The John Paul Vann of Afghanistan Speaks

In the book The Operators by Michael Hastings there is a quote from Command Sergeant Major Michael Hall comparing General Stan McChrystal to John Paul Vann. John Paul Vann was a former army officer who went to Vietnam as a soldier and stayed on working as a Provincial aid advisor. He was famous for his ability to drive around and live in contested districts (alone) and was a tireless advocate for the Vietnamese people. He was also a compulsive womanizer, an alcoholic, and  a shameless self promoter. Remove those negative traits, replace them with a typical all-American Midwest kid raised in a stable two parent household where he developed a strong sense of commitment, a bias for action combined with the ability to thrive while taking calculated risks, and you have Chris Corsten. He was the John Paul Vann of Afghanistan

Our two-decade long involvement in Afghanistan has been a fiasco. Every aspect of our performance had major issues, none more so than the herculean efforts at re-building and rehabilitating the war-torn infrastructure. Yet buried deep inside the legacy of failure are stories of remarkable success. Carter Malkasain described one example of competent development leading directly to local prosperity (briefly) in the book The War Comes to Garmser.

Another example has just been published by my friend Chris Corsten detailing his decade in Afghanistan working both as a soldier and heavily armed humanitarian. The book is 3000 Days in Afghanistan, but I need to reveal something that you will not glean from Chris’s writing. In the world of outside the wire contractors, men (and a few women) who worked in contested districts infested with Taliban, who lived in local compounds, drove local cars, rarely spoke English outside their compound, wore local clothes and lived off the local economy to deliver massive aid projects on time and on budget, Chris Corsten was the best there ever was.

Chris stayed the longest, he had the most impact, he did, by orders of magnitude, the most projects and he was a shura ninja when it came to working through problems with tribal elders. Chris Corsten is a legend – to those of us who knew what accomplished and also to thousands of Afghans who became self-sufficient as hundreds of thousands of acres of farmland became productive again thanks to his irrigation programs.

The book is a clear reflection of Chris and if you know him the two personality traits that stand are conscientious and integrity. Those two traits were combined with an attitude that was the common denominator among all of us working outside the wire; zero tolerance for wasted efforts, make work stupidity, and excuses. Add to this mix the fact that Chris is a modest man who is not prone to exaggeration, routinely attributed all success to his subordinates, and loathes the idea of self-promotion and you have a writer who is going to lay out the facts. Which he does in a manner that is almost business like.

As you get towards the end of this remarkable story Chris lists the spectacular amount of work accomplished during the 2010-2011 surge, and if you know what was going on then in Afghanistan, it is easy to get confused. It seems impossible that Expats (mostly American, British, South African and Australian) were living and working in local Afghan communities while supervising massive irrigation projects in districts where the military was sustaining casualties on a regular basis.

If you don’t know much about Afghanistan, you can read through what Chris accomplished and miss what he accomplished. If you don’t know what was happening in provinces like Khost, Kandahar, Paktia, Kunar, Helmand, Farah, Nangarhar, Herat etc… in 2010 it is hard to appreciate the feat of finishing every project you started with supervision by expats who were out and about in Taliban contested areas daily.

What Chris and his crew proved was aid in contested areas can be delivered effectively, but it has to be done by guys who know what they are doing and have skin in the game. And, at least in Afghanistan, they needed to be armed.

Let me explain the weapons. Our model was if you can’t be safe be hard to kill. The threat to outside the wire contractors took many forms. The biggest was getting kidnapped, the other major problem was we had to store, transport, and distribute large amounts of cash. You are not safe when you are living in a local Afghan compound that contains a safe with over a million dollars in cash. You are not safe when you go to the local branch of the Kabul Bank and withdraw $700,000 for your monthly project payroll. You have to know what you are doing to convert $700,000 in Benjamins into small denomination Afghani’s.

Not all of us carried firearms either – Jeff “Raybo” Radan, a former Marine infantry officer and Ranger School graduate (thus the Raybo call sign), worked a year in the Helmand and never carried a weapon. He did projects in contested towns like Now Zad but being a former Marine he knew how to get a ride on Marine air and thus was able to travel safely. But most of us were armed, and all of us had weapons, including belt fed machine guns (in some provinces), inside our living compounds. Our arming authority came from the Provincial governors and if we ever used our weapons, we were accountable to them as well as the US Embassy.

Chris explains why former, experienced, military men, who have already acquired knowledge of local atmospherics and a solid understanding of local culture, are the best option for staffing aid programs in conflict zones. All the men mentioned in Chris’s book (he uses assumed names) were prior military and all of us had years on the ground before we were able to transition into what I term “Free Range” contracting.

3000 Days in Afghanistan should be required reading at both US AID and the Department of State as they sift through 20 years of lessons learned in Afghanistan. This week a senior USAID executive, who had extensive Afghanistan time, released a paper titled USAID Afghanistan: What Have We Learned. He concludes his assessment with four lessons;

  1. do not try to do everything
  2. stick to proven development principals
  3. flexibility and adaptability are key, and
  4. expect and plan for high levels of oversight.

All four of these lessons are addressed in detail by Chris as he explains how he avoided graft, corruption, security services shake downs, how he dealt (effectively) with theft, and delivered aid that was meaningful while injecting cash directly into local economies. The added benefit of taking Taliban off the battlefield by exchanging a couple months of hard labor for a decent amount of pay was something we discovered early in the program but had not anticipated.

Chris throws no stones as he explains what we were doing and why we felt we should do more. He describes his disappointment at not getting traction with USAID and the State Department and then moves on. The program he was running got plenty of attention in the press at the time. There were NPR radio interviews, 60 minutes segments, multiple magazine articles including this classic account in the Toronto Star about our team in Kandahar. The FRI blog was booming back then as I documented our massive infrastructure projects in Nimroz province. In the end none of that mattered, it turns out being successful where everyone else is failing can be problematic.

As William Hammink admits in his review of USAID in Afghanistan, we threw too much money into a country that could not absorb it. What is now obvious is that Chris Cortsen showed USAID exactly how to do Afghanistan aid. Spend a few years and a few million dollars to get all the irrigation systems back up and running, build a few schools, pave a few roads, bring in engineers with some commercial demo to blast rock and build runways in remote mountain-top towns, and you have done about all that should be done to get the country heading towards self-sufficiency.  Then you can leave.

3000 Days in Afghanistan is an easy read about a remarkable guy who sticks to the facts to make a case on how sustainable development in conflict zones should be done. Buried behind the facts and the business-like narrative are the stories that someday will emerge from this program as historians start to comb through the records in the search of what really happened in Afghanistan. They will find plenty about Chris, hopefully telling  his story in rich detail. There is a lot there and although Chris may not be seeking recognition for what he accomplished he certainly has earned it.

Apocalypse Not #10 Something is Happening Here

What it is ain’t exactly clear; and that’s an understatement. In the past national emergencies brought the country together, at least a for awhile. From the reaction to 9/11 to the legions of people conducting water rescues after Houston flooded a few years back, we have always come together as a people to face down a threat. When the COVID-19 virus was discovered it appeared to bean an existential threat. Based on modeling from epidemiological experts we expected millions, then hundreds of thousands, then tens of thousands of deaths and this with the extreme lock down measures included in the modeling.

The models were not just wrong they were not even close. We now know, based on COVID -19 antibody testing in California, Boston, and Iceland that the infection fatality rate (IFR) is somewhere between 0.1 and 0.3 percent. The more testing we do the lower the IFR drops as the number of positives (the denominator) increases.

Last week a trio of Silicon Valley legends (T.J. Rodgers, Joe Malchow, and Yinon Weiss) conducted a regression study to determine if the rate of lock down  in each state had a statistically significant effect on the number of reported cases. They found the correlation coefficient on early vs late (or no) lockdowns was 5.5%. That number is so low that it is essential no correlation. The lockdowns had no effect on the outcome in each of the 50 states.

One of the most eminent Professors of Epidemiology, Medicine, and Population Health, John P.A. Ioannidis, MD, DSc  has again warned, we are making high-stakes decisions without reliable data. Yet the narrative marches on with the media and authorities using the case fatality rate (CFR), not the infection fatality rate (IFR) to justify their caution.

So what now?

Unfortunately there is no what now; instead there is a deeper polarizing division within the population. A good percentage of the population would agree with my timeline and assessment. But it is also apparent there is a large percentage of Americans who believe there is a deadly virus out there that will scythe through the population if we lift the various lockdowns affecting 43 of the 50 states.

There is no way forward if we cannot, as a nation, agree on or define the threat. The problem now is defining the threat becomes a threat to the reputations of the leading scientists running our public health system, powerful academic institutions like John Hopkins and the Harvard T. H. Chan School of Public Health, as well as powerful philanthropists like Bill Gates and, of course, the legacy media.

The failure to adopt to the virus as it has presented itself is, according to physicians on the front line, costing lives. John Hinderocker from the Powerline blog explains the details in this post. He quotes from Dr. Paul Marik, Chief of Pulmonary and Critical Care Medicine at the Eastern Virginia Medical School, Critical Care COVID Management Protocol

It is our collective opinion that the historically high levels of morbidity and mortality from COVID-19 is due to a single factor: the widespread and inappropriate reluctance amongst intensivists to employ anti-inflammatory and anticoagulant treatments, including corticosteroid therapy early in the course of a patient’s hospitalization. It is essential to recognize that it is not the virus that is killing the patient, rather it is the patient’s overactive immune system. The flames of the “cytokine fire” are out of control and need to be extinguished. Providing supportive care (with ventilators that themselves stoke the fire) and waiting for the cytokine fire to burn itself out simply does not work… this approach has FAILED and has led to the death of tens of thousands of patients.

As Powerline further notes:

The systematic failure of critical care systems to adopt corticosteroid therapy resulted from the published recommendations against corticosteroids use by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the American Thoracic Society (ATS) amongst others.

It appears the most effective treatment for COVID-19 is a combination of very inexpensive, readily available drugs. This will prove catastrophic for reputations of those who continue to insist that mass testing and a proven vaccine or effective drug targeting the virus like remdesivir, the antiviral medicine from Gilead Sciences , are required before the lockdowns can end.

The lockdowns are going to end and they are going to end soon. Shelter in place  type orders have proved an incredibly destructive policy, and the harms have not been distributed evenly across the United States. Some people are suffering much, much more than others.

Yet the lockdown continues here in Texas with the Kabuki theater of partial openings. Restaurants cannot turn a profit when they are forced to run at 50% capacity. I’m not sure why you would open movie theaters but keep gyms closed given the co-morbidity associated with lifestyles of the large and lethargic.

Getting the population out into fresh air and sunshine to bolster their immune systems with some exercise would seem to be what public health officials should want to do. But what they are doing is pretending they can calibrate the economy to limit exposure to a nasty bug despite the fact that “science” in the form of epidemiologic  studies and regression analysis would tell you these steps are not helping – they are hurting.

As Texas and other states come out of lockdown there will be more positive tests because there will be more tests. What we will not see is a giant wave of critically ill patients needing ICU beds. That hasn’t happened yet and it is not going to happen now or in the future.  When what is not going to happen, happens, what are the elites and the press and all the politicians who have been crying wolf for months now going to do? Who know? Owning up and admitting their mistakes is not part of their DNA so we can rule being honest out.

The great and powerful Texas historian T.R. Fehrenbach once wrote that America is a land so great that even fools cannot destroy it. We are in the middle of seeing his thesis tested. Let’s hope he was right.

Apocalypse Not #9 What Happened to the Models?

It is now obvious the modeling driving the COVID-19 response was wrong. They caused the nation to overreact and now that we realize COVID-19 is not the threat we were told it was what do we do?  What theTrump Administration just did, right in front of you, was disappear the models, switch data sets, and start talking recovery. It was awesome to watch made more so by the fact that not many people realized what they were seeing.

During Thursday’s Corona Virus Task Force presser all mentions of modeling were gone, replaced with slides from the   US Outpatient Influenza-like Illness Surveillance Network. From the linked article:

Birx said the Centers for Disease Control and Prevention will be relying on its existing surveillance practices for “influenza-like illnesses,” which will be attuned to look for coronavirus, and fielding more new tests even for asymptomatic people to get better fidelity about the pervasiveness of the virus.

It appears the death rate from this virus will not exceed the number of flu deaths from the 2018-2019 flu season. We are learning, through anti-body testing, that the China Flu bug arrived here earlier than thought and has already passed through a good percentage of the population.

This is fantastic news but we’re not celebrating, or relaxing the lockdown, or re-starting the economy.

In Texas our governor has just appointed a commission to look at how to open up the state. When he announced the members of the commission he included Ross Perot, who died a year ago, which is suspicious. We are weeks away from spring football practice and the governor, instead of acting on facts, is appointing dead people to commissions. That is not very Texan like and I wish we had a better leader like one of the seven governors who were not bullied into economic suicide by hysterical progressive elites.

Governor Kristi Noem of South Dakota – An American hero for keeping her state up and running. Too bad she isn’t a Texan; we could have used her common sense down here last month.

On the very day Governor Abbot announced his strike force Governor Inslee of Washington State launched a tweet storm of unhinged ad hominem attacks on the President. He is convinced The Wuhan will mow down millions if we dare break the protocols established to flatten a curve that never came, predicted by models that were wrong.

The insistence of progressives politicians in believing the obviously flawed models of elite academics is going to, without question, kill Americans. And we don’t need models to know how many. Citizen Journalist Betsy McCaughey points out:

No model or guesswork is required to foresee the deadly impact. Job losses cause extreme suffering. Every 1% hike in the unemployment rate will likely produce a 3.3% increase in drug overdose deaths and a 0.99% increase in suicides according to data provided by the National Bureau of Economic Research and the medical journal Lancet. These are facts based on experience, not models. If unemployment hits 32%, some 77,000 Americans are likely to die from suicide and drug overdoses as a result of layoffs. Scientists call these fatalities deaths of despair.

The impact of layoffs goes beyond suicide, drug overdosing and drinking. Researcher Michael French from the University of Miami points out the death rate for an unemployed person is 63% higher than for someone with a job. It is obvious that the unwarranted and unnecessary lockdowns come with a butchers bill that is larger than the COVID-19 threat.

Why can’t our leaders see this? There are dozens of pieces coming out daily pointing out the same thing yet the narrative continues on as if the pandemic is performing as predicted. 

After the terrorist attacks on 9/11 our country went through a spasm of federal government action to “make us safe”. What came of that was the TSA. The TSA is in the business of ‘Security Theater‘; it fails, over 95% of the time, security tests. They routinely allow weapons and ammunition to be unintentionally carried onto aircraft, something I’ve done myself. No security professional mistakes the TSA as anything other than Kabuki Theater. If you want safe air travel screening you need to do it like the Israelis do, but we won’t do that because of Muh Racism.

The Kabuki theater being generated by this crisis is going to be continued  ‘social distancing’ and mask wearing. As Dr John Lee, joining hundreds of other reality based front line physicians like Keith Rose and Jonathan Greach, point out there is no direct evidence the lockdowns are working. The argument that social distancing and mask wearing slows the spread of the Wuhan virus makes sense, but then again so does the argument for developing  herd immunity.

It is impossible to evaluate scientific data when the credentialed experts working the data do not agree on what it is saying. Occam’s Razor is a solid approach and it was the reason I have said at the start of the Pandemic, that we were too slow and bug had long ago escaped into the population. I had no way of knowing it would prove mostly benign but it did and here we are.

The truth about the threat of COVID-19 is obvious. The reluctance of progressive democrats to accept that their academics, experts, and pundits were wrong is fascinating to watch, but this isn’t funny. Lives are now in jeopardy by continued forced unemployment and forced loss of assets on the part of local and state governments.  If this does not end quickly we are going to lose more than the 2020 NCAA football season.

Apocalypse Not #8 South Texas Lockdown

The Rio Grande Valley consists of four counties Cameron, Hidalgo, Starr and Willacy. The population is almost 90% hispanic, and the majority of the folks born and raised here, whites included, speak fluent Spanish. Despite the prevalence of Spanish speaking It’s still an unmistakably American place. The infrastructure is new as the population has grown significantly over the last 20 years. The VA system here is excellent as military service is and always has been popular with South Texans.

The migration pressure on the border comes from Central Americans who muster at collection points on this side of the border for speedy processing. Once processed and released they are taken to Catholic Relief shelter, given food and a bus ticket to the interior and dropped off at the Greyhound station. Mexican citizens can cross the border and stay in the valley as long as they want but they can’t go inland without a visa. A significant percentage of the local economies in cities like McAllen comes from Mexican tourism, especially during Christmas and Easter.

The McAllen/Edinburg area has a serious public health problem; we are (according to a recent Grub Hub ranking) the fattest metro area in the United States.  Morbid obesity leads to type II diabetes and hypertension, and all three are the principal comorbidity factors contributing to fatal outcomes from COVID-19.

The counties have all issued shelter in place orders and masks must be worn in public except when exercising. Cameron County has issued the most draconian mandates which include prohibiting more than two in a vehicle, which will be a problem for lawn maintenance crews, and children under age 14 have been confined to quarters. These measures are exactly the wrong ones to take if we are concerned about the health and welfare of our fellow citizens.

One of the known characteristics of COVID-19 is that hypertension, diabetes and being overweight dramatically increase hospitalization and fatality rates. It seems to me the perfect vehicle for public health officials to attack the epidemic of obesity in the population. If there was ever a time to start messaging about the necessity of a balanced diet combined with regular outdoor exercise that time is now.

Instead local officials have done the exact opposite. When the schools and non-essential businesses closed the local parks and play grounds were active. They were not crowded, there were no social distancing issues, but you would see groups of half dozen cross-fit folks working out together, families using the picnic benches, and others running or using exercise stations.

I would think the city leader would be encouraging people to get out of the house and into the many city parks to let their kids burn up some energy. Instead the city placed barricades around all jungle gyms, removed every picnic bench, closed all the park parking lots, and made it clear it doesn’t want people exercising in the parks.

Remember the purpose of flattening the curve was not to shelter in place until the bug was gone, the assumption that we will all eventually be exposed remains in place. If we are all going to get the bug eventually should we not be strengthen our immune systems now when we have all this time on our hands? Getting people, especially children, outside and active strengthens immune systems. Being immobile and sedentary indoors, passively watching television while eating highly processed food decreases immune systems.

The Land Shark is a lock down essential. It’s flat here, the streets are empty and this old school custom bike can fly. Getting outside to exercise instead of using an indoor gym has been the surprise of the COVID quarantine. I had forgotten how good it felt to train outside – and its good for the immune system too.

The local hospitals are empty so the curve has flattened which was the purpose of social distancing and mask wearing. Now that we accomplished the goal of the shut down why are we continuing the shut down?

The reason to open the economy is it will save more lives than it will cost.  There is little question that the lives lost to the economic catastrophe following an extended shut down and collapse of the economy would dwarf the numbers of lives lost from  COVID-19.

The alternative to relaxing the quarantine and allowing the virus to run its course is to remain locked down until there is a vaccine or cure. This is why prominent health policy types like Dr. Ezekiel Emanuel are talking about an 18 month lockdown. That is flat out insane. How can American look herself in the mirror and call herself the land of the free without NCAA football this fall? The question answers itself.

Apocalypse Not #7 Policy Based Evidence Making

The projected fatality numbers from the Wuhan Flu are sinking like a stone which is no surprise to anyone who has been paying attention to the story line. From the start I have maintained the COVID-19 projections and mitigation steps were total BS based on my conviction when the federal government has closed the proverbial  barn door the horses are long gone. It is not “anti-science” to be skeptical of government claims to expertise in medical, social and political matters, it is “pro-historical.”

But there is no reason to take the word of a retired Marine on this topic. Dr Keith Rose explains, in an enjoyable 50-minute podcast, the medical perspective on the over-reaction to COVID-19. He is spot on and using contemporary data to explain why we should be getting back to work.

It is now so obvious that the Wuhan flu modeling is wrong that the legacy press now accuses republican politicians of using the bogus numbers to intentionally scare the public into reelecting them.

You cannot make this stuff up.

We have shuttered our economy, sentenced an unknown (but large) number of citizens to penury in an attempt to slow a virus we know very little about. To this day we have no idea how far it has spread or how deadly it really is. When we listen to “experts” explain why the mitigation steps are necessary keep in mind those experts do not know or understand the characteristics of the COVID-19 virus any better than you do. They are guessing at both its virility and morbidity based on obviously inaccurate computer modeling based on flawed data obtained from an untrustworthy international competitor.

Serious journalists are now challenging the coronavirus narrative. From the linked article:

Alex Berenson has been analyzing the data on the crisis on a daily basis for weeks and has come to the conclusion that the strategy of shutting down entire sectors of the economy is based on modeling that doesn’t line up with the realities of the virus.

The models are flawed, and you cannot say social distancing worked without first testing a significant percentage of the population for the COVI-19 antibody.

We will not know how easily this bug is transmitted or how deadly it is without extensive testing of the general population for COVID-19 antibodies. That provides an accurate denominator to use with the body count for determining lethality. When we have an idea on infection rate we still may over-state the Wuhan lethality as the legitimacy of the nominator  (body count)  is now questionable.

Remarkably, our meritocratic elites insist on doubling down on their flawed models and assumptions. We have seen Dr Anthony Fauci, continiously equivocate over the use of hydroxychloroquine in treating the Wuhan despite the fact that it obviously works. The legacy media, on cue, has been blasting away at the off label use of the anti malarial with articles like this one in today’s USA Today; What do you have to lose talking hydroxychloroquine? Potently your life.

What the press has refused to do is ask how many medical professionals in New York City are taking hydroxychloroquine as a prophylactic. (anecdotally the number is high, but who knows)? That the drug works is now so obvious the  governor of Michigan has switched from outlawing its use  to demanding millions of doses.

An even worse example of ignoring the obvious is Dr. Ezekiel Emanuel, the White House adviser for health policy under former President Barack Obama. He just said the following in a April 7th interview:

Realistically, COVID-19 will be here for the next 18 months or more. We will not be able to return to normalcy until we find a vaccine or effective medications. I know that’s dreadful news to hear. How are people supposed to find work if this goes on in some form for a year and a half? Is all that economic pain worth trying to stop COVID-19? The truth is we have no choice.

If we prematurely end that physical distancing and the other measures keeping it at bay, deaths could skyrocket into the hundreds of thousands if not a million.

Do any of you honestly believe that lifting our half ass quarantine will lead to a million deaths? That is obvious lunacy, a real time demonstration of cognitive dissonance among our meritocratic elite. The reality is the models used by our expert class were wrong, any attempt to attribute the flatting  curve to the effectiveness of social distancing or cower in place orders is disingenuous.

The COVID-19 is not even approaching the morbidity of this years flu season. Hat-tip to John Hinderacker at Powerline

The reaction to the Wuhan flu virus clearly demonstrates the futility of using computer modeling to make dynamic decisions in an environment characterized by limited, conflicting,  intelligence coupled with the demand for immediate action. A combat experienced infantry battalion commander would have the ability to make better decisions that react faster to the threat then an epidemiologist. One has trained to make life and death decisions quickly with a bias for action,  the other has trained in microscopic sleuth hunting and generating and manipulating data for use in academic research papers.

Maybe one of the lessons learned here will be to bring experienced high pressure decision makers into the process. Given the as incalculable damage to the economy and the lives of millions of our fellow citizens by flawed decision making one would hope for several volumes of lessons learned from federal, state and local officials.

There should foreevermore be healthy skepticism about our academic and scientific elites, the legacy media, seedy federal politicians who used this crisis to push their agendas, and state and local officials exercising excessive ’emergency’ powers. Special attention needs to be paid to elite institutions that drove us over this cliff; they are compromised by Chinese money and need to divest from it. Their research labs and programs are infested with Chinese spies; and there is no reason to continue to ignore this belligerent behavior from China.

You may not find the  Harvard Department of Health Management and Policy accepting a 350 million dollar naming endowment from China alarming, but I do. It is now the T.H. Chan School of Public Health and if you think the flow of money into institutions that formulate public policy is benign you are not paying attention to what is happening with the COVID-19 pandemic.

When the dust settles there better be some scalp collecting along with a transparent investigation into how and why the experts were (again) completely wrong about COVID-19. We have to develop better strategies that protect the vulnerable without shutting down our economy.

Apocalypse Not # 6 Reality is Disrupting the Legacy Media Narrative

I started the Apocalypse Not series because I do not trust computer modeling nor do I trust any experts warning of apocalyptic doom based on computer modeling. As Richard Fernandez who writes the Belmont Club blog observed: “My dear old statistics teacher used to say that relying on any model however good but founded on past data was like driving by looking at the rearview mirror; fine as long as the future looked like the past“.

It is now clear the future does not look like the past. I knew a flu virus, that had the same symptomology as the Wuhan flu, swept through the Rio Grande Valley last December/January,  Given the reported virulence of the Wuhan strain, it made sense to conclude what had swept the valley was the Wuhan flu. This mild form of Wuhan was no picnic, my wife has never been so sick, for so long, as she was around Christmas.

I went on to note that on March 3rd scientist has identified two strains of the Wuhan virus, one that spreads quickly but is relatively mild, and one that spreads slowly that is dangerous. That explained to me what we experienced last Christmas, but my speculation was met with alarm by my liberal friends (and I have many who I value and respect) who responded with arguments from authority  that stressed I was no expert and should not be commenting on topics I do not understand.

But then I remembered I was an expert, one of the few people who has ever deployed ashore off naval shipping into a combat zone to hunt down a microscopic pathogen that was turning into a killer. I mentioned this tongue in cheek, I was a navy corpsman, trained as a advanced medical laboratory technician, sent ashore to obtain and process samples identified by environmental health officers who were the real experts.  It is on such thin gruel claims of expertise are often made.

HM2 Tim ‘Doc’ Lynch ashore in Beirut in February 1984 hunting down the source of a nasty typhoid outbreak at the Beirut Airport

Despite not being a real expert it now seems the rest of the world is catching up to me. This morning USA Today published an article saying there are 8 strains of the Wuhan circulating the globe. Plus the fatality numbers in the USA are not adding up (as I have been pointing out for a month now) with most of our cases being confined to New York City.

Existential  crises reveal the character of both our leaders and the people. The governors of Washington State, Michigan, and Nevada have been revealed to be not only incompetent, but cowardly. The Governor of New York and the mayor of New York City have been revealed as opportunistic. They are cooperating with the Trump administration to cover for their gross incompetence in emergency management preparation. It is no coincidence that New York City is getting slammed by the flu, they were completely unprepared.

Our country has unprecedented wealth, leisure, economic freedom, and security because men who are the antithesis of Mayor de Blasio  and Governor Cuomo have eradicated every existential  threat to the people of the United States. Those two men are directly responsible for the lack of preparation in New York.  As Julie Kelly, writing in American Greatness observed;

A public policy researcher in 2015 detailed long waits in New York City emergency rooms. The head of the emergency department for the Mount Sinai hospital system quit in 2018 after less than a year on the job.

“I had to follow my moral compass and leave and decide this is not an organization that cares for patients,” Dr. Eric Barton told the New York Post.

Last year, city nurses threatened to strike due to overcrowding at three major hospital systems. “Nurse Anthony Ciampa said he had to choose recently between feeding an elderly patient at New York Presbyterian and treating several acutely ill patients because there weren’t enough other nurses on duty,” according to a March 2019 report in the Daily News.

And the outcry about ventilators? State officials were informed several years ago that the stockpile of ventilators was woefully inadequate to handle a severe pandemic. But instead of preparing for a looming crisis and buying 16,000 ventilators, the state’s health commissioner formed a task force to develop a system to ration the life-saving equipment. The task force “came up with rules that will be imposed when ventilators run short,” the New York Post reported last week.

I expect gross incompetence from big city governments and democratic governors. They have been focused for years on ramming through their progressive agenda while painting all opponents as virulent racists or stupid hicks who don’t understand the need to eviscerate our traditional relationship with governmental organizations. What is alarming to me is the new intolerance of dissent on display in the chattering classes. As Brandon O’Neil observed;

…the implacable rage against anyone who deviates from the Covid-19 script and asks if shutting down society really is the right thing to do. Like medieval scolds, they brand such people dangerous, insane, a virus, accessories to manslaughter. ‘Shut them down!’, they cry, thinking they are signalling their concern for the public’s health when really they are advertising their profound contempt for freedom of thought and critical debate.

We do not know how badly the over-reaction to this virus will hurt our economy. We do not know how many citizens will be financially ruined by the heavy-handed response. What we can safely assume is that measures to control the public (smart phone tracking for one) will be part of our lives from this day forward. That is not good.

What is also not good is our crappy main stream media. Here is the perfect example of how crappy they can be (hat tip to the Mark Margolis at PJ media):

Here are the top six countries by confirmed cases (based on the case numbers from the Center for Systems Science and Engineering at Johns Hopkins University as of 2:30 pm ET March 27) in descending order:

  1. USA (94,238)
  2. Italy (86,498)
  3. Spain (64,059)
  4. Germany (49,344)
  5. Iran (32,332)
  6. France (29,593)

Now, here are the top six countries by confirmed cases per capita (based on population numbers from the CIA World Fact Book):

  1. Italy (1386.13)
  2. Spain (1280.78)
  3. Germany (615.57)
  4. France (436.17)
  5. Iran (380.72)
  6. USA (283.30)

The United States’ confirmed cases are the lowest of the top six countries affected by the virus. Yet the media and the shitbird democrats want you to believe we are far behind the curve because Orange Man Bad. This nightmare will end sooner than you think.  When it does, the public officials who displayed gross incompetence, who used this crisis for personal gain, and who refused to work with the federal government because Orange Man Bad, should be voted out of office. The politicians who loaded the stimulus bill with traditional DC pork should become social pariahs.

The MSM is  trying to make you believe that the coronavirus in the United States is spiraling out of control. They want you (you dumbasses) to understand Orange Man Bad when the majority of us think he’s doing a good job. But the most ergregious crime of this crisis is the destruction of our economy. For that the press, the alarmist governors, and the so-called “experts” who continue to cry wolf in the face of solid evidence they are wrong should pay a steep price.   

No matter what happens de Blasio, Schumer, Pelosi and that strange  looking woman who is now the governor of Michigan (wasn’t she a he before and a olympic decathlon winner)?  will do fine because they have no skin in the game. Destroying our economy will cause no disruption in their lives, they don’t stand in line for toilet paper, they know there will always be a respirator and hospital bed for them, they will always get a paycheck, and they will always have well compensated employment.

This crisis should spell the end of virtue signaling politicians. As this lockdown continues we shall see what the consequences are for shills who ruined millions of American families for their own vanity. If this lasts for months, without the massive numbers of deaths we are being told are inevitable; there will be blood.

Apocalypse Not # 5 Argumentum ab Auctoritate

Argument from authority is defined as “Insisting that a claim is true simply because a valid authority or expert on the issue said it was true, without any other supporting evidence offered.” It is a classic logical fallacy that is used to stifle conversations that are becoming uncomfortable to those in authority.  There are technical areas that I know little about, and in those areas my observations are worthless, we all have that problem. One of the areas where I am not rank amateur is epidemiology, thus I feel comfortable weighing in on this important topic.

HM2 Tim Lynch ashore in Beirut hunting down the source of a nasty typhoid outbreak in early 1984. How many men do you know with real world pathogen hunting experience?

In fact, back when combat helmets were made of steel (as were the men who wore them), I was dispatched ashore at the Beirut International Airport to find the source of a para-typhoid bug that had damn near killed several artillerymen. I was an advanced lab technician  and my job was to obtain samples from sources the Environmental Health officers ashore had identified as potential problems. I obtained the samples, put the them in transport medium to take back to the ship (USS Guam LPH-7).  I then attempt to isolate the pathogen so we could target it with effective antibiotics instead of shotgunning every antibiotic we had into the fallen Marines.

I never isolated the bug, about a week into my attempt we pulled out of Beirut and headed for liberty call in Haifa, Israel.  Once we pulled the plug on the Beirut I autoclaved all the samples and prepared to fly back home. We clearly knew the problem Salmonella Paratyphoid but we never isolated or identified the strain.

I had forgotten all this until I started the Apocalypse Not series and got so much pushback from my liberal friends that I concluded I might be an asshole for writing what I was thinking. But I know a lot of assholes and I also know I’m not like any of them, so I’m continuing my attempt to explain why what you are seeing, has little resemblance to what the experts are telling you is happening.

The pushback from my earlier posts can all be summed up with “are you an authority? No? STF up then”.  The classic argument for authority response. Turns out I am an authority, I even have a degree (associates but still a degree) in medical technology and had mad, cutting edge, microbiology skills back in 1984. So, from this point forward remember that everything I say comes from a position of authority.

Now look at this:

Graph by John Hinderaker at Powerline

And this:

I believe what we are about to experience demonstrates the limitations of modeling. I have never believed the man-made climate change hysteria because it was based on models. The United States Marine Corps is about to become completely irrelevant as it sheds infantry, tube artillery and attack helicopters in favor of missiles, and that plan is based exclusivly on modeling. The lesson we are all about to learn is that modeling and reality are different things. In reality there are too many unknowns we cannot explain or anticipate that are never captured in computer models.

A relevant example of this can be seen in the reality of our current heavy handed public health measures. The biggest concern of every emergency management official when discussing the implementation of quarantines is public unrest. Yet around the country the public has accepted these extreme measures, have cooperated with authorities, and have caused no unrest (yet). The public unrest may yet surface but to date the American public is handling the destruction of their lives and livelihoods with remarkable equanimity.

What happens in two or three weeks when the crisis we have been told is eminent fails to materialize? What about the citizens who have been ruined by lockdowns and forced closures for a bug that was no worse than a flu bug? How will we look at “the experts” in the future when, once again, they were not a little wrong, but dead wrong about the nature of this pandemic?

The overreaction to this flu should drive a stake through the heart of man made climate change because the models supporting that theory are based on more speculative data then epidemiological models. That may be the only silver lining in this crisis.  I doubt identity politics, political correctness, open borders, and encouraging homelessness have long shelf life now either.  Those are issues of concern for affluent, educated people who have the time and resources to spend a lifetime worrying over shit they can’t change or understand.

I forgot where I found this but it speaks truth to current progressive power

My 1 virus 2 strain theory is surfacing again as people who are not experience virus hunters like myself catch up.  People are starting to understand the Pandemic has failed to materialize outside of New York City and the Pacific Northwest. The fatality rate in those two areas remains low, well below the morbidity and mortality of a regular flu bug. I understand that those numbers can shoot up and the bug suddenly start killing people in Ghenghis Khan type numbers because the New York Times told me so in this nifty graph they made to explain a complex event you cannot see out in flyover country.

What the experts cannot explain is how a virulent pathogen arrived in the country last November but waited until now to start replicating.

Even the Huffpo took a break in their 24/7 Trump Derangement Syndrome outbursts to publish “Is It Possible That You Had The Coronavirus Earlier This Year?” This article mirrors comments I’ve been seeing on Facebook as thousands of people speculate the flu bug that burned through the population in December/January was most likely the Wuhan flu. We will not know if that theory is true until we develop a test for COVID-19 antibodies. But the observations of my fellow citizens matches mine and I have to remind you I am an authority. My 1 virus 2 strain (which I’m unilaterally modifying to a 1 virus multiple strains because of expert reasoning I can’t explain to you damn laymen)  theory has more fact behind it than the NYT’s graph.

I am concerned about the millions of Americans who are stuck at home with no money, no food, no job, and bored children. The measly 1400 bucks that may show up in a few weeks is too little, too late to help them. What happens when the people understand that we have been fooled again by charlatans who will weather the storm they created without a problem or concern in the world? The people who are posing the unreasonable restrictions on every aspect of your life do not have to worry about getting tested, access to a ventilator if they fall ill, not having any money in the bank, or food in the house.  In fact they will make money buying stock at fire sale prices and (of course) rewarding themselves by allocating more tax money to themselves.

This analysis by the ever prescient Kimberly Strassel, writing in the Wall Street Journal, which you can now read because the paywall is down, sums up the new stimulus package nicely:

‘Missing from their list is an important category, which underlines an inescapable fact: Government mostly “Cares” for government. Bills that hand out money are written by appropriators. And appropriators never miss an opportunity to expand departments, agencies, bureaus and commissions. A rough calculation suggests the single biggest recipient of taxpayer dollars in this legislation—far in excess of $600 billion—is government itself. This legislation may prove the biggest one-day expansion of government power ever.”

Talk about never letting a crisis go to waste.

There is good news from this crisis; celebrates, professional athletes, and social influencers are no longer important or relevant. I like that because I find celebrity and pro sports culture unappealing.

Joe Rogan the actor/comedian is now irrelevant, Joe Rogan the podcaster is very relevant.   On the 10th of March he had on Michael Osterholm, an internationaly recognized expert on infectious disease, and the podcast was downloaded 17 million times. It unquestionably freaked out a large proportion of his vast audience. Here are some quotes from the interview:

First of you have to understand the timing of it in the sense that is just beginning and so in terms of what hurt pain suffering death is account happened so far is really just beginning. I think what people don’t quite yet understand and is this really is acting like an influenza virus something that transmits very very easily through the air we now have data to show that you’re infectious before you even get sick….I brought some numbers and we estimate that this could require 48 million hospitalizations, out of 96 million cases actually occurring and  over 480,000 deaths over the next three to seven months with this situation so this is not one that to take lightly.

Seventeen days later do any of those predictions sound likely to you? Granted maybe we dodged the bullet because of the lock downs and social distancing. My expert opinion is that is unlikely, the bug has been here since November and not one expert I know of can explain the curious lack of bilateral pneumonia cases that should be evident around the country given the virulence of the pathogen and delay in its detection (thanks to China, not Trump).

My county in South Texas is now on lock down,  if you leave the house for an unofficial reason and you could be fined 1000 bucks.  We have no Wuhan Virus cases in the county and the “shelter in place order” is scheduled to last two weeks. President Trump said he wanted to get the country back to work by Easter Sunday but we are on lockdown until the day after Easter Sunday….. maybe that is a coincidence, or maybe that is a dig at a President the elites despise, but who is growing more popular with the people by the day…you decide.

For now the only thing we can do is “shelter in place”, cooperate with the authorities and watch out for our neighbors. This is the land of the free which is why we should support our civic leaders but at the same time express our alarm at the destruction of our economy. Arguments from authority are a cowards way out of explaining what is increasingly obvious, cannot be explained.

Apocalypse Not #4: What Now?

I was convinced if the Wuhan Corona Virus was as virulent as advertised we would have already seen evidence of it. My theory that  a nasty strain of flu that swept the Rio Grande Valley last December was the S strain of the Wuhan was a SWAG and we can now see I was wrong. I then thought the data driven analysis explained the lack of an outbreak but that too, has been debunked.

New York City has been hit hard, but at least one hospital, Lennox Hill is using HydroxyChloroquin, and they have yet to lose anyone of the 100 plus cases that they are treating. That is encouraging. Although the number of positive tests for COVID-19 will skyrocket there as testing comes on live there has yet to be a flood of pneumonia patients outside of New York City.

That too is encouraging.

One of the most popular videos in my area on the pandemic  is this one from Dr Emily Porter, an Emergency Medicine physician from Austin, Texas.  In her analysis she assumes a low end infection rate of 45% of the population and then does the math to show how large a catastrophe  that would be.  I’m certain the forecasted numbers have decreased since she made her presentation and I don’t think we are going to see those kinds of numbers. But again I base that on the assumption that we would already be seeing a surge in emergency room admissions for pneumonia. Maybe I’m wrong and we will see a surge in hospitalizations in the coming weeks. I sure hope not.

Tokyo,  despite being one of the most densely populated places on earth, has weathered the Wuhan virus well.  The Japanese success at stopping the virus is an excellent argument for taking our shoes off before we enter the house. It’s not a bad habit to adopt these days.

I can no longer traffic in “Do you know anyone with Wuhan?” meme’s because my friend Smari McCarthy, who lives in Iceland, tested positive. He’s going to be OK which is good news. He reminded me about riding out the Swine Flu epidemic in Jalalabad, Afghanistan in 2009. I don’t have the ingredients for the malaria chai though, that needs some #1 hash ghee and a little tincture of opium and those are in short supply in Texas. Helps to have somebody who knows what they’re doing brewing the stuff too.

Without the malaria chai we are left to do little else but stay off the streets, help our neighbors as need and wait to see what happens.  The President was quoted as saying he will reassess where we are in two weeks and maybe lift the bans as appropriate.

I still suspect we should have isolated the venerable while protecting our economy but future events may well prove me wrong. I’m just encouraged by each new day that arrives without another cluster overwhelming a local hospital system. As long as that continues we’ll be OK, and if it doesn’t continue I think we’ll see Americans, at the community level, coming together to work through the crisis at hand.

For now the only thing to do is stay at home, look after your neighbors and check up on the elderly folks who are not getting out much to see if they need anything.

Apocalypse Not # 3 Data Driven Safety

The first rule in medicine is to do no harm, but our response to the Wuhan Corona Virus pandemic is doing nothing but harm.

If COVID-19 is as virulent and easily transmittable as the models predict it to be it would have already  manifested in a massive health emergency. If it were an aerosol the first sign would have been a high infection rate in airline crews because they spent the most time, in a confined place, with infected people.

My earlier speculation centered on a nasty flu bug that burned through the Rio Grande Valley last December.  When it was discovered there are 2 strains of the Wuhan virus, one lethal (L strain) and one not lethal (the S strain) I thought the S strain had arrived first based on the assumption it was  a highly contagious disease passed through aerosols.

The 2 strain 1 virus theory appears to be incorrect because the assumption the virus is transmittable via aerosol is not correct. .  The most recent data on the bug indicates you need to come in contact with a obviously sick person to catch it.

Yesterday a long, detailed article from Aaron Ginn,  a Silicon Valley technologist who is published widely in Tech journals, analyzed  the current data for COVID-19. He published in his findings in Medium but his post has been removed and is now “under investigation or was found in violation of the Medium Rules”.

Aaron Ginn applied his analytical skills to the most current data on COVID-19 and what he found was good news. The reason his article is under review was his pointed criticism that the current containment steps are unnecessary. Interesting facts like this caught my eye:

CDC’s guidance on closing schools specifically for COVID-19 –

Available modeling data indicate that early, short to medium closures do not impact the epi curve of COVID-19 or available health care measures (e.g., hospitalizations). There may be some impact of much longer closures (8 weeks, 20 weeks) further into community spread, but that modeling also shows that other mitigation efforts (e.g., handwashing, home isolation) have more impact on both spread of disease and health care measures. In other countries, those places who closed school (e.g., Hong Kong) have not had more success in reducing spread than those that did not (e.g., Singapore).

It appears social distancing, travel restrictions, closing schools and businesses etc… will have no impact of the spread of this disease. The CDC guidelines clearly indicate that. The best and only defense is hygiene – hand washing and cleaning of surfaces infected people have touched.

Because the article was removed I’m going to post it below so you can decide for yourself if he has made a convincing argument. The current public health measures in place have little impact on my daily routine, my gym is closed and that’s it.  But if I were sitting at home watching my business going under, watching my job go away? And on top of that worried about a killer virus; I would want to know what the data said.

What alarms me also alarms Mr. Ginn; and I’ll let him explain. I put the ending of his piece first, followed by his data and argument. I’ll let you decide if he has made a solid case.

Aaron Ginn

Aaron Ginn

Mar 20 · 33 min read

These days are precarious as Governors float the idea of martial law for not following “social distancing”, yet violating those same rules in their press conferences. Remember this tone is for a virus that has impacted 0.004% of our population. Imagine if this was a truly existential threat to our Republic.

The COVID-19 hysteria is pushing aside our protections as individual citizens and permanently harming our free, tolerant, open civil society. Data is data. Facts are facts. We should be focused on resolving COVID-19 with continued testing, measuring, and be vigilant about protecting those with underlying conditions and the elderly from exposure. We are blessed in one way, there is an election in November. Never forget what happened and vote.

You may ask yourself. Who is this guy? Who is this author? I’m a nobody. That is also the point. The average American feels utterly powerless right now. I’m an individual American who sees his community and loved ones being decimated without given a choice, without empathy, and while the media cheers on with high ratings.

When this is all over, look for massive confirmation bias and pyrrhic celebration by elites. There will be vain cheering in the halls of power as Main Street sits in pieces. Expect no apology, that would be political suicide. Rather, expect to be given a Jedi mind trick of “I’m the government and I helped.”

The health of the State will be even stronger with more Americans dependent on welfare, another trillion stimulus filled with pork for powerful friends, and a bailout for companies that charged us $200 change fees for nearly a decade. Washington DC will be fine. New York will still have all of the money in the world. Our communities will be left with nothing but a shadow of the longest bull market in the history of our country.

Total cases are the wrong metric

A critical question to ask yourself when you first look at a data set is, “What is our metric for success?”.

Let’s start at the top. How is it possible that more than 20% of Americans believe they will catch COVID-19? Here’s how. Vanity metrics — a single data point with no context. Wouldn’t this picture scare you?

Look at all of those large red scary circles!

These images come from the now infamous John Hopkins COVID-19 tracking map. What started as a data transparency effort has now molded into an unintentional tool for hysteria and panic.

An important question to ask yourself is what do these bubbles actually mean? Each bubble represents the total number of COVID-19 cases per country. The situation looks serious, yet we know that this virus is over four months old, so how many of these cases are active?

Immediately, we now see that just under half of those terrifying red bubbles aren’t relevant or actionable. The total number of cases isn’t illustrative for what we should do now. This is a single vanity data point with no context; it isn’t information or knowledge. To know how to respond, we need more numbers to tell a story and to paint the full picture. As a metaphor, the daily revenue of a business doesn’t tell you a whole lot about profitability, capital structure, or overhead. The same goes for the total number of cases. The data isn’t actionable. We need to look at ratios and percentages to tell us what to do next — conversion rate, growth rate, and severity.

Time lapsing new cases gives us perspective

Breaking down each country by the date of the first infection helps us track the growth and impact of the virus. We can see how total cases are growing against a consistent time scale.

Here are new cases time lapsed by country and date of first 100 total cases.

Here is a better picture of US confirmed case daily growth.

The United States is tracking with European nations with doubling cases every three days or so. As we measure and test more Americans, this will continue to grow. Our time-lapse growth is lower than China, but not as good as South Korea, Japan, Singapore, or Taiwan. All are considered models of how to beat COVID-19. The United States is performing average, not great, compared to the other modern countries by this metric.

Still, there is a massive blindspot with this type of graph. None of these charts are weighted on a per-capita basis. It treats every country as a single entity, as we will see this fails to tell us what is going on in several aspects.

On a per-capita basis, we shouldn’t be panicking

Every country has a different population size which skews aggregate and cumulative case comparisons. By controlling for population, you can properly weigh the number of cases in the context of the local population size. Viruses don’t acknowledge our human borders. The US population is 5.5X greater than Italy, 6X larger than South Korea, and 25% the size of China. Comparing the US total number of cases in absolute terms is rather silly.

Rank ordering based on the total number of cases shows that the US on a per-capita basis is significantly lower than the top six nations by case volume. On a 1 million citizen per-capita basis, the US moves to above mid-pack of all countries and rising, with similar case volume as Singapore (385 cases), Cyprus (75 cases), and United Kingdom(3,983 cases). This is data as of March 20th, 2020.

Here is a visualization of a similar per-capita analysis.

But total cases even on a per-capita basis will always be a losing metric. The denominator (total population) is more or less fixed. We aren’t having babies at the pace of viral growth. Per-capita won’t explain how fast the virus is moving and if it is truly “exponential”.

COVID-19 is spreading, but probably not accelerating

Growth rates are tricky to track over time. Smaller numbers are easier to move than larger numbers. As an example, GDP growth of 3% for the US means billions of dollars while 3% for Bermuda means millions. Generally, growth rates decline over time, but the nominal increase may still be significant. This holds true of daily confirmed case increases. Daily growth rates declined over time across all countries regardless of particular policy solutions, such as shutting the borders or social distancing.

The daily growth data across the world is a little noisy. Weighing daily growth of confirmed cases by a relative daily growth factor cleans up the picture, more than 1 is increasing and below 1 is declining. For all of March, the world has hovered around 1.1. This translates to an average daily growth rate of 10%, with ups and downs on a daily basis. This isn’t great, but it is good news as COVID-19 most likely isn’t increasing in virality. The growth rate of the growth rate is approximately 10%; however, the data is quite noisy. With inconsistent country-to-country reporting and what qualifies as a confirmed case, the more likely explanation is that we are increasing our measurement, but the virus hasn’t increased in viral capability. Recommended containment and prevention strategies are still quite effective at stopping the spread.

Cases globally are increasing (it is a virus after all!), but beware of believing metrics designed to intentionally scare like “cases doubling”. These are typically small numbers over small numbers and sliced on a per-country basis. Globally, COVID-19’s growth rate is rather steady. Remember, viruses ignore our national boundaries.

Viruses though don’t grow infinitely forever and forever. As with most things in nature, viruses follow a common pattern — a bell curve.

Watch the Bell Curve

As COVID-19 spreads and declines (which it will decline despite what the media tells you), every country will follow a similar pattern. The following is a more detailed graph of S. Korea’s successful defeat of COVID-19 compared also to China with thousands of more cases and deaths. It is a bell curve:

Here is a more detailed graph of S. Korea graphed against the total number of cases.

Here is a graph from Italy showing a bell curve in symptom onset and number of cases, which may point to the beginning of the end for Italy —

JAMA — https://jamanetwork.com/journals/jama/pages/coronavirus-alert

Bell curves are the dominant trait of outbreaks. A virus doesn’t grow linearly or exponentially forever (if assuming reasonable assumptions about time). It accelerates, plateaus, and then declines. Whether via environmental factors or our own efforts, viruses accelerate and quickly decline. This fact of nature is represented in Farr’s law. CDC’s recommendation of “bend the curve” or “flatten the curve” reflects this natural reality.

It is important to note that in both scenarios, the total number of COVID-19 cases will be similar. The primary difference is the length of time. “Flattening the curve”’s focus is to minimize a shock to the healthcare system which can increase fatalities due to capacity constraints, as seen in Italy and Wuhan, China. In the long-term, it isn’t pure “infection prevention”, rather it prioritizes lower healthcare utilization. Unfortunately, “flattening the curve” doesn’t include other downsides and costs of execution.

Both the CDC and WHO are optimizing for healthcare utilization, while ignoring the economic shock to our system. Both organizations assume you are going to get infected, eventually, and it won’t be that bad.

A low probability of catching COVID-19

The World Health Organization (“WHO”) released a study on how China responded to COVID-19. Currently, this study is one of the most exhaustive pieces published on how the virus spreads.

The results of their research show that COVID-19 doesn’t spread as easily as we first thought or the media had us believe (remember people abandoned their dogs out of fear of getting infected). According to their report if you come in contact with someone who tests positive for COVID-19 you have a 1–5% chance of catching it as well. The variability is large because the infection is based on the type of contact and how long.

The majority of viral infections come from prolonged exposures in confined spaces with other infected individuals. Person-to-person and surface contact is by far the most common cause. From the WHO report, “When a cluster of several infected people occurred in China, it was most often (78–85%) caused by an infection within the family by droplets and other carriers of infection in close contact with an infected person.

From the CDC’s study on transmission in China and Princess Cruise outbreak –

A growing body of evidence indicates that COVID-19 transmission is facilitated in confined settings; for example, a large cluster (634 confirmed cases) of COVID-19 secondary infections occurred aboard a cruise ship in Japan, representing about one fifth of the persons aboard who were tested for the virus. This finding indicates the high transmissibility of COVID-19 in enclosed spaces

Dr. Paul Auwaerter, the Clinical Director for the Division of Infectious Diseases at Johns Hopkins University School of Medicine echoes this finding,

“If you have a COVID-19 patient in your household, your risk of developing the infection is about 10%….If you were casually exposed to the virus in the workplace (e.g., you were not locked up in conference room for six hours with someone who was infected [like a hospital]), your chance of infection is about 0.5%”

According to Dr. Auwaerter, these transmission rates are very similar to the seasonal flu.

Air-based transmission or untraceable community spread is very unlikely. According to WHO’s COVID-19 lead Maria Van Kerkhove, true community based spreading is very rare. The data from China shows that community-based spread was only a very small handful of cases. “This virus is not circulating in the community, even in the highest incidence areas across China,” Van Kerkhove said.

“Transmission by fine aerosols in the air over long distances is not one of the main causes of spread. Most of the 2,055 infected hospital workers were either infected at home or in the early phase of the outbreak in Wuhan when hospital safeguards were not raised yet,” she said.

True community spread involves transmission where people get infected in public spaces and there is no way to trace back the source of infection. WHO believes that is not what the Chinese data shows. If community spread was super common, it wouldn’t be possible to reduce the new cases through “social distancing”.

“We have never seen before a respiratory pathogen that’s capable of community transmission but at the same time which can also be contained with the right measures. If this was an influenza epidemic, we would have expected to see widespread community transmission across the globe by now and efforts to slow it down or contain it would not be feasible,” said Tedros Adhanom, Director-General of WHO.

An author of a working paper from the Department of Ecology and Evolutionary Biology at Princeton University said, “The current scientific consensus is that most transmission via respiratory secretions happens in the form of large respiratory droplets … rather than small aerosols. Droplets, fortunately, are heavy enough that they don’t travel very far and instead fall from the air after traveling only a few feet.”

The media was put into a frenzy when the above authors released their study on COVID-19’s ability to survive in the air. The study did find the virus could survive in the air for a couple of hours; however, this study was designed as academic exercise rather than a real-world test. This study put COVID-19 into a spray bottle to “mist” it into the air. I don’t know anyone who coughs in mist form and it is unclear if the viral load was large enough to infect another individual. As one doctor, who wants to remain anonymous, told me, “Corona doesn’t have wings”.

To summarize, China, Singapore, and South Korea’s containment efforts worked because community-based and airborne transmission aren’t common. The most common form of transmission is person-to-person or surface-based.

Common transmission surfaces

COVID-19’s ability to live for a long period of time is limited on most surfaces and it is quite easy to kill with typical household cleaners, just like the normal flu.

  • COVID-19 can be detected on copper after 4 hours and 24 hours on cardboard.
  • COVID-19 survived best on plastic and stainless steel, remaining viable for up to 72 hours
  • COVID-19 is very vulnerable to UV light and heat.

Presence doesn’t mean infectious. The viral concentration falls significantly over time. The virus showed a half-life of about 0.8 hours on copper, 3.46 hours on cardboard, 5.6 hours on steel and 6.8 hours on plastic.

According to Dylan Morris, one of the authors, “We do not know how much virus is actually needed to infect a human being with high probability, nor how easily the virus is transferred from the cardboard to one’s hand when touching a package”

According to Dr. Auwaerter, “It’s thought that this virus can survive on surfaces such as hands, hard surfaces, and fabrics. Preliminary data indicates up to 72 hours on hard surfaces like steel and plastic, and up to 12 hours on fabric.”

COVID-19 will likely “burn off” in the summer

Due to COVID-19’s sensitivity to UV light and heat (just like the normal influenza virus), it is very likely that it will “burn off” as humidity increases and temperatures rise.

Released on March 10th, one study mapped COVID-19 virality capability by high temperature and high humidity. It found that both significantly reduced the ability of the virus to spread from person-to-person. From the study,

“This result is consistent with the fact that the high temperature and high humidity significantly reduce the transmission of influenza. It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19.”

The University of Maryland mapped severe COVID-19 outbreaks with local weather patterns around the world, from the US to China. They found that the virus thrives in a certain temperature and humidity channel. “The researchers found that all cities experiencing significant outbreaks of COVID-19 have very similar winter climates with an average temperature of 41 to 52 degrees Fahrenheit, an average humidity level of 47% to 79% with a narrow east-west distribution along the same 30–50 N” latitude”, said the University of Maryland.

“Based on what we have documented so far, it appears that the virus has a harder time spreading between people in warmer, tropical climates,” said study leader Mohammad Sajadi, MD, Associate Professor of Medicine in the UMSOM, physician-scientist at the Institute of Human Virology and a member of GVN.

In the image below, the zone at risk for a significant community spread in the near-term includes land areas within the green bands.

As of right now reported cases as a function of latitude, about one-third of the world’s population is below 22.5°N yet has not experienced meaningfully high levels of infections.

About 95% of all infections in a latitude band encompassing 55% of the world’s population, which includes a large portion of America.

Infections as a function of temperature and humidity: 90% still in the blue zone

Children and Teens aren’t at risk

It’s already well established that the young aren’t particularly vulnerable. In fact, there isn’t a single death reported below the age of 10 in the world and most children who test positive don’t show symptoms. As well, infection rates are lower for individuals below the age of 19, which is similar to SARS and MERS (COVID-19’s sister viruses).

According to the WHO’s COVID-19 mission in China, only 8.1% of cases were 20-somethings, 1.2% were teens, and 0.9% were 9 or younger. As of the study date February 20th, 78% of the cases reported were ages 30 to 69. The WHO hypothesizes this is for a biological reason and isn’t related to lifestyle or exposure.

Even when we looked at households, we did not find a single example of a child bringing the infection into the household and transmitting to the parents. It was the other way around. And the children tend to have a mild disease,” said Van Kerkhove.

According to a WSJ article, children have a near-zero chance of becoming ill. They are more likely to get normal flu than COVID-19.

  • A World Health Organization report on China concluded that cases of Covid-19 in children were “relatively rare and mild.” Among cases in people under age 19, only 2.5% developed severe disease while 0.2% developed critical disease. Among nearly 6,300 Covid-19 cases reported by the Korea Centers for Disease Control & Prevention on March 8, there were no reported deaths in anyone under 30. Only 0.7% of infections were in children under 9 and 4.6% of cases were in those ages 10 to 19 years old
  • Only 2% of the patients in a review of nearly 45,000 confirmed Covid-19 cases in China were children, and there were no reported deaths in children under 10, according to a study published in JAMA last month. (In contrast, there have been 136 pediatric deaths from influenza in the U.S. this flu season.)
  • About 8% of cases were in people in their 20s. Those 10 to 19 years old accounted for 1% of cases and those under 10 also accounted for only 1%.

However even if children and teens are not suffering severe symptoms themselves, they may “shed” large amounts of virus and may do so for many dayssays James Campbell, a professor of pediatrics at the University of Maryland School of Medicine.

Children had a virus in their secretions for six to 22 days or an average of 12 days. “Shedding virus doesn’t always mean you’re able to transmit the virus”, he notes. It is still important to consider that prolonged shedding of high viral loads from children is still a risky combination within the home since the majority of transmission occurs within a home-like confined environment.

A strong, but unknown viral effect

While the true viral capacity is unknown at this moment, it is theorized that COVID-19 is more than the seasonal flu but less than other viruses. The average number of people to which a single infected person will transmit the virus, or Ro, range from as low as 1.5 to a high of 3.0

Newer analysis suggests that this viral rate is declining. According to Nobel Laureate and biophysicist Michael Levitt, the infection rate is declining –

“Every coronavirus patient in China infected on average 2.2 people a day — spelling exponential growth that can only lead to disaster. But then it started dropping, and the number of new daily infections is now close to zero.” He compared it to interest rates again: “even if the interest rate keeps dropping, you still make money. The sum you invested does not lessen, it just grows more slowly. When discussing diseases, it frightens people a lot because they keep hearing about new cases every day. But the fact that the infection rate is slowing down means the end of the pandemic is near.”

What about asymptomatic spread?

The majority of cases see symptoms within a few days, not two weeks as originally believed.

On true asymptomatic spread, the data is still unclear but increasingly unlikely. Two studies point to a low infection rate from pre-symptomatic and asymptomatic individuals. One study said 10% of infections come from people who don’t show symptoms yet. Another WHO study reported 1.2% of confirmed cases were truly asymptomatic. Several studies confirming asymptotic spread have ended up disproven. It is important to note there is a difference between “never showing symptoms” and “pre-symptomatic” and the media is promoting an unproven narrative. Almost all people end up in the latter camp within five days, almost never the former. It is very unlikely for individuals with COVID-19 to never show symptoms. WHO and CDC claim that asymptomatic spread isn’t a concern and quite rare.

Iceland is leading the globe in testing its entire population of ~300,000 for asymptomatic spread, not just those that show symptoms. They randomly tested 1,800 citizens who don’t show symptoms and, as far as they knew, were not exposed to positive individuals. Of this sample, only 19 tested positive for COVID-19, or 1.1% of the sample.

Obviously, this type of viral spread is the most concerning; however based on the level of media attention and the global size of positive infections, it seems more probable we keep looking for a COVID-19 viral trait that doesn’t exist.

Another way of looking at virality and asymptotic spread is the number of flight attendants, airport staff, or pilots that have tested positive for COVID-19. Out of the thousands of flights since November 2019, only a handful of airport and airline staff have tested positive (such as AA pilotsome BA staff, and several TSA employees).

Outside of medical and hospital staff, these individuals are in greatest contact with infected persons in confined spaces. Despite having no protective gear and most likely these people were asymptomatic, airline and airport staff aren’t likely to catch COVID-19 compared to the rest of the population. Those employed in the travel sector are infected at a lower rate than the general population or healthcare workers.

“We still believe, looking at the data, that the force of infection here, the major driver, is people who are symptomatic, unwell, and transmitting to others along the human-to-human route,” Dr. Mike Ryan of WHO Emergencies Program.

If the symptoms are so close to other less fatal coronaviruses, what is the positivity rate of those tested?

93% of people who think they are positive aren’t

Looking at the success in S. Korea and Singapore, the important tool in our war chest is measurement. If we are concerned about the general non-infected population, what is the probability those who show symptoms actually test positive? What is the chance that the cough from your neighbor is COVID-19? This “conversion rate” will show whether or not you have a cold (another coronavirus) or are heading into isolation for two weeks. Global data shows that ~95% of people who are tested aren’t positive. The positivity rate varies by country.

  • UK: 7,132 concluded tests, of which 13 positive (0.2% positivity rate).
  • UK: 48,492 tests, of which 1,950 (4.0% positivity rate)
  • Italy: 9,462 tests, of which 470 positive (at least 5.0% positivity rate).
  • Italy: 3,300 tests, of which 99 positive (3.0% positivity rate)
  • Iceland: 3,787 tests, of which 218 positive (5.7% positive rate)
  • France: 762 tests, of which 17 positive, 179 awaiting results (at least 2.2% positivity rate).
  • Austria: 321 tests, of which 2 positive, awaiting results: unknown (at least 0.6% positivity rate).
  • South Korea: 66,652 tests with 1766 positives 25,568 awaiting results (4.3% positivity rate).
  • United States: 445 concluded tests, of which 14 positive (3.1% positivity rate).

In the US, drive-thru testing facilities are being deployed around the nation. Gov. Cuomo of NY released initial data from their drive-thru testing. Out of the 600~ that was tested in a single day, ~7% were positive. Tested individuals actively show symptoms and present a doctor’s note. This result is similar to public tracking on US nationwide positivity rate.

University of Oxford’s Our World in Data attempts to track public reporting on individuals tested vs positive cases of COVID-19. For the US, it estimates 14.25% of those tested are positive.

Last week, the US was significantly behind in testing, near the bottom of all countries worldwide. As of March 20th, a week later, the US is much closer to other G8 and European countries, but there is a long way to go.

Based on the initial results and the results from other countries, the total number of positive COVID-19 cases will increase as testing increases, but the fatality rate will continue to fall and the severity case mix will fall.

In general, the size of the US population infected with COVID-19 will be much smaller than originally estimated as most symptomatic individuals aren’t positive. 93% — 99% have other conditions.

Globally, the US has a long way to go to catch up in testing. As testing expands, the total number of cases will increase, but the mild to severe case ratio will decline dramatically.

1% of cases will be severe

Looking at the whole funnel from top to bottom, ~1% of everyone who is tested for COVID-19 with the US will have a severe case that will require a hospital visit or long-term admission.

Globally, 80–85% of all cases are mild. These will not require a hospital visit and home-based treatment/ no treatment is effective.

As of mid-March, the US has a significantly lower case severity rate than other countries. Our current severe caseload is similar to South Korea. This data has been spotty in the past; however, lower severity is reflected in the US COVID-19 fatality rates (addressed later).

Early reports from CDC, suggest that 12% of COVID-19 cases need some form of hospitalization, which is lower than the projected severity rate of 20%, with 80% being mild cases.

For context, this year’s flu season has led to at least 17 million medical visits and 370,000 hospitalizations (0.1%) out of 30–50 million infections. Recalling that only comparing aggregate total cases isn’t helpful, breaking down active cases on a per-capita basis paints a different picture on severity. This is data as of March 20th, 2020.

Declining fatality rate

As the US continues to expand testing, the case fatality rate will decline over the next few weeks. There is little doubt that serious and fatal cases of COVID-19 are being properly recorded. What is unclear is the total size of mild cases. WHO originally estimated a case fatality rate of 4% at the beginning of the outbreak but revised estimates downward 2.3% — 3% for all age groups. CDC estimates 0.5% — 3%, however stresses that closer to 1% is more probable. Dr. Paul Auwaerter estimated 0.5% — 2%, leaning towards the lower end. A paper released on March 19th analyzed a wider data set from China and lowered the fatality rate to 1.4%. This won’t be clear for the US until we see the broader population that is positive but with mild cases. With little doubt, the fatality rate and severity rate will decline as more people are tested and more mild cases are counted.

Higher fatality rates in China, Iran, and Italy are more likely associated with a sudden shock to the healthcare system unable to address demands and doesn’t accurately reflect viral fatality rates. As COVID-19 spread throughout China, the fatality rate drastically fell outside of Hubei. This was attributed to the outbreak slowing spreading to several provinces with low infection rates.

John P.A. Ioannidis is professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanford’s Meta-Research Innovation Center recently wrote about fatality rates and how our current instrumentation is leading to faulty policy solutions:

“The one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers. The case fatality rate there was 1.0%, but this was a largely elderly population, in which the death rate from Covid-19 is much higher.

Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases — a risk factor for worse outcomes with SARS-CoV-2 infection — than the general population. 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%.”

Looking at the US fatality, the fatality rate is drastically declining as the number of cases increases, halving every four or five days. The fatality rate will eventually level off and plateau as the US case-mix becomes apparent.

  • 4.06% March 8 (22 deaths of 541 cases)
  • 3.69% March 9 (26 of 704)
  • 3.01% March 10 (30 of 994)
  • 2.95% March 11 (38 of 1,295)
  • 2.52% March 12 (42 of 1,695)
  • 2.27% March 13 (49 of 2,247)
  • 1.93% March 14 (57 of 2,954)
  • 1.84% March 15 (68 of 3,680)
  • 1.90% March 16 (86 of 4,503)
  • 1.76% March 17 (109 of 6,196)
  • 1.66% March 18 (150 of 9,003)
  • 1.51% March 19th (208 of 13,789)
  • 1.32% March 20th (256 of 19,383)

Source: Worldometers.info

Mapped against other countries, our fatality rate and case-mix are following a similar pattern to South Korea which is a good sign, a supposed model of how to manage COVID-19.

Here are deaths weighted by the total number of cases as of March 20th, 2020. Ranked by the total number of cases, our death rate is closer to South Korea’s than Spain’s or Italy’s.

The initial higher fatality rate for the US is trending much lower than originally estimated. A study of about half deaths within the US (154 of 264), almost all fit a similar demographic profile as the other global ~11,000 fatalities.

Another analysis by Nature, comparing the fatality rate (since revised down) and infectious rate of COVID-19 to other illnesses. COVID-19 is now within range of its less potent sister coronaviruses.

As the global health community continues to gather and report data, the claim that “COVID-19 isn’t just like the flu” (though still severe) is looking less credible as fatality rates continue to decline and measuring of mild cases increases.

It is important to consider case-mix when looking at fatality rates. The fatality rate is significantly higher for patients with an underlying condition.

The fatality rates by underling condition mimics the rise in the average fatality rate with those with underlying conditions who get the seasonal flu.

  • Pneumonia and influenza: 1.53% — 1.93%
  • Chronic lower respiratory disease: 1.48% — 1.93%
  • All respiratory causes: 3.04% — 4.14%
  • Heart disease: 3.21% — 4.4%
  • Cancer: 0.68% — 1.05%
  • Diabetes: 0.26% — 0.39%
  • For all underlying conditions: 10.17% — 13.67%.

Comparing case-mix across countries with a wide range of fatality (China and Italy) and those with low fatality rates (S. Korea) reveals a stark difference in age; therefore, underlying conditions also vary significantly across countries. These two factors contribute the most to a country’s fatality rate.

Source: Goldman Sachs

Divided by most at risk and low risk, Italy had significantly more cases of high at-risk patients than Germany or Korea

Source: https://medium.com/@andreasbackhausab/coronavirus-why-its-so-deadly-in-italy-c4200a15a7bf

Based on an initial CDC study of 2,449 COVID-19 cases (almost half of current US cases have missing demographic data), the United States case-mix looks more like S. Korea and Germany rather than China or Italy. Approximately 69% of COVID-19 cases are in the lower at-risk population of under 65, while 31% are older than 65 and in the higher-risk population. This suggests the US will experience a declining fatality rate; however, the US has over 100 million adults with underlying and chronic illnesses that will negatively impact our fatality rate.

An older population skew within the infected population explains most of the disparity in fatality rates between high and low countries. According to a study of the fatalities of COVID-19 cases in Italy, 99% of all deaths had an underlying pathology. Only 0.8% had no underlying condition.

Most of those infected in Italy were over the age of 60, but the median age of a fatality was 80. All of Italy’s fatality under the age of 40 were males with serious pre-existing medical conditions.

This doesn’t factor in a wide variance in healthcare capacity, such as hospital beds per 1,000 citizens which could affect health outcomes; however, this doesn’t seem to be highly correlated with fatality rates at this moment.

  • S. Korea — 11.5
  • Germany — 8.3
  • China — 4.2
  • Italy — 3.4
  • United States — 2.9
  • Singapore — 2.4

So what should we do?

The first rule of medicine is to do no harm.

Local governments and politicians are inflicting massive harm and disruption with little evidence to support their draconian edicts. Every local government is in a mimetic race to one-up each other in authoritarian city ordinances to show us who has more “abundance of caution”. Politicians are competing, not on more evidence or more COVID-19 cures but more caution. As unemployment rises and families feel unbearably burdened already, they feel pressure to “fix” the situation they created with even more radical and “creative” policy solutions. This only creates more problems and an even larger snowball effect. The first place to start is to stop killing the patient and focus on what works.

Start with basic hygiene

The most effective means to reduce spread is basic hygiene. Most American’s don’t wash their hands enough and aren’t aware of how to actually wash your hands. Masks aren’t particularly effective if you touch your eyes with infected hands. Ask businesses and public places to freely distribute disinfectant wipes and hand sanitizer to the customers and patrons. If you get sick or feel sick, stay home. These are basic rules for preventing illness that doesn’t require trillions of dollars.

More data

The best examples of defeating COVID-19 requires lots of data. We are very behind in measuring our population and the impact of the virus but this has turned a corner the last few days. The swift change in direction should be applauded. Private companies are quickly developing and deploying tests, much faster than CDC could ever imagine. The inclusion of private businesses in developing solutions is creative and admirable. Data will calm nerves and allow us to utilize more evidence in our strategy. Once we have proper measurement implemented (the ability to test hundreds every day in a given metro), let’s add even more data into that funnel — reopen public life.

Taiwan is held up as a model for its approach. They embraced both data, tracking, free movement of people, evidence-based prevention, and focused their energy on those most vulnerable — preexisting conditions and those over the age of 65. Here are some of the steps they took:

  • QR code scanning and online reporting of each person’s travel history
  • Health symptoms were used to classify traveler infectious risks based on flight origin and travel history in the past 14 days
  • People with low risk were sent a health declaration border pass via SMS to their phones for faster immigration clearance
  • Those with higher risk were quarantined at home and tracked through their mobile phone to ensure that they remained there during the incubation period
  • Taiwan also proactively seeks out patients with severe respiratory symptoms (based on information from a national health database) to see who had tested negative for influenza so that they could be retested for COVID-19

Open schools

Closing schools is counterproductive. The economic cost for closing schools in the U.S. for four weeks could cost between $10 and $47 billion dollars (0.1–0.3% of GDP) and lead to a reduction of 6% to 19% in key health care personnel.

CDC’s guidance on closing schools specifically for COVID-19 –

Available modeling data indicate that early, short to medium closures do not impact the epi curve of COVID-19 or available health care measures (e.g., hospitalizations). There may be some impact of much longer closures (8 weeks, 20 weeks) further into community spread, but that modeling also shows that other mitigation efforts (e.g., handwashing, home isolation) have more impact on both spread of disease and health care measures. In other countries, those places who closed school (e.g., Hong Kong) have not had more success in reducing spread than those that did not (e.g., Singapore).

Based on transmission evidence children are more likely to catch COVID-19 in the home than at school. As well, they are more likely to expose older vulnerable adults as multi-generational homes are more common. As well, the school provides a single point of testing a large population for a possible infection in the home to prevent community spread.

Open up public spaces

With such little evidence of prolific community spread and our guiding healthcare institutions reporting the same results, shuttering the local economy is a distraction and arbitrary with limited accretive gain outside of greatly annoying millions and bankrupting hundreds of businesses. The data is overwhelming at this point that community-based spread and airborne transmission is not a threat. We don’t have significant examples of spreading through restaurants or gyms. When you consider the environment COVID-19 prefers, isolating every family in their home is a perfect situation for infection and transmission among other family members. Evidence from South Korea and Singapore shows that it is completely possible and preferred to continue on with life while making accommodations that are data-driven, such as social distancing and regular temperature checks.

Support business and productivity

The data shows that the overwhelming majority of the working population will not be personally impacted, both individually or their children. This is an unnecessary burden that is distracting resources and energy away from those who need it the most. By preventing Americans from being productive and specializing at what they do best (their vocation), we are pulling resources towards unproductive tasks and damaging the economy. We will need money for this fight.

At this rate, we will spend more money on “shelter-in-place” than if we completely rebuilt our acute care and emergency capacity.

Source: https://www.macrobond.com/posts/blog-central-banks-go-big-covi-19-market-crash-crisis/

Americans won’t have the freedom to go help those who get sick, volunteer their time at a hospital, or give generously to a charity. Instead, big government came barrelling in like a bull in a china shop claiming they could solve COVID-19. The same government that continued to not test incoming passengers from Europe and who couldn’t manufacture enough test kits with two months’ notice.

Let Americans be free to be a part of the solution, calling us to a higher civic duty to help those most in need and protect the vulnerable. Not sitting in isolation like losers.

People fear what the government will do, not an infection

Rampant hoarding and a volatile stock market aren’t being driven by COVID-19. An overwhelming majority of American’s don’t believe they will be infected. Rather, hoarding behavior strongly demonstrates an irrational hysteria, from purchasing infective household masks to buying toilet paper in the troves. This fear is being driven by government action, fearing what the government will do next. In South Korea, most citizens didn’t fear infection but the government and public shaming. By presenting a consistent and clear plan that is targeted and specific to those who need the most help will reduce the volatility and hysteria. A sign the logic behind these government actions aren’t widely accepted, nor believed as rational by the American people is the existence itself of the volatility and hysteria. Over three-fourths of Americans are scared not of COVID-19 but what it is doing to our society.

In CDC’s worst-case scenario, CDC expects more than 150–200 million infections within the US. This estimate is hundreds of times bigger than China’s infection rate (30% of our population compared to 0.006% in China). Does that really sound plausible to you? China has a sub-par healthcare system, attempted to suppress the news about COVID-19 early on, a lack of transparency, an authoritarian government, and millions of Chinese traveling for the Lunar Festival at the height of the outbreak. In the US, we have a significant lead time, several therapies proving successful, transparency, a top tier healthcare system, a democratic government, and media providing ample accountability.

Infection isn’t our primary risk at this point.

Expand medical capacity

COVID-19 is a significant medical threat that needs to be tackled by both finding a cure and limiting spread; however, some would argue that a country’s authoritarian response to COVID-19 helped stop the spread. Probably not. In South Korea and Taiwan, I can go to the gym and eat at a restaurant which is more than I can say about San Francisco and New York, despite a significantly lower caseload on a per-capita basis.

None of the countries the global health authorities admire for their approach issued “shelter-in-place” orders, rather they used data, measurement,and promoted common sense self-hygiene.

Does stopping air travel have a greater impact than closing all restaurants? Does closing schools reduce the infection rate by 10%? Not one policymaker has offered evidence of any of these approaches. Typically, the argument given is “out of an abundance of caution”. I didn’t know there was such a law. Let’s be frank, these acts are emotionally driven by fear, not evidence-based thinking in the process of destroying people’s lives overnight. While all of these decisions are made by elites isolated in their castles of power and ego, the shock is utterly devastating Main Street.

A friend who runs a gym will run out of cash in two weeks. A friend who is a pastor let go of half of his staff as donations fell by 60%. A waitress at my favorite breakfast place told me her family will have no income in a few days as they force the closure of restaurants. While political elites twiddle their thumbs with models and projections based on faulty assumptions, people’s lives are being destroyed with Marxian vigor. The best compromise elites can come up with is $2,000.

Does it make more sense for us to pay a tax to expand medical capacity quickly or pay the cost to our whole nation of a recession? Take the example of closing schools which will easily cost our economy $50 billion. For that single unanimous totalitarian act, we could have built 50 hospitals with 500+ beds per hospital.

Eliminate arcane certificate of need and expand acute medical capacity to support possible higher healthcare utilization this season.

 

 

 

Apocalypse Not #2 -There are two COVID-19 Strains

My first Apocalypse Not post speculated that the Wuhan Corona Virus had already washed through the continental United States. I based that on my understanding of viral transmission rates combined with the length of time between the arrival of the virus and the start of mitigation efforts.  I had no explanation why the virus had passed through the population without sending massive numbers of Americans to the hospital. I have an explanation now.

On the 3rd of March The Oxford Academic National Science Review published a study titled On the origin and continuing evolution of SARS-CoV-2. An extract from the overview is pasted below:

Population genetic analyses of 103 SARS-CoV-2 genomes indicated that these viruses evolved into two major types (designated L and S), that are well defined by two different SNPs that show nearly complete linkage across the viral strains sequenced to date.

Dr Michael Skinner, Reader in Virology, Imperial College London, explained the findings this way

  • They speculate that the L form might be more ”aggressive” but that is not an adjective we normally apply to viruses, where we talk about transmissibility, fitness, virulence.
  • ”Viruses have to be able to replicate in each sequential host and transmit serially between them. It is quite possible for one form of the virus to be better at replication, another at transmission.

What he is saying is the  L strain is the most aggressive at replication which is why it is a potential killer. The S strain is easily transmittable but less aggressive. The paper went on to note that infection by the S strain provides immunity from the L strain and speculates that only the S strain is transmitted through aerosols.

This would explain the significant lag time between the arrival of the virus and a noticeable surge in hospitalizations. In fact there is still no noticeable surge of hospital admissions for pneumonia in the USA. I just goggled that and found nothing.

There are three facts at play: the first is  the virus arrived in the USA long before the first case was diagnosed. The second is there are two strains; one the is easily transmissible but not deadly and one that is not easily transmissible and very deadly. The third is there have been no reported increase in admissions or deaths from bilateral viral pneumonia.

The current panic being stoked by the legacy media and the actions being taken by  politicians are based off modeling by  highly credentialed  experts. The models have predicted that we are on the brink of a massive surge in hospitalizations due to respiratory complications (bilateral pneumonia). These results have to be taken seriously despite knowing the models have serious limitations.

In response the President has started daily press briefing with his China Virus team and they have been trying to talk down the panic with facts. Dr. Deborah Burke, who has been speaking at the daily press briefing with the President, had this to say about models.

Reporter: “Can you speak to the study predicting as many as 2.2 million people in the United States could die if there were not this kind of action taken by the government”.

Dr Burke: “ So I think you know the models are models and are  based on input and they’re based on infectiousness without any controls. I can tell you we’ve never seen that level of infection modeled up to 2.2 million in mortality… I have dealt with a lot of modelers in my time, they are wonderful people, but they all have their favorite inputs and they all have their favorite integration functions, so we’re evaluating all of those so we can integrate and create the best model for the United States based on the best data.

The State of Texas has now joined the panic and demanded all gyms, restaurants, and bars close. The damage that will done to our economy is incalculable and remember there has been no surge in deaths or hospital admissions reported yet in the USA.

There is no reason to believe the models without seeing evidence that the models are correct. Tweets like the one below are not helping anyone, Dr. Scott Gottlieb has less observable truth behind his tweet then I do with my two strains, no apocalypse theory.

Each day that ends without a reported spike in viral pneumonia deaths should be raising questions. In this era of diminished corporate  media, desperate for clicks and page views, it is difficult to tease out what is important. What is important is an explanation as to why so many senior leaders are taking such drastic action. Is this based solely of computer models and WHO concerns? That is hard to believe but what other explanation is there?

I do not know if the testing being developed for the Wuhan virus can differentiate between the L and S strains. I suspect,  just as Dr Burke has said repeatedly, that the number of reported cases will skyrocket as more testing comes on line. I also suspect that there will be no giant spike in COVID-19 deaths because the COVID-19 S strain has already washed through the population.

Time will tell, but if we don’t see a giant spike in hospital admissions soon we’ll know we have dodged a huge bullet thanks to the hyper competitive nature of Mother Nature. Having a mild flu out-compete a deadly flu for hosts, thereby saving the host reservoir for another day…you can’t make that kind of stuff up.