guess), then you would expected that (very roughly) 1/3 of 1% of those people who die today of other causes are coincidentally infected with COVID-19. 1/3 of 1% of 2000 is about seven.

      So the answer is, yes, some of the 2K CV-19 deaths would have died today anyway, but very few. Not enough to appreciably affect the statistics.

      Now, if you ask a different question, like “how many of the 2K CV-19 deaths would have died of something else within a few years?” it’s a higher number, because we know that this disease tends to pick off the old, weak & sickly. But that doesn’t mean those 2K people weren’t killed by CV-19. Even when CV-19 is just “the straw that breaks the camel’s back,” and kills a very elderly, sickly patient, it’s still a CV-19 death. The straw is not exonerated from killing the camel simply because other loads made the camel’s back vulnerable to breaking.

      If anyone reading this thinks that attribution is unfair to CV-19, that it should not be blamed for such deaths, then think of the other deaths caused by CV-19, for which it is not blamed. For example, when hospital staff is stretched thin because of burden of caring for CV-19 patients, other patients get worse care, and some of them will die as a result, who would have lived but for the CV-19 epidemic.

      • Oops, parity error between the ears.

        On an average day, when there’s no epidemic, 7000-8000 Americans die of all causes, not 2000. If 1/2 of 1% of the American population is infected with COVID-19 right now (a reasonable estimate), then you would expect that (very roughly) 1/2 of 1% of the people who die today of other causes are coincidentally also infected with COVID-19. Some of those cases could be mistaken for COVID-19 deaths.

        1/2 of 1% of 7500 is about 37, but that includes deaths by automobile accident, suicide, murder, fire, drowning, heart attack, stroke, etc., none of which would be attributed to COVID-19. But even if those deaths were all blamed on COVID-19, it would still inflate the COVID-19 death toll by less than 2%.

        What’s more, the COVID-19 epidemic is adversely affecting medical treatment for other problems, and doubtless causing deaths even among people who never contract the disease. My regular MD and dentist have both closed their offices except for emergencies. That cannot be good, in the long term, for the health of their patients.

        So the answer is, yes, a very few of today’s approx. 2000 CV-19 deaths in the United States might have been people who would have died anyhow, but not enough to appreciably affect the statistics.

  89. State GOP Chairman Andrew Hitt downplayed the health concerns, noting that Wisconsin residents are still going to the grocery store, the liquor store and even boating stores classified as essential businesses.

    “This isn’t New York City,” he said.
    https://www.nbcnewyork.com/news/local/pandemic-politics-wisconsin-primary-moving-forward/2363253/

    Status Number (%) of People as of 8.04.2020
    Negative Test Result 30,115
    Positive Test Result 2,756
    Hospitalizations 790 (29%)
    Deaths 99
    https://www.nbcnewyork.com/news/local/pandemic-politics-wisconsin-primary-moving-forward/2363253/
    Will we see the effect in a few days?

    • I live in WI and yes we got all kinds of flack for keeping our democracy running and the polls open yesterday. Despite a large portion of absentee ballots being cast.

      I said on another post that this has become about piety and shame into conformity. I for one am very glad that our state legislature went to our supreme court to keep the polls open, if it were up to the Governor, he’d be happy to keep everyone exactly where they are forever. Well that’s not the way it works. But dang if expressing your right to vote hasn’t brought on the finger pointing and damning of other states…”for shame that you did not give up your freedoms in the face of this pandemic!” And in that shade throwing forget that our state had mostly absentee ballots anyway.

      Thank you State Legislature for fighting to continue our democracy. For recognizing that while our 2 urban areas have been barely hit with this the vast majority of our state lives in the woods and hasn’t even seen a case.

  90. Willis – Many thanks for a very interesting analysis. Some of your questions do have possible answers explanations:
    1. Your estimates based on the 50-50 hypothesis (50% before peak, 50% after) match the model quite well. It’s possible that the model directly or indirectly uses the same hypothesis.
    2. You report that, unexpectedly, later intervention is associated with a flatter curve. Maybe a higher rate of infection leads to more intervention to try to stem it. ie, maybe cause and effect are the wrong way round in the expectations.
    3. I think the jury is still out on closing schools. Your arguments are compelling, but as you point out your statistical analysis barely supports it – but as you say maybe there’s not enough good data. Maybe, just maybe, the explanation is that children just don”t catch and spread the virus as effectively as adults.

    I heartily endorse your call to look at the whole cost/benefit, and not to make the cure worse than the disease. I’m also mindful of the fact that clamping down too hard early on will merely set the scene for a second wave (like the Spanish flu) – unless there is an effective cure or vaccine by then.

    One possible advantage of curve-flattening that you don’t mention is that it gives time to develop and distribute a cure or vaccine. My own thought is that we haven’t been too successful at that with the ordinary flu, so we shoouldn’t get over-optimistic about this one.

    Australia has implemented strong social distancing measures, but seems to have managed to keep a lot of the economy going, with the obvious exceptions of sport and anything travel- or tourism-related.

    I’m off to the local cafe now, to get a coffee – got to help local business keep going …..

    • Mike I’m an Aussie in my seventies and have tried to do all the correct things, like regularly washing hands, using dettol to kill 99.9% of bugs, don’t drive except for essentials, exercise by walking for 25 minutes day etc.
      What more would you recommend and are you in a much younger age group than me? I will also have the flu shot soon because I don’t want to be fighting more than one of these bastards at any one time.
      The malaria drugs seem to be an obvious choice to me if we test positive to CV-19.

    • Australia has implemented strong social distancing measures, but seems to have managed to keep a lot of the economy going, with the obvious exceptions of sport and anything travel- or tourism-related.

      No, we’ve shut down almost everything, and stopped movements between states for most people. A million or so unemployed (at least 10% of the workforce) already, many more to come.

  91. Fauci is causing incredible damage to the United States and must be removed immediately I agree completely with Willis these people in the CDC haven/t got a clue about how coronaviruses operate. People need to be naturally immunized as the Swedes and Germans are doing and Fauci is preventing this. We shall see my 2 cents worth bet Sweden will come out of this economically intact whereas USA will be destroyed economically. Poor old Trump has been led along by the CDC swamp left over from Clinton era this idiot Fauci who has no comprehesion of viral immunity. By doing social distancing Fauci is prolonging the survival of the virus and should be held accountable for the deaths he is causing.

    • But he won’t be held accountable. On the contrary, the legacy media will hail him as a hero genius restrained from full glory by the subhuman narcissist Trump.

      When in fact, Fauci has been wrong about everything, remarkably, usually in both directions. Like Kerry, he was wrong before he was wrong.

    • Eliza

      You are acting the part of a professional in Epidemiology. So is your opinion based upon any actual knowledge of infectious diseases? Are you such and expert you know what course of action is best.

      Can you present any credentials that you have any clue of what you are saying? Your opinions are strong but are they worth anything.

  92. The chi-com totalitarian killers must pay. They have been murdering their own people for 75 years and are now spreading death around the globe thanks to our feckless governments.

  93. ” the reality is we’ll all be exposed to to coronavirus sooner or later.”
    Did we all get exposed to SARS, or Ebola? The reality is that this virus gets passed from person to person – hence the early exponential growth, many from those who travelled.
    Reduce the contacts that enable person to person spread, and most people will never come in contact with this virus, so overall less deaths.

    • A very thought provoking comment. Is COVID-19 destined to infect everyone? That may have been the thinking of the US response in January. WHO’s “no person-to-person” spread was definitely contributing to that view. It seems also to be the strategy of S. Korea: test-track-contain.

      It seems that CDC/Fauci have thrown in the towel and nothing short of a vaccine (12-18 months away) will stop the spread. Certainly anyone talking of a “second wave” is in this camp.

  94. Willis posts: Flattening the curve does not reduce the total number of cases or deaths.
    ..
    This is false.

    If we stretch the curve out far enough, we can and will use the time gained to develop/perfect a vaccine which will give us herd immunity. We might even discover a therapy in the time gained to save lives.
    ..
    The reason why your statement is false is because you implicitly assume that no vaccine, or therapy will be developed.

    • –Willis posts: Flattening the curve does not reduce the total number of cases or deaths.
      ..
      This is false. —

      If focusing modeling {and you know can’t model all factors} it is true enough.
      Any efforts involved with flattening the curve have other factors related to deaths caused by sum total action.
      But in simple terms flattening curve, will reduce other deaths. And flattening curve will cause other deaths {very hard to model, but quite obvious to economists}.

  95. @Willis – in the main, I agree with your analysis.

    However, there is one thing that I truly wish you would stop doing, and that is conflating the actions of the STATE governments with those of the NATIONAL government.

    Nearly* all of the shutdown pain is being administered by the STATE governments. There is no NATIONAL shutdown being enforced.

    *Explanation of “nearly.” The FEDERAL government has caused economic pain in a very few areas:

    1) The shutdown of much international travel. That action definitely harmed airlines and other travel industries, no argument possible there.

    2) Ordering FEDERAL workers to stay at home, which would have severely affected business activity in areas where FEDERAL workers are thick on the ground (although those areas are closed anyway by local action, so really not all that much, except the few “essential” businesses that they are no longer patronizing).

    3) The individual credits – extremely unwise economically. No argument. Shoring up the unemployment system, a tax holiday, etc., would have been better, of the bad options actually subject to FEDERAL action.

    4) Loans to small business. Okay, inflationary – money coming into those businesses when they are NOT producing. But the long-term damage to the economy from those businesses going belly up (and not in a “capitalistic culling event”) is difficult to calculate. Whether the avoided damage is greater than the cost, or the cost is greater than the avoided damage, can be debated endlessly (and we are unlikely to ever have a reliable analysis of which way it goes, even from 20/20 hindsight ten years from now).

    Net – at least 90% of the rolling economic disaster is being caused by STATE governments, not the FEDERAL. Of that percentage, the major part is centered in the two economic “engines” – California and the East Coast megalopolis. One of the reasons that those areas are so hot on getting cash into the hands of illegals; they constitute a very large part of their GDP.

      • Bad for those States whose ratio of illegal/undomiciled to legal/domiciled residents has increased. Good for those States experiencing the opposite.

        Bad for those with a burning need to know how many toilets are in your household. Good for those who still believe that the Fourth Amendment means what it plainly says.

  96. RE lord Mockton who I had a high regard for this man before but now he appears to be more no more than a pompous British royalist git who now has become an expert in viral diseases. BTW I am. I now i have serious doubts about his 1.5C warming data analysis it could be minus 2 or 1C or plus five for christ sake this man is a joke. I dont think WUWT should be posting anything except comments from this person anymore

    • now he appears to be more no more than a pompous British royalist git who now has become an expert in viral diseases. BTW I am.

      You’re saying you are a pompous British royalist git?

  97. 8 Apr: Fox News: Birx says government is classifying all deaths of patients with coronavirus as ‘COVID-19’ deaths, regardless of cause
    by Louis Casiano
    The federal government is classifying the deaths of patients infected with the coronavirus as COVID-19 deaths, regardless of any underlying health issues that could have contributed to the loss of someone’s life.
    Dr. Deborah Birx, the response coordinator for the White House coronavirus task force, said the federal government is continuing to count the suspected COVID-19 deaths, despite other nations doing the opposite…
    https://www.foxnews.com/politics/birx-says-government-is-classifying-all-deaths-of-patients-with-coronavirus-as-covid-19-deaths-regardless-of-cause

    saw a weekly US pneumonia deaths graph somewhere yesterday and the numbers for recent weeks showed a massive decline from previous years. are non-covid pneumonia deaths being counted as COVID?
    convenient we have a pneumonia virus that particularly attacks the elderly!

    23 Mar: UK Telegraph: Why have so many coronavirus patients died in Italy?
    The country’s high death toll is due to an ageing population, overstretched health system and the way fatalities are reported
    By Sarah Newey
    According to Prof Walter Ricciardi, scientific adviser to Italy’s minister of health, the country’s mortality rate is far higher due to demographics – the nation has the second oldest population worldwide – and the manner in which hospitals record deaths. ..
    Prof Ricciardi: “So essentially the age distribution of our patients is squeezed to an older age and this is substantial in increasing the lethality.”…

    “The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.”…
    “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,” he says. ..
    https://www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-italy/

    Ricciardi’s comments were not picked up by MSM, and did not cause MSM to question Italy’s covid death count.

  98. I think the actual words are:
    “straightening the curves, flattening the hills”
    But then maybe I’m just a good ol’ boy.

  99. Hi Willis

    Thank you again for a thoughtful missive.

    I will be frank, however, that the most valuable “take away” (for me) from your discussion is not the details of your position, but in the differences between your discussion and the other interesting missives of Christopher Monckton, David Middleton, Dr Roy Spencer, Eric Worrall…and others that I have missed. Add Dr Fauci and Dr Birx. Certainly not an all inclusive list by any means…just some of the most obvious people I have paid some attention to.

    I will admit right up front that I do not “believe” there is any clear “right” answer(s) to dealing with Covid-19 disease. It is a chaotic mix of poorly understood biology, combined with intrinsically chaotic politics, with a large measure of ego thrown in. In other words, a typical human reaction to any problem dealing with disease.

    If I were in charge, my first action would be to lock the above mentioned folks in a room and LISTEN to them for a couple days. A moderator might be nice to minimize bloodshed (:)). I would be focusing on what the differences are between their various positions. From this I think one could draw useful information about what we don’t know. This then would lead to a slightly better ability to understand what we do know. From there, I think one could begin to formulate an incrementally “better” way forward.

    I harbor no illusions of some binary solution here. The most honest assessment is: It’s complicated, and I really have very little idea of what is going one, and therefore I have very little real ability to manage a path forward. This is the intrinsic status of humanity, but I do think we make incremental progress. There are, after all, nearly 8 billion of us, and we clearly live longer than we used to. Some measure of progress (to some…)

    Regards,
    Ethan Brand

    • Thank the ChiCom tyranny for lack of relevant information upon which to make sound decisions.

    • Add Rud Istvan and Steven Mosher and Willis Eschenbach (in case not clear…)to the list.

  100. When the kids finally go back to school, it will be interesting to see what effect the doctrine of “social distancing” has on classroom management. For many years, the education gurus have been pushing the virtues of collaborative learning. Walk into any grade school classroom, and you will probably find the desks are arranged in clusters that put students literally elbow to elbow and often face to face with maybe two or three feet separation. When I started teaching (over 30 years ago now) it didn’t take me long to figure out that the closer together the kids are sitting, the more distracting social interactions you have to deal with. So I spaced out the desks as far apart as was practical. (And I discovered it wasn’t so difficult to assemble groups for cooperative learning when that was appropriate.)

    I have wished for years that some researcher with nothing better to do would test the hypothesis that undesirable social interactions vary inversely with the square of the distance between the desks. So also might the probability of microbes passing from one student to another, although this factor would doubtless be swamped by the gazillion other opportunities for cooperative infecting.

  101. The IHME model requires another term, that being the number of deaths of people made homeless by the shutdown and later die on the street clutching a small cardboard sign.

  102. “But you need to give your phone GPS data to the government to make that work. There’s no way Americans, or most westerners in general, would do that.” I suspect that our government already has access to anyone’s location if their phone is functional. After all, they have all the metadata for every cellphone call.

  103. I found this quote by C.S. Lewis that addresses this subject:
    “I dread specialists in power because they are specialists speaking outside their special subjects. Let scientists tell us about sciences. But government involves questions about the good for man, and justice, and what things are worth having at what price; and on these a scientific training gives a man’s opinion no added value.”

  104. “Be clear, however, that this is just a delaying tactic. Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period. Valuable indeed, critical at times, but keep in mind that these delaying interventions do not reduce the reach of the infection. Unless your health system is so overloaded that people are needlessly dying, the final numbers stay the same.”

    Willis, this is not necessarily true. When R0 starts out as an early estimate, that is for a free-running epidemic. That doesn’t happen in humans because once the word is out, R changes because behavior changes. Rt (or Re as I call it) is the effective rate after people understand the situation and decide they don’t want it the disease. That can be any number of actions, but the type of action or behavior doesn’t matter. What matters is suppression of transmission. If R decreases, you can estimate the herd immunity needed by using 1-1/Rt. So when R goes from 3 to 2, herd immunity goes from 66% needing infection, to 50%. Even then, an epidemic can be snuffed out quickly and the population will collapse with fast action. As long as you use strong suppression for longer than a few generations of the disease, it’s over. So there is absolutely no reason for the areas under the curves to be the same. They are the same because you standardized them, so they are, by definition, 1.

    Here are some results from my model, with zero suppression, light suppression, and heavy suppression. The key is to act fast and hard, and you can stop something like this dead in its tracks. The area under the curves is DEFINITELY not equal.

    https://naturalclimate.wordpress.com/2020/03/24/coronavirus-model-what-level-of-suppression-is-enough/

    The real world is more complicated because there are multiple seeds, certain populations that don’t obey the rules (nursing homes), kids playing with neighbors who then take the virus back home, endlessly for generation after generation, etc.

    • Good work.

      It’s always nice to see someone actually do the math rather than just shoot from the hip.

  105. This is not an easy equation to reduce to numbers. The case fatality rate is still not obvious. It will vary for numerous reasons. Age is the obvious one but obesity seems to be a prevalent underlying condition that makes this worse. Western countries have a lot of overweight old people. Were this virus allowed to spread freely, the thing would be over in a matter of weeks. The main wave of the 1918 flu pandemic in New York ramped up to its peak in just one month and was over in another. At the peak it killed 6 people in every hundred it infected in the city. The cfr of covid19 seems to be about 1% but it could be higher or lower. Nobody is prepared to gamble on it being lower.

    As I understand it, when something that novel hits a population, it can infect a very high proportion of the population, in a short space of time. You cannot avoid it. Herd immunity is a very high figure – up to 95%. However if you slow the infection rate down, the people who have already caught it and got better are a bit like a fire brake. Herd immunity is lower – maybe as low as 60% (give or take airline travel or mutations). Your chance of crossing paths with someone infected drops.

    The second issue is health care. First the essential workers need to be protected (not just the medical staff). If they all go sick at once, everything fails. No country was ready for a pandemic. There wasn’t the PPE, the ventilators or the drugs. Medical staff are at very high risk of death. The higher the dose of virus you are infected, the more likely you are to be overwhelmed by the disease. So along with all the old fat people, you can wave your health care workers away. Assuming they stick around at virus ground zero. The viral load issue would have also made a short, sharp pandemic more likely to up the cfr in the general population. Very bad on mass transit or schools.

    The drugs and the vents are important to give people a chance but to also make the deaths of those who succumb more bearable. Read some of the accounts of those who watch others die and then decide that large numbers of people gasping their last at home with no help available is a humane thing to do. Care homes have been abandoned by staff because they can’t cope with the dying and fear for their own lives. In a short, sharp pandemic, most of us would be in the same boat if we had a bad reaction. The more time the scientists get the more likely there will be a cure. Even recovered patients can be used to help the sick. If everyone gets sick together, nobody has the antibodies to help anyone else, even if the scientists could extract it.

    There are many more arguments but I’ll give you one more. Say Trump set the virus free. Sent everyone back to work and let this rip through the population. Almost everyone would know and maybe see someone close to them die in agony. How long would it be before a Republican got back into the Whitehouse?

    • “The drugs and the vents are important to give people a chance but to also make the deaths of those who succumb more bearable.”

      Cuomo said only 20% of patients who are put on a ventilator will survive. Fail. Did the ventilator prolog their misery or did it end it? More bearable? I doubt it.

      The lockdown and the ventilators are not working. Do we do more of the same or do we try something different? Most countries are still doubling cases every week or so. That’s better but it’s still an enormous growth rate.

      • A lot of those on vents aren’t the very elderly, they’re the middle aged or younger. I’m sure that the 20% aren’t ungrateful to be alive. The very elderly are dying in care homes and/or not deemed suitable for invasive life support. And what about the drugs? Those drugs used to ‘make people comfortable’, the euphemism for knocking them out or numbing them at the end are in short supply. Even oxygen, also helping those who don’t end up on vents eventually would run out. If the health care system collapsed for a while, most victims wouldn’t even go to hospital. There wouldn’t even be access to simple painkillers or antbiotics. A lot of people are calculating the cfr based on the cruise ship Diamond Princess. The passengers got some of the best medical care in the World and went into lockdown, so that a lot of passengers didn’t get infected. Eventually they were allowed off the ship, as if their pandemic was over.

        Lockdown isn’t working? It was never going to stop this immediately, especially as we didn’t start soon enough, nor are we as strict as China was. People are infectious without showing symptoms, some of them for weeks. However, the number of severe infections are not wiping out our hospitals or devastating our essential services. It would be a lot worse if lockdown wasn’t in place.

        But hey, I would be ok if the US or even the UK tried cancelling lockdown. My vulnerable people are either already gone or can protect themselves from this disease anyway. Go for it.

  106. Wealth saves lives. Wealth pays for better food, better hospital care, better living conditions, more education. More research. Safer cars. Everything. How many lives would be saved if Californians were a trillion dollars richer? That’s how many lives are now lost.

  107. This makes the first time I have seen agreement with what I have been derided for i.e. that ‘delaying death’ is a more accurate expression than ‘saving life’.

    This looks like a very useful study demonstrating the futility of continuing the shutdown.

    Future deaths from covid-19 will be greatly reduced by introduction of fast detection and effective treatment. Hydroxychloroquine has shown compelling promise, is starting to be used and is being subjected to rigorous assessment in spite of harassment and fake news by the Trump Haters. I wonder how many thousands of deaths have occurred as a consequence of knee-jerk anti-Trumpism. A misleading signal might result from delaying until it is too late. After starting on a ventilator is too late. The earlier that hydroxychloroquine is used, the better the outcome. There is strong evidence that it might even prevent onset of the disease. Delaying the use of hydroxychloroquine because it is unproven to treat covid-19 is an appalling lack of common sense. Nothing is proven to treat covid-19.

    David Middleton provides an informative report of this and very recent developments here: https://wattsupwiththat.com/2020/04/07/wildly-exaggerated-chicom-19-models-are-driving-policy-decisions/#comment-2959397

    • ‘delaying death’ is a more accurate expression than ‘saving life’.

      Indeed, this a typical misrepresentation you’ll find in the Guardian when (mis)reporting the dangers of PM2.5 etc. They will say that a “new study” finds that fine particles cost upto 200,000 lives a year ( or some such figure ) when what it actually found that there was statistically 50,000 to 200,000 whose lives were shortened by an average of 6 days.

      Lies, damned lies and journalism.

      I’d rather have my individual autonomous transport now and all the time that will same me and pay for it when I’m bed-ridden and incontinent and don’t know what day of the week it is.

  108. icisil, I saw that and said “Yep”.

    A 95-year-old guy with congestive heart failure. He dies of congestive heart failure. He is tested. He has coronavirus. The CDC says, count that as a death from coronavirus.

    Madness.

    w.

    • They weren’t getting enough that way so now CDC does not even require test results, merely if the decedent could have been exposed.

    • Even if everyone who died of any cause at all were tested for CV-19 (which won’t actually happen for many deaths, such as automobile accident, heart attack, stroke, suicide, murder, drowning, etc.), the “coincidental positives” would inflate the number of CV-19 deaths by a minuscule percentage (less than 2%).

      What’s more, it is unquestionably a fact that many more people are dying of CV-19 without having a CV-19 diagnosis, than are mistakenly attributed to CV-19 when dying of other causes. If someone dies at home after a brief illness, there is generally no requirement that he be tested for CV-19. In the U.S., a family could presumably request that he be tested, but it would cost them money that they might not want to spend. (That might vary w/ jurisdiction.)

  109. Willis,

    “death number as a percentage of the total number of deaths. For convenience I’ve called this number the “peak factor”,”

    Comparing the outcomes of two states using a self-selected single factor affecting Ro and morbidity hardly qualifies as reliable analysis.

    Sure, peak death may
    approximate total deaths, but there a slew of factors ultimately contributing to mortality, viz; penetration at time of modeling, relative health of infected population, availability of therapeutic medicines, and most importantly, efficacy at isolating the infected.

    Attempting to model Morbidity with limited data is analogous to climate models only inputting sensitivity to a doubling of CO2 and expecting a degree of precision.

    It’s garbage in and garbage out my friend. You cannot pretend to know what may have been, sans efforts (as variable as they may be) to limit contact.

    With regard to Dr. Fauci’s position on Chloroquine; I saw the original brief where he mentioned initial results were promising but not yet conclusive.
    This is entirely compatible with scientific convention. I’m a big fan of Inductive logic and the numbers have become increasingly convincing. The press were foolish to bet against such inductive evidence and Fauchi was correct to take a cautious position.

  110. Well, here’s a good one.

    You recall that just before I published this post, which was yesterday, the IHME put out a revision of their model dropping deaths from 93,000 to 81,000.

    A friend just notified me. New revision. Projected US deaths?

    60,415 …

    Remember how I and many others took a lot of grief for saying that in the US this was not unlike the flu?

    2017-2018 flu season deaths in the US?

    61,000.

    w.

    • A friend just notified me. New revision. Projected US deaths?

      60,415 …

      I was going to ask if I was missing something, because that’s the number I saw on the page you referenced. So they went from 93,000 to 81,000, and now to 60,415…all in a matter of days.

      And on March 29th, Anthony Fauci estimated 100,000 to 200,000 U.S. COVID-19 deaths (though he didn’t give an end time). It’s a good thing he clarified that he did not want to be “held to that” estimate.

  111. A few things, roll your socks up and protect your ankles

    words quoted:

    1. “Yes, if you do a full-on surveillance state detecting, tracking, and contact tracing like South Korea has done, that will work. But you need to give your phone GPS data to the government to make that work. There’s no way Americans, or most westerners in general, would do that.”

    Not true. GPS data is not required to do contact tracing. It can help, but absolutely not necessary.

    Take the super spreader in Korea. The officials know where she went because she told them.
    Are you arguing that Americans will not help their fellow citizens by telling doctors– I went to lunch
    with my friends and to church twice? That was all the needed to track down the 1000 or so people
    she infected. or take the guy who infected hundreds of his co workers. No GPS needed

    But it’s even easier than this. 80% of all transmission in China was family to family.

    In short, the GPS tracking etc is only needed to wipe it out completely.

    80 20 rule

    Jane gets sick.

    1. test her family
    2. test her co workers
    3. test her customers
    4. test the people in her building

    This gets you 80%+ of all transmission. its the last 20% that Might require GPS data.
    Thats been pretty clear day in and day out in Korea,

    And the disease makes this EASY because it takes days for symptoms to show up, if at all.
    thats days of time to test close contacts, etc

    Further Now you don’t need GPS data with Singapore’s new approach. The app has been open sourced it’s
    pretty cool. No GPS required, it tracks contacts anonymously and securely. It tracks the anonymized
    ID of the people you have come within 2 meters of. So, if Willis uses the app it will make a little
    log. Willis (“w”) passed within 2 meters of a,b,c,d,e,f,g,h,i,j,k
    next week ‘k” tests positive. “K” then consents to have their list of IDs shared. “K” has a list
    like this x,t,w,p,r,q. hey look! K was close to w. So Willis would get a text.
    ‘Willis, you recently had close contact with person who tested positive, please come in for your free test”

    what you need GPS for is labeling “hot zones” that’s how it is used in Korea and China.

    Willis gets in his car. he goes to the bait shop to buy some night crawlers. He tests positive later.
    Now everyone in the country will get a map on their phone showing that bait shop.
    So you can do “good enough” contract tracing without this.

    So, 80/20 rule. If you get a sick person 80% of the people they infect will be known to them already.
    Family, Close contacts. 20% wont, 20% will be chance crossing of paths, public surfaces, etc.
    want an idea of how many tests you do per person? Dunbars number. 1 sick person, test on
    average 150 people.

    Suppose Jane works in a Restaurant. In that case you probably want to know and test everyone who
    ate there. You don’t need GPS data to do that either.

    So bottom line. you don’t NEED GPS data to do the job, it helps do it perfectly. 80% of the time you’ll catch all related cases by immediately testing families, co workers, friends. neighbors of sick people.

    Of course that means you might end up actually testing a lot of people.
    better than being unemployed.
    and some people might resist testing. Like the super spreader in Korea who resisted tested.
    I think they changed the law so you have to comply with the swab up the nose.
    could be worse considering all our openings.

    2. you don’t flatten the curve to reduce deaths.
    The IHME model is used by PLANNERS who need to decide before there is enough data how much demand there will be for hospital beds ,ICU units and ventilators. Deaths is the wrong metric. Ask the people who use the model if it is useful. the actual effectiveness of distancing measures will be measured
    differently.

  112. Can you do some analysis on Australia and New Zealand? Our cases here down under seem very low, and the stay at home orders appear to be working very well. Or maybe we just shut our borders down early enough, I don’t know.

  113. in other news:
    {good news}
    A Rapid Test for Covid-19 Arrives Via a 20-year-old Technology Already in Many Hospitals

    “In late March, the FDA approved the use of Cepheid’s GeneXpert rapid molecular diagnostic machines to test for the new coronavirus. The automated modules—5000 of which are already installed in U.S. health facilities, while 18,000 are in operation in other countries—don’t require a lab facility or special training to operate. What’s more, they generate accurate results in about 45 minutes.”
    https://spectrum.ieee.org/view-from-the-valley/the-institute/ieee-member-news/a-rapid-test-for-covid19-arrives-via-a-20yearold-technology-already-in-many-hospitals
    linked from
    http://www.transterrestrial.com/

  114. the final numbers stay the same
    ==================
    Willis, this is likely incorrect. Flattening the curve buys time and this allows improved treatment, reducing the numbers of death.

    This happened in the past and it is happening now, as doctors share what works and what doesn’t. Add to this improved testing and contact tracing, which was impossible early in the pandemic.

    • You are right that flattening the curve buys time. I agree.

      The problem is, I’m just not seeing the current interventions as flattening the curve.

      I’ve shown in both Europe and the US that despite widely different levels of interventions, they don’t seem to affect the end results much if at all.

      w.

      • The problem you face is a difference in population density, sampling rates and classification criteria. You cannot accurately make a meaningful comparison because you are comparing apples to oranges.

        For example, all that is required to achieve a low covid-19 infection and death rate is to use a test with a large number of false negatives.

        Another problem is how you classify patients that die of pnuemonia with covid-19.

        In fact covid-19 kills very few if any. What kills peoole is pneumonia or organ failure. So death rates can be a reflection of medical guidelines.

        For example, in the US doctors are taught to lust from specific to general on the death certificate, but the CDC guidelines for covid-19 want doctors to list from general to specific.

        For example, someone is admitted with a gunshot, and their blood test is positive for coronavirus. Is they die was it the gunshot or coronavirus that killed them?

        Now expand this to underlying morbidities.

        Until there is randomized antibody testing there is unlikely to be a reliable metric to evaluate different strategies.

  115. Willis,
    I didn’t slog through all the comments to find out if someone else has the same idea as I have but I haven’t seen anyone, anywhere, relate the cost of the shutdown to the simple fact that wealth is ONLY created by someone selling/trading some service or thing (of value) to someone else. That’s what workers do – something of value. Stop folks from working and you have stopped creating value. Stop a lot of folks from working and a lot of value/wealth is simply not generated in that moment. Government (or anyone else) can send cash to pay rent, keep health insurance, etc but THAT is not creating value, it is the opposite.
    And it is also important to note that money ($) is just a measure of value, not value itself. In the US we recognize the dollar as the measure – others use other names. So dollars can represent both an increase OR a decrease in value depending on the circumstance. Simple example – spend a few dollars on a hamburger and eat it – that amount of value is gone, for ever! Sell a bag of potatoes for more than it cost you to acquire or grow them and you create more wealth to balance the hamburger.
    The real effect of this virus/shutdown is SCARY serious.

  116. “…incompetent Dr. Fauci. (In passing, let me note that he’s been wrong…” Everyone who is wrong is incompetent? Where does that place others, including yourself? Why not stick with strengths?

    • If Dr. Fauci were wrong once, that wouldn’t be remarkable. But he has been wrong at every turn, which is why I called him incompetent. Perhaps a better description would be “out of his depth”. As to his strengths … I haven’t noted any, other than his ability to convince smart people to take up ridiculous positions.

      w.

      • I find Fauci to be a slimy character. He has been busy quietly walking back his predictions well ahead of time. From The New England Journal of Medicine:

        If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively. – NEJ Med 382;13, March 26, 2020

  117. I think your naive hope that this will become ‘just another flu’ is reckless.
    Immunity is the key here. Some viruses we never become immune to, the cold being one of them, and this one may be even worse:
    https://www.scmp.com/news/china/science/article/3078840/coronavirus-low-antibody-levels-raise-questions-about
    This is so many times worse than a cold, transmissibility, virulence and maybe no immunity, hence no vaccine.
    Cure is the only way to isolate and eradicate and until we have cure, then mass isolation is correct.
    If we find no cure and there is no immunity we will get a standard death rate in the population of at least 5% per annum. There ain’t no small town businesses when there are no people left standing.
    This is that serious.

    • wow, lot of misinformation in one post. We do become immune to flu viruses, coronaviruses, adenoviruses and rhinoviruses, they just mutate constantly so we have some reaction to the new strains. Not even the Imperial College study suggested a 5% death rate of the entire human population every year so I am very impressed by your ability to do so. Curing the disease caused in an individual by coronavirus does not eradicate the virus, it is still out there in some human and animal hosts or surviving in niches. Coronaviruses are not rapid mutators, so there actually is good reason to think that both through natural immunity and vaccines we will be in pretty good shape. If you take away its ability to home in on frail elderly patients, this isn’t a particularly lethal pathogen for the bulk of the population.

    • 1) Antibody production is very low on first presentation of a pathogen. For a large percentage of the population, it is not detectable by standard testing. This does not mean that production will be abnormal on the second and subsequent presentations, unless the patient is otherwise immunocompromised.

      2) CHICOM publication = likelihood of veracity ~0.000001%

  118. It will be interesting watching the Belarus experiment in doing pretty much nothing. Old, sick, etc are kept as safe as possible and everybody else go to work, school etc.

    If at the end of this Belarus has the same death rate per capita that everyone else has then a lot of people will have trillion dollar egg on their face.

  119. Willis,
    You set out a clear case for less shutdown. However, your case can only be as clear as the data you put into it. As many others have noted, the data are not good enough for a lot of types of modelling, for reasons that are not your blame and which you have several times noted yourself.
    It is very easy for analysts to rattle off terms like “damage to the economy” but it is fiendishly difficult to define “damage” and “economy” to the degree demanded of a benefit:cost analysis that is meaningful in the ways that you note.
    In Australia, our PM uses the term “hibernation”. Think about that as a way to model in your mind what happens to the economy. We are vaguely aware of bears that take time out each year to do nothing much except breathe, yet when they start up again, they seem much the same as other types of bears that do not hibernate. Hibernation does not seem to do damage per this example. Should we reduce our economic estimates of damage to let hibernation show its effects?
    You also have the question of whether alleged damage is permanent, transient, ready for short-term or fated for long-term recovery. You have to examine each little part of each sector of industry and ask questions like “Would hibernation of this activity cause harm? If so, a lot or a little?” We all know that many activities loosely labelled as “work” are not required, however nice they make us feel. Example, there is a large tourism sector that could be put into hibernation with no harm to anyone, because it is optional. Worse, it might have negative value because it diverts people from productive work to fun work. How does society value fun? Quite high, it seems.
    Thoughts about industry sector hibernation can quickly lead to the old saws of “Goods” versus “Services”, the value of production of real goods that can be bought and sold for meaningful $ values, as opposed to intangible services whose value is more to the user than to society as a whole. I raise this matter because countries after their shutdowns will probably think of changes to industry balance for several reasons. I have already suggested for example that Australia should develop anew a larger, more tailored pharmaceutical manufacturing industry so that an economic shock in the future will not catch us so short. At times like this it can be prudent to examine the national work balance and not put life back into many activities that have probable negative value already. Some such industries are manufacture of personal cosmetics, the making and marketing of alternative medicine hocus-pocus, or in short, many activities whose life support is intensive and expensive advertising of goods with no inherent value. Like the fake news industry. We persist with these for little more reason than we grew up with them and they seem part of normal life. They are not. Some are highly abnormal, undeserving of their existence. In a hard, serious analysis, major sectors like insurance, banking, investment are overdue for a study of real value.
    This note is already too long, but the concepts in your essays are complex. Please note that I am a strong free marketeer, heavily against regulation, despite my words maybe suggesting otherwise.
    Geoff S

    • “posed to intangible services whose value is more to the user than to society as a whole. I raise this matter because countries after their shutdowns will probably think of changes to industry balance for several reasons. I have already suggested for example that Australia should develop anew a larger, more tailored pharmaceutical manufacturing industry so that an economic shock in the future will not catch us so short.”

      I think most countries will consider that. It should be a wake up call about retaining an industrial base.

  120. Sorry Willis, I’m late to the party. But thanks for one of the few rational takes on this pandemic.
    More evidence why we should not take the proscriptions of “experts” without question. Always question.

  121. I appreciate the time you take to dig through the numbers. Unfortunately, many don’t understand the basic problem. Those of us who are appalled at the cost-is-no-object approach are not minimizing or discounting the risks or dangers of this disease. We simply believe that there is a (much) lower cost way of achieving the same results. I mentioned the quarantine of Miami in 1899 for yellow fever before. The city was quarantined but not the mosquitos. This is take two but on steroids. Are the measures quarantining an airborne virus?

    I think masks are effective for the following reasons. First of all, the math is wrong in my opinion. It seems to me that the modeling is assuming smooth peanut butter. I think the peanut butter is chunky. The chunks may grow exponentially, but the smooth peanut butter grows very little if at all. I was taught to model that by assuming an average R naught. Let’s assume the R naught is two. In smooth peanut butter, each person infects two. In chunky peanut butter, 499 out of 500 don’t infect anybody. 1 out of 500 infects 1,000 people. The average R naught is also two, but the behavior is very different. Add to that an assumption that the chunky bits do a random walk through the peanut butter and you are in Lorenz territory.

    Of course, if you do nothing, then the chunky bits will eventually grow throughout the peanut butter. It’s as if they were zombies. Every bit they come in contact with become zombies also. However, if you adopt a strategy that reduces the infectivity of the super-spreaders then the math changes also. So, if everyone has to wear a mask, then maybe the super-spreader doesn’t infect 1,000 but only 100. Using my example above, the R naught now becomes 0.2. That is a very effective way of controlling a pandemic.

    What is not recognized by the policy makers, except maybe for President Trump, is that the current policy is unsustainable. The patient will die. Its like telling someone that to avoid inhaling virus particles that they just need to hold their breath. Our economy can hold its breath for a short period, but we are reaching that limit. This can’t go on for ever.

    On a relatively small scale (several hundred people), I had an outbreak of a very contagious disease (strep throat) and a super-spreader that infected 180 before we noticed. I tested everybody, found the super-spreader and isolated her and put masks on everybody while they were being treated. The outbreak was stopped in its tracks. No further cases were detected and masks were worn until everybody tested negative. Scaling this up is, of course, very difficult, but masks are very helpful in lowering the R naught at a much lower cost than present policy. Testing and isolation of super-spreaders is essential. All three are necessary.

    Thank you again for making such a strong case for a change in policy.

  122. Within the military, orderly retreat is considered a much more difficult maneuver than attack and pitch battle

    How and when to cut the shackles and fully open the economic tap? Too late and there will only be a trickle. Like it or not politicians will eventually have to address the trade-off question and face the music, like any general

    The Chinese claim to have won the end game. Swine with flu can fly

  123. in other news:
    {good news}
    A Rapid Test for Covid-19 Arrives Via a 20-year-old Technology Already in Many Hospitals

    “In late March, the FDA approved the use of Cepheid’s GeneXpert rapid molecular diagnostic machines to test for the new coronavirus. The automated modules—5000 of which are already installed in U.S. health facilities, while 18,000 are in operation in other countries—don’t require a lab facility or special training to operate. What’s more, they generate accurate results in about 45 minutes.”
    https://spectrum.ieee.org/view-from-the-valley/the-institute/ieee-member-news/a-rapid-test-for-covid19-arrives-via-a-20yearold-technology-already-in-many-hospitals
    linked from
    http://www.transterrestrial.com/

  124. If anyone doubts the effectiveness of lockdowns, watch the UK over the next 1-2 weeks.
    We were slow implementing lockdowns and they were not especially restrictive, until about two weeks ago. As a result, our daily death rate is about to overtake the worst that happened in Italy.

    And by the way, the numbers of deaths are under-reported in UK. They only include deaths in hospitals, so exclude care homes, prisons etc – and for technical reasons reported deaths lag actual deaths by several days,

    • So what are we supposed to be looking out for an what conclusion do you think we should be jumping to?

      Deaths will be high in UK because we have one of the most run down health systems is Europe. UK has 129,000 beds, Germany has 120,000 ventilators ! Will that help us see the effectiveness of lockdowns?

      Like the viscous viscount, you seen to think that any change can automatically be attributed to confinement, and any if UK performs badly that is because confinement was not done early enough.

      You have one variable which you assume is the control knob and any change is therefore automatically attributed to it.

      This is climatology all over again.

      Monckton is doing exactly what he has been criticising in climatology here for decades to much applause. One wonders why his brilliant, incisive classically trained mind cannot see this.

    • Based on what? The announced death rate, which isn’t the daily death rate? The actual daily death rate which is just people dying who have tested positive?

      And care homes are now included by the ONS.

      Your statement is based on ignorance of the data you claim backs you up.

      • Our hospital death rate is about to overtake Italy’s worst day – possibly as early as today. Nothing to do with ONS figures which come later, and nothing to do with Germany.

        Everyone has been saying that the death rate in Italy has been because of run-down health care, poor underlying health, oldest population in Europe etc, but they are going to have better outcomes than we do.

        And as I said, watch the figures.

  125. Coronavirus lockdown has led to increase in suicides, police chiefs say as fears grow that domestic violence and sex abuse are also on the up
    Police Federation’s Simon Kempton said ‘early indications’ of a rise in suicides
    There is concerns about a possible rise in crimes such as domestic violence

    SOURCE

    Coronavirus: Mental health incidents rising during UK lockdown, police say
     
    Increasing numbers of mental health incidents are being reported to police during the coronavirus lockdown, senior officers have said.

    SOURCE

    Chillingly, Scariest Coronavirus Death Toll May Not Come from COVID-19
    A great deal of scientific research indicates the coronavirus containment strategy will cause more deaths than COVID-19 would have.
     
    The link between unemployment and suicides will be a concern that has to be addressed while the majority of the population stays-in to duck the coronavirus pandemic. | Source: REUTERS/Carlo Allegri
     
    While many countries are in lock down to prevent COVID-19 deaths, the reaction to coronavirus is likely to kill more people than the disease itself.
    That’s because coronavirus layoffs have already surged across the US. And unemployment projections are already as high as 4.6 million.
    Meanwhile, there’s a firm body of scientific literature establishing a strong link between unemployment and higher suicide rates.

    SOURCE

    L.A. suicide hotline sees rise in coronavirus-related calls. Counselors feel the pain

    SOURCE

    In Portland, Police Chief Jami Resch said Tuesday suicide threats or attempts are up 41 percent from this time last year and have jumped 23 percent since 10 days before a declared state of emergency, according to local Oregon news outlet KATU.

    Allysen Efferson, a therapist in east Tennessee told The Federalist that the link between suicide and financial hardship has been well established and that policymakers should be taking the current epidemic over suicide already at play into account when crafting measures to counter the virus.

    SOURCE

    I’m just posting these to show that as I’ve been saying, the lockdown itself is killing people …

    My point is that in this cost/benefit analysis of the economic shutdown, there’s blood on both paths.

    w.

  126. “Remember that knowledge is a ruler and wealth is its subject.” – Saying 146 from Nahj Al-Balagha (599-661 BCE)”

    I agree with Willis but in the spirit of the notion that knowledge is power, I feel the particular circumstances require a little more sarcasm:

    The whole thing has nothing to do with a worldwide financial collapse that had begun* just prior to the viral outbreak! A massive liquidity crisis was already underway when the NY fed started pumping extraordinary amounts into the repo market. Over half a trillion as of February and the banks are still not trusting each other! The world is sitting on the biggest debt bubble in its history, over 250 trillion, 320% of GDP** as we all twiddle our thumbs in lock down!

    The two largest bubbles are those of China and the US and of course it is yet just another remarkable coincidence that they had been working together*** on bat coronaviruses for at least the last 10 years!****

    The fact that central banks have been unable to re-establish trust, despite pumping trillions into the market month after month, has absolutely nothing to do with the global lock down. It is just a coincidence that the start date of the “pandemic” coincided with structural failure in the global intergrated financial system.

    Fear the virus, don’t worry about the economy, even as this lock down now makes the greatest financial crash in history inevitable! ;-(

    I hope I’m wrong because Australia is also sitting on its largest debt bubbles since settlement, directly linked to foreign credit markets and if they go down, we go with them!

    * 17 September 2019 to be exact, when the NY fed began by pumping 53 billion into the repo market
    ** https://www.iif.com/Portals/0/Files/content/GDM_Aug2019_vf.pdf
    *** This is just one of many peer reviewed papers discussing cooperative experiments that included both the Wuhan lab and its scientists and US scientists, universities, and funding (USAID-EPT-PREDICT funding from EcoHealth Alliance, for example.) :

    circulating bat coronaviruses shows potential for human emergence.
    Nat Med 21, 1508–1513 (2015). https://doi.org/10.1038/nm.3985
    https://www.nature.com/articles/nm.3985

    The paper above was controversial at the time, subsequently the creation of chimeric viruses was briefly banned but ultimately lifted in 2017:
    https://www.nature.com/news/engineered-bat-virus-stirs-debate-over-risky-research-1.18787

    You really have to read just a little of the non-technical portions of some of these papers; it is simply mind blowing to accept that this isn’t science fiction! :

    Moving beyond metagenomics to find the next pandemic virus
    Vincent Racaniello
    PNAS March 15, 2016 113 (11) 2812-2814; https://doi.org/10.1073/pnas.1601512113
    https://www.pnas.org/content/113/11/2812

    **** Recombination, Reservoirs, and the Modular Spike: Mechanisms of Coronavirus Cross-Species Transmission
    Rachel L. Graham, Ralph S. Baric
    DOI: 10.1128/JVI.01394-09
    https://jvi.asm.org/content/84/7/3134?ijkey=1559c872714c94954c805dab900793cae9e6a00b&keytype2=tf_ipsecsha

    • Correction:
      The US moratorium* began in 2014. The study mentioned above** – already underway – was allowed to proceed.

      * US suspends risky disease research:
      Government to cease funding gain-of-function studies that make viruses more dangerous, pending a safety assessment. https://www.nature.com/news/us-suspends-risky-disease-research-1.16192

      **circulating bat coronaviruses shows potential for human emergence.
      Nat Med 21, 1508–1513 (2015). https://doi.org/10.1038/nm.3985

    • Since posting my comments above, my personal website has been down. It is just my artwork site and nothing political but it is my own!

      I can’t get anything intelligible from the web site hosts – TPP- as to why it is down and they have been demonstrating complete ineptitude.

  127. I’d like to put forward another theory : That lockdown will increase the eventually death rate.

    Imagine a small town, X. Into X comes Covid 19 via someone from City Y, the infection spreads to schoolchild, Johnnie. That child infects others in his class and school who then take the disease to their families etc etc. After a few months everyone has been exposed to Covid-19 and those with normal immune systems have built up immunity, the famous “herd immunity”. Summer comes and cases drop as immunity increases due to higher levels of vitamin D and less indoor living.

    Next winter Covid-19 comes back to town but there is herd immunity so it is more difficult to spread the disease and cases are fewer. This is the normal pattern of disease for mankind.

    Now if you’d had lockdown before Johnnie had spread the disease to his classmates what would have happened? Less of them would have caught the disease so there’d be less immunity and when lockkdown is removed Covid-19 returns. It now has more possible carriers to spread it, anyone whose immunity has recently become compromised is now as at risk of exposure as before. If it is winter then even more so.

    And if Covid-19 has mutated it could be a more deadly strain and those without immunity will be at a higher risk than previously. Better that we follow human history of millions of years and all get exposed in one season rather than hide indoors and have no immunity to something that may be more deadly. I believe this is what happened with the Spanish flu, returning troops brought novel versions of the Spanish flu back en masse to their home town and themselves had little immunity to other strains that were there. They also had compromised immune systems due to the stress of trench warfare, exposure to vermin and the dead and a poor diet of tinned food.

  128. ‘Who should we ask? Badger or Toad?’ said Ratty

    ‘Badger!’ said Mole ‘And that’s a fact, and no mistake!’

    ‘I am convinced that the Corona mortality rate will not even show up as a peak in annual mortality. ‘In Hamburg, for example, not a single person who was not previously ill had died of the virus: All those we have examined so far had cancer, a chronic lung disease, were heavy smokers or severely obese, suffered from diabetes or had a cardiovascular disease. The virus was the last straw that broke the camel’s back, so to speak. Covid-19 is a fatal disease only in exceptional cases, but in most cases it is a predominantly harmless viral infection.’

    Professor Klaus Püschel, head of forensic medicine in Hamburg

    ‘….the internationally renowned epidemiology professor Knut Wittkowski from New York explains that the measures taken on Covid19 are all counterproductive. Instead of social distancing, school closures, lock down, mouth masks, mass tests and vaccinations, life must continue as undisturbed as possible and immunity must be built up in the population as quickly as possible. According to all findings to date, Covid-19 is no more dangerous than previous influenza epidemics. Isolation now would only cause a second wave later.’

    ‘Professor John Oxford of Queen Mary University London, one of the world’s leading virologists and influenza specialists, comes to the following conclusion regarding Covid19: Personally, I would say the best advice is to spend less time watching TV news which is sensational and not very good. Personally, I view this Covid outbreak as akin to a bad winter influenza epidemic. In this case we have had 8000 deaths this last year in the ‘at risk’ groups viz over 65% people with heart disease etc. I do not feel this current Covid will exceed this number. We are suffering from a media epidemic!’

    ‘How a profession that is supposed to control the powerful as an independent, critical, impartial Fourth Estate can succumb as quickly as lightning to the same collective hysteria as its audience, almost unanimously, and give itself over to court reporting, government propaganda and expert deification: It’s incomprehensible to me, it disgusts me, I’ve had enough of it, I dissociate myself from this unworthy performance with complete shame.’ Harald Wiesendanger journalist and author on medical matters for over 25 years

    ‘Facts about Covid 19’

    ‘Policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19’

    The Lancet

    The experts clearly now know what it is that they are, in fact, dealing with.

    Time to get back to work.

  129. Calculating COSTS of the interventions is tricky.
    Sure – interventions and lockdowns cause economic damage – no doubt about it. But… even without government interventions and lockdowns, some considerable damage to the economy will result from this epidemic – which is a natural disaster (not government made). Even if Government stays aside and does nothing – the economy gets hurt by things or measures people will do to protect themselves from the plague.

    Old people will stay home – voluntarily, all will refrain from recreational trips, the tourism industry is decimated, sports and concerts closed… social distancing…all voluntary “interventions”.

    You should put on the “costs” side of the equation only the ADDITIONAL damages cause by Government decrees, damages that were not bound to happen anyway.
    This plague, this natural disaster, causes economic damages… not way to avoid them. I suspect that the additional damages added by unnecessary Government intervention are much smaller than the total you presented of estimated.

  130. Couple of typos, I know you hate those, Willis:

    “Fex-Ex”
    “There’s really no attempt being made being made to track contacts.”

    • Thanks, Jeff, fixed. I do indeed hate typos, they slow down the reading and sidetrack the understanding.

      w.

  131. New Orleans, the epicenter of Deaths, (other than the other epicenters of Deaths; it seems governors and mayors are fighting for air time over the title), was in the news for almost 2 weeks about getting their convention center ready to accept corona patients. Building to a crescendo the day before it opened, TV crews were on hand touring the convention center with dignitaries posing. Since opening on Monday April 6, there has Not.Been.One.Story. Nothing. No cameras showing the ambulances, army vehicles, or ‘refrigerated trucks’. The convention hall is set up to handle 1,000 according to breathless pre-opening news reports and interviews with plans to increase that to 2,000. Now four days later, Not.One.Story. Can’t hype an empty building?
    It doesn’t mean people aren’t still dying (like the flu). It doesn’t mean some aren’t still being hospitalized (like the flu). It is evidence that this “over worked, over capacity, over flow” has been over hyped.
    Search: morial convention center covid corona

  132. I am not shy.
    If I want to blame something on someone, or if I think someone is full of crap, I know how to say so.
    I do it all the time.
    I said nothing like that.

  133. Good blog. The most comprehensive set of Infectious Disease Mortality in the US was published by Armstrong et al in JAMA in 1999

    Look at Figures 1 & 2. They show a 95% decline in Infectious Disease mortality since the Spanish Flu in 1918. Likely, this means public health, penicillin, vaccines and herd immunity have done their jobs.

  134. A trillion in losses are on the cost side of the cost/benefit analysis. And on the benefits side, all we have is a two-week delay in eighteen hundred unavoidable deaths? That’s it? That’s all that a trillion dollars buys you these days?

    This statement is based on flawed analysis of death rates and little understanding of economics.

    The understanding and analysis of flattening the curve is wrong. Think more in terms of crushing it. That is the nature of exponential growth. Act slow and the situation is out of hand very quickly. There would be no global pandemic if flights out of China were grounded in January when Wuhan was locked down.

    Taiwan has managed the risk the best of any nation. They got in fast with effective action. They avoided the need to lock down.

    The US government has created money to give to many people to have a holiday in doors. As long as essential services and food supply are good then it will not be inflationary. It is not taxpayers money. It is new money that will end up in savings accounts. The pandemic is highly deflationary on all but food supplies. Maybe inflationary pressure on guns in the USA! Those in essential services like road and rail freight are enjoying reduced costs of fuel and increased efficiency due to lower congestion.

    Much of the medical infrastructure is underutilised to massively increase standby capacity. To balance that, medical emergencies of all types are down; fewer road accidents, fewer flu cases, fewer violent robberies.

    It appears the US population has largely avoided the bullet. They have been conditioned to interpersonal space and possibly benefit of masks. It is reasonable to expect the lockdown to be gradually eased in May as the death rate comes under control.

  135. Flattening the curve

    https://www.nih.gov/news-events/news-releases/rapid-response-was-crucial-containing-1918-flu-pandemic

    “Nonpharmaceutical interventions may limit the spread of the virus by imposing restrictions on social gatherings where person-to-person transmission can occur. The first of the two historical studies, conducted by a team of researchers from NIAID, the Department of Veterans Affairs, and the Harvard School of Public Health, looked at 19 different public health measures that were implemented in 17 U.S. cities in the autumn of 1918. The second study, undertaken at Imperial College London, looked at 16 U.S. cities for which both the start and stop dates of interventions were available.

    Schools, theaters, churches and dance halls in cities across the country were closed. Kansas City banned weddings and funerals if more than 20 people were to be in attendance. New York mandated staggered shifts at factories to reduce rush hour commuter traffic. Seattle’s mayor ordered his constituents to wear face masks. The first study found a clear correlation between the number of interventions applied and the resulting peak death rate seen. Perhaps more importantly, both studies showed that while interventions effectively mitigated the transmission of influenza virus in 1918, a critical factor in how much death rates were reduced was how soon the measures were put in place.

    Officials in St. Louis introduced a broad series of public health measures to contain the flu within two days of the first reported cases. Philadelphia, New Orleans and Boston all used similar interventions, but they took longer to implement them, and as a result, peak mortality rates were higher. In the most extreme disparity, the peak mortality rate in St. Louis was only one-eighth that of Philadelphia, the worst-hit city in the survey. In contrast to St. Louis, Philadelphia imposed bans on public gatherings more than two weeks after the first infections were reported. City officials even allowed a city-wide parade to take place prior to imposing their bans.”

    “The second study also shows that the timing of when control measures were lifted played a major part. Cities that relaxed their restrictions after the peak of the pandemic passed often saw the re-emergence of infection and had to reintroduce restrictions, says Neil Ferguson, D.Phil., of Imperial College, London, the senior author on the second study. In their paper, Dr. Ferguson and his coauthor used mathematical models to reproduce the pattern of the 1918 pandemic in different cities. This allowed them to predict what would have happened if cities had changed the timing of interventions. In San Francisco, which they found to have the most effective measures, they estimate that deaths would have been 25 percent higher had city officials not implemented their interventions when they did. But had San Francisco left its controls in place continuously from September 1918 through May 1919, the analysis suggests, the city might have reduced deaths by more than 90 percent.”

    R Hatchett et al. Public health interventions and epidemic intensity during the 1918 influenza pandemic. PNAS DOI: 10.1073/pnas.0610941104 (2007)

    M Bootsma and N Ferguson. The effect of public health measures on the 1918 influenza pandemic in US cities. PNAS DOI: 10.1073/pnas.0611071104 (2007)

    • Thanks, Steve, good stuff. They seem to agree with my statement that the effect of flattening the curve is to lower peak mortality rates but not total mortality, vis:

      Early implementation of certain interventions, including closure of schools, churches, and theaters, was associated with lower peak death rates, but no single intervention showed an association with improved aggregate outcomes for the 1918 phase of the pandemic.

      In line with theoretical arguments, we found the time-limited interventions used reduced total mortality only moderately (perhaps 10–30%), and that the impact was often very limited because of interventions being introduced too late and lifted too early

      Near as I can tell from reading the studies, no location pulled the wheels off of the economy and left it to rot as we have stupidly done, viz:

      A range of interventions was tried in the U.S. in 1918, including closure of schools and churches, banning of mass gatherings, mandated mask wearing, case isolation, and disinfection/hygiene measures.

      Nothing in there about shelter-in-place, nothing about not going to work, nothing about citizens being cited or arrested for merely walking the streets. I’d say that 100 years ago, our state and city leaders were far smarter than the current charming crop that include folks like our brain-dead California Governor, Gavin Newsome.

      The question still remains—when threatened by a pandemic, does destroying your economy create overall benefit? I say absolutely not, that in the US at least the damage from the economic shutdown will far, far outweigh the few thousand deaths that MIGHT have been saved by the actions.

      w.

  136. What is the mathematical equation that describes the time dependent function showing the number of cases and/or deaths; looks like a Poisson distribution.

      • Nice job. It’s good to see someone actually working it out instead of just scoping it out.

        For what it’s worth: One thing I noticed in doing this stuff is that some of the results are sensitive to population size. If you do a simulation that has waves–i.e., people distance themselves and then relax when the contagion initially subsides–the result you get for population = 10,000 can be quite a bit different from population = one billion. So you may want to check that out if you do such a simulation.

        (By the way, such a simulation debunks this site’s common wisdom that “flattening the curve” wouldn’t reduce overall deaths except to the extent that it permits otherwise-impossible adjustments in medical care/technology.)

        • Joe, I took a look at your simulation. It seems to suggest that the eventual steady-state level of an infective pathogen depends on how it is introduced into the population. I fear that I don’t see how that would happen. It seems to me that the eventual level in the population is a factor of R0, and that in the long run how it was introduced makes no difference.

          Best regards,

          w.

          • It seems to suggest that the eventual steady-state level of an infective pathogen depends on how it is introduced into the population. I fear that I don’t see how that would happen.

            No, what it shows is that the final infected percentage of the population depends on whether the population (1) temporarily adopts behavior less transmissive (in the example, R0=1.5) than its more-transmissive (in the example, R0=4) usual behavior or (2) instead never deviates from its usual behavior. The reason for the difference is what I’ll call “inertia.”

            Suppose a single infection is introduced into a large, perfectly mixed population so practicing social distancing that with zero immunity a single infected person would on average directly infect only 1.5 others: R0=1.5. Since R—that is, the product of R0 and the current percentage susceptibility—initially exceeds unity, the disease will spread despite the distancing, and, with no change in behavior, the resultant epidemic would not die out until 58% of the population had been infected and thereby become immune.

            This is true even though increasing immunity would already have reduced R to below unity when the immunity exceeded 33-1/3 %. The epidemic would blow through that level because a large number of people are still infectious at the time R falls below unity, so there’s some “inertia”: the epidemic continues while their infection chains die out.

            Now suppose that when the epidemic has thus subsided the population so relaxes its behavior that if immunity were zero a single person would directly infect four others: R0 =4. If a single person gets infected now—let’s say it turns out the disease has not quite died out completely—the disease will spread despite the acquired immunity, because R=(1-0.58)x4=1.68 exceeds unity. And, “inertia” being what it is, this second wave won’t die out in the absence of a behavior change until immunity reaches 87%.

            That’s greater than the 75% value at which R falls below unity, but it’s less than the 98% that “inertia” would have caused if the population had never deviated from its normal R0=4 behavior.

            In summary, temporarily adopting the R0=1.5 behavior not only flattened the curve but also reduced the percentage ultimately infected, from 98% to 87%.

          • Joe, thanks for persevering. I finally see how it is working. It is indeed the inertia as you said, I was 100% wrong. There will be some avoided infections after the disease has run its course.

            How many? Unknown If the various interventions made the difference in your example, R0 of 4.0 down to 1.5, it’s about 10%. If it were that big, though, we’d have seen it. And that’s theoretical max. So maybe 5% fewer people get the disease, 93% instead of 98%.

            Now, if we follow the course of the IHME models to 60,000 deaths by August, that is a population death rate of 60000 / 330,000,000 = 0.018% of the population. If up to 5% fewer people end up getting infected, that would be 330,000,000 * 5% * 0.018% = maybe as many as 3,000 fewer deaths by the end of the time from when the lockdown is lifted until the pandemic finally subsides.

            Next question, of course, is does that make a difference to us now, and if so how much of a difference compared to the cost of some given action?

            My bottom line is this: shut down schools, shut down rock concerts, but DON’T SHUT DOWN THE ECONOMY!

            Thanks again for your patient explanation, well done.

            w.

          • Although I’m inclined to agree with your overall conclusion, I quite frankly just don’t know.

            Even if what we’re doing saves more than you think (and, although I obviously just pulled numbers out of a hat, I’m guessing it will), it seems way too expensive at first blush.

            People talk about, what, 25% GDP loss? Even if that would reduce infections by 10% of the population and thereby avoid 330,000 deaths, that’s $5 trillion ÷ 330,000 ≈ $15 million per saved life, which obviously is much too expensive, particularly since the lives saved would mostly be those of old guys like you and me, who are coming up on our sell-by dates anyway.

            But we need to distinguish between the GDP loss from a government-imposed lockdown and the GDP loss that voluntary response to the contagion would cause even without government intervention. Similarly, we need to distinguish between death reduction from a government-imposed lockdown and that from inevitable voluntary protective measures.

            On the one hand we’ll sustain much of that loss even if the government stands back and does nothing but provide us statistics, so maybe government action isn’t costing us so much. On the other hand, maybe we won’t save many more lives by government action than would be saved anyway by voluntary measures.

            Teasing those components apart is beyond my ability. So, again, I just don’t know.

  137. Willis; I take it the curves for WV/Mo are you using the IHME model, as the site seems to only have countries. I assume the X-axis label SD stands for Single Death, not Standard Deviation. Makes it easier for me to understand.

    A month ago I decided to “believe” the models, as a pretty fair general account of what was going to happen. But too clever-clever. We know how hard it is to count even votes. Death is final, but not simple; at least not why it happens or when it gets counted. so I could not fall wholly in love with those lovely lines. Although I continued to believe they were useful.

    So simplify. Each curve starts at zero, ends at zero, peaks halfway. Straight lines form an isosceles triangle. Almost no lost data points., and the data being so fuzzy, a clever model’s accuracy may be spurious.

    Here, our isosceles triangle is for deaths. It’s height H the daily max, the base D is the duration of the epidemic, and the area N is the total number of deaths.

    Willis, I agree that social distancing does not (per se) reduce the total number of deaths – so N is a constant. It means that peak deaths and how long the epidemic lasts, are inversely proportional. Does that mean the more brutal the lockdown, the longer it needs to last, and the more costly? To some extent, I suppose it does.

    Death, as we all know, shall have no dominion, and it applies here too. We tend to take deaths as a measure of heath system capacity. But the crux may be morbidity. Not limited to the old; many of those who get sick and do not die, are younger. And those who need treatment, need it for longer; no quick release for them.

    The more sophisticated a model, the more likely for to fix itself in the mind of the user. We have seen this with the climate modellers, and I see something similar daily in the Birxy and Fauci show.

    • I’ve done innumerable simulations, mostly of physical systems. Lately I spent a bit of time on the one I just showed of the Coronavirus. One thing I’ve learned, or realized especially lately, is that more complicated is NOT better. It only ensures that the simulation designer is the only one who understands it. New features and complications only provide more parameters that can actually smear the simulation and run it off its rails. Complexity also makes it so others find it too daunting to question or just too big a hill to climb to gain understanding. So they just figure that the modeler knows best, and accept the results. This is true of process models, financial models, Markov simulations like mine, whatever.

      Models are great for seeing what each parameter does to the result, because this can direct your attention to changing the ones that are most profitable. In this case, suppression is most profitable in terms of saving lives, but the degree of suppression has to be weighed against economic effects, which is always the hard part. What is a living body worth, as opposed to a dead one, exactly? And suppression can take many forms, which I don’t specify. I just change the transmission rate according to a suppression factor and see what happens. The lower resulting R also implies a lower required herd immunity, a lower peak, lower total deaths, lower infections, medical costs, capacity requirements, etc. This is why the areas under the curves are not the same.

  138. Flattening the curve does not reduce the total number of cases or deaths. It just spreads out the same amount over a longer time period.

    I don’t think this is entirely correct.

    Flattening the curve means to reduce the “reproduction number” (R0). The peak of infections is reached when the effective reproduction number is reduced below 1.0. This can be reached by both social distancing and herd immunity.

    Herd immunity occurs when a significant proportion (P) of the population are immune.

    The equation turns out to be P = 1 – 1/R0

    This means that if we by social distancing reduce the R0, fewer people will need to be immune to stop the virus.

    Without vaccine, the only way to becoming immune is to have the disease.

    /Jan

    • I agree with you and disagree with Mr. Eschenbach, but it could be that, unlike me, you actually agree with what he intended instead of what you understood.

      I think he’s assuming that everyone returns to their previous, higher-R0 behavior after the epidemic peaks. If you think that this merely means that the infected percentage will rise to 1 – 1/R0 for the higher R0 value, then you and Mr. Eschenbach may actually be in agreement.

      I, on the other hand, think that distancing actually would make an ultimate difference, even if people return to their own behavior: https://wattsupwiththat.com/2020/04/08/flattening-the-curve/#comment-2961791.

  139. “it will be over in a month”.

    Viruses dont go away after the first wave. Expect some longer term restrictions, but with less economic damage until there is an effective vaccine.

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