Tag Archives: COVID-19

COVID-19, Good Friday, Lent

A distant hill: Reflections on Good Friday 2020

Leave a comment

It is close to the start of Passover in 33 CE.  Jeremiah and his family had a land inheritance of about four acres that they worked by hand.    They had a few fruit and nut trees.   The neighbors had similar sized farms.   The small community shared a well for household water, which naturally served as a meeting point.    They were poor by city standards, but managed to survive on the small farms.  The last few years had been hard, and the tax on their farm was keenly felt.  They were too poor and too far away to make the trip to Jerusalem for Passover, so the family usually celebrated the Seder together at home.  The date of the Seder was determined by observations in Jerusalem, and the information never seemed to arrive in time.  So, they took their best guess.  This year they didn’t have a lamb, just a few goats, so there would be no sacrifice of a lamb.  The work on the farms was tough work, and they were falling behind, so this year they decided on celebrating the Seder on the Sabbath, it was close anyway, and they hadn’t heard from Jerusalem yet on the exact day.   Today they were busy getting ready for the Sabbath and finishing up the weekly work on the farm.

As noon approached a dust storm seemed to arise out of nowhere, blotting out the sun.  It made working in the fields difficult, so they abandoned their work, picked up the tools and headed back to the house.  Preparation of the Seder was in progress as the family gathered.   Somewhere around mid-afternoon the dust storm stopped and the earth trembled.   Three years ago there had been an earth quake, and the community had to make some repairs to the houses.  So they took note and waited.  The earth quake stopped and they didn’t see any damage to the houses.   They breathed a sigh of relief.

The sun set and they had the Seder, memorializing Israel’s escape from bondage in Egypt.   One of Jeremiah’s sons had sold some grain in the local village, so after dinner conversation centered on the gossip he had heard about the goings on in Jerusalem.  No one around the table had ever been to Jerusalem, so the stories of the Temple and large buildings strained their ability to even imagine the sight.  There were always rumors of messiahs, and this Passover was no exception.  The idea of a messiah that would really make a difference seemed a flight of fantasy. For the subsistence farmer the more things changed the more they stayed the same, or got worse.  A good year was when nothing major happened; no drought, no famine, no soldiers tramping fields, and no death. The evening’s prayers included the hope for better times, better harvests, and for health. 

How could they know that on Golgotha the Messiah they gossiped about had been hung on a tree and died?  They could not know what that death would portend for the world, it was just another Saturday.  Sunday, Easter Sunday, they would go back to work their fields.  How long would it be until they knew of the events and what it meant?

Stories take on a different meaning when you know the ending.  On Good Friday, we know that Easter is just a few days away.  We know that the disciples will establish a church that will spread though out the world.    Jeremiah knew nothing of this story as it was happening.  Perhaps Jeremiah and his community will hear of the news as gossip reaches the village.  Jeremiah cannot know what future possibilities were brought into being on that day.  

We are probably unaware of some of the real changes that are becoming possible because of what is happening today, either good or bad.   We may not even know the major events, which will be for historians to reveal.  We see the dust storm and earthquake, but like Jeremiah, we do not yet know the ultimate significance of recent events.  For most of us, we are physically separated from our church, just as Jeremiah and his family are separated from the Temple.  Like Jeremiah, we can live in the present and celebrate Lent as best we can with our families.  We know not what the future will bring.   

Since the 15th century the Seder ends with the phrase “Next year in Jerusalem.”  Let’s take that as a reflection of hope that we will be reunited next year.   May it be so.  

COVID-19, Financial Ethics

COVID-19 and Financial Ruin: some reflections

Leave a comment

Pres. Trump wants to restart the economy as soon as possible and possibly sooner.  The unemployment rate is skyrocketing.   A recession seems likely, and even a depression has been discussed.  The economic pain is real, and not to be discounted.  The urge to get it over with and move on is real, but very dangerous from a public health standpoint.  Some times when the desire to get back to work  is raised in social media the response is something along the lines of “how dare you put financial consideration ahead of lives.”  This is an understandable response, but not helpful to those who are fearful and suffering.  Such a response may feel good, but is not effective in either changing peoples minds, or giving comfort to those who are fearful of the future.

A Good Question

A person responded to one of my Facebook posts with the following question.

And what do you propose for those of us who stand to lose everything if it all remains closed? Honest question

I have decided to extend my remarks to their post, correct some grammar, and clarify some points. The result is below.

Confronting our Fears

Your question is an honest and good question. My answer would depend on an individual’s particular situation. For me losing everything is more like losing a child, a parent, a spouse. People cannot be replaced by money. But financial stress and uncertainty are real and important.  I would suggest that you change the wording of your question slightly, to help clarify your thinking. I suggest you replace “lose everything” to something more specific to your situation like; “risk bankruptcy”, “become homeless”, “be unable to pay the mortgage or rent”,” find something to eat”, or whatever is the actual financial fears you face. Let me give you a personal example.

I am retired; my retirement funds are in things like 401K’s TIAA accounts etc. I do not yet receive Social Security.  The value of those investments has taken a nosedive.  I started my adult financial life in the massive inflation of the late 1970’s early 1980’s (peaked at 14.75%), and high interest rate (prime at it is peak was like 15%). So I naturally fear that excessive federal spending will push up inflation as we emerge from COVID-19.  The response to this could raise interest rates, a repeat of the late 1970’s. Of course inflation will lower the real financial values of my retirement and high interest rates will hurt many investments.  I expect my financial situation to continue deteriorating for quite a while.   The fear therefore is that I will no longer have enough money for retirement.  Confronting my fears allows me to consider options. I am lucky, in that I have options to consider (come out retirement, etc…) 

So, my answer to your question would depend on the given situation you are in (which I do not know).   So let me examine several possibilities.

Those unable to cope financially

Some people in the United States are living in a constant state of financial crisis.  They did not have adequate financial resources or income to adequately meet basic needs (shelter, water, food, medical care, etc.) before the pandemic.   COVID-19 makes their situation even worse.  Institutions that help (food kitchens, homeless shelters, etc.) normally struggle to meet their needs, and now when they are needed more, supplying that help is more difficult.   A far better safety net for those who were living below or near the edge of financial viability needs to be developed.  It is simply immoral to throw the most vulnerable under the bus.  To do this well will probably mean increased tax burden on the rest of us.  So be it.  Perhaps a truly progressive income tax system is one positive result that might emerge.  

Those just getting started financially

I can really sympathize with this group.  Getting my first job in the midst of high inflation and high interest rates meant that I saw my income erode in earning power month by month.  It did teach me a few things.  It taught me to manage my money and budget.  It taught me to keep some food in the house so if I ran out of money by the end of the month I had something to eat.  It taught me the difference between what I actually needed, and what was a desire.  It was a tough time.  It did come to an end.  

If you had to pick a point in your life when you went through a major financial crisis that took you to the breaking point (and perhaps beyond), having it early in your career has several benefits.  First, you have more time to recover.   Second, you might have less investments and resources to lose than you will have later in life (like a mortgage).  Finally, you probably have less investment in a particular career.  Of course having an entire working life without going through such turmoil is preferred to living through a crisis.  But that is beyond your pay grade….

A mid-career crisis

For those that are mid-career, but have skills that are valued and needed, yes you might have to start over, you might suffer a drop in your lifestyle, or you might not. Many individuals have faced that possibility before. Your house burns down and insurance doesn’t adequately cover the replacement cost, so you have to start over.  An illness in your family forces you into a medical bankruptcy.  You are then forced to seriously downgrade your lifestyle. Divorce causes a massive drop in your income.   People go through all these things every day.  It happens, most survive and adjust. 

In my life time there were periods when a lot of highly skilled engineers and scientists were laid off, with almost no possibility of reemployment.  This is more like today, where everyone is being hit simultaneously.  One such time was just after the moon landings.  There were other times since then as well.  It seems we can’t go too long without going through this.   I had an acquaintance that hid their PhD so they could get a job pumping gas (an extreme case I admit). Other’s started new careers in their 40’s and even 50’s. The choice is between fear, bitterness, or using the experience to reshape one’s life using the experiences already gained.

Near retirement

Other’s near retirement (60’s+) often have a really tough time getting another job if they are laid off (age discrimination is very real).  For those near retirement there is little chance to recover from a major financial loss.  So this would often mean delaying retirement and a real downsizing of the standard of living. It happens. Better to happen before retirement than after retirement.

Retired

Social Security payments do not provide even a moderate standard of living by themselves.  That means either retired people have to work, of have some income from savings, or retirement account. Financial losses at this stage can be disastrous.  Social security benefits are the subject of much political infighting.  I can only guess at the damage COVID-19 is going to do the retired poor.   It will be an uphill battle to address this issue in the federal government. 

Where does that leave us?

The categories I have considered are by no means complete.  We haven’t discussed differences in financial hardships due to: race, immigration, undocumented persons, religious backgrounds, location (rural vs urban), etc.  But I hope we have done enough to come to a tentative way of looking at the issue. 

Those of us that face financial hardships now, have not had to face them in the recent past, and have built up some financial cushion, are privileged (myself included).  Also privileged are those to whom financial troubles are new and have time in their lives to recover financially.  We have options.  We may not like them, but we have options.

This situation can allow us to consider the difference between our actual needs and our desires. Before this pandemic I was giving a talk about energy policy and less developed countries. One of my points was a personal definition of greed that comes from my Christian background. Greed is when my desires become more important to me than my neighbor’s needs. Many times I stand self accused of this kind of greed.

The future will present difficulties. Those of that are able need to support those of us without the necessary resources.  That is what love your neighbor means in the day to day activities that constitute our lives.  That support can take many forms.  If you look around, you will see individuals acting out of their love of neighbor.  

Conclusion

I acknowledge (and share) your sense of financial fear. It may well be justified.  If you have the resources right now, here is my suggestion, which perhaps you have already done. Find a local charity that runs a food bank, or provides shelter for the homeless, and make a donation. Make it 50% larger than you think reasonable. Then be thankful that you can do this.

There used to be a book called What color is your Parachute, it was pretty good.  This book, or some book like it, might provide some insight as to the options you have in a post COVID-19 world.  Make it your intention to turn adversity into opportunity.

In closing

Wash your hands. Don’t touch your face.  Practice social distancing.  Stay at home, if directed to do so. 

Be safe: I hope to see you on the other side.

COVID-19, Politics, Science and Politics

Walking the Arete between science and Trump

Leave a comment

Being a scientist working with Trump under public scrutiny has to be like walking along a arête, a knife like ridge between two mountain peaks. Falling over one side is loosing one’s position (and influence) by clearly contradicting Trump, even when he is wrong. Falling over the other side is saying something that is questionable scientifically, thereby loosing ones credibility, in order to pacify Trump. It seems as if one of the key scientists (Dr. Birx) may have fallen off the ridge on the side of trying to justify Trump’s optimism. If so, we should question everything she says.  Credibility is hard to gain, and easy to loose.

Whom am I to say?

This is a hard thing for me to write. I am not an epidemiologist. In any per review in an epidemiological journal, I would not qualify as a reviewer. So  I am out of my discipline , I admit it.  The scientist in me (Physicist) says, I am not qualified to judge, so rather than risk my own credibility I should remain silent.  Credibility is hard to acquire, and easy to loose, and is the currency of the successful scientist.   But in this pandemic the risk of staying silent perhaps outweighs the risk of losing ones credibility.  I also need to walk an arête.
 
On the other hand,  as a computational physicist I find I can read the technical literature on the mathematics of epidemiological  modeling and understand it. In fact, my work in modeling physical systems (from graduate student thru retirement) involved far more involved mathematics than is present in at least the basic epidemiological models based on differential equations.  Some of the models developed are impressive team efforts.  The simpler, well known, epidemiological models can give plenty of insight.  
 
My weakness with the modeling is in correlating policy to the mathematical constants in the equations. This is made more difficult  because the analysis of COVID-19 is still in process.   Perhaps it is even more difficult to know societies response to the various public policies.   

Misleading statements on Attack Rate

Dr. Birx suggested that the models are inaccurate and overstate the threat of Covid-19.   If you like you can see a video of her presentation on 3/26/2020 here
 
I have a few questions about her presentation:
 
“In no country to date have we seen an attack rate over 1 in 1,000” (1:04 in the above video).  
 
First, what is the definition of attack rate?  If I go by the CDC’s online self study course, which also agrees with other authors. 
 
 
“Incidence proportion is the proportion of an initially disease-free population that develops disease, becomes injured, or dies during a specified (usually limited) period of time. Synonyms include attack rate, risk, probability of getting disease, and cumulative incidence. Incidence proportion is a proportion because the persons in the numerator, those who develop disease, are all included in the denominator (the entire population).” {I added the Bold}
 
Now the population needs to be specified, and she did, a country.  But the period also needs to be specified.  She added “to date.” When you are in the middle of the pandemic the attack rate “to date” doesn’t tell you much!  What you would like to know is how large the attack rate will become!   However, the statement was almost certainly not true when she said it.  
 
Italy, on 3/25/2020 had 74,386 cases with a population of 60.5 million or an attack rate of 1.2 per thousand.   This data is from the John Hopkins tacking website on 3/25/2020 at 1:12 pm.  The same number is in the World Health Organization Special Report number 66.
 
 
Worse than being wrong, this is highly misleading.  Few countries have yet been through the entire pandemic sequence.  So the number for Italy has already risen.  Right now (3/28/2020 2:30 pm) Italy has 92,472 cases for “to date” attack rate of 1.53 per thousand and rising.
 
Restricting the geography to country allows for a larger denominator and lower rates.   Why does this matter?  New York city (population: 8.7 million) the evening before her talk,3/25/2020 had 20,011 cases according to the John Hopkins site.   This is 2.3 per thousand and climbing!  Now that has climbed to 29,158 so the “to date” attack rate is 3.34 per thousand and climbing.   
 
In addition, in the US we are not testing everyone with symptoms.  So the figures for New York City are lower that the actual number of infections.  It takes time for symptoms to emerge.  So the current testing measures what has happened a few days ago (or longer). 
 
Ironically at 4:13 she acknowledges that some of us will look up the numbers (yup) and that we will only find “small countries” that will top 1 in 1,000.   She didn’t do her homework, even though between 1:41 and 1:57 she talks about Italy.
 
At best her statement wasn’t up to date (she should have checked).  At worst it was deliberately misleading. 

Can 20% of the Population become infected?

She suggested that models that predict that 20% of the US could be infected were over estimating the problem.  (2:11)  She didn’t actually say that, but it was surely implied.  Just before that was a general downplaying of the accuracy of the models, and assertions that they were not predicting the correct behavior.
 
Can 20% of the United State become infected?   Of course we cannot fully know the what will happen in the United States, much of that depends on how we react to the situation.    We can look at the ordinary flu data to see if it is POSSIBLE for 20% to become infected.  Again lets go back to the CDC website.
 
 
This is directly from the website (3/28/2020)
 
“A 2018  CDC  study  published  in  Clinical  Infectious  Diseases  

looked at the percentage of the U.S. population who were sickened by flu using two different methods and compared the findings. Both methods had similar findings, which suggested that on average, about 8% of the U.S. population gets sick from flu each season, with a range of between 3% and 11%, depending on the season.

Why is the 3% to 11% estimate different from the previously cited 5% to 20% range?

The commonly cited 5% to 20% estimate was based on a study that examined both symptomatic and asymptomatic influenza illness, which means it also looked at people who may have had the flu but never knew it because they didn’t have any symptoms. The 3% to 11% range is an estimate of the proportion of people who have symptomatic flu illness.”

We vaccinate people for the flu.  Looking around the web perhaps 50% of the population gets a flue shot.  However there is no vaccine for the current SARS-CoV-2 virus.  So the 3% to 20% range of the number above is more like 6% to 40% of the population that is not  vaccinated.  It should be noted that the H1N1 pandemic in 2009 is estimated to have effected 19.9% of the population.  

https://academic.oup.com/cid/article/52/suppl_1/S13/498323

(see last paragraph before the summary)

So yes, 20%  of the population COULD (not will, COULD) become infected.  It is our job to prevent that.

Again, her statements are at best misleading, playing down the dangers that we confront.

60% to 70% in 8 to 12 weeks is …. (3:46-3:59)

Dr. Birx closes with a statement about no models show 60% to 70% of the US affected within the next 8-12 weeks. Let me start this off by saying that I do not think that the pandemic will get that bad in the US. I have faith that enough people will act appropriately to prevent this. Notice I didn’t base my comment on models. Non the less, we should parse the numbers and ask if this is possible.

Before Dr. Brix spoke John Hopkins reported 68,572 confirmed cases in the US. The population of the United States is roughly 327 million. 70% of that is 229 million. Thus the number of cases would have to grow by a factor of 4,768 (327,000,000/68,572). If (and its a very big if) we were to continue to grow exponentially this would require a little over 12 doublings. (212 = 4,096).  12 doubling in 12 weeks is one doubling a week.  Is that possible?  Take a look at the data yourself from the WHO, plot it up in excel and fit an exponential to it.  So yes, IF the current trends continue, this is mathematically possible.  Is it likely? Only if we are very foolish and twiddle our thumbs, refusing to change our behavior, while the epidemic runs through the country.  

My issue with Dr. Birx’s statement is the potential that it be interpreted as saying: we don’t have to worry.   But with Trump’s wanting to start the company up, and Dr. Birx as his adviser, this is the wrong message to send. At Best Dr. Birx should have qualified the statement by indicating whose models she was considering.

Be concerned, but funnel that concern into actions that help.  Practice social distancing, wash your hands and do it right, know the symptoms and if you have them, self isolate.  We can do this, but not without some self sacrifice and effort.

The Biggest Issue

Perhaps the biggest problem with Dr. Birx’s statements is she hasn’t shown us her data.   Perhaps she would make the argument that she was only talking about the one study she mentioned.  But she inferred much more.

Scientists are data based.   If a scientist is unwilling to show the data, then they cannot be taken seriously.  Statements about models that are hidden from public view are not to be trusted.  A scientist is obligated to share their work, their data, and their reasoning so that others can examine, and critique their work.  Any scientist that makes statements about the data, that they are unwilling to submit to per review, are not to be trusted.  Period, end of story, drop the mic.  It is per-review that puts the disinfectant of public disclosure on ones work.  

Conclusion

I morn the loss of a trust worthy insider in the Trump inner circle.  Perhaps this was all a show to keep her job, thinking that she can  more good in her job than outside.  But until proven otherwise, I will treat anything that Dr. Brix says with a bit of suspicion.  That doesn’t mean that anything she say is false.  It just means we need independent verification before we can believe what she says.

Sadly a scientific colleague may have fallen off the arête, and I don’t have a rope to throw to her.