So it's been about 2 weeks since I last updated about where I see the whole CoViD-19 situation going. This is due to my wanting to have more data, before I started ranting. Well much of that data is in, so here we go...
First, we've seen some of the most amazing things with respect to reopening. Things I would not have thought would happen in my lifetime. First, we've seen people openly carrying weapons on to the grounds of the state capital building in Lansing, MI. (Interestingly, they even carried them into the building lobby, but were not allowed to carry in their signs. That's just plain surreal.) We've seen people starting to openly defy the stay closed orders, some for beaches in Orange County, CA, and now more and more examples of business owners who are reopening their business without 'permission'. The people are speaking and voting with their feet (and "arms"). Plus many "red" Governors are rapidly opening their states. The map of open versus closed states is looking more and more like the electoral college results of the last election. So who is right? The people? The "red" Governors? The "blue" Governors? Some of all? None of the above?
Sadly, I am forced to conclude that the correct answer is 'none of the above'. Here's a smattering of reasons why (focusing on states I have a personal interest in):
1) Not one group is using the only sane and sensible method to reopen. The one I blogged about back on April 19 (that's 19 days ago!). The one based on the data. Nope, not one of all the Governors, regardless of their party affiliation, are actually using the data to do things right. I have yet to hear a single Governor talk about opening the economy, but warning the old or those with underlying conditions to remain as isolated as reasonably possible, and to tell the rest that they simply must stay away from those who are still isolating.
2) Ohio: Even DeWine, (a 'red'), who has done, so far I can tell, a wonderful job to this point, is simply ignoring the data and using the broad brush approach. It's like to trying to fight a fire by spraying water in random directions, even if the blaze is not within view. As an aside he's fallen into the trap I pointed out back on April 26. He's quoted as saying:
Clearly he 1) can't see that increased testing will push the reported numbers up, even as the rate of infection drops, and 2) seems unable to recognize that 362 is actually less than than 442 and 54 is less than 70.
[The number from Monday, April 27] of 362 more cases was below the recent five-day average of 442 cases. He pointed out hospitalizations of 54 on Monday as compared to the daily average of 70. “We’re not going down [my emphasis] ... but we’re moving in the right direction,” he said. Before providing the reopening details, DeWine again stressed that an increase in virus testing and contact tracing to track down those potentially exposed to coronavirus will accompany the restarting of Ohio. (see here)
3.A) California, state: Our wanna be socialist tyrant (yes, a 'blue') has had his plans thoroughly changed due to pressure from the populace. First, he wanted to re-close all the beaches, but had to back down in response to the overwhelming backlash. Then he shifted from the first phase of reopening going from "weeks away" to "days away" when the people started realizing that he had no intention of ever giving up his total control and just started reopening on their own. But he's also still pushing stupidity over data. He isn't making the obvious warnings, but he is requiring that to reopen, every business has to take the temperature of every employee as they report for work. Does he really believe that's anything other than a freaking waste of time? The number of people who have the disease while remaining asymptomatic is not clear, but it is certainly much greater than 0. I've seen three reasonable estimates. The pregnant women checking in to a New York hospital for labor that tested positive were 33 in 215. But only 4 had "symptoms", that's 88% asymptomatic. The USS Theodore Roosevelt reported that "about 60% of the people who tested positive had no symptoms." Finally, the reports from a Tennessee prison are that "98% of the inmates and staff who tested positive did not have any symptoms". Take the middle value. Only 1 in 9 will have a fever. So go ahead and require temperatures be taken. It won't hurt, but it isn't even in the ballpark of being a reasonable way to identify the infected and really it strikes me as possibly illegal (I'm not a lawyer, but I can read, and I read the HIPPA law).
3.B) California, San Diego City/County (a mix of red and blue - how refreshing!): They have a lot of good data, on a very accessible website. They've just starting adding a new plot to their data. Essentially one of the ones I showed in my post of the 26th. It's a plot of the running average of the fraction of tests that come back positive (here). It is wonderful. It shows that the rate of positive results is slowly declining (and has been since the beginning of the plot back on March 26th). Initially, it was about 7.5%, but has rather steadily declined to about 6% now. That is as close to proof that the county is showing progress in controlling the rate of spread, as anything could be. But can we reopen? Yes, but only very slowly, because our Governor says so. Oh, and nothing about it might be smart to have the young healthy open faster than the old.
4) Maine: The Governor (blue), is saying “We are thinking about making some changes before Memorial Day,” (Yes, that's basically a month from now). So how horrible are the conditions in ME? Well of their population of 1.33+ million they have 37 people in the hospital. Yes, that's the stunningly high rate of 0.0028%. Compare: New York City had, at the peak, about a month ago, around 1,600 people added each day to the hospitals. So with roughly 6.5 times the population they had 43 times as many hospitalization each day than ME's current total number. If the average hospital stay is a week the number in the hospitals would have been just over 300 times as big. The reported rate of current active cases in ME is pretty stable at about 430. New York City, at the peak, was reporting well in excess of 5,000 each day (if the infection lasts 10 days that's a stable rate above 50,000). Given the deep and overwhelming concern Gov Mills is showing, and given that they have about 140 traffic deaths each year, I can't see how she will sleep at night until she is able to ban cars.
5) Michigan (blue): The story here is so crazy I don't even know where to begin. Let's just agree that any set of policies that results in significant numbers of people walking on government property carrying semi-automatic weapons is probably worth re-thinking.
6) New York, State and City (both blue as blue can be): They have a nice website for the City. They have some really good data (even if it keeps changing and is really only trustworthy once the data gets to be about 6 to 10 days old). The bottom line is that the number of cases is dropping rapidly. Doing a quick fit of the data (Mon-Fri average new cases) to an exponential decay indicates that for the last three weeks their cases have been dropping by a factor of ~3/4 each week, presumably while the number of tests has been growing (that's an assumption on my part, but I can't believe the number of tests is dropping). The numbers of hospitalizations shows the same shape. So does the number of deaths (although that lags by about a week). To really believe that those are real (and I do) you have to conclude that a large fraction of the entire city has had the virus and what we are seeing now is the onset of herd immunity. [Aside: The city reports 176,000 confirmed cases. At the rate they are going by the end of May it will be around 200,000. We know that the actual number of cases is much larger than the confirmed cases. The measured/estimated ratio runs from 16 to 190. The one that can be calculated from the one NYC 'experiment' is 32. That suggests that 6.4 million of the total population of 8.6 million has been infected. That's about a 75% infection rate for the population. That would agree that herd immunity is just around the corner for the city.] We've seen them send the USNS Comfort back. Clearly things are much better than a month ago. So is the city preparing to reopen? Not anytime soon. I don't get it. If the data suggest that anywhere can reopen it is New York City. Sure they should keep the social distancing and increased hygiene going (it really would be just stupid to not do that). Yes, of course, only the young and healthy should open, everyone else needs to remain isolated. But seriously, anyone who looks at the numbers knows that NYC can reopen, and reopen now.
How about the state? Well Gov. Coumo is considering starting the reopening in upstate New York around May 15, if they can meet his 7 criteria (here). But the rates of infection there are not what they are in NY City. The need for smart reopening in the upstate sections are pretty much as for any other state. But not a peep about about the need to be, and how to be, smart. Well not exactly. Not a word about it from the Governor, or anyone at the City, but there is this Issue Brief. It seems familiar to me somehow. But no one is listening.
So that's my reasoning for concluding that not a single state will reopen smartly. So if we are doomed to open stupidly, what should we expect? We should expect the number of cases to increase. We should expect the number of deaths to increase. We should expect that the politicians will all blame each other for not following and not enforcing the (patently stupid) guidelines. We should expect to be forced to endure "Shutdown: The Sequel". We should expect that after several more months of forced confinement, we will go at round two of the reopening. That will go a bit better. But then the fall and winter will set in, and the virus will come back again. There still won't be a vaccine. We still won't have developed anything even approximating herd immunity (I'd guess that the actual immunity will be about 20-25%). Oh, and the economy will be totally destroyed.
We still have a chance to develop the herd immunity. It will require that the young and healthy go out and get sick (but mostly just a little sick, many won't even know it).
I certainly hope that wasn't as depressing for you to read, as it was for me to write.
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