Friday assorted links

1. What do we know about superspreader events?  And indoor transmission in China.  And what Arnold Kling has come to believe.

2. “We show irradiance and in particular solar zenith angle in combination with cloudopacity explain COVID-19 morbidity and mortality growth better than temperature.”  Interesting, though still more interpretation is needed there.

3. Covid-19 in Haiti.  And what is Wuhan like right now?

4. In Germany, they consult humanities scholars about how to end the lockdown.  And from a French philosopher.  And we need blogs back for the pandemic.

5. “Southern New Hampshire University, known for being on the cutting edge of collegiate learning, plans to slash tuition for incoming freshmen as it drastically revamps how it conducts on-campus learning beginning in the fall.As part of the changes, tuition will be cut 61%, from $31,000 to $10,000 starting in the 2021-2022 academic year.”  Link here.

6. No strong statistical evidence for the BCG vaccine claim.

7. Is the internet economy going to crash as the real economy shrinks?  Several interesting points in that one.

8. de Rugy and Kling on government-backed lines of credit for small business.

9. Bundled insurance markets in everything: “COVID-19 insurance comes free with food delivery in Hong Kong now.”

10. Thread on the meaning of the new NY results.

11. Toward a theory of Tyrone.

12. Test different recovery levers.  And Zeynep speaks sense.


Did SHNU decide to cut tuition due to competition from South Hampshire Institute of Technology?

Gooooooo Sandwiches!

Ad. 2 UV supposedly kills the virus - so sunny weather should reduce outdoor infections.

It's a hot week in Los Angeles. Maybe we are catching a break.

(The flip side is that people stay indoors more in rain.)

It's UV plus humidity. The humidity slows the virus so the UV can kill it. It takes both.

Someone said a couple weeks back that it's "absolute humidity" though, not "relative humidity", which is based on the air's ability to hold water, which is higher at higher temperatures.

In other words, cold, dry overcast days, which most of the most-affected areas on the globe have experience this time of year, are the worst.

“In other words, cold, dry overcast days, which most of the most-affected areas on the globe have experience this time of year, are the worst.”

Thus the novel coronavirus is akin to influenzas in at least one respect. We may have to face seasonal recurrences.

LA solar insolation is very high due to record clean air due to Trump decarbonization from cutting Bush-Obama pandemic prevention spending.

It's rather ironic that nature is countering Trumps efforts to drive up fossil fuel burning to spite Bush and Obama.

After all, its Bush who signed the energy conservation laws and renewable energy tax incentives which have helped california decarbonize, and now Trump has provided the clear skies to prove decarbonization takes California back to the clear skies of a century ago.

Outdoor transmissions are probably rare in any event, but yes, sunshine, vitamin D, mental health, exercise. People should definitely get out in nice weather.

Plus lots, and lots, of distance.

One advantage to outside is that there is so much of it.

That's true. I see solitary couples in big parks, and they are doing it right. But as I've said, a short distance away too many people run clockwise and counterclockwise loops on "the running trail."

True runners *always* run counter-clockwise.

UV light does cause significant damage to RNA but it is very apparent only for short wavelength UV, like UV lamps at 254 nm. In this part of the spectrum the sun irradiance is much lower, of the order of uW/ m^2. Most of it is absorbed by the ozone layer. You have to be above 300 nm to see significant UV at the surface (UVB/UVA). There are some papers claiming tRNA damage in E coli at UVA wavelengths, or crosslinking ,oxidative damage and formation of RNA photoproducts. How much of that can be applied to droplets or aerosols suspended outdoors is not clear to me.
There does seem to be a seasonality to most respiratory viruses. Is it due to:
: temperature/humidity, UV irradiance, people spending less time indoors, higher resistance due to vitamin D uptake, thicker mucus, unknown factors or a combination thereof is not clear.

1. Thanks for this link. I find information about super spread events lacking, as well. Here's some information about one of the Detroit super spreader events. It shows the challenges in gathering information:
The Detroit Health Department did not learn about the positive COVID-19 test results tied to the Police and Pancakes event until March 17, department spokesman Vickie Winn said. The health department conducted contact investigations and recommended that officers in attendance go into quarantine through March 20, two weeks after the breakfast.

The quarantine recommendations were made to all attendees though a notification the department posted on its website March 18. The notice was removed on March 24th, Winn said.

The Free Press asked the health department Wednesday about possible exposure to the police department after it learned Stoudamire was at the Police and Pancakes event. Winn did not provide any information about infected members of the police department that LeValley described two days later.

When asked if anyone else at the event tested positive, Winn said she could not provide a complete answer.

“The event was open to the public so no complete guest list was available. Because DHD does not receive negative test results from hospitals and commercial labs, we would not have a complete picture of test results, and DHD only reports on Detroit residents,” Winn, the public health division administrator and communications director for the department, wrote in an email.

Told Friday that three officers who attended the Police and Pancakes event tested positive for COVID-19, Winn again said her department had limited information about the guest list.

There was also a football coach's clinic that created an outbreak.

I, too, am frustrated by the lack of information of superspreading events, which seem like an obvious research area to illuminate exactly how the virus hops from person to person. The Ouillette article is a great start, but why is it coming from an admitted layperson journalist instead of the CDC, with all its resources?

One SSE I'd like to hear more about is the Seattle choir practice. It boggles my mind that (presumably) one infected individual could infect 45 others merely by singing. Not just expose 45 people, mind you, but actually infect 45 people! I'm thinking there had to be a table with shared food or beverages, some place where the index patient could cough on, or handle, items touched by everyone else in the room. But I've never seen a news story mention food in the room.

I'd also like to hear more about that Fusco family dinner where 4 older members of the family later died. Where were people sitting, were they smoking, kissing? I'm not going to go knocking on one of the survivors' doors to find out, but somebody from the CDC should.

#5 Do employers respect a degree from Southern New Hampshire University say as much as a degree from a mid to low range state university?

100% no.

>"Southern New Hampshire University, known for being on the cutting edge of collegiate learning"

This is the funniest thing I've read in a very long time. SNHU is a safety school for those who can't get into UNH. And almost everyone gets into UNH.

UNH was so uninspiring that Brett Pesche left after one year to complete his education with the Carolina Hurricanes.

1. Kling: I stopped at 1 on his list because he doesn't know why so many covid patients put on ventilators die. Get a room. No, get an oximeter. Covid patients put on a ventilator are already (nearly) dead.

This is actually something I hear on physician-twitter. Things like "people were asked to put down their cell phones co they could be intubated." Thus demonstrating that at the same oxygen levels Covid patients might be a bit better off than a typical pnemonia.

And do you know about "proning?"

Here's an idea: read the link.

I have to admit I got bored by the story-fied version. It's hardly written in the "inverted pyramid" style, but yes if we stick with it..

Dr. Levitan calls it "Covid pneumonia". How is it different from ordinary pneumonia? The patient has no symptoms until he can't breath and the lungs have already been destroyed.

I think he is using pneumonia in the sense of congestion, and not in the sense of secondary infection.

I don’t understand why proning is all the rage in the news- it isn’t new & isn’t COVID-19 specific-it is standard therapy for severe lung disease d/t inflammatory processes- ie ARDS

Yeah, proning is all over the healthcare news and social media, but not the normie news and social media.

My brother died from leukemia. Well, the immediate cause of death was sepsis, triggered by a persistent lung infection that eventually resulted in sepsis because his immune system had been destroyed from the leukemia (and the treatment for it). In the ICU, unconscious, he was put in the prone position, as is the case with any immobile patient, to prevent the lungs from filling with fluid, with the nurses rolling him to his side for awhile, and later to the other side, and then back to his stomach. Before what would the last turn, the ICU nurse came into the room to tell me that they would do the next roll in 15 minutes. Okay. He looked at me and said my brother's heart would likely stop when he was rolled. I can't remember if to the left side or if to the right, but a physician would know. When the nurses returned in 15 minutes, they looked at me and paused. It was 3:15 am. I left the room, and soon enough I could hear the alarms from the machines keeping him alive. It was over. My brother had CLL, which means his proces of dying was long. A Covid patient with "Covid pneumonia" is much different. The prone position for a patient with Covid pneumonia is pointless as the patient's lungs have already been destroyed by the time he presents difficulty breathing and, as the final act of desperation, is put on a ventilator.

You're missing his point. The early narrative was that ventilators were key. General Motors and Ford were ordered to start cranking them out under the Defense Production Act. Ventilators were going to "raise the line" that the flattened curve would fit under.

Kling merely notes that ventilators weren't the answer after all. He doesn't address the details of why, and doesn't really need to.

Bleeding the patient was once considered the best cure. It killed Washington, among many others. Or as Mr. Jefferson said: When two or more physicians gather, buzzards can't be far. Next, Kling will belittle bleeding. He doesn't have to explain why and doesn't really need to.

Ventilators were considered "the" solution mere weeks ago, in the mainstream narrative. Not a detour into centuries-old irrelevance.

Kling is fitting nine bullet points into a single blog post. Point number 2 was that vaccines are hard. He doesn't mention why. I suppose that's not to your liking either.

Kling is a provocateur. The opposite of our host.

5. SNHU isn't a college, it's a television commercial: If you are a soldier or veteran, stand up. If you are the first in your family to graduate from college, stand up. If you are a mother, stand up. If your are a one-legged dwarf, stand up.

the scheisse disturber par excellence

We are ALL (yes, you too!) just monkeys hammering away on keyboards. It seems as though our fate rests on the hope that some monkeys will generate some great insight by pure chance. The rest of us monkeys will then worship them as geniuses.

I thought the comments made by the 68 year old French philosopher TC linked to showed him to be a particularly insightful monkey. He fears Alzheimer’s more than Covid, fears sanitary correctness, worries about the economy— a robust economy is needed to pay for health spending — and recommends reading Montaigne.

I echo the sentiment.
We monkeys need to be about our monkey business (gathering food, reproducing, enjoying the company of other monkeys, etc).
Monkey society will collapse if all we do is screech and bang on our keyboards about all the different ways there to die.

OK. I think I've got the monkey similitude out of my system.

9. Humor is good. Everything today is "bundled". I've always been impressed by "flight insurance" that pays only if the designated flight does a Boeing 737 Max. It's the opposite of bundled. My question: what is the one-time premium for flight insurance while flying on a Boeing 737 Max? What is the one-time premium for covid insurance while visiting an assisted living facility? A Publix? The Villages? An evangelical megachurch? Ruth's Chris Steak House?

5. Okay, I'm one for experimentation and refactoring in education, but this doesn't seem like a great plan:

"Under the SNHU plan, for the first year incoming freshmen will take their courses online with learning support while living on campus and participating in all campus clubs, activities, athletics and other experiences."

Go all the way. Students stay home, and drop the tuition another $5k.

By the way, you know, I sit on the stand and it’d get hot. I got a lot of — I got hairy legs that turn blonde in the sun, and the kids used to come up and reach in the pool and rub my leg down so it was straight and then watch the hair come back. I love kids jumping on my lap.

It sounds like the point is to be ready to continue the classes seamlessly should it be necessary to send everybody home (and require instructors to prepare for only the online version, not both). It also has the benefit of allowing older instructors to teach who might not want to share the same enclosed spaces as a bunch of intermingling 'young and invincibles'.

It seems clear at this point that the ability to identify and treat cases early can reduce the IFR by a factor of 3 or so.

Most of America has yet to be infected. Getting a quick, reliable test to identify infections is probably the most important thing we can do right now to save lives.

At the same time, baby steps toward re-opening need to be taking place. Every day, the case for re-opening gets a little stronger.

So the "Test&Trace + Reopening" standard plan.

Yeah, nothing relevatory, but the picture is clarifying, like a slo-mo Polaroid, which helps. Looks like three possibilities:

1. Success. Treatment/testing improvement breakthrough, gradual, successful re-opening, limited economic damage, 100K US deaths, unemployment <8% in 2021.

2. Diligent but grinding response (most likely). Long-tail/ recurrence. 200K US deaths, significant economic damage. Dig out begins 2021.

3. Ineffective response. 500K+ US deaths, significant economic damage. Dig out begins 2021.

Right now, we know 3 is avoidable. Less so in NYC than elsewhere. 3 is where Belgium is headed.

Belgium has been a lot more aggressive in counting deaths from Covid-19, counting suspected cases along confirmed cases. It makes their death toll/M look worse. Their number of daily cases has dropped significantly. They're on the right side of the peak like just about every country.

That's helpful, thanks. Do you have a sense of how much that would inflate their numbers?

Still, increases in Belgian cases are still running hotter than Spain, Italy, France, and increases in deaths quite a bit hotter. I wouldn't expect the rate of increase to be biased by definition much.

On reported counts, per capita deaths are 18%, 33%, and 67% higher than Spain, Italy, and France, respectively, so I'm sure they are in the running for worst virus outcome if not the clear leader.

Whoever wants to compare our number with other countries has to divide it by two," Steven Van Gucht, who chairs the government's scientific committee for coronavirus, told POLITICO. "Any other comparison isn’t relevant at all.”

While most countries are only counting confirmed deaths in hospitals, Belgium is including all potential deaths in nursing homes.
52% of their deaths come from nursing homes but only 4.5% of these were confirmed by a test.

#10 the way he talks down the infection rate is quite grating.

Starts off “in NY state the infection rate is 13%”
Next “since the infection rate in NY city is 13% that means ...” the study did not say that. It said ~21%.
“Assume a highly insensitive test, that means the infection rate is 7% in NY” — based on no data
From this logic he concludes that the studies in CA were far off.

My god.

He writes: "This doesn't say we are missing very large numbers of asymptomic patients...but clearly some"

Being off by at least an order of magnitude is missing "some" patients!

Seems like there's some difficulty in climbdown for the "North Italy CFRs are probably the true IFR; all else is 'forced optimism'!"crowd. Particularly after they thought they'd "won" after Germany's CFR started rising (showing that they were correct all along that those low IFRs were just the lag of deaths).

It turns out that the guys who saw themselves as the cool, clear-eyed, tough-headed, sane, reality-confronting, 'Hard men who make hard decisions' were... roughly totally wrong on the true IFR (and in fact locked up in their own fantasies and poses, quite distant from reality), and somewhere in the middle of John Ioannidis' range was roughly right.

(To quote Ioannidis - "Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%”, so a median reasonable estimate of 0.5% IFR."... and that is exactly what the middle of the reasonable estimates are today).

Of course this reasonable range is still at a level to lead to lots of excess death and there is plenty of room for debate about how to handle it. But it's not at the levels that the guys who wanted to pat themselves on the back as being the tough, ahead-of-the-curve preppers who could really handle the truth wanted it to be at, and so it's... difficult for them.

IFR won't be uniform everywhere. We know they depend on demographics, health of the population, health care availability and perhaps temperature/humidity . New York scores rather poorly in the first 3, Iceland scores high, so does Germany, so we will get a spread.
0.5% is not a bad median estimate.

Hmm I'm not sure NYC has bad health overall, relative to Germany or Iceland (hardly a hotspot of diabesity, comparable life expectancy to Germany), but I could see them having more coinfections, since the burden of normal low lethality diseases probability is higher in such a megacity. That might matter.

Germany is also rather old - second or third highest average age, after Japan and Italy - though admittedly their life expectancy not too high on European scale, so may be due to lots of middle aged people, relatively fewer elderly.

"Southern New Hampshire University, known for being on the cutting edge of collegiate learning": in Killarney they talk of little else.

1. Indoor transmission link is actually to the SNHU story. I assume this is the correct link:

Not knowing the culture or climate of Wuhan, how many people are typically outdoors in December and January? Was most of the transmission indoors because that's how the virus spreads or because that's where the people were? If it's the latter, moving gatherings outside won't necessarily help much, if at all. I didn't read the paper, but the abstract and associated articles don't seem to address this.

The indoor transmission in china link is wrong. maybe?

Or this one describing the transmission in a restaurant setting.

#5 damn GDPR!

1. I come to believe nursing homes are deathtraps. If your kids put you in one, they hate you and want to see you gone soon.

#4. "Humanities scholars" is an oxymoron.

It seems to me that that theory of Tyrone (#11) is proposing a Girardian reading via negative mimesis. Is that a kind of Straussian reading?

The contrast is striking. The nation that lost WWII is seemingly able to grasp that a pandemic is not a war with an unseen enemy, but a challenge to a society.

From 4 - Working together at an “incredibly quick” pace via Zoom, the group’s education specialists raised fears that school closures meant that children from poor families would fall further behind their wealthy peers; jurists wondered if restrictions on basic freedoms were legitimate; and ethicists and philosophers stressed that stopping the spread of the coronavirus would depend far more on public willingness to fall in line with moral norms than any coercive state action, he explained.

Well South Korea seems like a much better example of a Home Run. But yeah, the Germans did make it across the plate.

Has Japan been an example of a home run, too? The have also had 300 Covid-19 deaths but their population is over twice as large as South Korea's. Japan may eventually have 600 deaths so then about the same per capita.

I don’t think anyone right in the head questioned the fact that COVID-19 is worse than the flu. The numbers have been consistent that this is about 5-10 times worse than the flu. Is it worth tanking the economy over? That is a separate question.

What is very clear is that people with no co-morbidity (obesity, CVD, diabetes, etc.) are almost immune to the harmful effects of COVID-19. This alone suggests though it was reasonable to shutdown restaurants, bars, and much of face to face retail, that it was utterly stupid to insist that the fitness gyms should close.

It is well-known that resistive weight training (e.g. “body building” workout) increases one’s production of HGH naturally. it has now been proven that increased HGH regenerates the thymus gland to give an older person the immunity comparable to a young person. It has also been shown that aerobic activity also increases immunity to COVID-19 (although it is easier to do aerobic exercise outdoors than it is resistive weight training. It is abundantly clear that forcing the fitness gyms to close is a very stupid policy.

" The numbers have been consistent that this is about 5-10 times worse than the flu. I"

The numbers were indicating 20-30x worse than the flu at the start of March. The Who was reporting 3.4% as the CFR.

I'm not disputing that it's lower than that, just indicating that the 5-10x number is fairly recent and still disputed by some.

This is special pleading. Plenty of people who go to a gym have health issues and in fact go there to mitigate them. Frequently touched surfaces and hard breathing in an enclosed space make gyms just as dangerous to higher risk people as restaurants.

1) Gym membership hardly confers health-the gyms are full of people with comorbidities.
2) there is no data that weight lifting is protective against COVID-19.
3) Gyms seem to be a great local for super spreading- heavy breathing, shared surfaces etc.

Can hot weather, like in Malaysia, stop coronavirus?

It hasn't in the building labourers' dorms in Singapore.

When the intelligent, competent people who run Singapore find this a toughie, it's a toughie.

4b is worth a read (and is not long). Comte-Sponville is not, IMHO, a great philosopher, but here he speaks sense, and it is useful.

This observation by Kling is interesting and potentially very important: "A fresh-air lifestyle is good for you. I am struck by the low death rate among homeless people and in India. Those populations ought to be at high risk, and the only story I can come up with is that they don’t spend as much time as we do indoors with HVAC."

The Bali post on MR from a few days ago fits in with that. Some of the comments there stated that there's very little use of air conditioning, even the airport is mostly open-walled.

But there is almost no air conditioning in France and even less in Italy (the big exception being the airports). So the correlations seems to indicate : cold air (natural or conditioned) is bad, hot air is good.
Which confirms my prior as a Mediterranean.

#7 Internet startups leaving Silicon Valley to conquer other sectors of the economy that have been slow to adopt the internet is a GOOD thing.

6. BCG vaccine is basically TB vaccine. I remember the debate over it as a kid in the 50s. Get the BCG vaccination and the TB skin test always turns positive.

Thus, very few US born persons have been given BCG vaccinations.

On the other hand, almost every resident of China over age 40 has been given the BCG vaccination no matter age, and everyone younger as children, so if the hypothesis that BCG prevents or lessens COVID-19, then SARS-Cov2 must not have spread from wuhan.

That Italy has BCG vaccination rates as low as the US is hardly justification for the BCG hypothesis.

Note, a hypothesis that polio booster vaccinations for those who test positive before symptoms argues the immune response triggered by the multiple live polio virus strains triggers a hyper immune response that will fight SARS-Cov2 strains.

But giving oral polio vaccine as a treatment is different than BCG as a preventative.

If outbreaks are to be fought by renewing BCG vaccinations, then the same should be tried with polio, maybe small pox, measles,...

11. This is like the tension between what I would call light libertarianism and dark libertarianism. Light libertarianism would like to see even authoritarian policies succeed because societies become more libertarian when they are wealthy and secure, whereas dark libertarianism would like to see authoritarian policies fail to vindicate themselves even though the failure of authoritarian policies typically results in a doubling-down on more authoritarian policies (such as the failure of the initial travel ban to stop COVID leading to a now ban on immigration in general). There is a constant tension between these two psychological tendencies, and dark libertarianism becomes more appealing when hope for a world of progress and greater individual freedom is lost.

This is probably better branded with "liberalism" ( in the proper political-philosophy sense, not the more American sense).

But leave that point aside, its rather Manichean; there's an excluded middle here, the 'grey' perhaps but I'd say the 'colourful', just as the true expressive colours of our world stand between idealised and cold white light and darkness.

The desire for authoritarian regimes to not fail or collapse, but to stagnate, to give them no power over others who are growing in or have grown in the direction of a more liberal direction.

If there is any effect of wealth making China more liberal, it is surely much smaller than the effect of the Party exporting it's system to quash liberal trends across the world. We want to see a China that stagnates, which can project no authority, as long as it stands under the Party, and the Party stands under men like Xi Jinping.

No need for dramatic, escalationist binaries; slow de-engagement, and letting the realities of public debt, repression of consumption, party controlled inefficiencies in society and business, and population aging all catch up with China, without the release valve of exporting their way out of their chosen path. Then they can choose a different one. No cheering on a collapse, but equally not giving the Party "free wins" to avoid stagnation and reform.

In an alternate world where the Nazis held rule over Western Europe, perhaps you'd cheer on their collapse, perhaps you'd believe that as the Party became more wealthy they'd inevitably liberalise (so let's make those Nazis rich!). Or perhaps you'd be one of those people who'd simply say that neither of those are the only possible outcomes of the only possible strategies.

#4.... "Let us not count on good feelings to take the place of politics."

What can we count on to take the place if politics?

BCG efficacy should be studied in New York's immigrant population. The epicenter of the outbreak in New York has a large Ecuadorian community. Is the IFR among Ecuadorian immigrants higher than Mexican immigrants?
Ecuador is the only country in Latin America that does not currently have a herenational BCG vaccination policy. According to the NY Times Ecuador had about 77,600 excess deaths
from March 1 to April 15.
See also here "Ecuadorians live mainly in the Queens neighborhoods of Corona, Jackson Heights and Elmhurst, comprising one of the areas hit hardest by COVID-19, not only in the city but across the nation. Although he doesn’t have official statistics, activist Walter Sinche, founder of Alianza Ecuatoriana Internacional in Corona, is certain that a large portion of Latinos affected by COVID-19 in Queens are Ecuadorians."

#8 First, kudos Libertarians who actually propose alternatives to kludgy market interventions!

Why not make such loans grants?

More to the point, it the Fed were flooding the banks with so many reserves (maybe a penalty rate on reserves held with the Fed would help) that banks HAD to go looking for clients, no formula and no partial guarantee or FDIC compulsion would be necessary. But the Fed has such tight money right now that the TIPS break-even inflation rate expectation is less than 1% p.a. over 5 years.

# 12
“Let any retailer sell commercially packaged and labeled goods. Create simple standardized consumer waivers of liability, if needed.”

Why would this not be good practice permanently? Or to be more precise, how can we find decision rules for regulation that work as well for pandemics as not?

# 12
If locality X is clearly past peak (Georgia and Tennessee are not) and the most critical part of health care response there is not overwhelmed, why shouldn't there be some relaxation there? Shouldn't the question be HOW to relax rather than WHEN to relax?

"A theory of Tyrone"?!?! I'm sure it wasn't intentional, but as Quora backs my gut reaction "Tyrone is about as black a name as you'll find" and you used it to link to an article linking on bad acting alter egos. Tyrone is Tyler's nefarious alter ego?. You may want to explore the powers of innate bias in future links.

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