Monday assorted links

1. Looming condom shortage?

2. Kotlikoff argues for group testing.

3. “The Trump administration is leaving untapped reinforcements and supplies from the U.S. Department of Veterans Affairs, even as many hospitals are struggling with a crush of coronavirus patients.

4. Why America took so long to test, and yes the FDA is largely to blame (NYT).

5. “Those shown to have developed immunity could be given a “kind of vaccination passport that allows them, for example, to be exempted from curbs on their activities”, Gérard Krause, a leading immunologist co-ordinating the study, told Der Spiegel magazine.”  (The Times)

6. Why Singaporean health care workers have remained relatively safe.

7. This Week in Virology podcast.  I have not heard it, but it comes recommended.

8. The Gottlieb/Rivers/McClellan/Silvis/Watson AEI policy paper.

9. Audrey Moore RIP, Fairfax County environmentalist, she influenced my life a great deal, both good and bad.  Fairfax County now has 427 parks, in part because of her.

10. Robin Hanson argues for variolation.

11. The gender gap in housing returns.  (Do women care more about the non-pecuniary factors?)

12. The Ebola scare helped Republicans.

13. New SEIR infectious disease model from NBER.  And a new James Stock paper with a model.

14. Summary of where John Cochrane is at.

15. MIT The Elevate Prizes, up to $5 million.

16. Viral load as a source of heterogeneity?

17. James Altucher interviews me about the coronavirus economy, podcast.

Comments

Seventeen. God gave Moses Ten Commandments.

A veritable melee of links from condom storage to virology. Appreciate the inclusivity!

#1 - It's all good. I put electrical tape over the muzzles. The Warden doesn't let me do any of that other stuff.

Lot of Whiney bitch beta cucks on this blog as of late - no difference from normal except you’re all even more cucked

Queue Mel Brooks!

"I have here these fifteen...(drops one stone tablet)...um, ten, ten commandments...."

in the midst of a viral pandemic
hanson thinks health care workers are the ideal candidates to isolate in "villages" and variolate (inject with the covid 19 virus).
health care workers are already in short supply and over exposed to the virus. how about if hanson variolates the over supply of socioligsts and humanities professors instead and let the health care workers take care of their patients

@MG - It should be voluntary and let the Herders volunteer. I bet the lines are short.

Bonus trivia: variolation, used before Jenner's smallpox vaccine, is much more dangerous than a vaccine, since you're using live viruses. The Turks had variolation against smallpox for youth, and some English woman wrote about it, which gave the germ of the idea, pun intended, to Jenner, along with the cow pox old maid's tales. Not Bruce Jenner, Dr. E. Jenner. Did he patent it? Nope. But he got everlasting fame, which, as TC has pointed out, to some self-selecting scientists is priceless (tho I prefer money over fame, one reason you probably won't be hearing from me in a CWT anytime soon, sorry Ray Lopez fans).

#8 - I read it yesterday and it's pretty consistent in terms of policy recommendations. One thing that is missing and also missing from the Pence Task Force is what type of PPE and measures will be taken in community testing situations. Abbott Labs received an early approval for there small test kit that runs in doctor and urgent care offices. Results are available in 15 minutes. However, the major manufacturing will be for the large hospital based analyzers where they are ramping up to 1 million tests kits per week. This small instrument version is only 50 thousand per day which works out to about 3 tests per each installed machine in the US per day. That is not mass testing capability.

The drive in test site pictures I've seen show those collecting swab samples in full PPE. What is the expectation in doctor's offices where patients intermingle? Most offices do not have a dedicated room for doing swab testing nor do they have the type of PPE that we have all seen.

https://www.zerohedge.com/geopolitical/spains-covid-19-case-total-passes-chinas-south-korea-reports-rash-new-cases-live
Italy Reports Lowest Number Of New Cases In 2 Weeks: Live Updates
---
Unreliable data, sure. But I am expecting this dynamic in my home town, a three phase battle to equilibrium. We need wider testing in the Northern Italian region that suffered first, how many are immune? But that is a very difficult test absent some safe way to stimulate the immunity and read the result. Harder to do than a vaccine I think. So second best is watch for second infection.

My optimistic view is that Northern Italy now has a significant immune population, the virus cannot easily travel.

5. A bit more context from Deutsche Welle dw.com/en/germany-mulls-mass-testing-for-coronavirus-immunity-report/a-52940096 "Researchers in Germany could begin mass testing for immunity against the novel coronavirus as early as April, Der Spiegel reported on Friday.

The respected weekly news magazine said the test results would show how many people have been infected and developed antibodies — the body's "memory" about how to fight a virus — as well as more accurate data about how many people have been killed out of all those infected.

Gerard Krause from the Helmholz Center for Infection Research is coordinating the testing efforts, Der Spiegel said, together with several of the country's scientific and health bodies including the Robert-Koch institute.

If researchers get the go-ahead from government health authorities, they would conduct the first tests using blood samples from 100,000 people with tests then repeated periodically. The first results could be back by the end of next month.

Scientists believe that the results of the study could make it easier to decide when schools can be re-opened, larger events can go ahead and people can go back to work.

"Those with immunity could be issued with a type of immune-certificate that could, for example, allow them to be exempt from the restrictions on their activities," said Krause.

But there are still some problems with the Sars-Cov-2 antibody test as it still occasionally shows up other coronaviruses – which 90% of adults are already immune to. Scientists are looking into developing a more reliable test within two to three months."

#16 Hanson has proposed that viral load is also correlated to the viral dose received by the infected. . This implies that larger viral doses are more likely to cause severe illness or death.
There seems to be papers validating this happening with SARS in mice and humans.

Chinese doctors have been trying to explain this to us this for over two months, finally it's news in the US. Why now?
"Doctor Yu Chengbo, a Zhejiang medical expert sent to Wuhan, told media that although most young patients do not tend to develop severe conditions, the glaucoma patient whom Li saw on 8 January was a storekeeper at Huanan Seafood Market with a high viral load, which could have exacerbated Li's infection." [wikipedia article on Li Wenliang]

viral dose correlating with disease severity is not a new or unknown idea
in the united states

Yet one month after it was obvious that the vaccine would come too late, only Robin Hanson has the guts to propose deliberate inoculation.

Mebbe we should boldly check the antibody titers
Of some of the peeps with positive antigen tests first

I haven't heard of anyone publishing that data and a month seems like more than enough time for somebody to produce it.
To preempt the obvious "you first", I would have happily volunteered for a ~100 virion exposure if it were available, more if they had some research. My guess is that I am already infected now though.

Actually, my preferred protocol would be to get dosed with 1 virion on day 0, 2 virions on day 2, 4 virions on day 4 - something like 2^(d/2) up to some maximum like 1024 virions on day 20.
That should ensure that the external dose is insignificant compared to any infection in progress so the risk of the extra dose is low, but it allows the experiment to proceed without waiting to see if e.g. 1 virion is infectious.

"That should ensure that the external dose is insignificant compared to any infection in progress"
have you ever had a graduate level virology or immunology course?
the current seatle trial probly makes more sense

This shotgun approach to links feels like a dodge. A few thoughts:

1. Social distancing and isolation are huge weapons that can and largely have been implemented fairly comprehensively and quickly. The only problem with this strategy is it imperils the economy.

2. Case load trends are worthless. We know there are lots of asymptomatic infections, every country is missing lots of cases, and if we're not testing much, we know our denominator for mortality is way, way off. We also know that if we ramp up testing, measures of "cases" will explode, exactly what happened in the USA. So tiresomely predictable. People applying statistical analysis to these numbers are wasting their time. Lots of people setting their hair on fire. Wholly counterproductive.

3. Heterogeneity is interesting. Dose, different strains, heat, humidity, genetics all may play a role. If it turns out heat and humidity aren't helpful, the poor world may get clobbered yet, they don't have great health care systems, and social distancing may be less feasible. For example, Chile appears to be ahead in testing by South American standards (high "case" load, like Norway two weeks ago, lots of 'recoveries') and they currently boast one of the lowest death rates per capita in the world.

The reason I mentioned Chile is they have the highest percentage of type-O blood in the world, so getting at possible heterogeneity.

"2. Case load trends are worthless. "

You didn't read enough of #3. The argument was to use group testing to open up the economy. 15-20 people get one group test and if they pass, they get 24 hours to proceed as normal, if the group fails, you can if resources permit find out how many are infected.

The critical issues are group testing in large numbers everyday and being able to reduce cheating for those in a failed group who are sure, they aren't infected.

Ultimately, testing will be helpful, but it is not needed to know what you and I should do over the next week to achieve the best outcome.

So yeah, keep testing and keep figuring out efficient ways to test, but the information will only be useful after we get over this first hump.

As far as I can tell, 90% of the conversation in the US has been around testing, and people are losing their shit over case numbers that should not be surprising.

Yes, I agree with what you are saying. #2 wasn't about the short term of the next couple of weeks but more about the long term of the next 2-6 months.

I'm still waiting for the new confirmed case counts to drop as we get caught up on testing. NY and NJ still show fairly low ratios of 1:3, so I imagine they are still fighting hard to catch up.

Once we catch up on testing there should be a step change downward in the number of cases. At that point, I'm interested in seeing what the underlying data looks like. How big is the drop? What's the trend in new cases? If upward, how fast is it trending upward?

heat and humidity don't seem to be protecting new orleans from the covid 19 virus

It's still relatively cool in New Orleans. The temperatures have just started climbing towards the low 30's (90F+). They'll be seeing rising temperatures within the next few weeks.

#8. I see no mention of masks. They're a cheap measure. I understand they may be a little hard to find right now but how hard would it be to ramp them up. Everyone seems to wear them in Asia.
I am struck to see the difference between Presidents Xi and Trump. Xi wears it, Trump never does.
He has a press conference with a bunch of people coming to the mike. None wear masks. These are people who interact socially a lot. They should set an example
Even home made masks offer some sort of protection to others. We should encourage it more. It's not an expensive investment

TWIV and Vincent Racceniello's other science podcasts (TWIM, TWIP, Immune, TWIEvo) are all very high quality, like attending a journal club meeting but with someone by your side to explain terminology and background concepts.

#11 "Gender differences in upgrade and maintenance rates, and preferences for housing characteristics and listing agents appear to be less important factors."

Strikes me as odd. Women in general don't like to negotiate as much, but I know more women who will negotiate hard than I do who can upgrade a house. I still assume that men's willingness to buy a crappier house and fix it up is the leading cause.

I think men are more willing to live in an "up and coming" neighborhood.

"Up and coming" can remain rough for 10 years.

Men are also more prone to risk taking than women. So more winners and more losers.

Audrey Moore died in December.

December 2018.

And she was someone that hated suburban developers with an undying passion. "Some of Mrs. Moore’s board colleagues would conspire to circumvent her on deals or else incite her into long tirades about the evils of developers. Sometimes derisive nicknames followed: “St. Audrey of Annandale,” “Mrs. No” and “The Sewer Lady.”

“We don’t accuse her of being a demagogue and we don’t accuse her of being unstable, so we don’t think she should be running around insulting the business community,” Philip M. Reilly, former president of the Fairfax Chamber of Commerce, told The Post in 1982. “Sometimes it seems she doesn’t know when to stop.”

She stuck in the game. “Everybody hates Audrey Moore but the voters” became a truism in county politics. And gradually, Mrs. Moore’s calls to protect the surrounding environment gained traction."

Were these ranked in order of priority?

Regarding #1, doesn’t matter, either way we will have a baby boom starting in 9 months. The Coronavirus will accomplish what the politicians didn’t: social security reform.

# 12. R's benefited because they exploited it: "We then show that politicians responded to the Ebola scare by mentioning the disease in connection with immigration and terrorism in newsletters and campaign ads. This response came only from Republicans, especially those facing competitive races, suggesting a strategic use of the issue in conjunction with topics perceived as favorable to them."

“ ... suggesting a strategic use of the issue in conjunction with topics perceived as favorable to them."

This just in! Politicians put a spin on events to make their own policies seem appealing and to cast aspersion on their rivals.

I'm sure the Democrats would never exploit Covid19 for political gain. /s

Nor would their Manchurian Media loudspeakers.

Considering the most anti-science, anti-vaxx administration let a wild pandemic infect the whole country, I say the Dems should exploit this with full ruthlessness and 100% for political gain.

...What? Swine Flu was 10+ years ago, why would the Dems exploit something a Dem did for political gain?

Anti-Vaxx and anti-science are adjectives for use on the D side and progressives mostly, see healing crystals and chakras as well.

this study is not consistent with
cousin malcoms book that told us that brain scans prove democrats are brave and conservatives are scared

4. When we assign blame are we doing it against an imagined ideal?

"To identify the virus, the C.D.C. test used three small genetic sequences to match up with portions of a virus’s genome extracted from a swab. A German-developed test that the W.H.O. was distributing to other countries used just two, potentially making it less precise."

I'm going to say that we could not then and still now actually make a decision about the best path without knowing the values for the precisions of these two tests.

And back in time, we have to recognize that the decision makers were making policy based on partial information: partial information about the reliability of existing tests, partial information about the ease of creating new and better tests.

The YD decided the WHO solution was bad, and went all-in on a replacement. If it had worked they'd be heroes. As it didn't, we can "blame" them.

But I'm not sure critics are grappling with the real question. This can't be about imagined perfect tests. The realistic question has to be should they have gone with mass production of a worse test, and would that have produced a better outcome?

No, that’s not what happened. That’s a willful distortion of the facts.

The CDC didn’t simply make their own test and botch it. That would have been unfortunate but not a catastrophe.

Instead they prevented anyone else from using the WHO test or developing their own test, and then repeatedly threatened Dr. Helen Chu when she decided that repurposing an influenza study might catch community transmission.

That was on February 2nd. After repeatedly being threatened over IRB standards for weeks, she decided to break the rules, gave the finger to the CDC, and confirmed community transmission had been taking place for several weeks. That was the last week of February.

They didn’t just screw up. They insisted on being a single point of failure, screwed up, and then threatened anyone who tried to help.

It is our system rgat the CDC and FDA approve tests, but again no one is pointing to a more accurate test that was rejected.

That is actually very important. it would entirely change this conversation if someone could say that the WHO test was something like 90% accurate, with something like 10% false positives or false negatives.

But no one is saying that.

Dr Chu used an entirely different class of procedures and instrumentation. She used research tools. Those simply could not scale to wide testing, though they were useful locally.

-1, what you said is clearly wrong by all the observable facts

"but again no one is pointing to a more accurate test that was rejected."

The CDC test was a complete disaster. The WHO Landt test has shipped millions of copies around the world and has been successfully proven in the field. Clearly by any use of a rational thought process the Landt test was vastly more accurate because it actually worked.

"Those simply could not scale to wide testing, though they were useful locally."

You are just babbling at this point. Dr. Chu is regarded as a hero for defying the FDA/CDC and she didn't stop until they issued a legal ultimatum.

Have you ever worked in a quantitative field in your life?

I did 20 years in clinical diagnostics, myself. And that has left me super sensitive to the difference between numbers and fuzzy claims.

This page says that in a small test (167 symptomatic patients) there were 3% false negative. That might be high considering that the symptomatic should all be shedding virus.

And it doesn't look at the group you really want to catch, the pre-symptomatic group, which should isolate sooner rather than later.

I wonder how much of the false negative rate comes from not
swabbing correctly.

This page is saying it is *still* hard to put a number on accuracy:

COVID-19 tests are new, and assessing their accuracy is challenging.

PCR tests may produce false negatives, failing to identify evidence of SARS-CoV-2.

Sometimes false negatives result from human error or problems with the procedure. Giving the test too early or late, for example, can lead to a false negative.

The accuracy of similar tests for influenza is generally 50–70%.

And to remind you of the data they were operating on at the time:

Late on Tuesday night, Dr. Birx confirmed that although she was responding to a question about the W.H.O. test, she was referring to a study of an early diagnostic test used in China.

The paper found that, in a specific subset of those tested in China — asymptomatic contacts of known cases — the tests wrongly found them to be positive 47 percent of the time.

and

A spokeswoman for the W.H.O. said she did not know what Dr. Birx was referring to, but the agency had been supplying kits to member nations since January.

The accuracy of the test was validated by three laboratories before it was rolled out, the spokeswoman said, and it had consistently showed “good performance in laboratory and clinical use, and neither a significant number of false positive nor false negative results have been reported.”

In summation, you are "blaming the CDC" while taking a claim without a number from the WHO to the bank.

Do you hate America that much?

What they have said is that their tests were not for wide testing at the numbers that ended up being required. You are right about what the Dr from Seattle was doing; limited and research focused. But that was what the CDC was doing as well.

There was a study that I saw that the chinese tests were showing 60%+ false positives. That wasn't a problem as a tool for controlling the outbreak; you don't want false negatives. But for figuring out all the dynamics of the epidemic, those inaccurate numbers aren't helpful.

The only criticism I would have of what they did was they created a single point of failure. They wanted perfect data. Then all hell broke loose.

I suspect without knowing that the CDC has contacts across the industry, and were collaborating with other labs. Then you have the FDA trying to stop things. All fine and wonderful until that three weeks ends up causing very serious problems.

9. Care to elaborate? Which parks would you rather see paved? Or is there an unbuilt freeway you're mourning? I am genuinely curious, never having been to Fairfax County. Perhaps you feel it might have been more populous, denser, livelier, more like some other place you have in mind? If it's just the ethnic food landscape, that's fine.

#4 The NYTimes article does not support the conclusion that "the FDA is largely to blame". It supports the conclusion that Trump's management of his administration is largely to blame.

Trump is ultimately responsible because he's the chief executive. However, he had nothing to do with the two really bad decisions that were made by the FDA & the CDC. Namely the CDC insisting on making their own test and botching it and the FDA/CDC sending out cease and desist orders and refusing to grant quick EUA's to state and private labs.

Well, he did have something to do with dismantling (taking apart and reassigning the functions of) the pandemic preparedness task force. It's possible if that existed in it's former form that some person higher up in the CDC/FDA might have jumped in and told the FDA/CDC to get out of the way.
Now some people are saying that it wasn't dismantled, but just reassigned to another group, but you ought to know that the difference between dismantling something and reassigning it's tasks is often trivial. There were lines of communication and organizational structure that ceased to exist. That happens every time you "reorganize" stuff. Evidently, the people at the NSC who were given the responsibility weren't talking to the bureaucrats at the CDC who were standing in the way of Helen Chu, or they were and didn't do anything about it. Either way, Trump was "involved" in the sense that he made decisions about who was responsible for pandemic preparedness, and those people didn't do their job.
Also, Trump could have personally issues an executive order telling the CDC and FDA to get out of the way, and he didn't because he didn't think that COVID-19 was a big deal. He didn't bother to find out what the CDC and FDA were doing well enough to work some of his supposed deregulatory magic and get them out of the way.

I agree that Trump is. undoubtedly, owed some of the blame.

-it appears the u.s. is scaling up a decent/rapid covid 19 screening test in about 3 months
-even the newyorktimes.com has previously said the WHO screening test was not available to the u.s. because they developed it for other countries
-anybody wanna take a guess how long it took to develop a HIV screening test after the disease started spreading? it was years not months
-remember a couple months ago how cnn.com was having multiple orgasms over how fast the communists built a hospital in china ?
the army corp of engineers is currently setting up about 10 hospitals
just as fast

Everything always happens faster, that's the result of scientific & technological progress. The question is, why didn't Trump act sooner? Nothing excuses this. In February he said the Democrats' characterization of his poor response was a hoax, and now he's saying if only 200,000 people die, "we've done a good job". When is the the first time the White House saw fatality estimates? January?

fatality estimates were all over the place and still are.
china said zero and it wasn't even communicable to humans
in january the house intelligence committee busy secretly selling
stock instead of informing the public about the their fatality estimates

These excuses will not work. There are other countries that did a much better job from the beginning. And why is Trump suddenly TRUSTING what China says? How is that an excuse? In fact, Trump had already slashed CDC staff in China (and other places). Now we are hearing that the impeachment distracted him. (Though it didn't distract Bill Clinton from anything important.) Yet Trump continued to downplay the covid-19 threat for six crucial weeks after his acquittal on February 5. All of the experts said this could be bad, and even the intelligence community warned him in January that it looked like a pandemic, and warned that China was minimizing the severity. So where is Trump getting his estimates, on the golf course of Mar-a-Lago?

hey rosanne rosanna danna that's a lotta questions/scapegoating
fatality estimates/models ranged from 0 to 80 million

Who in US epidemiology forecast 0 or 80 million deaths from covid-19?

Spanish flu infected mebbe 500 million
80 million possible worldwide deaths is a case scenario number
that has been projected for viral pandemic wargames
nobody is gonna have the correct answer for when to shut down the economy until after its too late

Trump should worry about US fatality projections first: it was never 80 million, and it was never "all over the place" as you wrote. It is entirely possible to have a good answer for when to shut down the economy, as S. Korea, California, Washington state have shown (among others). Where did you find your estimate that there would be 0 deaths worldwide?

-us fatality projections are gonna be related to the rest of the worlds
- u.s projections models were indeed all over the place from
minimal to several million
-china initially reported/lied that the covid 19 virus was not transmitted to humans

Where's the 0 projection you mentioned? You do not appear to be a factual commenter and you keep rehearsing the same excuses. Again, none of this matters to the top point that any POTUS is ultimately responsible for failures at the FDA, and this Administration woefully nixed prior pandemic preparations which had the decision chains laid out, and then denied the severity of the situation for 6 or 8 crucial weeks.

otoh
- when china told the rest of the world(late nov or early dec.) the virus was not transmitted to humans (after they knew this was not true) that is a projection for zero human fatalities
-the u.s. declared a health emergency in the last week of January
-WHO did not make the pandemic designation until the 2nd week of march

--Since when does Trump (or anybody else) believe China's statements, about ANYTHING? This is the third time you've tried this bad excuse.

--HHS's January declaration of a health emergency said "the risk to the US public is low." Its provisions are weak boilerplate.

--Trump's proclamation of a national emergency wasn't until March 13 (after it had spread in the US for, how long? Eight weeks?)

--WHO declared covid-19 to be a "public health emergency of international concern" requiring "international cooperation" back in January. WHO's later declaration of a "pandemic" is "borderline semantics", as Fauci said.

-you can't totally disregard everthing china says because that is where the pandemic started.
-"pandemic" is not semantical term
-you remind me of my most annoying ever ex girlfriend

When China said that the reports of the detention of a million Uighurs is a "fabrication", did you believe that, too?

What is the semantic difference between the WHO's January and March statements?

And since WHEN does Trump respect the opinions of the UN or other countries (besides Putin)?

Then, after you answer the above:

Why should it excuse Trump's public downplaying of the problem for 6 weeks throughout February into March, during which he held a dozen campaign rallies and spent another dozen days on the golf course?

you are a adam schifftysized goalpost shifter just like uncle paulie(nyt)
but the answer to your queries
1-no
2-according to WHO
The declaration of a global health emergency can work to galvanize international funding. According to the WHO's procedures, the three criteria for such a declaration are that it is an "extraordinary event," that it "constitute[s] a public health risk to other States through the international spread of disease" and that it "potentially require[s] a coordinated international response."
-here is the pandemic meaning (basically it is worse than a global health
-https://www.who.int/csr/disease/swineflu/frequently_asked_questions/pandemic/en/
3- don't know & irrelevant
4- that's a irrelevant rant&scapegoating/intellectually lazy framing
the president has probably made more bigly decisions visavis
the pandemic since ww2

So in other words there is no difference between WHO's first and second statement, with regard to the steps that a head of state should consider. And you say it's irrelevant that he didn't warn the country how dangerous this was going to be, instead of campaigning a playing golf. But now it's clear you're a Trump supporter: No matter what he blabbers he's right, and he's making the biggest decisions since WW2! (Except he's not on top of what was going on his own administration, and he's being forced into big decisions because he is incompetent.)

-what sociology school did you graduate from?
-don't think you read the definitions very carefully or mebbe you need to invest in a dictionary
-didn't vote for trump but
the president is being forced into making big decisions because of a viral pandemic not because he is incompetent/competence

The point is he is making the big decisions late. Last year he dismantled the White House task force that was on the lookout for just this kind of emergency. He also reduced CDC staff stationed in China. You want to blame the WHO but other countries did much better responding to covid-19 so the WHO is irrelevant. It's not the federal bureaucracy either: a President is elected to be on the lookout, to take charge and to cut through the red tape in emergencies. He didn't do his job.

donta thinka you understand viral pandemic dynamics
but you are a major maestro scapegoatist

Since other countries did better at flattening the curve, you yourself don't understand pandemic dynamics.

you are pretty good at slinging non sequitars

It's an easy sequitur.

#10 Variolation. What the author leaves out is that variolation is all must be variolated, or none.

First, variolation (used prior to the Jenner smallpox vaccine) produced a mortality of about three percent (as compared to over thirty percent for smallpox acquired in the usual way). BUT anyone exposed to someone who had variolated would acquire smallpox in the usual way. And therefore would have a 1-in-3 probability of dying.

Therefore either everyone in a community would variolate, or no one: this had to be a community decison and could not be left to individuals.

Whether something as drastic as a COVID-19 variolation could even be done today seems unlikely, but before it was even considered you'd need to carefully validate that some method equivalent to smallpox variolation could be created and would work as expected.

But politically I don't see how it could be done, at least not unless the mortality were truly as high as with smallpox. And perhaps not even then, for who would be willing to take responsibility for mandating it?

Whereas the "solution" of having individuals decide for themselves whether or not to accept it would be far worse than just doing nothing.

I've been clear to propose voluntary infection PLUS isolation until recovery.

Your plan is not politically viable. The current plan in most areas is to get to herd immunity while pretending to try to stop the spread. That's why almost no one wants to count real cases. The notion that the UK has only 22k cases is patently absurd. The idea that it has only 10 times that many is too.

Merkel, Johnson, Trump, Bolsanario . . . they all know: herd immunity is the only way we don't live in fear forever now that the genie is out of the bottle. It's just that the public is not ready to hear that. Politics is the art of the possible.

3. It's one thing to deploy VA resources to help out when the emergency isn't directly affecting Vets. Helping with a hurricane response works. With COVID19, the VA is charged with caring for one of the most vulnerable populations - older vets with medical issues. They do not expect to have any capacity to help others and are in fact starting to work with their communities to help the VA when the expected flood of patients arrives.

At least if this is to be trusted - "The Department of Veterans Affairs on Monday reported five new coronavirus-related deaths in New Orleans, accounting for nearly half of all new deaths across 170 VA hospitals nationwide.

That hospital now has 239 cases, the agency said in an updated toll, nearly a quarter of all VA hospital infections and far more than any other VA medical center in the country, even in hard-hit New York City.

The growing toll on the veterans population of more than 18 million is especially grave considering that older people are considered more vulnerable to infection. More than half of the U.S. veteran population is 65 or older, VA said last year.

The impact on the New Orleans hospital prompted officials to shift some non-coronavirus patients to a VA hospital in Biloxi, Miss., to receive treatment there, the Biloxi Sun Herald reported."

#4. So in other words, the incompetence of the Trump administration caused (or will cause in the near future) a historic public health crisis that resulted in tens of thousands of deaths and trillions of dollars of economic losses.

The failure of the FDA (and CDC) has stemmed almost entirely from career bureaucrats being too slow to cut red tape that's questionable under the best of circumstances and disastrous during a true emergency.

In order to conclude that this is the fault of the "Trump administration," you'd have to believe that some other administration would have done more to ignore and overrule the career civil servant scientists who are supposed to be the experts. That's not a particularly realistic belief.

Well, he did disband the "pandemic preparedness team". It's possible, had he not done that, that some other bureaucrat would have overruled the bureaucrats and career civil servants lower down in the ranks.

Uh, no he didn't. It got moved to under a different dept.

Ok, so then explain this:
https://time.com/5806558/administration-officials-fight-criticism/

and this:
https://www.politico.com/news/2020/03/25/trump-coronavirus-national-security-council-149285

Maybe it somehow got reorganized, but even so, they didn't follow it's recommendations apparently.

https://www.washingtonpost.com/opinions/2020/03/16/no-white-house-didnt-dissolve-its-pandemic-response-office/

Yes, he gave the responsibility for pandemic preparedness to the NSC biodefense group - a completely different group of people. I don't know how much work you have done in large corporations, but often when you reassign responsibility for certain tasks to another group, some of that responsibility gets dropped, because people are busy doing other stuff. So where the hell was this NSC team while Helen Chu was being blocked from testing by the CDC ? Were they even talking to the CDC? Did they know what the CDC was doing?

TMC do you work? Then you should know what "reassignment" really means.

FYI, using an opinion piece to refute factual reporting doesn't work.

https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html

The 2009 H1N1 Pandemic: A New Flu Virus Emerges
The (H1N1)pdm09 virus was very different from H1N1 viruses that were circulating at the time of the pandemic. Few young people had any existing immunity (as detected by antibody response) to the (H1N1)pdm09 virus, but nearly one-third of people over 60 years old had antibodies against this virus, likely from exposure to an older H1N1 virus earlier in their lives. Since the (H1N1)pdm09 virus was very different from circulating H1N1 viruses, vaccination with seasonal flu vaccines offered little cross-protection against (H1N1)pdm09 virus infection. While a monovalent (H1N1)pdm09 vaccine was produced, it was not available in large quantities until late November—after the peak of illness during the second wave had come and gone in the United States. From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States due to the (H1N1)pdm09 virus.
----
The death rate, relative to hospitalization, was a half point. The current virus has one and a half points. Anyone remember the virus? It happened right during crash 10 years ago.

256,000 hospitalized, so far the equivalent number of cases is 100k. So if we can get the death rate down to a half point then we can concentrate on doing the 'This time is different' and have a good old fashioned 2008 style crash and bailout.

#10. Radical scandalous speculation ...
While watching all this unfold, something has struck me as a bit wierd - that the dramatic increases in caseload in both Italy and the USA occurred AFTER states implemented social distancing rules and told people to stay home. In a dark corner of my mind, I wonder if making people stay home somehow increased exposure and resulted in more cases, rather than less. Maybe walking around in public, picking up just a little bit of the virus at the supermarket or restaurant is sort of a natural form of variolation.

I’ve had similar thoughts, and it makes me wonder if person to person contact is the primary or only disease vector as is assumed. What might the Iranian, Italian, Spanish, and New York elites have in common? Some kind of contaminated food or beverage, or a household pet?

They all kiss to greet?
Wait that doesn't really apply to new york elites ... or does it?

I think New York is a bit different ... but Iran, Italy, and Spain, people kiss to greet. Also France. Not so much Germany. *ding* *ding*

Here's a random comment on a message board suggesting New Yorkers actually DO kiss to greet.
http://www.city-data.com/forum/long-island/551506-kiss-hello.html
"This is something I randomly discovered on another blog. Apparently kissing people hello/goodbye on the cheek is not common outside the New York area. In some places, like the south and midwest, it is seen as awkward and looked down upon. Growing up on Long Island, I was shocked to read this; being that I have always kissed people of the opposite sex hello and goodbye. Even people I meet for the first time will usually get a hug and cheek kiss goodbye. I am wondering if any of you who have lived outside New York have picked up on this cultural gap? "

Also ....
https://ask.metafilter.com/338826/Cheek-kissing-as-a-greeting-in-the-US

https://www.quora.com/Why-do-Americans-greet-each-other-by-kissing-on-the-cheek-and-then-hugging-We-didnt-do-that-before

Interesting ....

While being exposed to a large amount of virus may kill you, eg. a doctor in Wuhan early in the outbreak, there is no evidence that being exposed to a small amount will vaccinate people. Technically it only takes one intact virus particle getting inside a cell to infect someone. If particles don't make it into a cell our bodies form no immune response to them. Otherwise we'd be building up immune responses to everything we encountered.

4. Why America took so long to test, and yes the FDA is largely to blame (NYT).
----
Because we are a huge economy in a huge geography under a republic style government. Then to make matters worse, we have a bunch of economists who think all government are perfect fluids, which confuses the whole debate and we end up comparing apples and oranges. This debate is a lost cause, it will always start with priors and end with priors.

1. The CDC sucks at designing primers. https://twitter.com/virusninja/status/1238559618265165825?s=21. See also criticism here https://twitter.com/hsalis/status/1240797466808725511 . Totally agree with JWatts here. The CDC's refusal to let anyone else use their own tests, including the WHOs, was a horrible choice that cost American lives. Their own inability to design primers -- a task that nearly every 2nd year grad student in a molecular biology lab could've done much better -- doesn't lend them or you much credibility.

That was meant as a reply to anonymous in his weird tete-a-tete w/ JWatts.

Condom shortage? Oh great, another pricing bubble. Let's just prick it now so that it unravels ;)

Not great. How am I going to push elevator buttons now?

Just to let people know, Australia is now giving businesses $465 US a week per employee as a "don't sack" payment.

6. Westerners need to develop longer memories. The Singaporeans cited said the 2003 SARS epidemic prepared them for COVID. North America had H1N1 in 2009 and it was all but forgotten. When I say longer memory, I mean cultural not just institutional.

Another random mystery possibly explained:
Apparently in China men shake hands as a greeting more often than women. That might explain a higher caseload among men as well as higher death rate if viral load is also related to more severe cases.

http://factsanddetails.com/china/cat4/sub19/item114.html
"The Chinese have traditionally not been big hand shakers but the custom is now widely practiced among men, especially when greeting Westerners and other foreigners. Sometimes Chinese shake for too long for Western tastes and have a limp rather than firm grip. A limp handshake is regarded as a gesture of humility and respect. When a Western man meets a Chinese person, especially a woman, he should wait for the other person to offers his or her hand first, before offering to shake hands."

Has there been any talk of using software like open table to do timed entry reservations for places that tend to get crowded like grocery stores? Trader joes is only allowing so many people in the store at a time, but the lines outside make me nervous and people aren't observing six feet of distance, instead they could be more safely waiting in their homes or cars.

15. The Elevate Prize awards a minimum of $300,000 spread over two years and a possibility of $5 million. The US government, on the other hand:

"During the press conference, an official announced the US is offering rewards of up to $15 million for information leading to the arrest and/or conviction of Maduro and up to $10 million for information leading to the arrest and/or conviction of other top officials.
______________________________________
In the last couple of years, the US Attorney’s Office in South Florida and its federal law enforcement partners have united to bring dozens of criminal charges against high-level regime officials and co-conspirators resulting in seizures of approximately $450 million dollars.”

It appears that authorities have ample funds for making rewards and that there should perhaps be a college program in bounty hunting.

Comments for this post are closed