“Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning.” – Albert Einstein

The Questions Nobody Is Asking 

I meant to write today about the economic impact of the Corona Crisis. But I feel compelled to continue with yet another discussion of the mysterious logic and undisclosed arithmetic that has been part of this crisis since the beginning. 

Answer This 

Here’s a question: If knowing that the lethality rate is important in plotting a strategy to deal with coronavirus, why haven’t we done the right kind of testing? Why are we testing only frontline workers and people that are exhibiting symptoms?

I’m serious.

Why aren’t we conducting a large random study to determine what percentage of the population has COVID-19? If we knew that, we could answer the critical question: How lethal is it?

If you’ve been following the major media, your answer will be: We have to test people with symptoms to save lives.

But is that true?

Think about it. This is the current protocol…

Step One: You feel that you have symptoms. You call your doctor or some public health service. You describe your symptoms. They ask your age – i.e., if you are over 65 – and if you have diabetes, cancer, asthma, or any other relevant comorbidity issue. If your answer is no, they tell you not to worry.

Step Two: You answer yes and get an appointment for a test. If the test is negative, you are sent home. If it is positive but your symptoms are not severe, you are sent home.

Step Three: Your symptoms are severe enough to be admitted to a hospital. They may, if you are lucky, give you an unproven medication like hydroxychloroquine to get more oxygen in your blood. If that doesn’t work and you get worse, they put you in ICU and keep an eye on you. If you can’t breathe, they intubate you. Your chances then of living are, at best, about 50/50.

Here’s the thing: If you are diagnosed with coronavirus today, your chances of being hospitalized are about 10%. Of those hospitalized today it looks like about 20% of them die. (This percentage is based on the states that are reporting this data.) So that sounds like your chances of dying from coronavirus might be 2%.

But again, this assumes that we have diagnosed 100% of those that have coronavirus, which we’ve seen is an understatement by a factor of 10 to 100. Factoring those numbers into the equation means that hospital intervention, though heroic, is effective for fewer than two-tenths of 1% (0.2%).

That’s sounds terrible, but it’s just another way of saying what the medical establishment has been saying all along: There is no statistically valid medical intervention for successfully treating coronavirus.

So why do tests?

There’s actually a very good reason. If, as I’ve been arguing, the real fatality rate of COVID-19 is a fraction of 1%, we need to know that. It could suggest another protocol for ending the disease than the one we are on now.

The Test We Need 

We can find the real mortality rate with a different sort of testing than we are doing now. If, instead of testing only those with symptoms (and even severe symptoms) we tested a good-sized random sample of apparently healthy people, we could arrive at the number we are searching for.

If we tested 50,000 Americans that don’t have symptoms, we could find out how many of them have been infected and use that percentage as the multiplier we need. Say, for example, that we found out that 10% of those tested had the virus. We could then assume that 10% of the population – about 33 million people – have been infected.

If we do that and discover that the fatality rate is 0.02% (see my April 13 blog), we could then begin an intelligent discussion about the best way to battle the virus.

We still wouldn’t have a treatment. But we would have the three most important facts: How lethal is it? How infectious is it? And how many people have already been infected?

I’m talking here about a big random test, big enough to come up with reliable answers to those questions. But you should know that there have already been several tests on smaller populations. And the results of those tests indicate that the real mortality rate is not the 10% that was first reported, nor the subsequent estimates of 6% and 3%, nor the 1% that Dr. Fauci and Surgeon General Jerome Adams have started using, but just a small fraction of that.

As I’ve been saying for two weeks now, if it turns out that the actual fatality rate is this low, it would mean that just about everything we’ve been doing so far to stop the disease hasn’t made any significant difference.

Not in terms of the final death toll.

I know. That’s sounds crazy. It contradicts everything you’ve been told. But hear me out.

Another Question That Nobody’s Asking 

Slowing the spread of the virus would mean fewer overloaded hospitals. That’s for sure. And that would mean, for example, a better chance that hospitals would have enough ventilators available for their COVID-19 patients that needed them.

But has a lack of ventilators actually been a problem?

I spent an hour this morning looking for cases where hospitals ran out of ventilators. I found none. As far as I’ve seen, everyone that has needed to be on a ventilator was put on a ventilator – even in New York City.

But let’s say, for the sake of argument, that 100 patients have been denied ventilators and that half of them died. Since we know that, at best, ventilators save half of those that are put on them (the consensus is between 50% and 10%), that’s 25 people out of a population of tens of millions that were infected. It’s not a statistically significant number.

As I mentioned on Monday, predictions of such shortages is what persuaded me to think that the protocol of social distancing and the shutdown was sensible. But if that isn’t the case, and isn’t going to be the case, we have to consider whether slowing the virus is going to save lives… or possibly increase deaths.

Again, I’m sure this sounds crazy if you trust the information and advice you’ve been hearing from Dr. Fauci and the major media. But what they are saying – that slowing the virus will reduce deaths – doesn’t make sense to me.

The only thing that can stop a virus from spreading is herd immunity.  I hear what you are saying: Vaccination is the way. But vaccination is a type of herd immunity, as I’ll explain in a minute.

Herd immunity is what happens when a large percentage of the population is immune to a virus. Depending on the virus, that percentage can range from 40% to 60%. When you get to those numbers, the virus cannot spread like it needs to because its host population is too small. So it dies off naturally.

This is what happens with the flu each year. Approximately 50% of the population gets vaccinated. And some other percentage catches the flu and gets over it. As I said above, vaccination is not a different strategy from herd immunity. It is an artificial way of accelerating it.

It is also a way to protect the most vulnerable, which is usually the old and those with a compromised immune system. That, too, is standard protocol for the herd immunity strategy. Protect the vulnerable from the higher risk of dying by encouraging them to get vaccinated. Do the same with the general population. But don’t worry if the young and healthy ignore that advice. So long as 40% to 60% of the population becomes immune (by vaccination or by contracting the disease), the virus will die out naturally.

Social distancing is not a way to achieve herd immunity. It is a way to slow the spread of the virus so that hospitals won’t be overwhelmed. But until you have herd immunity – either by vaccinating 40% to 60% of the population or by allowing that many to be infected – the virus won’t die. It will keep coming back until the host population is too small.

This is why epidemiologists are warning us about a second and third wave. It is almost certain to happen precisely because we are slowing the spread of the virus with social distancing.

Put differently, social distancing neither decreases the lethality of coronavirus nor the eventual number of people that die from it. It only decreases the speed at which it spreads.

(Now isolation is another matter. If you are old and have comorbidity issues, self-isolation will definitely reduce your chances of contracting the disease and thus dying. I’ll handle that in a future blog.)

A Final Question 

This brings me to my final question: If we could achieve herd immunity before the middle of next year – i.e., before we can vaccinate 120+ million Americans – wouldn’t that be what we should be striving towards?

If we accept the facts that (1) herd immunity is the only way to kill the virus, (2) the real fatality rate is 0.1% or 0.2%, and (3) that a vaccine is a year or so away, doesn’t it make sense to try to achieve herd immunity as quickly as we can before then, while doing everything we can to isolate those who are most vulnerable?

By achieving heard immunity naturally, by isolating the vulnerable but otherwise letting the virus spread, wouldn’t that render the second and third waves weak or even impotent?

Of course, I don’t know the answers to those questions. But it bothers me that so few people are asking them.

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Some of my friends are arguing about the administration’s response to the Corona Crisis. I’m not interested in that discussion, except from a social and psychological perspective – i.e., how social myths affect rational thinking . But here are some of the facts:

US COVID-19 Case and Death Timeline 12/31 to 4/14 

December 31: China reports virus to WHO

Case and Death Toll: 1 case, no deaths 

January 6: CDC issues travel notice to Wuhan

January 17: CDC starts health screening at SFO, JFK, and LAX

Case and Death Toll: 1 case, no deaths 

January 20: Dr. Fauci says NIH working on vaccine

Case and Death Toll: 5 cases, no deaths 

January 27: CDC announces Level 3 travel notice

January 31: Trump announces travel ban to start on 2/2

February 6: CDC starts shipping testing kits

February 24: Administration requests $2.5 billion to combat the virus

Case and Death Toll (2/28): 9 cases, 4 deaths 

February 29: FDA allows certified labs to begin testing while pending applications; Trump raises travel advisory to Level 4

March 6: Trump signs $8.3 billion coronavirus spending bill

Case and Death Toll (3/7): 407 cases, 27 deaths – 6.6% case fatality rate (CFR) 

March 9: Administration asks Congress for payroll tax cut

March 11: Trump announces travel restriction for Europe

March 13: Trump declares national emergency to access $42 billion in funds

March 13: FDA approves Roche AG and Thermo Fisher tests

Case and Death Toll (3/14): 4,240 cases, 63 deaths – 1.4% CFR 

March 14: Coronavirus Relief Bill passes House

March 16: FDA allows testing in state labs

March 18: US Navy deploys two hospital ships

March 19: Trump announces hope for hydroxychloroquine

March 21: Administration places orders for millions of N95 masks through FEMA

Case and Death Toll (3/21): 45,093 cases, 297 deaths – 0.65% CFR 

March 28: Trump and Cuomo talk

Case and Death Toll (3/28): 107,930 cases, 2,001 deaths – 1.8% CFR 

April 2: Trump invokes Defense Production Act

Case and Death Toll (4/4): 229,268 cases, 8,379 deaths – 3.6% CFR 

April 5: 3,000 military and medical personnel deployed to NY

Case and Death Toll (4/11): 522,843 cases, 16,593 deaths – 3.1% CFR 

April 12: FDA authorizes devices to decontaminate 4 million N95 respirators per day

Case and Death Toll (4/14): 602,473 cases, 25,668 deaths – 4.2% CFR 

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verbing (noun) 

I’d like to interrupt all this Corona Crisis coverage to raise an objection to something bothersome that has been accelerating during this time of stress. I’m talking about the soon-to-become ubiquitous “verbing” (the practice of using a noun as a verb) of pivot – e.g., “We may have to pivot here and change our marketing strategy.”

I’m not crazy about impact or medal as verbs, either. But pivot is an odious development. Please join me in resisting the temptation to use it. If we can keep a good social distance from it for at least until the Corona Crisis has passed, perhaps it will die out naturally.

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The Fault in Our Stars by John Green

A synopsis of the plot that I found on Shmoop.com crystalizes my initial impression of this tender, teenage novel:

“Dying girl meets hot boy. Hot boy and dying girl fall in teenage love and go on adventures to Amsterdam together. Dying girl is disappointed by her meeting with a certain author whom she idolizes. Dying girl and hot boy admit their love to each other and have physical relations. In a horrible twist of fate, dying girl lives while hot boy dies. The end.”

Yes, it’s a novel for teens. No, I don’t know why it was a selection for our all-adult-male book club.

Actually, I do. Although the plot, diction, and characters are appropriately aimed at teenagers, the central theme – finding meaning in an apparently meaningless universe – is always worth an earnest discussion. And we had one. (After we japed at those that enjoyed it.).

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“Hozier Sings ‘The Parting Glass’”  – a beautiful rendition of a beautiful Irish song that might bring some thoughts and feelings back into a larger perspective.

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