A Bad Day for Iron County

Nine positive test results today alone: Washington County (with over 3 times as many people) had eight.

Iron County is down to doubling every 13 days. Here's the chart:

That dropoff is mostly since Thursday.

Keep in mind that I said in class back in March that Iron County would be in trouble when we got to about 125 cases. I was figuring a fifth of those would require hospitalization (25), and a fifth of those (5) would need to be in the ICU, and we'd be fairly close to filling up our 6 beds with COVID-19 patients.

That wasn't quite correct, and I know more now.

I think we're probably in trouble when we hit something like 75 cases within a week. I'm still thinking the one fifth, and fifth of a fifth, so that makes three. But I now expect those people to each be in the ICU for a minimum of a week, and for the ICU to require about half its beds for non-COVID-19 patients.

We're at 27 for this past week.

Cedar City Protest March

For those of you not in Cedar during the pandemic ...

There was a protest march today. I was surprised at the size: perhaps 200 people. We're probably the only place in the world with more protesters than COVID-19 cases.

There were some students I recognized, but not many. Also, President Wyatt, Mindy Benson, the new Provost (Jon Anderson), Cynthia Kimball-Davis, MJ and me (in an SoB shirt).

The march went from the PE building, down to Main St., out to Brad's Food Hut, down to Hurst hardware, and to City Hall. Then down to Lin's again, and back to the PE building.

Many people from town offered free water bottles. And Schvalla Rivera met everyone at the end with snacks and drinks.

There were two 8 minutes and 46 second moments of silence held during the march.

All was peaceful. A few people drove by and jeered, pealed out, or flipped the bird. A counter-protest at the parking ramp was threatened, but I don't think it ever came together.

Not Really Conflicted At All

I'd like to be sympathetic to the good cops out on the streets this week, dealing with demonstrations and rioting.

But someone I know, love, and trust was charged for multiple crimes they didn't commit, and ended up pleading guilty to some to avoid a worse outcome. That bad detective is very likely out working the demonstrations in Salt Lake City tonight.

The bad detective responsible is very likely out working the demonstrations in Salt Lake City tonight.
I can only sympathize with the African-American situation, and perhaps have some empathy. But, for my part I know that the cops aren’t on my side either.

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In the big scheme of things, the events of the past week are not as important as the pandemic. But, they're acute and painful, so I'll insert this into this blog. I hope I don't have to start covering this too.

COVID-19 Co-Morbidities, the Old, and Nursing Homes

The stupid ideas that COVID-19 mostly kills the old and/or members of minorities are still hanging around.

These are stupid ideas because they come from doing this. First, create two bins. Say, those over 65 and those under 65. Second, assign each death to a bin. Third, conclude from the fact that “old” bin has more in it if you’re young you don’t have much to worry about.†

If Jordan Peterson has contributed anything long-lasting to the thinking of many laypeople, I sure hope it’s the idea that if you’re doing social science with just one variable, you’re being pretty dumb. That’s OK as a textbook exercise, or as an undergraduate paper. But the real world is multivariate, and journalists should only talk about the results of multivariate studies.

With disease, those other variables we should look at are called co-morbidities. We are already certain about a few of these: having high blood pressure, or being obese, makes it more likely that you’ll die of COVID-19.

The thing is, most old people have more than one co-morbidity. The question then is, after you account for all the other co-morbidities, does being old still make you more likely to die?

The jury is still out on that one, although most are leaning towards it making a difference.

But there’s clearly another co-morbidity that we need to make sure we include: living in a nursing home or other group home. It should be clear to everyone by now that our policies towards nursing homes are a big part of the problem. For example, in both Washington and New Jersey, nursing home operators were able to hide either sick or dead patients in their care. Further, in New York, it turns out that hospitals were required by policy to discharge patients who tested positive back to nursing homes to infect more people.

Anyway, there’s a lot going on here, and I’m still not convinced that being old is a big part of the problem with COVID-19.

† The story with minorities is much the same, although the bin with African-Americans in it will be smaller. So they add a fourth step: divide the size of each bin by the size of the population it’s drawn from. It’s a fair question to ask if minorities have more co-morbidities, and a problem if they do. But just saying that African-Americans are more at risk, and implying that this is because there’s something wrong with society, is both stupid thinking, but also probably wrong.

Washington County: Not Pretty

From KUER:

“When I look at the trend, what I see happening in the hospital, I think it’s hard to not call this a surge event,” said Dr. Patrick Carroll, the medical director at Dixie Regional Medical Center.

The surge comes one week after the state epidemiologist warned that such an event could take place in Southwest Utah.

The Utah Department of Health recommends that hospitals should not exceed a 60% occupancy rate during the pandemic to create a buffer for a potential surge.

In a press briefing on Thursday afternoon, Carroll said that Dixie Regional, which is the biggest hospital in the area, has now surpassed that threshold.

He added that the hospital still has enough beds and has not yet implemented any of its surge contingency plans. But it may have to if current trends continue.

“This is community spread,” he said. “These are not cases that are all coming from exposure outside of Southern Utah or outside of Washington County.”

Another key shift Carroll identified is that most of the COVID-19 patients receiving care at Dixie Regional are Washington County residents ...

I hate to say I told you so, but I did ... ten days ago to be exact.

BTW: The Iron County numbers took a turn for the worse on Thursday. More on that in another post.

Please keep in mind that, for all we complain about the U.S. healthcare system, what all that money buys us is extra capacity. While the situation in New York City was/is tragic, and while there were widespread worries about ventilator shortages and PPE shortages, we never got as far as triaging patients ... like they did in Italy.

So, that 60% number cited above implies that they expect to fill 40% of the hospital with COVID-19 patients. Further, that 60% is a tad below their average capacity of 63% (found here). DRMC has 32 ICU beds, 132 additional beds, and is licensed to add up to 81 more. So there you go: they feel they might need 13 ICU beds, and 53 additional beds just for COVID-19 patients. Currently, there are 17 people hospitalized for COVID-19 in the 4 county Southwest Utah Health Department's region (of course, that's mostly Washington County).

Washington County Update

Just noticed that this did not publish last Friday.

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Counts of positives go up. The real key is figuring out how much they should have gone up by.

One way of looking at this is days-to-double. Here's today's chart:

By this metric, I think they've had 3 good days in a row.

Nada

It's been a concern that perhaps the virus was in the U.S. prior to January.

This isn't definitive, but Stanford took every preserved nasal swab they had (almost 2K or them) from November and December, and tested them. They got zero positives.

The University of Washington also did this, but for all 3K + samples from the months of January and February. They found nothing prior to February 21st.

Locals Volunteer in NYC Hospitals

I guess it's a normal thing, but it's still a little sad that human respond better to anecdotes than to data.

Anyway, some of you know Dr. Jarid Gray and/or nurse Justin Robbins from our hospital. The two of them volunteered to work in New York City. There full account is in Iron County Today's May 13 issue (you can download the whole thing, their story begins on page 3).

It's pretty harrowing.

... Gray went to ... a 585-bed hospital ... At their peak they had 750 patients, and over 90 percent of them were COVID-positive. When I arrived, the number of patients was down to 650, with 170 patients on ventilators, and still over 90 percent of them were COVID-positive.
 ...
 I [Robbins] was assigned ... about double my patient load at Cedar City Hospital. ... When I was there at Southwell, for two weeks I only discharged two patients. The COVID patients on Med/ Surg were there a long time, I personally worked with the same group the entire time
 ...
The demographic of patients had much less pulmonary disease than one would think. “Not a lot of asthma, not a lot of people with COPD,” says Dr. Gray. “Hypertension was the most common thing among the patients, second most common was diabetes or coronary artery disease. I was struck by the fact they were a little younger than I would expect to see. The average age of the patients was 61. The patient’s comorbidities (having two or more chronic diseases or conditions in one patient at the same time) were not as extensive as you would think. Maybe it’s because all of those patients had passed away by the time we got there and we were just seeing the survivors.”
...
“The physician that oriented me at Long Island Jewish was pretty defeated,” says Dr. Gray. “He would say ‘Nothing is helping, nothing is working, patients are just dying and we can’t do anything about it.’” He was scared.
...
“Northwell is a progressive, forward thinking company,” says Dr. Gray. “They’d contracted with 500 traveling nurses in anticipation, started ordering additional PPE, and did everything they could to try and stay ahead of the game. But I think it was Mike Tyson who said ‘Everyone has a plan… till you get punched in the mouth.’ And they got punched in the mouth pretty hard. Northwell didn’t realize that, essentially, their entire hospitals were going to be COVID patients. They thought they could manage it with the bed population they had. For example, they normally have 35 ICU beds. When COVID hit they had to expand to 200. It took over full units of medical beds, with them having to put multiple patients in the same room. They thought they’d be able to manage it with the providers they had. But they ended up repurposing everyone in their system and put them in the hospital
...
Dr. Gray says having been a physician for over 20 years, he has never seen a hospital be taken down with one single condition like this. “Please don’t compare COVID-19 to flu,” says Dr. Gray. “It is a lazy comparison.
...
“I have responded to more rapid response calls (patient in distress) in the two weeks I was at Long Island Jewish than I have over the course of my entire career. I have heard more code blue calls in one day than I have heard at our hospital over the course of a year

They also did a Zoom meeting after they got back. Supposedly COSE was going to post that somewhere for the community, but I haven't seen it yet.

UPDATE: Here is the direct link to the video on YouTube. BTW: Dr. Gray is an SUU alum as well. It can also be found on the Alumni Relations site at https://www.suu.edu/alumni/forever/ .

P.S. One thing that I got out of the video that I haven't seen elsewhere is that Dr. Gray reported that the hospital system he was at had 300-350 patients who had survived COVID-19, but due to lung damage would have to be on ventilators for life.  The prognosis for that is horrific. Before polio was brought under control through vaccination in the late 1950's, people who survived it often had to live inside an "iron lung". In short, those 300-350 people are looking at lifetime institutionalization in a skilled nursing facility.

Day Late and a Dollar Short? Washington County Edition

The Governor's coronavirus task force reviewed the data from Washington county on Wednesday. Wonder if they read my post from Tuesday (which, BTW, sat from Sunday half-written, based on stuff I'd noticed late last week).

Not bragging (well maybe a little), but definitely trying to point out to SUU economics majors that you have the tools to figure this stuff out, and may be better at it than higher authorities.

State officials are reviewing an increase in coronavirus cases in Southern Utah and expressing concern – especially for Washington County where cases have gone up 50% in the last week.

...

... in the last 72 hours, someone in Washington County has tested positive for the COVID-19 virus every two hours.

...

Much of that has come within the city boundaries of St. George, as the Utah Department of Health has started releasing data specific to small areas and cities. Of the 156 cases in St. George, as of Wednesday, more than 100 have been in the last two weeks.

...

Dr. Angela Dunn, the state epidemiologist with the Utah Department of Health, told St. George News that Southern Utah got the attention of the governor’s coronavirus task force, which reviewed the data from the area Wednesday morning. She said it was determined the hike in the local case rate cannot just be linked to an increase in the number and availability of testing.

“It doesn’t seem to be linked to increase in testing. We’re seeing an increase in the percent positive as well,” Dunn said. “There is the potential for more of a surge in Southern Utah. At this point, we’re asking the community there to be a little more diligent about social distancing.” 

All those quoters were from the article entitled "State concerned about rise in Washington County COVID-19 cases, local officials not as alarmed". Hat tip MJT.

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For my part, the last 2 days of data that I can see on the site of the Southwest Utah Public Health Department look a tad improved. Keep in mind that it improved the same way from the 13th to the 15th. (One thing I intend to post about soon is that you need to have be careful with high frequency epidemiological data: it gets lumpy and bumpy. I'll show you how to fix that too).

Also, I've been doing the same charts for Iron County as I did for Washington County. They look better. BUT ... the last week in Iron county looks worse. Nothing like Washington county, but definitely not improving.

Unflattening in Washington County (Utah)

Uh oh.

Cases are going up at a somewhat more disturbing rate in Washington county, Utah (St. George metropolitan area). I'm going by memory, but I believe about a quarter of SUU students are from there, so this should be of special interest.*

I'm still up here in Iron county, and the data is not showing the same behavior here. Possibly, this is because infection rates here are about half of what they are in Washington county.

Utah has been opening up for a little over 2 weeks. This is due to widespread perception that we have "flattened the curve".

I sense that more people use that phrase than really understand what it means. That is, a flattening of a curve on some time series chart with a log scale, like this one:

The log scale is important; "flattening" is defined with respect to logged data only. It corresponds to "growing more slowly" (part of the reason data scientists like logs is that the slope on a graph like this is proportional to a growth rate). The base for the logs is not important for seeing flattening. But, the base is important for some other things you might want to do with this graph. I prefer to use 2 as my base (most sources online use 10 as their base, which to me is inexplicable, and smacks of innumeracy).

What we see for Washington county is that the epidemic, while small, was growing quickly in March. While the world is new to shelter in place orders, the general belief is that they take a couple of weeks to produce a difference. We see that here: April was a month of flattening for Washington county. But May ... not so much.

Another way to look at this is how long it takes a variable to double (we could do other multiples, but people are most comfortable with doubling). This is where the usefulness of base 2 logs comes in: doubling on a chart of base 2 logs corresponds to going up by one. And, for any two days where that logged data goes up by 1, we can just count the days off along the horizontal axis. Even better, we can chart that too:

 

This chart "looks backwards": from a date on the horizontal axis, how many days do we have to count backwards before we get to half as many cases. The quick drop to low numbers in March shows the outbreak getting a foothold in the county. The steady increase through April shows the effectiveness of shelter in place orders. But things have gotten worse in May. The latest date shown here is May 19th, and Washington county's cases have doubled since May 9th.

The same thing has happened with deaths. There have only been four COVID-19 deaths in Washington county so far. Initially, they doubled from one to two in 28 days. They doubled again from two to four in 25 days.

Keep in mind that what is shown here is positive test results. Those are not a great measure of the status of an outbreak, but this is the best one anyone has got. Cases are positive test results. They will go up when there are more infections, but only when more tests are done. They will also go up when infections are not increasing if more tests are done. After considerable delay, by early April the U.S. was testing more than other countries, so that second reason is probably not a concern anymore.

* County level data on cases and deaths is now being tabulated by The New York Times, and is freely available for download from GitHub.
† I do have people from outside my classes read this blog, and in particular from outside of Utah. Washington is a fairly common name for counties, so I specified that in the title.

COVID-19 # 65

Like a ton of other places, it appears Mexico is lying too.† An anti-corruption group in Mexico leaked death certificate information (from Mexico City  only) to the Associated Press. This data suggests the actual toll is over 3 times higher than the official numbers.

Anyone paying attention anymore??? China now has 108 million people under quarantine. These are different people from earlier this year, in a different part of the country. Oh ... and Wuhan had a bunch of new cases this week.

Antibody tests in Los Angeles county show a 95% confidence interval of 2.5% to 7.1% of the population as having been infected. The median estimate amounts to 367K infections. The number of current positive test results is a tenth of that.

STATNews has a piece showing an ugly side to Utah. Entitled "Utah went all-in on an unproven COVID-19 treatment, then scrambled to course-correct" it details how the state bought a large amount of chloroquine/hydroxychloroquine from a politically connected seller with scant evidence. The story had to be uncovered using public records requests. They cited this expertise:

“Our president came out and suggested the medications,” Babitz said. “So we’re very confident this could make a significant difference.”

Babitz is deputy director of the state health department. The other two experts highlighted include the owner of a mail-order pharmacy based in Utah, and an MD from the U specializing in musculoskeletal disorders and the evaluation of commercial drivers". Ultimately a different division of state government (read between the lines here ... crossing into new turf usually requires executive action) order $800K of the drugs. All of this was done without going through the state epidemiologist, Angela Dunn, who Governor Herbert always put in a place of prominence at his press conferences. Folks, this is crony-capitalism, and it's what gives free markets a bad name. On the bright side, Utah is also pretty good about cleaning up its messes; the $800K purchase was eventually refunded.

Brazil has been in the news. The epidemic is getting larger there, and is being downplayed by their president. Not to encourage that, but it sounds like a lot of places around the globe, so I don't think it's that informative. Here's what I think is informative: it's autumn there, moving into winter, and a lot of the areas of Brazil where a lot of people live are temperate. We need to pay attention to this one to see how sensitive the virus is to the seasons.

FWIW: If you recall, I mentioned in class in the spring semester that I had a family member with COVID-19 like symptoms in January. We all got antibody tests last week. I'll let you know the results. Also, my brother in New York state thought he had it in early February; his test came back negative.

† For the life of me I cannot understand how some people in the United States can assert that the death tolls are overstated in some sort of shadowy conspiracy, when there is solid evidence from a number of different countries of governments covering up the true death counts. WTF.

UPDATE: The issue with Mexico is a nastier and less common one. Many countries and regions have had deaths occur so often that they have been unable to keep track of them, or to categorize them appropriately. Instead we now have solid evidence that Mexico is announcing official death tolls that ignore about 70% of the coroner's or attending doctor's medical diagnoses on death certificates. That's far worse, and in fact may be the worst case yet; since all we have about China and Iran is conjectures, accusations, and circumstantial evidence of undercounting.

Seoul Bar Cluster Update

One guy did this by going out on one night:

KCDC Seoul nightclub outbreak update:

153 people in total so far infected. 90 club goers infected. 63 friends , family and colleagues caught COVID19 from them.

More than 46,000 people have been tested for covid19 in connection with these cases.

— Laura Bicker (@BBCLBicker) May 15, 2020

Nightclubs and bars are open in South Korea because they had daily new cases down below twenty.

COVID-19 # 64

There's new research on social distancing (by a team of economists no less, using econometrics' techniques). And it works like a charm: they estimate the reduction in cases in the U.S. from March 1st to April 27th at 90%. Interestingly, the also provide simulations showing that social distancing did us almost nothing in March (because the outbreak was still small), but those small gains were amplified in April. They broke down social distancing into 4 categories. They found that banning large events, and closing schools did little or nothing. All the effects were from shelter-in-place-orders, and shutting down of bars, restaurants, and other entertainment-related businesses.

Of course, this means that it's crazy for New York City to have allowed bars to re-open this weekend.

It's a big mistake by @NYCMayor -- he ordered streets blocked off to allow safe distance strolling. But in parts of Brooklyn, bars & restaurants opened windows, selling booze & food along those streets. Result: giant mask-free parties.https://t.co/gFaAHEcnOl

via @GoogleNews

— Laurie Garrett (@Laurie_Garrett) May 17, 2020

I must have been prescient when I noted the other day that I'm starting to think DeBlasio and Cuomo are not heroes at all. ProPublica, an investigative website, published a long article noting  the different policy choices between the mayors of San Francisco and New York City, and between the governors of California and New York. While smaller, New York ended up with 10 times as many deaths, most of them in New York City.

Also, you may recall BD and I noted this it might be premature, but it was not unusual, for the mayor of San Francisco to declare an emergency before they had any cases. Now this seems ... enlightened. Do note that in that post I wrote that it is common to declare an emergency before the emergency hits, to free up funds earlier. I also wrote that this policy is "goofy". Poor word choice ... I meant that it's unexpected when you learn about it, rather than stupid.

There's been a super interesting break out of China. Jennifer Zeng (definitely anti-Xi) reports that Foreign Policy, a respected periodical, has obtained an internal database from China tallying cases and totals. It was gathered by academics for use by the military in providing medical support throughout China. Here's the thing: the database has 8 times as many records ("rows" of data sometimes detailing more than one case) than China's official number of cases. The periodical is keeping a lid on the database currently as they try to confirm its details.

Javier O, writing at Medium, does a lot of digging about early cases in various places around the globe (here, here, and here). He finds an interesting correlation: auto production plants near initial outbreaks in many countries. Why is this interesting? There were 7 major international auto shows in the fall, including 3 in Wuhan (the Detroit of China), running for 12 days between November 1st and 17th. Uh on.

I am guarded about this. But, from a Bayesian perspective, it's getting awfully hard not to conclude that that the virus escaped from a lab. I was quite dismissive of that conclusion in February, both on this blog while in class (sorry BD), and in the seminar I presented to faculty and students on the 27th. Then we found out:

• China has level 4 virology lab near Wuhan.
• That lab's safety was criticized not just by the U.S. government but China's as well.
• They studied bat coronoviruses. In fact, they imported live bats into the region.
• No animal host has ever been as strongly correlated with SARS-CoV-2 as bats.
• They had a satellite lab just around the block from the wet market, again with live bats.
• The lab did work on augmenting bat coronaviruses (basically, letting them evolve in a petri dish to better infect human cells, so we can figure out our own weak spots).
• The samples of the bat coronovirus closest to SARS-CoV-2 were destroyed (they kept the genome).
• Cellphone data shows that the most secure part of the main lab was shut down for over 2 weeks in October.
• It's been a month now that China has been saying that a researcher who went missing from that lab was just working elsewhere. In a month, you should be able to find them for a zoom conference.

Each point pushes me from near 0 probability that the virus came out of a lab, towards 100% probability that it did come out of a lab. I'm not sure where I am right now, but I'd say well over 50%.

COVID-19 # 63

The New York Times reported that most viruses nationwide appear to be related to the strain from the outbreak in New York, rather than the initial one in the Seattle area (oh yeah ... remember that one??).

Even in Utah 90% of the viruses sequenced are from New York. In turn, that strain appears to have come from Europe, in particular Italy. This suggests a couple of things. First off, long-distance travel (primarily planes) is really effective at spreading the virus. But second, even so, the virus did not take off in many locations the same way that it did in the NYC area. So there's something else going on ... subways maybe.

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What's worse, is that those same researchers figure there were 10,000 undiagnosed cases spreading in NYC by March 1. It's hard to recall this now, but both New York City and New York state dawdled rather than shut down. For example, San Francisco shut its schools 3 days earlier than NYC, which had 18 times as many positives at the time with only 9 times as many people. The entire Bay area beat NYC with a stay-at-home order by 5 days.

It seems that NYC may be the lily pad case outlined by Megan McArdle. She focused on the end game: if lily pads on a pond are doubling every day, and it takes 30 days for them to double, on what day do they cover half the pond? The answer is day 29. But, if you flip that around, if you can delay the lily pads at the start by 1 day, you'll only have half the pond covered by day 30. Looking back at the data, deaths in NYC doubled (almost exactly) 3 times between March 17th and March 22nd. By May 1st, they'd only doubled 6 additional times.

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As is typical, the media are availability entrepreneurs. And the politicians in New York have been available. Governor Cuomo and Mayor DeBlasio are getting a lot of attention.

But the real heroes in all this may be political executives like California Governor Newsom and San Francisco Mayor London Breed. We're not hearing a lot about them because they made better choices first, rather than fixing their initially bad choices. †

† There's an analogy to quarterbacks here. It frustrates me endlessly that sports journalists extol the number of 4th quarter comebacks made by quarterbacks (John Elway was famous for this). Perhaps they should be asking about quarterbacks who never get themselves into that position in the first place.

COVID-19 # 62

I laughed:

"You’ll be pleased to know that, rather than double down on our containment efforts, we’ve decided to dissolve the velociraptor containment task force altogether, and focus instead on how we can get people back into the park as quickly as possible."https://t.co/wpH7Ny6Dqu

— Dr Alexandra Phelan (@alexandraphelan) May 7, 2020

The linked article goes into more satirical depth.

Avoid misinterpreting the nursing home data. Rough estimates suggest that 1/3 of the people who have died in the U.S. were living in a nursing home at the time of infection. It's easy to conclude from this that age is an important risk factor (and I'm not saying it isn't, just that we should not overdo it). Anyway, think about it: people in nursing homes often have multiple pathologies beside age that might lead to a COVID-19 death. Let me add another one: merely living in an institution may be a risk factor. In short, if someone is talking about age as a risk factor, and they're not also talking about all the covariates that they corrected for ... you should probably stop listening. Yes, that advice targets just about all the legacy media. We are also starting to get some data in from countries with little or no nursing home industry (for example, Belarus), and they are not noting high death rates amongst seniors.

On a related note, it's also time to start thinking about what risk factor has made New Yorkers so likely to become infected. The obvious one they are looking at is widespread use of public transportation.

I have a lot of personal connections to Ghana, so I get emails. The growth rate there hit 29% per day last Friday. Today their president reported that a single infected worker in a fish market has been linked to over 500 cases. I have also gotten reports that food is starting to get scarce in the stores. And, I've noted a couple times over the last few months that crises are often used to shift the balance of political power, and I have first hand reports of decisions from Ghana which use the outbreak to shift resources towards favored groups.

Seoul has also seen a super-spreader event: a man who went clubbing last weekend has been linked to over 100 positive cases.

The city of Shulan in northeastern China is on lockdown. Also, Wuhan had its first case in about a month.

New York City reported this week that they are having trouble figuring out how a majority of new cases were transmitted: no exposure, social distancing, no public transportation, etc. This means it is circulating in the open air in sufficient quantities to infect people.

Here's the Iran news:

#Iran: #Coronavirus death toll exceeds 40,700 in 316 cities
Regime officials admit increase in number of infections in Khuzestan, Tehran, Gilan, Semnan, and Kermanshah#COVID19 https://t.co/088uIj1lzv

— Mohammad Mohaddessin (@Mohaddessin) May 11, 2020

Do keep in mind that this is from a site opposed to the current regime. BTW: that disturbing video that came out about 2 weeks ago from Tehran does not show a field of graves ready to be filled. It's worse than that: those are crypts. The narrow trenches are for worker access to place many shrouded bodies on shelves all at once, then the whole thing can be bulldozed with dirt and covered with flagstones. That's a surprising degree of scale and efficiency for a regime that says they don't have much of an outbreak.

Of course, I'm writing this in the week where the outbreak has penetrated the White House, with a valet for the President, and a spokesperson for the Vice President testing positive, two members of the Joint Chiefs of Staff, and 3 top public health officials all on quarantine.

But it's worse in Russia. Putin is holed up at his country home, and hasn't been seen outside in weeks. Meanwhile, several top aides there have tested positive, including the figurehead prime minister, and Putin's longtime personal spokesman (who has been hospitalized). Russia passed the UK for the 2nd worst outbreak in the world yesterday.

Greg Mankiw

A lot of you used Mankiw's texts for either micro or macro.

He posted a great piece about his mother's life on his blog: child of immigrants, no chance at college, worked as a cosmetologist, bad first marriage, better second marriage, had a gifted son and returned to work to get him into a private school early, eventually retired to the Jersey shore.

You can probably anticipate the punchline:

This is, I am afraid, where the story ends. Last week, Dorothy Theresa Sawchak Mankiw tested positive for Covid-19. Yesterday, she died.

Another Milestone

Students may be a little young to remember the tsunami of 2004 (videos here). Anyway, largest earthquake in the world in 40 years, sudden vertical rise of the seabed by several meters, initial wave of about 35 (and tsunami waves do not break offshore), eventually ocean water up to 170 feet deep on land. And 228K people killed. Many vacation spots around the Indian Ocean were hit (the day after Christmas) so it was a global catastrophe.

Passed that this week too. We're up to 256K worldwide now.

We're now ranking this with worst natural disasters in human history. COVID-19 is number 6 right now. We should pass another during the week of the 11th (the 1920 earthquake in China), and another during the week of the 18th (the Haitian earthquake of 2010).

COVID-19 # 61

Oh ... crap. Google/Blogger and the EU have made it harder (again) for me to repost images.

Apologies. Took some days off: grading and gardening time.

Doctors in France believe 2 patients admitted to hospitals in Paris in December were positives. One alleged his daughter got ill before he did. If confirmed, this would completely blow the lid off the whole wet market in Wuhan story.

King Un is alive and well. Or is he? Internet sleuths are claiming the videos released the other day show a body double. Un is known to have more than one.

Hospitals in Wuhan are still not turning their central air-conditioning on. Temperatures have been as high as 91° (not sure if that is an outside or inside temperature, probably the latter). This is due to recent research believed to show transmission through a/c.

Chinese internet sleuths have identified a lab worker from that Wuhan virus lab who has disappeared. Rumor is that she was patient zero. Here's the thing: like most internet rumors this can be easily shown to be absolute and complete nonsense if she'd just make a public appearance. Unless ... she can't.

Lots of states are "re-opening": 27 at last count. While the guidelines for this are rough at best, only 9 of those 27 actually pass on all counts.

Here's the bad news. People have convinced themselves we are doing a good job. Except that 1) we're doing about as well as predicted by the CDC:

There's a lot to say about newly released projections for #COVID19 in the USA. I'll be talking about it on @NewsHour tonight. But let's take a look at some of the stark, terrible new data and forecasts.
First, new infection rates will soar in May/June, hitting 3K/day.
MORE pic.twitter.com/ztkEbJAJEW

— Laurie Garrett (@Laurie_Garrett) May 4, 2020

and 2) the CDC forecasts things to get worse. Ummm ... hey folks out there ... the CDC isn't making mistakes on this, you are. Also, the Washington Post obtained internal documents from the White House forecasting 3K deaths/day by the end of the month. Try clicking through this link to see the chart that I'm talking about.

This is probably a good time to remind you that I posted about this exact sort of behavior about 2 months ago when we were still meeting classes face-to-face.

It is also worth remembering that the initial approach of the UK was very much like that of Sweden. In both cases, the countries made an assessment that the public would fatigue of social distancing before the virus stopped doing its thing. They didn't think social distancing was ineffective; they thought we were all morons (but were too polite to blurt that out).

Of course, you already knew this:

April 2020, United States
and likely will be #1 for months to come
by @PostGraphics pic.twitter.com/QXGKcJClIq

— Eric Topol (@EricTopol) May 3, 2020

 But I like the new visualization. Except they won't let me repost the visualization any more, so you have to click here.

The Prime Minister of Russia tested positive the other day. That's not Putin, but a figurehead just underneath him.

Have you looked at case counts in San Juan county lately (that's Moab, Monticello, Blanding, Bluff, Mexican Hat, and part of the Navajo reservation)? It's rate is now # 3 in the state, ahead of both Salt Lake and Utah counties.

Oh ... and Gallup (on the other side of that reservation) was quarantined by the Governor of New Mexico. It's rate of 4,500 positives per 100K people is twice what it is in most of New York City.

What is it with repressive place releasing prisoners? Now Cuba has done it too.

What European Union? President Macron of France believes that borders will not re-open in the Shengen area until September.

I'll end with some trivia. Saks department store is close to bankruptcy. Hold that thought. When teaching principles of micro, students often ask what the oldest corporation in the world is. It's a little bit surprising: it's a department store in Canada. If you've ever been there, most malls have a store called The Bay. What most people don't know is that reaching way back into your American history classes, there were trappers in the western U.S. who came down from Canada and worked for the Hudson Bay Company. That Hudson Bay Company, founded in 1670, runs through one unbroken corporate line down to The Bay of 2020. And The Bay also borrowed a lot of money to buy Saks  few years ago. The structure of the original deal is not quite clear, and renegotiations are in progress, but there have been rumors going around for a couple of weeks that bankruptcy of the Saks subsidiary may take the parent company down with it, after a 350 year run.