There’s a reason casinos make money. They fully trust in statistical probability
and have a multitude of customers believing somehow they are an exception. The house will pay no heed to any individual
placing a single bet, winning, and walking away never to return. There are more than enough who stay until
their pockets are empty and others until their bank account is drained and credit
cards maxed out. Sadly, there are those
who even stay at the table until they’ve lost their home or worse.
As for COVID-19, death is going to collect the house
take. There is nothing we can do about
it. The only way to reduce the human
cost is by reducing the number of people with the virus. Shutting down most of America is mitigating
the crisis, but isn’t sustainable and is coming at a tremendous cost to her
prosperity. Ending the shutdown in
totality isn’t the answer either. We need
to find a way to keep people out of the coronavirus casino. The answer is actually simple, but hard to
implement. Korea still remains one of the
best models.
Why was Korea able to keep borders open and business
operating throughout the crisis? Why did
their schools reopen this week? First,
they implemented an identification, isolation, and contact tracing program, preventing case numbers in most areas from ever becoming unmanageable, and effectively permitting daily life to continue with appropriate limitations. They continue to aggressively work every identified
case. Yesterday, they completed 20,650 tests for yesterday’s
47 positive cases (439 negative cases for every positive). They continue
to maintain a testing capability in excess of their requirements because they’ve
never let the total number get beyond control.
Korea is one of the most densely populated countries in the world and
what works here should work anywhere.
For more detail, take a look at the Korean CDC’s daily press release.
https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030
https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030
In Korea, extreme measures have been focused on the areas
with the greatest problem (primarily the Daegu area and the airport). Areas without cases have correspondingly fewer
restrictions. Given a rapid testing
capability, many of our rural areas and sparsely populated states in America could quickly
resume a semblance of normal life. I
believe most already have individuals who keep track of where everybody else has
been and what they think they’ve been doing. ;)
Once the shutdown lowers the case number to a manageable level (many
communities are already there) restrictions can be lessened appropriately in
those cities, counties, and states. Without
the tools, they’ll continue entering the casino (at just a relatively slower
rate of growth) and greatly risk overwhelming their irreplaceable health care heroes.
The second critical factor is protecting individuals when
they go out in public. As individuals,
we can protect ourselves using common sense and basic hygiene appropriate for
the environment we are living in (and we’ll continue to live in for the
foreseeable future). I was encouraged to
see America’s shift in attitudes towards wearing masks. It seems to be working in Asia. However, we
need to go further. Since N95 masks
protect our health care professionals in close proximity to the most contagious
cases, a member of the general public should be just as protected. If everyone in public was wearing the best
available masks, the contagious would be restrained and everyone without the
virus would be reasonably protected. I
understand the urgency of distributing our limited supply to those on the front
lines, but I have yet heard this question asked, “When will production of N95
masks be readily available to all Americans?”
I’m looking forward to FINALLY returning to my country and attending “Mask
Day” at the ballpark!
---------------------------------------------------------------------------------I currently have some free time to update my blog from 10 days ago. I was in the wrong place at the wrong time last week and the coach benched me until 2 April. I was wearing a mask, kept at least 6 feet from everyone, and used hand sanitizer when I got back in my car. While my chance of catching the virus is extremely low (and I don’t have any symptoms), these are the rules we’re playing by.
For Korea, I’m encouraged
by the Korean CDC data. The country
looks like it is well on the down side of the curve. Since 16 March, the number of individuals
isolated with COVID-19 has dropped from 6,789
to 4,398 (further reducing the stress on the health care system). Additionally, the number of patients being
discharged continues to be greater than number of new cases. They are capable of completing over 18,000 tests
a day and aren’t using their full capability.
I read yesterday, they are even sending tests to America now.
With
significant limitations, Korea has continued to stay in business. They haven’t shut off visitors from China,
Europe, and the US. Of today’s new
cases, 21 came from the airport.
Testing, contact tracing, disinfection, and isolation processes are
working. While the death rate has risen
from ~1% to 1.59%, the rate reduction in overall infections has greatly limited the
number of deaths.
I’ve done some reading on Germany and their low death rate .85%
isn’t just luck. They implemented an effective
testing program early and have locked their country down. No more than two people can meet. If they were any stricter, they’d be missing
out on the “Coronakids” boom expected next year ;) Unfortunately, they can’t loosen up until
their overall active numbers (and those of their neighbors are lower).
As for America, I don’t feel good about writing down what I
believe. While the death rate has only
risen from 1.64% to 1.74%, the number of total cases has ballooned out of
control, we’re well past where a testing and contact tracing methodology would
work, and our health care system is in for a difficult time. My prayer, is we’re
spared the grief of Italy and Spain.
Quickly cutting off travel from China and Europe bought us time,
but the infection numbers have grown to the point where contact tracing isn’t
feasible and lock-downs are the only option.
For example, Korea completed 15,028 tests today for 105 new cases. America identified 17,412 new cases today. To
achieve the same rate, we’d have to complete 2,492,000 tests in one day. The president’s decision to push social distancing
guidelines to 30 April is unavoidable. After listening to a Bill Gates interview yesterday, I'm convinced a 15-day nationwide shutdown at
the start would be also prudent.
Country
|
Total Cases
|
Deaths
|
Death Rate
|
USA
|
140,990
|
2,457
|
1.74%
|
Italy
|
97,689
|
10,779
|
11.03%
|
China
|
81,439
|
3,300
|
4.05%
|
Spain
|
80,110
|
6,803
|
8.49%
|
Germany
|
62,095
|
525
|
0.85%
|
France
|
40,174
|
2,606
|
1.74%
|
Iran
|
38,309
|
2,640
|
6.89%
|
UK
|
19,522
|
1,228
|
6.29%
|
Switzerland
|
14,829
|
300
|
2.02%
|
Netherlands
|
10,866
|
771
|
7.10%
|
Belgium
|
10,836
|
431
|
3.98%
|
S. Korea
|
9,583
|
152
|
1.59%
|
From March 19
---------------------------------------------------------------------------------------------------------
The odds are pretty low the government or media will listen to Coronavirus advice from some random American living in Korea, but I’ve been blessed with Freedom of Speech, a blog with 2 followers, and an ever present hope that something I write will someday go viral. Plus, everyone who actually reads this post from start to finish will eventually find a package of toilet paper on a grocery store shelf near home. Now for the advice!
Instead of spinning the Coronavirus for political advantage, our media and politicians should work together on solving the crisis at hand. They could be a tremendous force for good if they’d just focus everyone’s attention on how we can best pull together to stem the spread of the Coronavirus. My advice is simple to say, but not so simple to implement. America must rapidly take decisive steps to improve two simple metrics.
1. The total number of COVID-19 tests completed daily.
2. COVID-19 Death Rate - The number of deaths divided by the number of confirmed cases.
Testing is crucial in quickly identifying, isolating, and treating those infected. Unfortunately, the United States is playing catch up in regards to testing. Take a look at the Korean Center for Disease Control (KCDC) testing data for comparison later with the US:
[Table 1. Total confirmed and suspected cases]
Period
(since 3 Jan)
|
Total
|
Tested positive
|
Being tested
|
Tested negative
| |||
Confirmed
|
Discharged
|
Isolated
|
Deceased
| ||||
As of 0:00
17 March (Tues)
|
286,716
|
8,320
|
1,401
|
6,838
|
81
|
17,291
|
261,105
|
As of 0:00
18 March (Wed)
|
295,647
|
8,413
|
1,540
|
6,789
|
84
|
16,346
|
270,888
|
Differences
|
+8,931
|
+93
|
+139
|
-49
|
+3
|
-945
|
+9,783
|
Korea has a capacity to complete 18,000 tests a day and aggressively follows up on the contacts of individuals testing positive. While a total victory in this war of attrition isn’t possible, at risk individuals are being given a fighting chance. The death rate (84/8,413) is slightly less than 1% and holding steady over time. I’m also encouraged that the number of patients discharged has exceeded the number of new cases every day this week, reducing the stress on the health care system.
Now look at America’s Center for Disease Control (CDC) test reporting page.
I believe it’s time for several levels of CDC mid-level management to be moved (you can’t fire civil servants) to less important jobs. They have a nice looking site, but the data is of little real value. The chart shows a current capacity to administer 4,000 tests a day, but the notes at the bottom are telling. The CDS counts a test when they receive it, the public health labs when the test is given, and private labs aren’t even being tracked. How many boxes are stacked up in the labs and how long have they been there?
Telling the public a million (or even a billion) test kits have been distributed only misleads the public. A test kit is just swabs and some tubes to place them in. The number of tests administered is a step up, but still misleading as is the date it arrives at the labs. A test isn’t of any value until the results are given to the individual, their doctor, and public health officials.
Even if all 4,000 tests being reported were actually completed, the number isn’t sufficient to achieve Korea’s level of performance. Based on the USA’s larger population, we’ll require the capability to complete ~115,000 tests a day. The CDC needs to start publishing a valid test metric and the goal we must achieve to succeed. Once we know what the goal is and how to measure it, the media can justly hold the politician’s feet to the fire. How many tests were completed today? How many will be completed tomorrow? When are we going to achieve full capacity?
The death rate is a morbid but important statistic, because it measures the overall effectiveness of a country’s effort. The lowest possible percentage is where everyone impacted receives the best possible treatment. A higher number likely indicates inequities in treatment, health care systems and providers being stressed beyond there capability, or a significant number of unidentified carriers. As of today, America's rate is 1.64% (9,464 cases/155 deaths). I suspect a large part is due to unidentified cases, but that will quickly change if our health care system becomes overwhelmed.
An interesting article on death rates:
“According to Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, COVID-19's mortality rate is probably around 1%, which is still about 10 times the flu's.”
Italy, Iran, and Spain illustrate what can happen if transmission rates get out of control and overwhelm the health care systems. It would be unconscionable for any country to not give all its citizens a fighting chance. My prayer is the unprecedented actions being taken worldwide will quickly stem the tragic loss of life inflicted by this pandemic. Our local, state, and national leaders should judge their own performance on the results of the actions they take today, not what they did or didn’t do yesterday. All I want to hear tomorrow is we completed a greater number of tests and the controllable portion of the death rate has been reduced and fallen below 1.64% There’ll be plenty of time to claim credit and affix blame after the crisis has passed. #killthevirus
