[Bryan Izatt]

I think it's safe to say that all of us are operating in completely new territory here, so perhaps we could dial back the intensity just a bit.  Not the discussion itself; just the intensity and the rhetoric.

It is very, very difficult to look at the objective information available about cases and deaths and not think that we've dropped the ball in the US; there just isn't much way around it.  That's without pointing a finger at who is to blame for that, which is another question, but putting aside China because of a lack of reliable information, we're pretty much leading the league in every category of the pandemic AND we have the steepest curves still today.  That's more than disturbing.

I'll content myself with listening to Dr. Fauci (assuming he continues to hold his job), and to obeying the orders of Gov. Cooper and Mayor Schewel, all of whom seem to be doing their dead level best to act on the available science.  If folks like those three, along with EVERY medical professional that I know anything about, say that we can't "reopen" the economy because of the bomb that would go off, then so be it.  And if golf becomes NOT ok in NC, I'm good with that, too.  As I've said, it feels like a bit of a guilty pleasure anyway, though safer than any other trip outside my house.

To be fair, if one wants to look at the objective information available, they should be looking at data that includes population.  The current numbers of deaths per 1M in population per country include:


Spain              370
Italy               338
Belgium          337
France            229
UK                 167
Nether.           165
Switz.             131
Sweden            91
Ireland             74
USA                 70
Germany          36
Canada            20
S.Kor.                4
Japan                1


China's numbers are bullshit.


Also, in regards to curves, objectively one should be looking at logarithmic curves.  This is what Dr. Birx is referring to during the briefings.  In regards to cases, the US logarithmic curve peaked on 4/4.  It remained flat thru 4/10 and has been falling for the last three days.  As far as deaths, the curve remained fairly flat from 4/7 - 4/10, with a slight peak on the 10th.  It has been falling the last three days.  Deaths are a lagging indicator and will not decrease at the same pace as new cases.  Of course things could change and head in the opposite direction.


Hopefully the worst is behind us here in the US, and hopefully the same for all our friends overseas.

Those numbers look similar to those from Johns Hopkins.


Cases and mortality by country

Country                  Confirmed         Deaths            Case-Fatality         Deaths/100k pop.

US                          555,313                  22,020                   4.0%                            6.73

Italy                        156,363                 19,899                   12.7%                         32.93

Spain                      166,831                 17,209                   10.3%                        36.83

France                    133,670                 14,412                   10.8%                        21.51

United Kingdom    85,206                   10,629                  12.5%                        15.99

Iran                          71,686                     4,474                    6.2%                           5.47

Belgium                  29,647                     3,600                   12.1%                        31.52

China                      83,134                     3,343                     4.0%                          0.24

Germany             127,854                      3,022                     2.4%                          3.64

Netherlands          25,746                     2,747                    10.7%                        15.94

I think it would be fair to say that the US is a few weeks behind the European countries in confirmed cases and deaths.  When the US catches up, the deaths/100K population will likely be among the top group.  The cases information is sort of useless at the moment because there is such a disparity in approaches across states in the US and between countries worldwide.

In Ontario, where I live, the number of cases has been trending down since March 17.  Turns out that the government was limiting the number of tests that were being done.  They are promising to expand the testing now. 

I've been tracking deaths between Macomb County MI, just north of Detroit, and Ontario. Ontario has about 15 times the population of Macomb County but only 1.3 times the death.  Hard to know why there is such a wide disparity.

[Bryan Izatt]

Bryan,


The things you have to research or fact-check are truly amazing.  Facts are very few in comparison to opinions.  Golf holes are not always 4.25"- in my case they seem much smaller.  The faith it takes to be an atheist is much greater, IMO, than to be a deist or a Judeo/Christian.  Some opinions are much better than others.  ANGC is a better course than PBGL, even off a seedy commercial street and without an ocean.

Always happy to amaze you, Lou.  I hope you read the whole article.

Below is a link to the most recent stats for my city and the two counties it sits in.


 [/size][size=0pt][/color]This Frisco table provides more information[/size]


If someone can make the case that we should be under the same guidelines and restrictions as a hot spot, say NYC, please, I am all ears.

I don't think anybody is trying to make that case.  The case I think is that the pandemic has and is spreading with blinding speed which means it is pretty contagious.  Maybe it just hasn't gotten serious in Frisco yet.  But since DFW is a pretty high density area, it is probably coming with more intensity.  It seems that the US, States, and Counties have for the most part erred on the saving lives side.  This seems to be true around the world.

If you want to keep track of your area, you could look at the Johns Hopkins site for Denton and Collin counties.  It's updated frequently and provides a lot of related information.  This link is for Denton:

https://bao.arcgis.com/covid-19/jhu/county/48121.html

Oh, and I welcome a good explanation why H1N1 was treated exponentially differently than COVID-19.  Certainly we don't have a better, more nuanced understanding of the Precautionary Principle today.  Methinks that the principal here and in a half-dozen other countries have a bit more to do with it than "the science".

I'm not going down that rabbit hole, but you could check out the Reuters fact check for a comparison of the two.  Perhaps it has to do with COVID being 10 times more deadly than H1N1 (according to the WHO a few hours ago).  Not sure how the Precationary Principle applies to the pandemic, but there are certainly more than a half dozen countries who are trying to control COVID-19 the same way.  Sweden seems to be an outlier with no restrictions.  Maybe you should look there and compare it to their neighbours Finland and Norway and report back.

[Lou_Duran]

Ulrich,


My first recollection of you is of the time you came up to our group in England and not asked but told me to speed up play.  Mind you that you were holes behind us and that we, like the group in front of us, were waiting on most holes to play our shots.  I thought it was quite cheeky and it normally would have earned a stern reply, but hey, you are a different sort of guy from a different culture and I gave you the benefit of the doubt.


Your most recent reply is personally offensive in style and content.  I've been around the block many times and don't need to be cussed at by a vulgar authoritarian bully who has a hard time seeing the trees from the forest.  Really, do you want to lecture me about compassion?  Or science?  And for a coup de grace, you throw in a dead pastor.  What is wrong with you?


Pete,

I shouldn't need to say this, but I certainly have not suggested that we should go about as nothing has happened.  I am saying that the practices needed in NYC are not the same ones for Frisco, TX.

Every day we read of new theories of how the virus is transmitted.  There is some pretty good evidence from various practicing doctors that it is mostly by air in close proximity for a prolonged period of time.

Bryan is asserting that C-19 is 10x more deadly than H1N1 (per the apolitical WHO, really?).  As Greg Clark and others have pointed out, we really don't know how many people died of the swine flu in 2009-10- the world "guesstimate" has such a wide range that it is not credible. The only thing that we know about C-19 at this time is that the same models which were forecasting horrific numbers of deaths to shut down our economy are now saying that the number is 20+ times lower.  And there is some evidence that we're lumping other causes into the C-19 totals.

RE: Frisco, we are about a half an hour from one of the busiest airports in the world.  Our population is highly educated on average and has a very large Asian contingent.  Many of our businesses are international in scope and people travel to all parts of the world, the far East in particular.  As far as I can tell, we are doing well in taking precautions and caring for our fellow citizens.  I do appreciate your advice and concern.  Best wishes to you as well.

[Lou_Duran]

Bryan,


The argument is not about no restrictions and complete shelter at home.  I am not going to get into a straw man tit for tat or a Moriarty/Paul debate.


I remain mystified why the reaction to C-19 has been so radical, acrimonious, and vitriolic while H1N1 did not earn more than a whisper in comparison.  Let's revisit the subject if we're both around in 12-18 months.  Hopefully the book will be nearly closed on C-19 and we can test your assertion of C-19 being 10x more deadly.  I won't even ask you to adjust for the 17 Million more Americans 65 years and older now than in 2009-10.


I suspect that you're playing dumb, but in case you're not, the Precautionary Principle applies here in that it holds that the more dire or severe the potential consequences are the more extreme the response should be even if data is incomplete and the probability of it occurring is relatively low.  2 Million+ Americans possibly dying justifies closing the country down.  60k, perhaps focusing on hot spots and various forms of containment and palliative treatment would suffice.

[Greg Hohman]

24,000 Americans have died as of this writing WITH greater and lesser unprecedented preventatives in place. How many would have died without them?

Re your mystification, Lou, about H1N1's "whisper": Know many people in medicine?

[Bryan Izatt]

Lou,


Some random thoughts.


The response to C-19 has been radical - I don't see so much acrimonious or vitriolic.  I understand that there may stronger reactions from some in the US being the land of the free, but I think by and large people are just scared and frustrated because there's no good magic bullet that's going to take us back any time soon to where we were.


It's certainly too early to do a postmortem on this pandemic and the reaction to it.  See you in 12 months. 


There are a lot of bright disease experts out there in many countries who have led the political side to where we currently are.  I think for now I'll trust their judgement that this is all necessary. 


I just heard from a doctor on TV who was comparing SARS, H1N1 and C-19.  His short answer to your question was SARS was lethal but not very contagious (remember that Toronto was an epicentre); H1N1 was very contagious but not very lethal (0.02%); C19 appears so far to be both contagious and lethal.


The assertion that C-19 is 10 times more lethal than H1N1 was from the WHO, not me.  Of course now that they have been smeared by your great leader, I guess they're not to be believed.


On FOX (I try to heed your admonishment about confirmation bias) I read one recovery plan that suggested that they should determine the risk group (old people with conditions) and quarantine them (you) and let everyone get on with their lives.


Unfortunately the data here is that the old over age 60 are accounting for about 40% of cases while the age group 20-59 are accounting for about 60% of cases.


Listening to people that are recovering, there was the comment that the outcome is not binary - you recover or you die.  Some who recover will have scarred lungs and compromised lung function.


And, lastly, tonight our staunchly conservative (we're open for business) Premier just announced he's extending the stay home direction for another 28 days. What does he know that your governor doesn't.


Enough thoughts for tonight. 

[Dónal Ó Ceallaigh]

Courses still open in Sweden. Actually, they just opened after the winter break.

[Tommy Williamsen]

Courses still open in Sweden. Actually, they just opened after the winter break.

From what I understand Sweden has not put any "stay in place" orders into effect. I pray it works out for you all.

[A.G._Crockett]

Of all the stats available, the one that interests me the least is per capita or per 1000 or the like.  Like the unemployment rate in "normal" times, until you disaggregate the data, you can get a REALLY misleading picture of what's going on, and pat yourself on the back when it really isn't merited.

Covid19 does NOT strike or kill proportionally across the entire country geographically, or equally within the population demographic.  So when it gets into an assisted living facility, such as the memory care facility where my 94 year old mother resides, the death rates are MUCH higher.  The same appears to be true for people of color, for the homeless, for essential workers (read that as low wage) and other segments of society. 


Saying "Ill be damned; the odds were against THAT happening!" isn't particularly helpful.  I imagine that Italians who were told or who read that their higher death rate was largely a function of having one of the older populations in the world didn't take much consolation from that if a loved one of ANY age died.


You can parse the numbers any way that you want; it doesn't matter to me, and it doesn't change anything anyway.  But we had a huge headstart on getting ready for this thing in the US, and at the VERY least and using a VERY nice word, we underutilized it, plain and simple.  Looking for statistics that put lipstick on a pig don't change that.

[John Kavanaugh]

I don't don't how you can look back and say preparing for this could have been put in a budget that was passed by congress at any time in the history of the country. It's not how democracy works.


It's like saying we should have cancelled the Super Bowl.

[A.G._Crockett]

I don't don't how you can look back and say preparing for this could have been put in a budget that was passed by congress at any time in the history of the country. It's not how democracy works.


It's like saying we should have cancelled the Super Bowl.

Who was talking about the budget?

[John Kavanaugh]

How can you prepare for a pandemic that never happened before without increasing the budget?

[MCirba]

John K,

There was a 69 page NSC Pandemic Playbook completed in 2016 that was completely ignored.

Unbudgeted emergency spending measures get approved often.   


Back to isolation.  Stay safe, everyrone.

[John Kavanaugh]

This crisis attacked our lungs and we didn't have thousands of respirators in warehouses lying at wait simply because we can't pay for any and all possible contingencies. What if Carl Reiner really did look into the future and the next pandemic removes our thumbs? Would you suggest that we build 600 million mechanical thumbs and pay for storing them just in case? It would never pass. Budgets get passed on what people believe they want not on future mythical needs.


One thing that I do believe is that no matter who is in power our private sector will build those thumbs just like we did the respirators. Cept I doubt we will get everyone a thumb in time.

[jeffwarne]

How can you prepare for a pandemic that never happened before without increasing the budget?

What i have learned in the last month is that we have no budget.

[Jeff Schley]

What will and should change after this is the federal government will ensure that PPE be able to be manufactured in the USA as a matter of national security, similarly when they deemed rare earth metals as being needed in the USA as a matter of national security as China had like 75% of the world's supply.  Manufacturing PPE seems much less important, until you realize you don't have the production and supply chain to do it in place set up. Hope it doesn't happen again with our pants down as healthcare workers deserve to be protected.

[Bernie Bell]

I don't know that I've learned anything definitively, but I've formed certain hypotheses and I'll wait to see if they prove out:
- There was a huge amount of work pre-COVID-19 by governments and pharma companies around the world on virus vaccines and therapeutics, much of which was spurred or accelerated by Bill and Melinda Gates Foundation.  COVID-19 is just different enough that they have to start over, but not exactly from scratch.
- There were ample warnings in the US about adequacy (or not) of medical equipment and testing capability that would be needed.  These warnings were consistently ignored at all levels of government responsible for preparedness, which include local, state and federal, starting years before Trump was elected and continuing thereafter. 
-  Testing controlled by the federal government was a disaster, and the ship was not righted until private enterprise was enlisted.
- Notwithstanding the shared failures at all levels of government, controlled by both parties, both before and after Trump, social media and television remains riven in two, with everyone lining up on one side or the other, disclaiming any responsibility and blaming everything on the evil others.  Are we really "all in it together"?  I hope so, but I'm not convinced.
- Birx and Fauci are cogently explaining reality.  Conversely, China can not be trusted.
-  On-shoring the manufacturing of essential goods must be our collective bipartisan policy
- Some people who know a lot about golf course architecture are pretty  . . . "quirky" . . . and ill-informed, but undaunted, on other subjects.
-  "Fools give full vent to their rage, but the wise bring calm in the end."  Proverbs 29.
Cheers

[Sean_A]

How can you prepare for a pandemic that never happened before without increasing the budget?

What i have learned in the last month is that we have no budget.

There hasn't been a meaningful budget since the last balanced budget.

It does not matter (much) what happened before Trump. Trump could have done more, he chose not to. Some reasons for his choices are likely good. Some reasons for his choices are likely bad. Regardless, Trump has all the necessary information to pre Covid 19 and when the shit got serious. He dropped the ball. Worse, he created panic and confusion. We got what we paid for.

Ciao

[Bryan Izatt]

How can you prepare for a pandemic that never happened before without increasing the budget?

What i have learned in the last month is that we have no budget.

There hasn't been a meaningful budget since the last balanced budget.

It does not matter (much) what happened before Trump. Trump could have done more, he chose not to. Some reasons for his choices are likely good. Some reasons for his choices are likely bad. Regardless, Trump has all the necessary information to pre Covid 19 and when the shit got serious. He dropped the ball. Worse, he created panic and confusion. We got what we paid for.

Ciao

FWIW you've had a Strategic National Stockpile (SNS) since 1998.  It apparently has/had $7-8 billion of supplies in it.  So much for Trump's claim the shelves were empty or broken.  Obviously there was and is a budget for accumulating and managing the stockpile.  Equally obvious is that the Stocjpile wasn't big enough for the current pandemic.  There were warnings.  Not sure what it has to do with democracies other than the electorate doesn't usually want to raise taxes to pay for "insurance" against future rare events. 

[John Kavanaugh]

Democracies give people what they want not what they need. It's a great system. To have on hand enough mechanical thumbs to retrofit our nation we would need to spend $9,000,000,000,000.00 just on inventory. It ain't gonna happen.


It's not unreasonable for a good set of thumbs to cost $15,000 per thumb. It's the one size fits all that drives the price up.

[Sean_A]

How can you prepare for a pandemic that never happened before without increasing the budget?

What i have learned in the last month is that we have no budget.

There hasn't been a meaningful budget since the last balanced budget.

It does not matter (much) what happened before Trump. Trump could have done more, he chose not to. Some reasons for his choices are likely good. Some reasons for his choices are likely bad. Regardless, Trump has all the necessary information to pre Covid 19 and when the shit got serious. He dropped the ball. Worse, he created panic and confusion. We got what we paid for.

Ciao

FWIW you've had a Strategic National Stockpile (SNS) since 1998.  It apparently has/had $7-8 billion of supplies in it.  So much for Trump's claim the shelves were empty or broken.  Obviously there was and is a budget for accumulating and managing the stockpile.  Equally obvious is that the Stocjpile wasn't big enough for the current pandemic.  There were warnings.  Not sure what it has to do with democracies other than the electorate doesn't usually want to raise taxes to pay for "insurance" against future rare events.

That is my cue to go on an anti Trump rant. There is no need. People knew what they were voting for and did it anyway. The sad part is that folks will vote for Trump again. Party politics eh?

Ciao

[Bernie Bell]

"It does not matter (much) what happened before Trump"

I respectfully but completely disagree with that, Sean.  I believe that the frontline responsibility for preparedness in US lies squarely with the states.  There are easily-found studies and recommendations, both done by individual states themselves (see NY), and from federal agencies and the National Governors Assoc to the individual states, going back some way that make clear the stockpiling of personal protective equipment and ventilators was an essential part of each state's pandemic preparedness.  The national stockpile is and was designed as a backstop to local supply.  As I understand it.  Happy to be corrected if I'm mistaken.

Moreover, it matters very much what local leaders have done after Trump.  Every state in the US has had the same Trump, and yet the NY metro region is a total statistical outlier in terms of this disease.  Local governance is not the only variable, but with Trump as a constant, the results from across the country so far suggest that the governmental decisions made in NY were, to be charitable, not as effective as the measures taken in Seattle and SF.  I'm not defending Trump's actions and inactions, I'm just saying that in terms of causation they alone don't come close to the "full truth" here.  Hopefully we can put together some sort of quasi-objective after-action reports that can get at the full truth.  "With every mistake, we must surely be learning . . . "

[John Kavanaugh]

"It May Look Like a Walnut" first aired in 1963. No matter who we elect we can not expect our government to be prepared for what we can't imagine, or even what we can.


I have little doubt that if our country woke one day without thumbs the death and destruction in the first week alone would surpass what we are seeing with Covid-19. Our Military would become obsolete overnight, the grid would shutdown and anarchy would reign in the streets. Many of you would seek sanctuary at your local golf course. If you didn't kill yourself on the drive over you would kill someone else by the eighth hole. All the while wondering what could possibly go wrong.


Don't believe me? Check your iPhone without using your thumbs.

[Lou_Duran]

Re your mystification, Lou, about H1N1's "whisper": Know many people in medicine?

Many.  When not handling snakes on Sundays, I play golf with an M.D. who is the #1 man in a 50+ office practice.  My Bachelor of Science (not Arts) includes the full series of Chemistry, Biology, and Microbiology classes required for medical school.  And you may wish to be a bit more precise when challenging me: two important words followed "whisper"- "in comparison" (to C-19).


Bryan,


Are you referring to the same stash from which all those out-of-date masks were shipped?


As to your observation about democracies being unable to tax themselves for "insurance", you do understand that most are essentially broke, right?  The U.S. can't pay its current bills without borrowing a $Trillion during great times. BTW, what dictatorship do you know that sets aside money for unforeseen events.  Cuba?  Venezuela?  Russia?  I suspect that before thinking about the niceties of respirator and mask inventories, being able to source tampons, aspirin, and tooth paste to meet pressing needs might have a higher priority.


Re: WHO, it has been dumped on many times well before Trump took notice.  You may wish to expand your admirable efforts to balance your biases beyond Fox News.  The WSJ has for many years covered the misdeeds of various global government supported non-profits,  Just recently, Anastasia O'Grady had a interesting piece on WHO's leader kowtowing to China.  There was also something on how WHO's Latin American offshoot is propping up Cuba in its medical export scheme which is effectively little more than trading slave labor for oil and foreign exchange.


As to vitriol and acrimony, one only has to read the finger-pointing nonsense on this thread as a reflection of what has been in the news every day for nearly four years  We can't even take a break during a major crisis.  It is totally unproductive except to affect the November elections.  We will see how well that turns out, but more importantly, what happens in the next few years if it succeeds.  I will predict one thing- we will see the end of modern monetary theory.  Stay tuned.


 

[Sean_A]

"It does not matter (much) what happened before Trump"

I respectfully but completely disagree with that, Sean.  I believe that the frontline responsibility for preparedness in US lies squarely with the states.  There are easily-found studies and recommendations, both done by individual states themselves (see NY), and from federal agencies and the National Governors Assoc to the individual states, going back some way that make clear the stockpiling of personal protective equipment and ventilators was an essential part of each state's pandemic preparedness.  The national stockpile is and was designed as a backstop to local supply.  As I understand it.  Happy to be corrected if I'm mistaken.

Moreover, it matters very much what local leaders have done after Trump.  Every state in the US has had the same Trump, and yet the NY metro region is a total statistical outlier in terms of this disease.  Local governance is not the only variable, but with Trump as a constant, the results from across the country so far suggest that the governmental decisions made in NY were, to be charitable, not as effective as the measures taken in Seattle and SF.  I'm not defending Trump's actions and inactions, I'm just saying that in terms of causation they alone don't come close to the "full truth" here.  Hopefully we can put together some sort of quasi-objective after-action reports that can get at the full truth.  "With every mistake, we must surely be learning . . . "

Bernie

You are missing the point. While Trump can unlock all sorts of scary powers by declaring a national emergency, it is at least as important to take positive clear and consistent action and deliver speaches which support these actions with expertise and facts. Trump utterly failed on all counts. In fact, he made matters worse by creating confusion, a completely false sense of safety and not doing due diligence to the issue as far back as early January.

Ciao

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