Weather and spread of COVID-19

One of the mysteries regarding the spread of COVID-19 is that the African countries and India have been largely spared. In fact worldometer finds that so far, India has had a total of 332 cases with 5 deaths with the last death being that of a 69-year old Italian tourist. Why is that the case?

A study by University of Maryland, which is referenced in this article states that:

The University of Maryland mapped severe COVID-19 outbreaks with local weather patterns around the world, from the US to China. They found that the virus thrives in a certain temperature and humidity channel. “The researchers found that all cities experiencing significant outbreaks of COVID-19 have very similar winter climates with an average temperature of 41 to 52 degrees Fahrenheit, an average humidity level of 47% to 79% with a narrow east-west distribution along the same 30–50 N” latitude”, said the University of Maryland.

“Based on what we have documented so far, it appears that the virus has a harder time spreading between people in warmer, tropical climates,” said study leader Mohammad Sajadi, MD, Associate Professor of Medicine in the UMSOM, physician-scientist at the Institute of Human Virology and a member of GVN.

There are two graphs from study that are particularly relevant with the first “image below, the zone at risk for a significant community spread in the near-term includes land areas within the green bands.”

The second image below is of relevance because “as of right now reported cases as a function of latitude, about one-third of the world’s population is below 22.5°N yet has not experienced meaningfully high levels of infections.”

Does the same correlation exist within US, i.e. the virus is more prevalent in the North? Based on the above image one would think so. This study collected the population data from:

https://simple.wikipedia.org/wiki/List_of_U.S._states_by_population

The latitude data is from the following two websites:

https://inkplant.com/code/state-latitudes-longitudes
https://www.latlong.net/category/states-236-14.html

The latitude data from the two sites differs slightly with mean difference of 0.21 and standard deviation of 0.81.

If we then divide the data into two bins of above 41N, which includes the states of Pennsylvania, Nebraska, Connecticut, Rhode Island, Iowa, Massachusetts, New York, Wyoming, Oregon, Vermont, New Hampshire, Idaho, Michigan, South Dakota, Wisconsin, Maine, Minnesota, Montana, North Dakota and Washington, and below 41N, whilst discluding Alaska, you get the following numbers.

Below 41N

Total cases 9,099
Total deaths 127
Total population 249,756,021
Total cases/1M people 36.4
Total deaths/1M people 0.51

Above 41N

Total cases 15,668
Total deaths 161
Total population 77,812,978
Total cases/1M people 201.4
Total deaths/1M people 2.07

The numbers are markedly different. Of course The Economist tries to stoke the fear by stating:

Fears are rising that the world’s second-most populous country might be on the brink of a big covid-19 outbreak. Until now India has been lucky with this coronavirus. It has relatively few visitors from the early centres of the pandemic—China, Italy and Iran. And Indian governments, at both federal and state levels, have been strikingly forceful in their response to the virus, with public-information campaigns saturating the television airwaves, and recorded messages pushed to mobile phones. So the number of Indian cases so far can be counted in the scores. But India has so far tested only a few thousand people, and some experts think it already has thousands or tens of thousands of cases. If so, decades of under-investment in public health have left India ill-prepared, with not enough doctors, beds or equipment for its 1.3bn people even in ordinary times.

Based on the Univ of Maryland study this is unlikely. Of course what it does imply is that the areas below the equator will suffer a similar fate in their winter.


.

A Journal of the Plague Year (4)

 

Image Credit: Imperial College, London (my old school!)

March 20th, 2020

As I write, Italy seems to be approaching a moment of truth. The case load for hospitals in the Lombardy region appears to be near critical. MIT Technology Review is running a website “Radio Corona” with excellent interviews with some of the leading medical minds—check it out.

I want to address a few points here that fellow scribes have raised which I think display faulty reasoning. And there is confusion about the absolute numbers, relative numbers, and the rate of change of numbers, each of which have different importance.


Point 1.


Much is made of the numbers of cases and deaths due to Covid-19 as compared to the standard flu that occurs every year. As Dalwhinnie points out (quoting the illustrious Professor Briggs):


• In Wuhan itself, the City of Doom, some 2,446 souls departed their fleshly existence earlier than expected. Google tells us the city has between 11 and 19 million, depending on whether you count the entire metro area as “the city”.
• The city had 49,995 cases. The case rate was 0.26% to 0.45%, depending on what China called “the city”. The total dead rate was 0.01% to 0.02%. The case dead rate was 4.9%.
• People fixate on that last number, forgetting you first have to get the bug before you can die from it. But everybody now seems to believe they’ll get it with certainty. Review Bayes Theorem & Coronavirus!

Nothing is wrong with these numbers or with the application of Bayes’ Theorem to the problem. However, it’s right only so far as it goes. The city had a total case rate of nearly 50,000 (0.5%) which doesn’t sound that bad, given a population of nearly 15 million. But this is only weeks AFTER a total shutdown of the city was instituted when even the Chinese leadership realized something big was happening. This is not what would have happened had that action not been taken. Witness Italy now and figure how far they were (are) behind the Chinese curve.

Further, this massive case load was IN ADDITION to the normal hospital case load of any city anywhere. And thousands of doctors and nurses do not miraculously appear overnight to care for them.

Moreover, it was only after the lockdown that (more than a week I think) the rate of increase of cases began to fall off. The effects of pushing down the value of R-naught, the base reproduction number, to below zero led to this. Case numbers continued to rise due to the appearance of symptoms in those who were already infected prior to the lockdown.

Point 2.

Even if a health care system can cope with greatly increased numbers at various times, a tsunami of new cases can rapidly overwhelm even the best system. Despite the fact that the Chinese government was criminally negligent at the beginning, at some point something snapped in the leadership when they realized that this thing will not go away or be suppressed politically. It was then that mass action started. Europe, and especially Italy, did not follow this path and is paying the price.  (CIDRAP, the Center for Infectious Disease Research and Policy, at the University of Minnesota is an excellent source).

It is not only hospitals and the medical workers that are affected, all kinds of supply chains and manufacturing are affected, especially in the West. Or they will be. As I alluded to in my previous missive, it’s not the absolute numbers at any time that count, but the rate of increase and the transmissibility of the thing.

Point 3.

Testing— Of vital importance, not only for those who are becoming sick, but for the general population currently unaffected, but possibly infected. This latter group is the source of further spreading. Tracking contacts and quarantine is the way to stop that and South Korea has shown that this works.

When an antibody test is available (apparently quite soon, maybe in a few days), this will enable us to detect persons who have been exposed to the virus and developed antibodies but have never become sick. Knowing this can give us a much better idea of the number of people who have been infected but never displayed sickness and the number who become sick (the afflicted). This greatly affects assessment of the case fatality rate.

If the health care system becomes overwhelmed at any time, the case fatality rate will rise as many sick people will get no treatment at all. Check out the graph at the top for possible scenarios.

So that’s it for today. This will not go away in a few weeks, we’re all in for a bumpy ride.

Rebel Yell

A Journal of the Plague Year (3)

Chloroquine: C18H26ClN3

March 19th, 2020

Meet your possible new friend—chloroquine. According to a paper from a few days ago, chloroquine (hydroxychloroquine, or in another form, chloroquine phosphate) can mitigate (apparently) symptoms of Covid-19 and also be effective as a prophylactic. Showing his usual dynamic leadership, President Trump has cut through much bureaucratic red tape that would usually hold up approvals to ensure that it is released and freely available.

What about possible side effects, you may ask? Well, chloroquine has been around for decades as a drug used to counteract malaria—years of experience have shown that it is safe.

However, my main point is that with the world-wide capabilities of the Internet, work done in conjunction with the Stanford University School of Medicine can be out and available in a matter of days. Although no guarantees, encouraging results. If not a silver bullet, maybe a bronze one?

Events are moving with amazing speed. Italy and Europe are now the epicenter of the pandemic and China seems to be on the brink of recovery. Chinese TV (CGTN) has some very interesting coverage[here]. Sure, it’s state media, but so is CBC. Get your news from around the world as do I. There’s no reason to doubt Chinese figures on the case load today—anyway, it’s all the data we have.

Yesterday, my fellow scribe, Dalwhinnie, posted about Professor Briggs, a noted statistician (who I follow regularly), who wrote an article on coronavirus—the Madness Has Arrived. And let me say up front, I have no argument with his figures or analysis. Bang on, as usual. But…

No matter how irrational the madness, however, the physical effects in society are real—the stock market crash, the death porn, the wailing and gnashing of teeth, a retail and restaurant crash etc.

Further, even if the case fatality rate is not much greater than standard flu (although it does appear so far to be about ten times greater), the transmissibility of the virus is really high leading to rapid spread. And, it seems that a person is highly infectious some time before they show any symptoms; again making it much harder to control.

This is why comparisons with absolute numbers, how many people die from regular flu, are not really relevant. They are built into our systems through years of experience. This new virus has no barriers of partial immunity in the population, and, coupled with the high transmissibility, makes it a particularly nasty beast.

The now infamous R0, R-naught, the base reproduction number, the expected number of cases directly generated by one case in a population where all individuals are susceptible to infection, has to be brought down to below one. If greater than one, the epidemic will grow exponentially; if less than one, it can be contained. R-naught is not a function just of the agent (here corona virus) but a function of how easily the infection can be communicated, particularly as it seems to spread via droplets. Hence, the importance of social distancing and personal hygiene.

These effects are what can lead to a wave of patients that can overwhelm the capacity of the medical system to cope—and herein lies the great danger. The measures now being taken in the US should have been taken sooner, but at least they are happening now. President Trump seems to have got the message seriously. (As for the media—words fail me when trying to describe their appalling behavior. In this scientific age, we would be hard pressed to find a more ignorant shower of people.)

Acting rapidly can avoid the situation getting like that in Italy. And who is helping Italy out? Not the EU bureaucracy, but China.   Think about that.

Check also further real information [here].

Hang tight,

Rebel Yell

A statistician looks at COVID-19: relax, that’s an order

William Briggs is a statistician, and he blogs at www.wmbriggs.com. I wish he were better known, but he does go off for pages on Thomas Aquinas when he is not commenting about numbers. This is his latest posting about coronavirus. His take? The fear is exaggerated. The reaction outlandish. I will say no more and let him speak for himself.

  • In Wuhan itself, the City of Doom, some 2,446 souls departed their fleshly existence earlier than expected. Google tells us the city has between 11 and 19 million, depending on whether you count the entire metro area as “the city”.
  • The city had 49,995 cases. The case rate was 0.26% to 0.45%, depending on what China called “the city”. The total dead rate was 0.01% to 0.02%. The case dead rate was 4.9%.
  • People fixate on that last number, forgetting you first have to get the bug before you can die from it. But everybody now seems to believe they’ll get it with certainty. Review Bayes Theorem & Coronavirus!
  • If everywhere will eventually be as bad as Wuhan, then, given 7.7 billion of us now speak with authority on “social distancing” and “flattening the curve”, as if we’ve been using these neologisms from birth, from 20 million to 35 million the world over will get the bug, and from 1 million to 1.7 million will croak from it. (Fifty million died from 1918’s Spanish flu.) ….[clip]
  • CDC estimates that so far this season there have been at least 36 million flu illnesses, 370,000 hospitalizations and 22,000 deaths from flu.

  • That’s in the United States alone, friends. Mostly pneumonia and old folks (God bless them). Worldwide at least ten times that number.
  • If the Wuhan numbers apply globally, losing a million or two of us worldwide is not welcome news, but it’s not panic-level, end-of-the-world, buy-every-roll-of-toilet-paper-in-sight news. It’s wash-your-damned-hands, stay-at-home-if-you’re-sick news.

There is much more that follows at the original site.

I have been reading Twitter a lot these past few days and have decided that, for most commentators, the advice and commentary is as significant as what is heard in the hen coop. Cluck, cluck, cluck.

How many ideas and institutions will not survive?

Rebel Yell and I were speaking yesterday (he from his castle, I from mine) about what the current plague will mean, does mean, for ideas and institutions that have wandered the landscape these many years that will disappear as snow in spring.

I predict the following will be gravely diminished or are about to be finished:

I think that all social institutions will be gravely hurt – which is bad – and that a lot of activity will have to move on-line if the isolation lasts more than four months:

  • churches
  • masons, fraternities, knights of columbus etc
  • sports leagues
  • schools

How are courts to function? How will witnesses be heard? How will lawyers argue?

Are universities necessary if they do not perform the function of educating students?

There is a part of me that figures this is all a plot of Satan (fill in your favourite force of evil in the spot occupied by Satan, but why not go to the top?) to further isolate people in their cells, to confine them to quarters, to have them willingly surrender their freedoms for a bit of security. We are becoming like the former Soviet Union, where zero trust is the operative condition; where you must have known people from high school before you are able to trust them with political discussion. We are nearly at that stage now in Ottawa. Or maybe we have been in that stage for thirty years and I am finally noticing the political repression.

Here is a piece of music written in equally fraught times by the Catholic composer William Byrd at the time of the English Reformation. Two pieces actually: Ne Irasceris Domine (be not wrathful, O Lord) and Sancta Civitas (Holy City) with its great line “Ieruslaem desolata est”. Jerusalem is indeed desolate this morning. But I am feeling quite well.

A Journal of the Plague Year(1)

March 17th, 2020

The world has changed, probably for ever. Who would have thought that it could happen so quickly? Mother Nature is reminding us that we are part of the ecology of Earth, not something outside it. Perhaps it will lead to a reduction in the fantasies that we can control Nature, be it health, disease or the weather.

Our apartment building has its own website and listserv. Many people are posting hints and help, asking elderly tenants by phone or email if they need help in getting supplies. Our glorious swimming pool is closed for the foreseeable future. Our bridge games are on hold. However, to everything there is a season, and a time to every purpose under Heaven.

Perhaps this is one of those times, a time to rise above the pressures of the material world and look more to the social and spiritual ties that bind us all, rather than the endless concern with money and prestige. Time to read “War and Peace” as you promised yourself so long ago; time to really listen to all those Bach cantatas; time, indeed, to examine ourselves inwardly a little more.

I am one of the lucky ones who can work at home. Mrs Rebel Yell has no problem, drawing on an extensive experience of bush living in the wilds of Ontario before I met her. A picture of calm.

We had planned a trip to the West Coast for April, but cancelled around mid-February. Why? Having had professional experience in emergency response operations for some years, when I saw the events unfolding in Wuhan (at that time an unknown city on the other side of the world), and, knowing what an exponential curve is, and, knowing what a case fatality rate is, a little light turned on in my head. Surely, this cannot be, in the modern day of medical science? As soon as the odd cases started appearing in other countries around the world, that was it. It’s really going to happen.

Knowing that politicians would be too slow to act, that’s when I started stocking up supplies. Fortunately, President Trump was quick off the mark with a travel ban on China—for which he was excoriated by the stupid journalists in the Fake News Media. He’s been a bit too slow on other issues, but he has had nothing but trouble from the media in the US whose reaction and behavior has been utterly reprehensible—especially CNN and MSNBC.

The CDC in the US is another bureaucratic organization that needs thorough reform, perhaps a complete rebuild. President Trump is cutting through that. But not fast enough. The Federal bureaucracy needs to be cut drastically both in the US and in Canada.

In any real emergency, it’s the first responders, local people, and local governments that really know how to get things done at the ground level, not some airhead policy wonk in a think tank. Your local Fire Marshall, medical officer, hazmat director, police chief; any of these people know better than politicians. And never listen to journalists—a complete waste of space.

That’s it for today, I leave a few links for some excellent easily understandable medical and scientific info….

Dr John Campbell (PhD, Nursing) [here], a British doctor with a daily video. Excellent medical info and practical advice for ordinary folk.

And hourly plague stats from Johns Hopkins University, Center for Systems Science and Engineering …[here]

Rebel Yell

Compared to what?

It is a rare day that I disagree with the courageous, and particularly with Heather MacDonald. Today is one of them. Miss MacDonald published an article in the New Criterion, entitled “Compared to What?” which argues that the response to the coronavirus is overdone by far.

She writes:

“Even if my odds of dying from coronavirus should suddenly jump ten-thousand-fold, from the current rate of .000012 percent across the U.S. population all the way up to .12 percent, I’d happily take those odds over the destruction being wrought on the U.S. and global economy from this unbridled panic.”

She then compares Covid19 deaths to the 38,000 traffic deaths across the United States in 2019 to the slightly over 5,000 deaths from the virus worldwide, and makes other reasonable arguments that the reaction to the virus has been overdone by far. She then says

“Rather than indiscriminately shutting down public events and travel, we should target prevention where it is most needed: in nursing homes and hospitals.”

This attitude is really quite foolish, for a number of reasons.

Covid19 is highly infectious, and is transmitted by breathing the same air as an infected person. The virus hangs about in suspension. One is infected for days before one shows symptoms. Some people will never experience any negative symptoms whatever, just as there were a few people who buried their families at the time of the Black Death in 1348 and went on to live long after the bubonic plague. Those people unaffected by Covid 19 are still infectious. So whether a person has symptoms or not, they can be transmitters.

Second, washing of hands may reduce the infection rate, but has no effect on the main transmission path, which is airborne. Increased vigilance about cleaning surfaces is welcome, for many reasons, because it gives people a sense of agency, but it will not do that much to prevent infection. This point was made clear in an interview by Joe Rogan with an epidemiologist, Michael Osterholm. (around minute 6 of the interview).

Third, you will have heard by now of the idea of “flattening the curve”, which means slowing the incidence at which the infection burns through society so that hospital facilities are not overwhelmed. I found this graph at Steve Sailer’s post in Taki Mag.

The dreadful assumption behind this graph is that eventually everyone, or sixty, or eighty percent of the population will get Covid19. The purpose of isolation measures is to slow the rate of infection so that medical resources are not overwhelmed.

Here is Stave Sailer on the topic:

“Fortunately, a new idea has emerged from the data released last Friday on new coronavirus cases in Wuhan up through Feb. 18. Back in January, each person with the disease was passing it on to an average of 3.86 other people. An R0 (the “basic reproduction number,” which is pronounced “R-nought”) of 3.86 represents exponential growth nearly to the power of four, a catastrophic rate.

“Mathematically, as long as R0 is greater than 1, the epidemic spreads. When R0 falls below 1, however, it starts to die out.

“Via heroic shutdown measures (basically, confining most of the population of this huge city to their apartments), the Chinese cut the R0 in Wuhan by more than an order of magnitude down to 0.32. New infections fell by almost 95%.”

As Michael Osterholm said in the interview with Joe Rogan, this is not a Coronavirus blizzard, this is a Coronavirus winter. Expect months of this. Whether the measures of isolation that have been ordained will work, and will be sustained, is a matter of social discipline.

So far every social and religious organization to which I belong has shut down. There are no church services in my denomination, no Masonic Lodge meetings, no fraternal or voluntary gatherings. Meetings of the condominium have been cancelled. More will follow.

The response in North America has been fully compliant. We have evinced a great measure of social cohesion in obeying what will be seen in a short while to be a significant burden.

Just as Canadians were climbing out of our burrows and sniffing the spring air, we have been sent back for more winter. It is enough to try the souls of men, and more such trials are coming.

Heather MacDonald has never written anything so silly, but until you come to grips with the mathematics of airborne plague – the doubling time of infection – it seems plausible that we have over-reacted. We have scarcely reacted enough, according to the epidemiologists, and maybe we are in time.

Do we do more harm than good by closing schools? Discuss.

At the moment the only appropriate response to slowing the rate of infection is to slow the rate of human interactions. Thank God for the Internet, because you will be spending a lot of alone time in the coming months. PornHub’s offer of reduced rates to Italians was actually insightful and wise. Italy is our future. Empty shopping malls will be the new normal.

Take a deep breath

I came across this paragraph as I ate breakfast this morning:

“In 1848, revolutions broke out again in Europe. For several years economic recession and hunger had provoked food riots in parts of Germany and France. By early 1848, almost a third of the workers of Paris were unemployed. In February, as the crisis rapidly worsened, the Parisians rose and overthrew the July monarchy”.

The citation comes from David Gress’ fascinating “From Plato to Nato: the Idea of the West and its Opponents” (at page 327).

Now that the Covid-19 plague is upon us, and as everything shuts down to slow the rate of infection, we can read paragraphs like that with fresh eyes:

hunger riots

one third unemployment

As recently as 1848!

Our current crisis is being met with cancellations of large meetings, shutdowns of sporting events, self-monitoring, isolation, quarantines, and concerns for whether the wine collection would last more than a week. My pension continues to arrive via electronic transfer. I may be seriously inconvenienced. Mrs. Dalwhinnie may not be able to visit some of her aged patients. The crisis is serious, but it not catastrophic.

In the duration I may finally be able to finish Gress’ book. It is highly recommendable for anyone whose interests include western civilization: does it exist? (yes) What does it stand for? (quite a lot) Has its meaning changed over time (yes). I thought I was learned in history before I read this book; clearly I was in error. Gress appears to have read and remembered everything since the pre-Socratics. A tour de force.