The following review of Ferguson’s Imperial Model is by Sue Denim. She uses it to demolish the hypocritical and dangerous Neil Ferguson model which blew up the world. The public sector at its very worst.
Imperial finally released a derivative of Ferguson’s code. I figured I’d do a review of it and send you some of the things I noticed. I don’t know your background so apologies if some of this is pitched at the wrong level.
My background. I wrote software for 30 years. I worked at Google between 2006 and 2014, where I was a senior software engineer working on Maps, Gmail and account security. I spent the last five years at a US/UK firm where I designed the company’s database product, amongst other jobs and projects. I was also an independent consultant for a couple of years. Obviously I’m giving only my own professional opinion and not speaking for my current employer.
The code. It isn’t the code Ferguson ran to produce his famous Report 9. What’s been released on GitHub is a heavily modified derivative of it, after having been upgraded for over a month by a team from Microsoft and others. This revised codebase is split into multiple files for legibility and written in C++, whereas the original program was “a single 15,000 line file that had been worked on for a decade” (this is considered extremely poor practice). A request for the original code was made 8 days ago but ignored, and it will probably take some kind of legal compulsion to make them release it. Clearly, Imperial are too embarrassed by the state of it ever to release it of their own free will, which is unacceptable given that it was paid for by the taxpayer and belongs to them.
The model. What it’s doing is best described as “SimCity without the graphics”. It attempts to simulate households, schools, offices, people and their movements, etc. I won’t go further into the underlying assumptions, since that’s well explored elsewhere.
Non-deterministic outputs. Due to bugs, the code can produce very different results given identical inputs. They routinely act as if this is unimportant.
This problem makes the code unusable for scientific purposes, given that a key part of the scientific method is the ability to replicate results. Without replication, the findings might not be real at all – as the field of psychology has been finding out to its cost. Even if their original code was released, it’s apparent that the same numbers as in Report 9 might not come out of it.
Non-deterministic outputs may take some explanation, as it’s not something anyone previously floated as a possibility.
The documentation says:
The model is stochastic. Multiple runs with different seeds should be undertaken to see average behaviour.
“Stochastic” is just a scientific-sounding word for “random”. That’s not a problem if the randomness is intentional pseudo-randomness, i.e. the randomness is derived from a starting “seed” which is iterated to produce the random numbers. Such randomness is often used in Monte Carlo techniques. It’s safe because the seed can be recorded and the same (pseudo-)random numbers produced from it in future. Any kid who’s played Minecraft is familiar with pseudo-randomness because Minecraft gives you the seeds it uses to generate the random worlds, so by sharing seeds you can share worlds.
Clearly, the documentation wants us to think that, given a starting seed, the model will always produce the same results.
Investigation reveals the truth: the code produces critically different results, even for identical starting seeds and parameters.
I’ll illustrate with a few bugs. In issue 116 a UK “red team” at Edinburgh University reports that they tried to use a mode that stores data tables in a more efficient format for faster loading, and discovered – to their surprise – that the resulting predictions varied by around 80,000 deaths after 80 days:
That mode doesn’t change anything about the world being simulated, so this was obviously a bug.
The Imperial team’s response is that it doesn’t matter: they are “aware of some small non-determinisms”, but “this has historically been considered acceptable because of the general stochastic nature of the model”. Note the phrasing here: Imperial know their code has such bugs, but act as if it’s some inherent randomness of the universe, rather than a result of amateur coding. Apparently, in epidemiology, a difference of 80,000 deaths is “a small non-determinism”.
Imperial advised Edinburgh that the problem goes away if you run the model in single-threaded mode, like they do. This means they suggest using only a single CPU core rather than the many cores that any video game would successfully use. For a simulation of a country, using only a single CPU core is obviously a dire problem – as far from supercomputing as you can get. Nonetheless, that’s how Imperial use the code: they know it breaks when they try to run it faster. It’s clear from reading the code that in 2014 Imperial tried to make the code use multiple CPUs to speed it up, but never made it work reliably. This sort of programming is known to be difficult and usually requires senior, experienced engineers to get good results. Results that randomly change from run to run are a common consequence of thread-safety bugs. or more colloquially, “Heisenbugs“.
But Edinburgh come back and report that even in single threaded mode they still see the problem, so Imperial’s understanding of the issue is wrong. Finally Imperial admit there’s a bug by referencing a code change they’ve made that fixes it. The explanation given is “It looks like historically the second pair of seeds had been used at this point, to make the runs identical regardless of how the network was made, but that this had been changed when seed-resetting was implemented“. In other words in the process of changing the model they made it non-replicable and never noticed.
Why didn’t they notice? Because their code is so deeply riddled with similar bugs and they struggled so much to fix them, that they got into the habit of simply averaging the results of multiple runs to cover it up … and eventually this behaviour became normalised within the team.
In issue #30 someone reports the model produces different outputs depending what kind of computer it’s run on (regardless of number of CPUs). Again the explanation is that although this new problem “will just add to the issues” … “This isn’t a problem running the model in full as it is stochastic anyway“.
Although the academic on those threads isn’t Neil Ferguson he is well aware that the code is filled with bugs that create random results. In change #107 he authored he comments: “It includes fixes to InitModel to ensure deterministic runs with holidays enabled“. In change #158 he describes the change only as “A lot of small changes, some critical to determinacy“.
Imperial are trying to have their cake and eat it. Reports of random results are dismissed with responses like “that’s not a problem, just run it a lot of times and take the average”, but at the same time, they’re fixing such bugs when they find them. They know their code can’t withstand scrutiny so they hid it until professionals had a chance to fix it, but the damage from over a decade of amateur hobby programming is so extensive that even Microsoft were unable to make it run right.
No tests. In the discussion of the fix for the first bug Imperial state the code used to be deterministic in that place but they broke it without noticing when changing the code.
Regressions like that are common when working on a complex piece of software which is why industrial software engineering teams write automated regression tests. These are programs that run the program with varying inputs and then check the outputs are what’s expected. Every proposed change is run against every test and if any tests fail, the change may not be made.
The Imperial code doesn’t seem to have working regression tests. They tried, but the extent of the random behaviour in their code left them defeated. On 4th April they said: “However, we haven’t had the time to work out a scalable and maintainable way of running the regression test in a way that allows a small amount of variation, but doesn’t let the figures drift over time.“
Beyond the apparently unsalvageable nature of this specific codebase, testing model predictions faces a fundamental problem that the authors don’t know what the “correct” answer is until long after the fact, and by then the code has changed again anyway, thus changing the set of bugs in it. So it’s unclear what regression tests really mean for models like this even if they had some that worked.
Undocumented equations. Much of the code consists of formulas for which no purpose is given. John Carmack (a legendary video game programmer) surmised that some of the code might have been automatically translated from FORTRAN some years ago.
For example on line 510 of SetupModel.cpp there is a loop over all the “places” the simulation knows about. This code appears to be trying to calculate R0 for “places”. Hotels are excluded during this pass, without explanation.
This bit of code highlights an issue Caswell Bligh has discussed in your site’s comments: R0 isn’t a real characteristic of the virus. R0 is both an input to and an output of these models, and is routinely adjusted for different environments and situations. Models that consume their own outputs as inputs is problem well known to the private sector – it can lead to rapid divergence and incorrect prediction. There’s a discussion of this problem in section 2.2 of the Google paper, “Machine learning: the high interest credit card of technical debt“.
Continuing development. Despite being aware of the severe problems in their code that they “haven’t had time” to fix, the Imperial team continue to add new features, for instance, the model attempts to simulate the impact of digital contact tracing apps.
Adding new features to a codebase with this many quality problems will just compound them and make them worse. If I saw this in a company I was consulting for I’d immediately advise them to halt new feature development until thorough regression testing was in place and code quality had been improved.
Conclusions. All papers based on this code should be retracted immediately. Imperial’s modelling efforts should be reset with a new team that isn’t under Professor Ferguson, and which has a commitment to replicable results with published code from day one.
On a personal level I’d actually go further and suggest that all academic epidemiology be defunded. This sort of work is best done by the insurance sector. Insurers employ modellers and data scientists, but also employ managers whose job is to decide whether a model is accurate enough for real world usage and professional software engineers to ensure model software is properly tested, understandable and so on. Academic efforts don’t have these people and the results speak for themselves.
Carla Jasper says
This is shocking to the core. We are living in a very complex and deceiving world. Thank you for being vigilant and and resourceful enough to get the truth out there.
Paul Plante says
Models of reality are not reality and models of reality neither control nor dictate what reality in the end will be, although that never seems to deter model makers from being arrogant enough to believe in the perfection of theirs to be able to do so.
Graham says
Academic computer models often are buggy. Academics rarely have the time to become professional programmers as well. The important thing is that this is now open to public scrutiny. It would be good if the model could be replicated in R. A simplified model can be made in excel using observed R0 and replication time, the results are much the same. Small changes in the starting inputs will always produce large differences in the final numbers. The header at he top of the article is desperately wrong. Exponential growth is relentless. That is the truth that has always been the foundation of reasoned responses to this crisis.
Paul Plante says
Graham, dude, pardon me, but I find your logic above here hard to follow where you state the following postulation, to wit:
I. The header at the top of the article is desperately wrong.
II. Exponential growth is relentless.
III. That is the truth that has always been the foundation of reasoned responses to this crisis.
The header in question states “Code Review of Covid-19 Model is riddled with bugs.”
Are you taking the position that the Covid-19 model is in fact bug-free?
And what exactly do you mean when you say “exponential growth is relentless?”
On what basis do you say that?
And how can you justify it?
Grow something in a Petri dish, and before it reaches the limits, it stops growing, no matter how rapidly it might have advanced, or in what matter, be it exponential or otherwise.
And that applies to COVID – it can only infect those it was designed by nature to infect, and no matter how rapidly it infects them, they are finite in number, and that spells the end of COVID.
Are you trying to state otherwise?
And where were the “reasoned responses” to what you are calling “this crisis?”
There weren’t any is that answer, which is how it became a crisis.
Graham says
Are you taking the position that the Covid-19 model is in fact bug-free?
No, I accept there are bugs, just that combined with 100 years of epidemiological knowledge these bugs are minor. My reference was to the implication in the commentary below the title that because the model has bugs, the covid – 19 response is invalid.
And what exactly do you mean when you say “exponential growth is relentless?”
On what basis do you say that?
And how can you justify it?
Yes I know there are limits to exponential growth. As more of the population becomes infected, there are less people to infect. The art of epidemiological modeling is to model these restrictions on growth. This can be done in a crude statistical way based on averages or by using a multilevel hierarchical model, which is what Fergussons model attempts rather badly.
So let us start with “crude” statistical modeling based on averages. At the end of January I could see the looming disaster. Using the data from Italy and China, I could make educated guesses on the averages of the two most important parameters of any model. R0, the reproduction rate (about 2.6) and the T0 the growth period (4 days). Assuming a death rate of 3% I modeled the potential UK growth from 1 March: (the formatting might be off)
Predicted Cases Date Deaths 4% Cumulative Deaths
35 March 1st 1 1
81 March 5th 3 5
193 March 9th 8 11
464 March 13th 19 26
1113 March 17th 45 63
2671 March 21st 107 151
6410 March 25th 256 363
14743 March 29th 590 846
35383 April 3rd 1415 2005
84919 April 7th 3397 4812
203804 April 11th 8152 11549
489131 April 15th 19565 27717
A caveat. Lockdown was introduced in the UK after March 25th so R0 should be adjusted after this date. I have kept the original calculation here to show the basic model corresponds well to the recorded data.
A simple spreadsheet calculation can show the approximated initial growth fairly accurately. I could have adapted the calculations after lockdown in the UK to show the reduced R0, but my point here is to show that a crude averaging model based on existing data and known concepts from 100 years of epidemiology research, works fairly well for the initial stages of infection. With a population of 66 million in the UK, exponential growth has plenty of (but rapidly diminishing) room to operate.
Now where we need the ICL model (& others like it) is to be more sophisticated in our model of growth and changes in R0. To do this the R0 is calculated for different subsections of the population (e.g school children, old people, service workers) and their expected interaction situations (schools, hospitals, public transport, etc). The Fergusson model attempts to do this based on data from flu pandemics. The other important parameters of this model are the specific interactions where no transmission occurs because of so called “herd immunity”.
Referring back to our crude model, all we are doing is refining decreases in R0 over time and placing a limit on the number of infections. So my overall point is that even though the ICL model is buggy & badly flawed, it just differs in detail from a crude averaging model based on 120 years of epidemiology research.
Are you trying to state otherwise?
In an academic sense Fergussons model has many flaws, but in its broad conclusions it is not desperately inaccurate. Where it matters is in detailed strategy for dealing with the pandemic. For example, what is the specific effect on R0 of closing schools? What is the specific effect on R0 of social distancing? Based on our knowledge of previous pandemics from Spanish Flu to Ebola, we know these measures have an effect. Our crude model (with a small refinement) could easily predict subsequent waves if lockdown were relaxed.
And where were the “reasoned responses” to what you are calling “this crisis?”
I refer to New Zealands eradicate plan and South Koreas & Singapores track, trace & isolate plans. These are based on what is known from previous pandemics and proven strategies to defeat epidemics. These responses did not require the details of Fergussons model. So whether the model is buggy or not has no relevance to the broad strategy that should be chosen.
“There weren’t any is that answer, which is how it became a crisis.”
There were, but I would tend to agree, many governments responses were woefully negligent. Simply because they did not listen to 120 years of epidemiological research & wisdom.
So in conclusion. There are many models out there, just because Fergussons model is flawed does not mean anything for the broad decision making processes. Exponential growth, or the potential for it, is the underlying truth of the pandemic at nearly all stages (immunity is only a significant factor in growth in the third wave). It is this potential, combined with knowledge from previous epidemics that should dictate broad policy. The details of Fergussons model are irrelevant. The fact that Fergusson is a bad programmer is for the judgment of his academic peers. As a statistician, I will certainly be criticising his sloppy practice.
Paul Plante says
Graham, thinks for getting back to us as you have done above here, which response spurs several more questions which I would hope you would address to better help people understand what is an esoteric topic to many.
And what exactly is it that you are trying to predict with the model?
The speed of transmission?
The overall number of peop0le impacted or directly affected by the virus?
Or just what you think the deaths are going to be?
You make this statement, which is not clear in terms of context, to wit:
“The Fergusson model attempts to do this based on data from flu pandemics.”
end quotes
When you say “attempts to do ‘THIS,'” could you be more explicit as to what “this” actually is that the model is attempting to do?
And this is confusing, as well:
In one place, you say this:
“I could have adapted the calculations after lockdown in the UK to show the reduced R0, but my point here is to show that a crude averaging model based on existing data and known concepts from 100 years of epidemiology research, works fairly well for the initial stages of infection.”
And then in another, you say this:
“There were, but I would tend to agree, many governments responses were woefully negligent.”
“Simply because they did not listen to 120 years of epidemiological research & wisdom.”
end quotes
Why 100 years in one sentence, and 120 years in another?
And let me say that I am joining the conversation as an associate level public health engineer with more than passing knowledge of epidemics going back more than 100 years and how the public health infrastructure has actually responded to typhoid, cholera and flu epidemics.
And as to your modeling, let’s start with this statement of yours, to wit:
“Using the data from Italy and China, I could make educated guesses on the averages of the two most important parameters of any model.”
end quotes
How and why?
If you consider demographics, Asia and Europe are home to some of the world’s oldest populations, those ages 65 and above, with Japan at the top with 28 percent, followed by Italy at 23 percent, while twelve percent of China’s population is age 65 or above, and that share is 16 percent in the United States.
Given that Italy has more elderly people than the U.S., how can you equate the two in terms of death rate?
What mechanism in your model accounts for that difference?
And then you make this statement, to wit:
“immunity is only a significant factor in growth in the third wave.”
end quotes
“Third-wave?”
Again, can you be more specific with what you mean by “third-wave” in terms of immunity?
Graham says
Apologies for the delayed reply, I am marking at the moment.
And what exactly is it that you are trying to predict with the model?
That particular “model” was actually the second I made on a spreadsheet the day the first in the wild case was detected in the UK. I just wanted to understand the initial potential growth of the virus in the UK and the risk to me from interaction with others. I work in crowded London as a lecturer. I was at the time dumbstruck that there was not rigorous trace, test & isolate in place.
As a general point to support what I say, I would like to remind you of the power of averaging as a statistic. I presented a crude averaging model to show how it could be as effective at giving the broad overall picture as a (flawed) multilevel hierarchical model such as Fergussons.
If you talk about averages to students, their response is often “Boring, I know how to calculate an average”. Whilst I am sure you are ready with counter examples of where averages can be misleading. I would like to start by saying that, if used correctly they are the most powerful statistical tool that we have. Try reading about Galtons tale of the dead Ox.
https://theconversation.com/how-to-unleash-the-wisdom-of-crowds-52774
The much vaunted R0 that is the foundation of any model, is in fact a very powerful average. It represents everything from the superspreader who infects hundreds other people (cf South Korea case 31) usually a small child. To the elderly person with few social contacts who infects only one other.
The speed of transmission? The time it takes for an infected person to infect others.
The overall number of people impacted or directly affected by the virus?
This was the population of the UK (approx 66 million). Given what we knew at that stage about the way the virus spreads, I felt no need to put population limits into the initial model. With millions to rip through and cull, there was plenty of room for the basic maths to operate without impediment.
Or just what you think the deaths are going to be? Any unecessary death greater than one is a tragedy.
You make this statement, which is not clear in terms of context, to wit:
“The Fergusson model attempts to do this based on data from flu pandemics.”
end quotes
When you say “attempts to do ‘THIS,’” could you be more explicit as to what “this” actually is that the model is attempting to do?
The “this” is the R0 for different population slices and interaction environments. What Fergussons model also attempt to do is calculate deaths and lost life years for each slice of the population.
And this is confusing, as well:
In one place, you say this:
“I could have adapted the calculations after lockdown in the UK to show the reduced R0, but my point here is to show that a crude averaging model based on existing data and known concepts from 100 years of epidemiology research, works fairly well for the initial stages of infection.”
And then in another, you say this:
“Simply because they did not listen to 120 years of epidemiological research & wisdom.”
Why 100 years in one sentence, and 120 years in another?
I was writing a reply, not an academic paper so did not rigorously check for errors. Although one could argue that he start of epidemiology was John Snow & the cholera epidemic of 1854 or the work of Thomas Greenhow in the 1830s
. In my mind, epidemiology took off with the mathematical work of William Kermack and Anderson McKendrick in the early 1930s. So 90 years to be precise! The 120 came from thinking about the work of Ronald Ross c1900 on whose work Kermack & McKendrick built.
There are of course even earlier attempts at epidemiological study lost in history. Fracastoro in Verona c1520, Wu in China c1600. The pragmatics of dealing with Plague were worked out even earlier, though his knowledge was lost to obscurity & rediscovered many times.
And let me say that I am joining the conversation as an associate level public health engineer with more than passing knowledge of epidemics going back more than 100 years and how the public health infrastructure has actually responded to typhoid, cholera and flu epidemics.
And as to your modeling, let’s start with this statement of yours, to wit:
“Using the data from Italy and China, I could make educated guesses on the averages of the two most important parameters of any model.”
How and why?
At the time, the only vaguely reliable data I had access to was from Italy, China and South Korea. The R0 calculations reported ranged from 2.3 to 3.1. The only data I had some confidence in was the deaths reported. So I worked back (built a simple regression model) from deaths per day to estimate the R0 and transmission time (the time It took for a new case to infect 2.4 others). In essence, the values I chose were a weighted average of the data from those countries. It has turned out that they were underestimates, but fairly good guesses. My guess at the death rate for identified cases 4% was a big underestimate. At the moment it is nearly 10% in the UK.
“If you consider demographics, Asia and Europe are home to some of the world’s oldest populations, those ages 65 and above, with Japan at the top with 28 percent, followed by Italy at 23 percent, while twelve percent of China’s population is age 65 or above, and that share is 16 percent in the United States.”
You are incorrectly focusing on the fact that covid-19 is more dangerous for the elderly. The data shows that covid 19 kills across all age groups. If you must make an age distinction, it would be more appropriate to consider the proportion of the population over 50.
What I considered is the observed mortality rate as a % of identified cases.
“Given that Italy has more elderly people than the U.S., how can you equate the two in terms of death rate?”
I was talking about the UK, not the US, the US is headed to disaster. If you want to take into account the older people, it is more appropriate to use the statistic of deaths per million people.
“What mechanism in your model accounts for that difference?”
None. As I said, it was a crude averaging model. My point was that crude averaging models can give a fairly accurate picture. Fergussons model deals with age (specific to the UK population). Although I can technically build a herarchical multi level model, there is no need because of the power of averages.
And then you make this statement, to wit:
“immunity is only a significant factor in growth in the third wave.”
end quotes
“Third-wave?”
Again, can you be more specific with what you mean by “third-wave” in terms of immunity?
If you look at models of infection growth and lockdown. The cases rise until distancing produces an R0 smaller than 1, then when distancing is relaxed the R0 rises, then falls again, repeat. In each wave there are less of the population to become infected (they are either dead or immune). Immunity only really starts to have a noticeable effect on lowering R0 when 67% of the population have been infected.
Herd immunity has never naturally occurred for a viral disease
Paul Plante says
Graham, good to hear from you and I am glad you are taking my inquiries seriously.
And thanks especially for providing some necessary context – that is appreciated, starting with the fact that you are tuning into the conversation not from the U.S., but the U.K, which adds a complete new dimension to the discussion.
I am presently mulling over your answers, and will be back to you soon.
And again, thank you for your time.
One last thing of interest is that the Cape Charles Mirror has made its way to the U.K. which I think is fantastic, given that it has brought you into the discussion with a whole new perspective that we might otherwise not have had access to.
Graham says
If you post interesting articles, you will attract a diverse audience 🙂 I was simply following a colleagues link on facebook. As you might have gathered, I am an academic & will defend the necessity of academic pursuit & expertise. I had to look up Cape Charles on wikipedia, I only knew it as a name before, because of the Chesapeake impact crater. I look forward to an interesting and civil discussion.
Paul Plante says
Graham, with respect to your statement above about “herd immunity,” let me share a couple of things about that from our records on this side of the pond which test your thesis, to wit:
The 1918 virus was an influenza and was especially lethal for those between the ages of 10 and 30.
Death from the 1918 flu came rapidly, usually within a week, some victims died the same day.
Within three days, pneumonia often followed and without antibiotics and ventilators, it proved fatal in 25% of the cases.
Those exposed to the spring 1918 influenza were immune to the deadly fall influenza.
Scientists still do not understand why the 1918 flu disproportionately impacted the young since most flu viruses’ prey on the very young and very old.
There are two theories.
One is that the flu produced a dangerously strong immune response called cytokine storm causing a lethal overreaction.
Other scientists believe that the older generation had been exposed to other flus, thus building antibodies.
– From “The 1918 Flu Epidemic on the Eastern Shore” by Angela Rieck on March 26, 2020
H1N1 Swine Flu pandemic: 2009-2010
The 2009 swine flu pandemic was caused by a new strain of H1N1 that originated in Mexico in the spring of 2009 before spreading to the rest of the world.
In one year, the virus infected as many as 1.4 billion people across the globe and killed between 151,700 and 575,400 people, according to the CDC.
The 2009 flu pandemic primarily affected children and young adults, and 80% of the deaths were in people younger than 65, the CDC reported.
That was unusual, considering that most strains of flu viruses, including those that cause seasonal flu, cause the highest percentage of deaths in people ages 65 and older.
But in the case of the swine flu, older people seemed to have already built up enough immunity to the group of viruses that H1N1 belongs to, so weren’t affected as much.
– Live Science, “20 of the worst epidemics and pandemics in history” by Owen Jarus – Live Science Contributor, All About History, 20 MARCH 2020
Graham says
“Graham, with respect to your statement above about “herd immunity,” let me share a couple of things about that from our records on this side of the pond which test your thesis, to wit:”
Epidemiological models account for both of those different scenarios.
First we must distinguish between models and data.
The data about a disease is important. How susceptible are the young, the old (how likely are they to catch the disease)? How likely are they to die? How many people will an infected person infect? These values differ for each variant of flu and each strain.
My point is that we enter data into the models, the models are not usually set up to predict that essential data. The models work on probabilities calculated using that basic data. They model the contagion process.
Sometimes if there is not accurate basic data, the basic parameters of the models are seeded with random numbers from a specific type of distribution and run hundreds of thousands of times (Fergussons model does this) to produce a distribution of results (this is called a Monte Carlo simulation).
Unfortunately we are departing now from my simplified model that I was trying to use as a science educator to help people understand. To the realm not just of differential equations, but interacting differential equations.
The simplest form of model used is a Susceptible-Infectious- recovered model (SIR). They have three parameters (that are continuous non – linear variables). These models are fairly good at predicting the spread of infectious diseases such as mumps, measles, smallpox, flu, polio etc. They predict transmission when people get immunity to a disease. One of the counter intuitive results from the differential equations that underpin these models, is that infection limits are governed by the number of infected remaining, not the uninfected in the population. This type of model is also useful for calculating the infection equilibrium. This occurs when the virus becomes endemic in a population and keeps breaking out in clusters. Previous relevant examples are polio and smallpox.
You can progress from this to a Susceptible, Infectious, Recovered, Deceased model. This is more sophisticated because it differentiates between Recovered and Deceased. This can be developed further to models that vary the population parameters over time (births & deaths). Then from this, you can develop age structured models and population structured models. Fergussons model is both age and population structured.
The two examples you give say nothing about the validity of epidemiological models. The parameters of the diseases differ and this can be accounted for with data driven changes to the parameters of the model.
I am not sure why you have chosen these examples, but I assume that you are making a point about not modeling the susceptibility of the elderly to covid – 19.
So to use an example, let us first establish some basic parameters.
15.21% of the UK population of 66 million is aged over 70.
That is just over 10 million people. (10, 038,600), approximately 200,000 of these are in care homes.
Now we know from the data on covid-19 in the UK that if an elderly person catches covid-19 they are more likely to die than a younger person (31% for males, 25% for females).
For people under 70 the death rate is mercifully far less. It averages out at around 10% of those infected.
In the very young (unlike Spanish flu) the death rate is <1%.
What we have to add to these parameters is the fact that young people tend to have far more social interactions than the elderly. For this reason, elderly people are far less likely to catch a virus and less likely to transmit it. This is where the need to have age and population structured models comes in.
Going on very recent data from Spain (where the toll is awful) around 5% of the population has been infected with covid -19. This leaves 95% of the population to be potentially infected. European countries who have suffered two months of the virus are nowhere near the stage where immune saturation affects the R0.
So although older people are more likely to die they are less likely to catch the disease. Assuming no interventions, I estimate 2% of 10 million = 200,000 of which 28% will die = 56,000. For the rest of the population I estimate (guess) around 6% of 56 million = 3,360,000 of which 10% will die = 336, 000. Combine these totals and you get 392,000 which is .59% of the UK population.
Where am I going with this? Well if we just use an average on the entire population of 66 million 5% catch the virus and 10% die that is 330,000.
The absolute numbers are horrifying, but not so much different when we partition groups of the population and use a variable infection & death rate.
So, I would defend my use of an averaging model to get a general sense of where the disease is headed. Even if all the 200,000 in care homes in the UK caught the virus there would be little difference in the magnitude of the overall figures. Of course, every number is a real person and my calculations are callous and indifferent to human suffering.
If we apply the data from Europe to the US, you are still in the stage where covid -19 is establishing itself as endemic in the population. It might be a good idea to try to avoid this. Once it is endemic then the endemic equilibrium predictions of the epidemiological models become relevant. At the moment you are still in the epidemic development stage and your death toll is going to top 500,000 with ease.
Paul Plante says
Graham, first off, let me assure you that I personally have nothing against either academics, or the necessity of academic pursuit & expertise.
I have a graduate degree in engineering, afterall, so at some point in my career, it was essential that I not only come into contact with academics, but engage in academic pursuit & expertise myself.
Since then, as an engineer, I have ripped to shreds a few reports by academics that were pure and easily debunked hogwash, but that is a commentary on them, not all academics, and I am glad that you have stepped up to the plate in here to further shed light on this subject.
And in that regard, let me introduce to you a recent paper on the use of statistics to predict COVID deaths in the USA, with our demographics as compared to other countries, to wit:
Health Affairs
“Estimating The Infection Fatality Rate Among Symptomatic COVID-19 Cases In The United States”
Anirban Basu
PUBLISHED:May 07, 2020
https://doi.org/10.1377/hlthaff.2020.00455
Abstract
Knowing the infection fatality rate (IFR) of SARS-CoV and SARS-CoV-2 infections is essential for the fight against the COVID-19 pandemic.
Using data through April 20, 2020, we fit a statistical model to COVID-19 case fatality rates over time at the US county level to estimate the COVID-19 IFR among symptomatic cases (IFR-S) as time goes to infinity.
The IFR-S in the US was estimated to be 1.3% (95% central credible interval: 0.6% to 2.1%).
County-specific rates varied from 0.5% to 3.6%.
The overall IFR for COVID-19 should be lower when we account for cases that remain and recover without symptoms.
When used with other estimating approaches, our model and our estimates can help disease and policy modelers to obtain more accurate predictions for the epidemiology of the disease and the impact of alternative policy levers to contain this pandemic.
The model could also be used with future epidemics to get an early sense of the magnitude of symptomatic infection at the population-level before more direct estimates are available.
Substantial variation across patient demographics likely exists and should be the focus of future studies.
An estimate of the magnitude of the truly asymptomatic fraction in COVID-19 remains unclear — population-wide antibody testing would be needed to establish this statistic.
Results from sero-testing from the Diamond Princess outbreak suggests that about 17.9% of infected persons never developed symptoms.
Consequently, a reasonable estimate of the overall IFR would be about 20% lower than our estimated IFR-S.
Our COVID-19 IFR-S estimate is not outside the ballpark of estimates becoming available from other countries, but certainly lower, as expected from addressing the upward bias in those estimates.
For example, the COVID-19 fatality rate for China (without correction for the upward bias inherent in looking at observed rates) was initially reported to be 5.6% (95% CI: 5.4–5.8%).
By February 20, the crude fatality rate for China was estimated to be 3.8%.
The fatality rate outside China was estimated to be 15.2% (95% CI 12.5–17.9%), which may be due to the more considerable upward bias during the beginning part of the pandemic within a county.
We see the same patterns in the United States, with observed rates being much higher during the initial part of the pandemic.
A recent estimate of CFR using individual-level data from Wuhan residents and also international Wuhan residents who repatriated on six flights was found to range from 0.66% to 1.4%.
If we carry out a thought experiment where 35.5 million individuals would contract COVID-19 illness this year in the US (i.e., the same number as flu last year) then, in the absence of any mitigation strategies or social distancing behaviors and the supply of health care services under typical conditions, our IFR-S estimate predicts that there would have been nearly 500,000 COVID-19 deaths this year.
To the extent that COVID-19 is more infectious than flu and does not have any protection from a vaccine or treatment, the number of infections, and hence the number of deaths, would be higher.
Certainly, with mitigation strategies, the death toll will be lower.
For example, the recent White House COVID-19 Taskforce projections of 100,000–200,000 deaths this year from COVID-19 is made with assumptions about the effectiveness of social distancing directives and measures currently in place.
Our estimated IFR-S applies under the assumption that the current supply (until April 20) of health care services, including hospital beds, ventilators, and access to healthcare providers, would continue in the future.
Constraints in the supply of health care services could surely increase IFR and the overall fatality rates.
https://www.healthaffairs.org/doi/full/ … 2020.00455
Graham says
Oh my goodness. I am not an expert epidemiologist. I just have a passing knowledge of the subject from my interest in statistical modeling. The author shows their ignorance of basic epidemiology and modeling concepts with several of their statements. There are thousands of opportunity papers being put out there each week. I have reviewed several and glanced at a couple of hundred over the past month. This is not a good one. I can take it apart line by line if you want, but it will take me a week. The politest thing I can say is that it is an underestimate.
The question of unsymptomatic infection is indeed a crucial one. Unfortunately we do not have accurate enough data at the moment (cue rant about lack of population testing and unreliable antibody tests). The authors overestimate the unsymptomatic rate. A paper I recently reviewed with Spanish data shows that the unsymptomatic rate of infection is quite low.
As regards academics. There is a paragraph at the bottom of the original article “On a personal level I’d actually go further and suggest that all academic epidemiology be defunded. This sort of work is best done by the insurance sector. Insurers employ modellers and data scientists, but also employ managers whose job is to decide whether a model is accurate enough for real world usage and professional software engineers to ensure model software is properly tested, understandable and so on. Academic efforts don’t have these people and the results speak for themselves.”
I am still reeling with horror at the suggestion. Epidemiologists don’t just model, they collect data. Day in, day out in a boring grind they refine their models with real world data and suggest further data that is needed. Now is when we need all their years of hard work.
Paul Plante says
As to the number of asymptomatic people with COVID, according to the WHO Coronavirus disease 2019 (COVID-19) Situation Report – 46, Data as reported by national authorities by 10AM CET 06 March 2020, for COVID-19, data as of that date suggested that 80% of infections of COVID are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation.
Healthline had an article on the same subject entitled “As Many as 50 Percent of People with COVID-19 Aren’t Aware They Have the Virus” written by Roz Plater on April 24, 2020:
There may be a lot of people walking around who have COVID-19 but have no idea they are spreading the virus.
The first word of this possibility came in early April from the Centers for Disease Control and Prevention (CDC) director, Dr. Robert Redfield, in an interview with National Public Radio affiliate WABE.
“One of the [pieces of] information that we have confirmed now is that a significant number of individuals that are infected actually remain asymptomatic.”
“That may be as many as 25 percent,” Redfield said.
Then a few days later, researchers in Iceland reported that 50 percent of their novel coronavirus cases who tested positive had no symptoms.
The testing had been conducted by deCODE, a subsidiary of the U.S. Biotech company Amgen.
In another new report, the CDC stated that researchers in Singapore identified seven clusters of cases in which presymptomatic transmission is the most likely explanation for the occurrence of secondary cases.
That report was backed up by a study published in mid-April that concluded that people with no symptoms are the source of 44 percent of diagnosed COVID-19 cases.
end quotes
The Center For Evidence-based Medicine has an article entitled “COVID-19: What proportion are asymptomatic?” by Carl Heneghan, Jon Brassey and Tom Jefferson on April 6, 2020, to wit:
Readers of the blog will be aware that we have little trust in the current reported COVID data.
Everywhere we look we cannot get a handle on the essential facts or at times we get 2 completely different answers to the same question.
The military historian Sir Basil Liddle Hart would have called this “the fog of a pandemic” or perhaps the “fog of information overload.”
So, we thought we would try to answer an important question: what is the proportion of people with SARS-COV-2 who are asymptomatic?
To answer this we searched LitCovid (a subset of Pubmed), medRxiv, Trip, Scholar and Google.
We retrieved 21 reports for analysis.
What did we learn (see the table for the analysis)
• That between 5% and 80% of people testing positive for SARS-CoV-2 may be asymptomatic
• That symptom-based screening will miss cases, perhaps a lot of them
• That some asymptomatic cases will become symptomatic over the next week (sometimes known as “pre-symptomatics”)
• That children and young adults can be asymptomatic
We also learnt that there is not a single reliable study to determine the number of asymptotics.
It is likely we will only learn the true extent once population based antibody testing is undertaken.
end quotes
So in truth, I find myself siding with them in the conclusion that when it comes to who might be asymptomatic with COVID, we really do not have a clue.
Paul Plante says
And let me follow that up with this:
BioSpace
“Multiple Studies Suggest COVID-19 Mortality Rate May Be Lower Than Expected”
Published: May 07, 2020 By Gail Dutton
As the mortality figures for COVID-19 continued to rise, people are wondering where they will stop.
The actual death toll for COVID-19 won’t be calculable for some time, but there are early indications that it may be significantly lower than calculations of deaths per confirmed cases lead one to believe.
As an article in Lancet Infectious Diseases pointed out, calculating mortality rates based on the number of deaths divided by the number of confirmed cases of infection is not representative of the actual death rate.
There are two issues, the authors said.
First, the denominator should be the number of people who were infected at the same time as those who died.
The second issue is that many people experienced very mild symptoms and so did not seek medical treatment and were not included in the calculation.
To get to the bottom of this, the National Institutes of Health (NIH) launched a 10,000 person study in mid-April.
It aims to determine how many adults in the U.S. who do not have a confirmed diagnosis of COVID-19 who have antibodies against the SARS-CoV-2 virus.
The results of this serosurvey will shed light on the spread of this virus throughout the U.S. and on which populations and communities are most affected.
*******
There are two possible inferences from all of these studies.
One possibility is that academics from our leading institutions – or the tests they employed – are error-prone.
Debates over methodology are ongoing, and questions swirl around error rates for tests that as yet are approved only under the FDA’s emergency use authorization.
Alternatively, these results may indicate the deadly COVID-19 pandemic – with mortality rates generally under 1% – is no more deadly than the seasonal influenza.
If that is true, the near-global stay-at-home mandates could have been an overreaction.
https://www.biospace.com/article/multip … expected-/
Graham says
In brief, deaths follow infections by a median of 3 weeks.
Even at 1% the death rate would be 10 times that of flu.
“If that is true, the near-global stay-at-home mandates could have been an overreaction.”
What these are designed to do is stop the growth of infection. The current issue is the potential exponential growth of the virus infections. What you seem not to understand is that the epidemic is still in its growth phase. With millions of people in the population there is plenty of room to grow before an equilibrium is reached.
When an epidemic starts, the only tried & tested effective medical response (with no vaccine) is quarantine, test, trace & isolate. If you fail to do that the epidemic can grow exponentially. The measures needed have a severe impact. There are always those who claim that they are an over reaction. The same voices were raised recently over the responses to SARS, bird flu & Mers.
Timee for bed for me, I am on UK time
Paul Plante says
Graham, here’s hoping you had a good sleep, and what I do understand is that regardless of what might have been going on over in the UK with respect to COVID, or anywhere else on the globe outside of the territorial boundaries of the United States of America where some other set of laws other than ours are in force, on 8 January 2020, the American CDC issued a Health Alert Notification about COVID as an emerging public health threat, which notification was distributed to state and local health officers, state and local epidemiologists, state and local laboratory directors, public information officers, HAN coordinators, and clinician organizations here in the United States of America.
What I do understand, quite well, having actually been a public health engineer in this country, is that those state and local health officers, state and local epidemiologists, state and local laboratory directors, public information officers, HAN coordinators, and clinician organizations form, or used to form the public health infrastructure in this country responsible for stopping the spread of communicable diseases.
And what I understand, this as an American citizen who might be more tuned into these kinds of nuances than say, yourself, removed as you are by some 3,459 miles from the epicenter of COVID in this country, that being New York City, is that that politically-compromised public health infrastructure failed us American citizens big-time, and that is because of the toxic partisan politics in this country where the one political party, in a continued effort to gain against the other party, was willing to sit back and do nothing and instead let COVID spread to create a public health crisis that they could then blame on the incumbent president who they hope to defeat in November of this year so they can take complete control of our national government to impose a one-party rule on is.
And now COVID is running rampant through the land.
That is what I understand.
And what I further understand is that once the lid is off Pandora’s Box, as it is in this country with respect to COVID, it can’t be put back on.
So, yes, Graham, people in America are dying.
In 2020, this year, an estimated 606,520 people are going to die of cancer in the United States with lung and bronchus cancer being responsible for the most deaths with 135,720 people expected to die from this disease.
In 2018, there were 48,344 recorded suicides in the U.S., up from 42,773 in 2014, according to the CDC’s National Center for Health Statistics (NCHS), and this year, we expect to see that number rise dramatically.
In 2018, there were 67,367 drug overdose deaths in the United States, and that too is a number we expect to see rise dramatically in this country.
And in America, about 647,000 Americans die from heart disease each year, which is 1 in every 4 deaths.
So yes, Graham, people in America are dying every day, just as they have been doing every day of every year of the over 70 years of my lifetime.
People dying is a part of daily life in this country, it seems, whether or not it might be different elsewhere, say, the UK.
Over time, and especially if one is a combat veteran such as myself, one reconciles oneself to that reality, lest one make themselves bat**** crazy worrying about what cannot be altered or changed, that being the impermanence of life here in America
And now you say were are going to lose another 500,000 to COVID, which divided by a population of 326 million, equals out to .153374233 percent of our population.
In reply to that possible reality, I find myself quoting from Dr. Roy K. Flannagan in his “Report of the Chief Health Officers, in Annual Report of the Health Department of the City of Richmond, Va., for the Year Ending December 31, 1918, where he informed Mayor George Ainslie that influenza was now “playing return engagements everywhere, and nothing that is done by health departments, whether of Army, Navy, State or City, seems to do more than to temporarily check it.”
“Renewed assaults by it apparently mean to take in the whole susceptible population.”
The disease simply has to run its course.
Graham says
I suspect that the only things we will probably agree on is that the tests used are not reliable. The others might be that there has been a negligent lack of focussed testing in the general population. The politicians response has not been data driven or coherent. There is an urgent need for good clear data so that we can make decisions.
The ideal effective medical response to a pandemic has always been clear. Everything else is a political decision. If you have competent politicians they would be pragmatic and make decisions based on the data.
I don’t yet buy the argument that there is a big percentage of asymptomatic cases. I concede that it is a possibility. Infectious hepatitis is a classic example of asymptomatic transmission. It is a well known phenomenon, we can spot the signs of asymptomatic transmission in population data.
Firstly the data I trust from the countries doing test, trace, test & track do not support this hypothesis. Secondly, a large percentage of asymptomatic cases would play havoc with the accuracy of R0 calculations. The residual variation in this data would show a pattern. It currently does not.
I would compare the possibility of large asymptomatic infection to a straw thrown to a drowning man (in this case people wanting to claim that covid -19 is not that bad). People grasp it with an enthusiasm proportional to their desperation. Surely covid-19 can’t be that bad? Oh yes it is ☹
All we need to know at the moment for an effective public health response is that it is more infectious than flu and that the death rate is certainly more than 10 times that of seasonal flu . Discussion about demographics is a side issue largely not relevant to contagion modelling.
Now on to your stats about deaths etc. I have seen a few modelling papers on expected changes in mortality rates.
Yes people die all the time and this background needs to be taken into account. We are fortunate that public data collection on deaths and causes of death is collected. The extent to which this is accurate in itself, is a subject of vigorous debate in the academic literature. For example, in the USA autopsies are seen as an unnecessary cost to cut (your wonderful privatised health system) yet they overturn the cause of death on the certificate a significant percentage of the time.
These are known errors in data that can be taken into account when analysing.
Firstly the issue of premature harvesting. Yes it is happening as it does every flu season. This information can be used in three ways. Firstly to try to argue that the deaths from covid 19 would have happened anyway and it is therefore not such a big deal. Secondly & more rationally is to look at expected life years lost. The data I have from the latest ONS figures in the UK is that median life years lost per covid 19 death is 32 years. That is a big number. You may conclude that I do not think the covid -19 death toll is trivial. In the reporting of covid -19 deaths we have a memory salience issue. All the reports of culling in retirement homes creates the perception that covid -19 mainly kills the old. It does not. Doctors tend not to put over 70’s on ventilators for sound medical reasons. They are more likely to die but are not the exclusive culling population. The population at most overall risk is men in their fifties (more chances of catching & transmitting balanced with high chance of mortality).
After a period of time the third thing we could analyse in the data is excess deaths over the yearly average per month balanced against lower frequency of deaths from other causes later in the year (a true measure of premature harvesting).
As regards changes to rates of causes of death. There will probably be less from travel related causes, less from other infectious diseases, more from untreated medical conditions, suicides and domestic violence. Again the calculations should be balanced by analysing life years lost. I suspect the numbers will balance out.
I know of some economic models. They tend not to predict deaths. We are in for a hard time is all I can say (we do not need statistics to make that prediction). As a data driven scientist my perspective on economics is slightly warped. To me the crucial factor is population spending and the wonderfully titled “Marginal propensity to consume”. Political decisions for economic support need to be driven primarily by this factor ☺
As regards other political issues. My government seems only second in the world for incompetence in dealing with covid-19. First place seems to go to the USA. For once in my life I am almost happy to say USA is the best 😛
Have to get back to marking now. Will reply tomorrow.
Ray Otton says
“As regards other political issues. My government seems only second in the world for incompetence in dealing with covid-19. First place seems to go to the USA. For once in my life I am almost happy to say USA is the best.”
Aaaannnnnnnddddd there it is. Just couldn’t help yourself, could you?
Here’s an idea from just a guy to an academic. Before spouting this nonsense dig about 5-6 pages deep in Google because that’s how far you have to drill down to find out what the US has actually been doing.
Since you won’t, I’ll go ahead and post a compilation of that timeline gleaned from multiple sources: ( Sorry Paul, I may now have the record for the longest post in CCM history……..and please God, do not take this as a challenge.)
December 31: China reports the discovery of the coronavirus to the WHO.
January 3: US CDC Director sent an email to the director of the Chinese CDC, offering to send U.S. experts to China to investigate the coronavirus.
January 5: CDC Director sends a second email to the Chinese CDC Director with the same offer.
January 6: CDC issued a level 1 travel notice for China due to the spreading virus.
January 7: The CDC established an incident management system to better share and respond to information about the virus.
January 11: The CDC updated a Level 1 travel health notice for China.
January 17: The CDC began implementing public health entry screening at the 3 U.S. airports.
January 20: Dr. Fauci announces the NIH is already working on the development of a vaccine for the coronavirus.
January 21: The CDC activated its emergency ops center.
January 23: The CDC sought a “special emergency authorization” from the FDA to allow states to use its newly developed coronavirus test.
January 27: The CDC issued a level 3 travel health notice urging Americans to avoid all nonessential travel to China.
The White House Coronavirus Task Force started meeting to help monitor and contain the spread of the virus.
The White House announced the formation of the Coronavirus Task Force to help monitor and contain the spread of the virus and provide updates to the President.
January 31: The Trump Administration:
– Declared the coronavirus a public health emergency.
– Announced Chinese travel restrictions.
– Suspended entry into the United States for foreign nationals who pose a risk of transmitting the coronavirus.
January 31: DHS funneled all flights from China into 7 domestic U.S. airports.
February 4: President Trump vowed in his State of the Union Address to “take all necessary steps” to protect Americans from the coronavirus.
February 6: The CDC began shipping test kits for the to U.S. and international labs.
February 9: The White House Coronavirus Task Force briefed governors from across the nation at the National Governors’ Association Meeting.
February 11: HHS expanded partnership with Janssen Research to expedite the development of a vaccine.
February 12: The U.S. shipped test kits to 30 countries who lacked the necessary reagents and other materials.
February 14: The CDC began working with five labs to conduct community-based surveillance to study and detect the spread of coronavirus.
February 18: HHS announced it would engage with Sanofi Pasteur in an effort to quickly develop a vaccine.
February 24: The Trump Administration requested at least $2.5 billion to help combat the spread of the coronavirus.
Febraury 25: HHS Secretary Azar testified before the Senate HELP committee on the Administration’s coronavirus response efforts.
February 26: President Trump discussed coronavirus containment efforts with Indian PM Modi.
February 29: FDA allowed certified labs to develop and begin testing coronavirus testing kits while reviewing pending applications.
February 29: The Trump Administration:
– Announced a level 4 travel advisory to areas of Italy and South Korea.
– Barred all travel to Iran.
– Barred the entry of foreign citizens who visited Iran in the last 14 days.
March 3: CDC lifted restrictions on coronavirus testing to allow any American to be tested for coronavirus,
March 4: The Trump Administration announced the purchase of 500 million N95 respirators over the next 18 months to respond to the outbreak of the novel coronavirus.
March 4: HHS transferred $35 million to the CDC to help state and local communities that have been impacted by the coronavirus.
March 6: President Trump signed an $8.3 billion bill to fight the coronavirus outbreak.
March 9: President Trump called on Congress to pass a payroll tax cut over coronavirus.
March 10: President Trump and VP Pence met with top health insurance companies and secured a commitment to waive co-pays for coronavirus testing.
March 11: President Trump:
– Announced travel restrictions on foreigners who had visited Europe in the last 14 days.
– Directed the Small Business Administration to issue low-interest loans to affected small businesses and called on congress to increase this fund by $50 billion.
– Directed the Treasury Department to defer tax payments for affected individuals & businesses, & provide $200 billion in “additional liquidity.”
March 13: President Trump declared a national emergency in order to access $42 billion in existing funds to combat the coronavirus.
March 13: President Trump announced:
– Public-private partnerships to open up drive-through testing collection sites.
– A pause on interest payments on federal student loans.
March 13: The FDA :
– Granted Roche AG an emergency approval for automated coronavirus testing kits.
– Issued an emergency approval to Thermo Fisher for a coronavirus test within 24 hours of receiving the request.
– March 13: HHS announced funding for the development of two new rapid diagnostic tests, which would be able to detect coronavirus in approximately 1 hour.
March 14: The Trump Administration announced the European travel ban will extend to the UK and Ireland.
March 15: President Trump discussed on-going demand for food and other supplies with grocery chain execs.
March 15: HHS announced it is projected to have 1.9 million COVID-19 tests available in 2,000 labs this week.
March 15: Google announced a partnership with the Trump Administration to develop a website dedicated to coronavirus education, prevention, & local resources.
March 15: All 50 states were contacted through FEMA to coordinate “federally-supported, state-led efforts” to end coronavirus.
March 16: President Trump:
– Held a tele-conference with governors to discuss coronavirus preparedness and response.
– Participated in a call with G7 leaders who committed to increasing coordination in response to the coronavirus and restoring global economic confidence.
– Announced that the first potential vaccine for coronavirus has entered a phase one trial in a record amount of time.
– Announced “15 days to slow the spread” coronavirus guidance.
March 16: The FDA announced it was empowering states to authorize tests developed and used by labs in their states.
March 16: Asst. Secretary for Health confirmed the availability of 1 million coronavirus tests, and projected 2 million tests available the next week and 5 million the week after that.
March 17: President Trump announced:
– CMS expanded telehealth benefits for Medicare beneficiaries.
– Army Corps of Engineers placed on ”standby” to assist federal & state governments.
March 17: President Trump spoke to fast food executives from Wendy’s, McDonald’s and Burger King to discuss drive-thru services recommended by CDC
Met with tourism industry representatives along with industrial supply, retail, and wholesale representatives.
Treasury Secretary Mnuchin met with lawmakers to discuss stimulus measures to relieve the economic burden of coronavirus on certain industries, businesses, and American workers.
Secretary of Agriculture Sonny Perdue announced a partnership between USDA, Baylor University, McLane Global, and Pepsi Co. to provide one million meals per weak to rural children in response to widespread school closures.
March 17: The Treasury Department deferred $300 billion in tax payments for 90 days without penalty.
The DoDefense announced it will make available to HHS up to 5 million respirator masks and 2,000 ventilators.
March 18: President Trump signed the Families First Coronavirus Response Act, which provides free testing and paid sick leave for workers impacted by the coronavirus.
March 18: President Trump announced:
– Closure of the U.S.-Canada border to non-essential traffic.
– Plans to invoke the Defense Production Act in order to increase the number of necessary supplies needed to combat coronavirus.
– Activated FEMA.
– Deployed the USN Comfort and USN Mercy hospital ships.
– All foreclosures and evictions will be suspended for a period of time.
March 18: Secretary of Defense Mark Esper confirmed 1 million masks are now immediately available.
March 18: HHS temporarily suspended a regulation that prevents doctors from practicing across state lines.
March 18: President Trump spoke to:
– Doctors, physicians, and nurses on the front lines containing the spread of coronavirus.
– 130 CEOs of the Business Roundtable to discuss on-going public-private partnerships in response to the coronavirus pandemic.
March 19: President Trump announced Carnival Cruise Lines will make ships available for use as hospitals in impacted areas to use for non-coronavirus patients.
March 19: Vice President Pence announced tens of thousands of ventilators have been identified that can be converted to treat patients.
March 19: The State Department issued a global level 4 health advisory, telling Americans to avoid all international travel due to coronavirus.
March 19: President Trump directed FEMA to take the lead on the Federal Government’s coronavirus response.
March 20: The U.S. and Mexico agree to mutually restrict nonessential cross-border traffic.
March 20: Secretary Mnuchin announced at the direction of President Trump that tax day will be moved from April 15 to July 15 for all taxpayers and businesses.
March 20: President Trump announced the CDC will invoke Title 42 to provide border patrol with tools to secure the borders
March 20: The DoE announced it will:
– Not enforce standardized testing requirements for the remainder of the school year
– Allow federal student loan borrowers to stop payments without penalty for 60 days
March 20: Secretary Azar announced:
– FEMA is coordinating and assisting coronavirus testing at labs across the country
– The CDC is suspending all illegal entries to the country based on the public health threat.
March 20: Secretary Azar sent a letter to all 50 Governors that the federal government is buying and making available 200,000 testing swabs
March 21: The Trump Administration announced HHS placed an order for hundreds of millions of N95 masks through FEMA
March 21: The FDA announced it had given emergency approval to a new coronavirus test that delivers results in hours.
March 22: President Trump announced:
– Governors will remain in command of National Guard forces & the federal govt will fund 100% of operations cost
– He directed the federal govt to provide 4 large federal medical stations with 2,000 beds for CA & 1,000 beds for NY & WA.
– FEMA issued guidance for tribal governments to seek federal assistance under the President’s emergency declaration.
March 23: President Trump signed an executive order invoking section 4512 of the Defense Production Act to prohibit the hoarding of vital medical supplies.
March 23: VP Pence announced FEMA established a supply chain stabilization task force so Americans get supplies they need.
The White House Office of Science & Technology Policy announced a public-private consortium to:
-Advance coronavirus research.
-Provide access to computing technology and resources for researchers.
– Attorney General Barr announced the JoD held a National Task Force meeting on hoarding and price gouging.
– President Trump announced HHS is working to designate essential medical supplies as scarce to prohibit hoarding of these items.
– The Treasury Department announced it is working with the Federal Reserve to lend up to $300 billion to businesses and local governments.
March 24: The Army Corps of Engineers & the National Guard are constructing four hospitals and four medical centers in New York.
Vice President Pence confirmed FEMA sent New York 2,000 ventilators.
Dr. Birx announced the U.S. has conducted more coronavirus tests in the last week than South Korea has over the prior eight weeks.
The U.S. Army issued orders for 3 army hospitals to deploy their health care professionals to New York and Washington state, at the direction of Secretary of the Army Ryan McCarthy.
March 25: President Trump & Vice President Pence held a conference call with 140 non-profit organization leaders, including The Salvation Army & The Red Cross, to discuss coronavirus response efforts.
He signed a bill reauthorizing The Older Americans Act, which supports senior citizens by providing meals, transportation, and other crucial services.
March 26: President Trump participated in a video conference with the leaders of the G20 to discuss the global coronavirus response & the need for countries to share information and data on the spread of the virus.
March 26: Dr. Fauci announced the Federal Government is working with companies to speed up production of potential coronavirus vaccines while those drugs are still in the trial phase.
March 27: President Trump signed The Coronavirus Aid, Relief, and Economic Security (CARES) Act into law.
March 27: President Trump signed a Defense Production Act memorandum ordering General Motors to accept, perform, and prioritize federal contractors for ventilators.
President Trump signed an executive order allowing the military to activate members of the Selected Reserve and Ready Reserve to active duty to assist with the Federal response to the coronavirus.
March 27: President Trump appointed Office of Trade and Manufacturing policy director Peter Navarro to serve as the Defense Production Act Policy Coordinator.
March 27: Emory University began enrolling participants for a phase one clinical trial, sponsored by the NIH’s National Institute of Allergy and Infectious Diseases (NIAID), of a new, potential coronavirus vaccine.
March 27: FEMA Administrator Pete Gaynor spoke to the director of each of the state’s emergency operations about the state-led, federally-supported coronavirus response effort.
March 27: The USNS Mercy arrived in the port of Los Angeles to help relieve the strain on hospital facilities in Southern California.
March 28: President Trump approved major disaster declarations related to the coronavirus outbreak for:
March 28: The CDC issued new guidance for residents of New York, New Jersey, and Connecticut to avoid non-essential domestic travel for 14 days to #StopTheSpread of the coronavirus within the U.S.
President Trump announced that CDC guidelines will be extended through April 30 to promote #socialdistancing and other measures to stop the spread of the #coronavirus.
President Trump met with supply chain distributors including FedEx, Cardinal Health, and UPS to discuss ways to get state and local governments necessary medical supplies to combat the coronavirus.
President Trump congratulated the Army Corps of Engineers for having completed construction on a 2,900 bedroom temporary hospital at the Javits Center in New York.
President Trump announced the on-going study of 1,100 patients in New York being treated with Hydroxychloroquine for coronavirus.
President Trump directed the Treasury & Labor Departments to look at reinstating deductions of business expenses at restaurants, bars, and entertainment businesses to help the hospitality industry.
“Project Airbridge” shipment of medical supplies from abroad, organized by FEMA, landed at JFK airport, carrying 80 tons of masks, face shields, and other vital medical supplies.
HHS accepted 30 million doses of Hydroxychloroquine, donated by Sandoz, and one million doses of Chloroquine, donated by Bayer Pharmaceuticals, for clinical trials and possible treatment of coronavirus patients.
March 30: President Trump announced that one million Americans have been tested for coronavirus and received their results.
March 30: President Trump approved major disaster declarations related to the coronavirus outbreak for:
March 30: Secretary Azar announced that the FDA has approved Battelle’s N95 mask sanitization process for use to decontaminate tens of thousands of masks per day.
March 30: President Trump announced further private sector commitments to manufacture personal protective equipment by MyPillow, Honeywell, Jockey, Procter & Gamble, and United Technologies.
President Trump announced, to date, FEMA has dedicated $1.3 billion to assist New York State’s coronavirus response.
President Trump announced “more than 14,000” National Guard service members have been activated to respond to the coronavirus outbreak.
March 30: President Trump announced that in the coming days the Federal Government will be delivering:
400 ventilators to Michigan
300 ventilators to New Jersey
150 ventilators to Louisiana
150 ventilators to Illinois
50 ventilators to Connecticut
President Trump spoke to Prime Minister Giuseppe Conte of Italy and pledged to send $100 million of medical supplies to aid Italy’s battle against coronavirus.
Answering President Trump’s call for the private sector to join the fight against the #coronavirus, Ford Motor Company committed to producing 50,000 ventilators in the next 100 days.
On coronavirus testing, Secretary Azar announced that the U.S. is currently testing nearly 100,000 samples per day.
HHS took steps to accelerate a clinical trial of a potential coronavirus vaccine developed by Janssen Research & Development.
CMS announced new regulatory changes to cut red tape and give flexibility to America’s health care workers by relaxing hospital workforce regulations,
President Trump officially issued “30 Days To Slow The Spread” guidance to mitigate the outbreak of coronavirus.
March 31: President Trump announced that the federal government is stockpiling 10,000 ventilators to be urgently distributed as needed once the coronavirus pandemic hits its peak in the U.S.
President Trump announced that the Treasury Department and SBA are rapidly mobilizing money from the CARES Act’s $349 billion paycheck protection program, with the program set to be “up and running” by April 3.
March 31: President Trump announced the Army Corps of Engineers & FEMA will construct:
– 8 facilities with 50,000 bed capacity in California
– A field hospital with 250 bed capacity in Michigan
– 2 field hospitals in Louisiana with 500 bed capacity
– An alternative care sight in New Orleans with a 3,000 bed capacity
Vice President Pence announced that 17,000 National Guard Servicemen have been activated across the country to assist in the coronavirus response.
The FDA issued an emergency use authorization for a two-minute coronavirus antibody test.
The Treasury Department and IRS launched the employee retention credit, created by the CARES Act to incentivize businesses to keep their employees on payroll.
=========================================
Whew, good thing Mr. Trump is a high energy fellow.
=========================================
April 1: President Trump spoke to Walmart CEO Doug McMillon about the need to procure gowns for hospitals
April 2: President Trump invoked the Defense Production Act to direct 3M to produce more N95 respirator masks.
President Trump invoked the Defense Production Act to help 6 companies (General Electric, Hill-Rom Holdings, Medtronic, ResMed, eRoyal Philips, and Vyaire Medical) get the supplies they need to make ventilators.
April 2: President Trump ordered the Federal Government to cover the costs of all National Guard operations in states with recently approved disaster declarations.
April 2: Secretary Mnuchin and Small Business Administrator Jovita Carranza announced that the Paycheck Protection Program, created by the CARES Act to provide $350 billion in loans to small businesses.
April 2: Vice President Pence announced that all Blue Cross Blue Shield Members will be waiving out of pocket costs for coronavirus treatment.
April 2: Rear Adm. Polowczyk announced FEMA’s Supply Chain Stabilization Task Force has delivered:
– 27.1 million surgical masks
-19.5 N95 million respirator masks
– 22.4 million surgical gloves
– 5.2 million face shields
– 7,600 ventilators
FTA announced $25 billion in federal funding to support public transportation systems in response to the coronavirus.
The DoJ and HHS distributed 192,000 N95 respirator masks confiscated from price gougers to health care workers in New York and New Jersey.
The FDA approved the first coronavirus antibody test, developed by Cellex.
The FDA issued new guidance to increase the supply of blood donations, reducing the deferral period for gay men from 12 months to 3 months.
HUD announced it was immediately making $3 billion of CARES Act funding available to help America’s low-income families and most vulnerable citizens across the nation.
April 3: The President met with energy execs from Phillips 66, Devon Energy, Continental Resources, Hilcorp Energy, Occidental Petroleum, The American Petroleum Institute, The Energy Transfer Partners, Chevron, & Exxon Mobil to discuss coronavirus’ impact on the energy industry.
April 3: President Trump signed a Presidential Memorandum blocking the export of N95 and other respirator masks, surgical masks, PPE gloves, and surgical gloves to ensure they are available in the U.S.
President Trump announced that Anthem will waive co-pays for coronavirus treatment for 60 days.
President Trump announced that uninsured Americans will have their coronavirus treatment covered, using funding from the CARES Act.
President Trump announced that 9,000 retired Army medical personnel have volunteered and are assisting the federal response to the coronavirus.
President Trump announced that the DOJ and HHS have together secured 200,000 N95 masks, 130,000 surgical masks and 600,000 gloves from hoarders and have distributed the supplies to health care workers.
Vice President Pence announced that 18,000 machines are already available across the country to administer Abbott 15 Minute Coronavirus Tests.
Secretary Azar announced a public-private partnership with Oracle to collect crowd-sourced data on coronavirus therapeutic treatments.
The SBA launched the Paycheck Protection Program for small businesses impacted by the coronavirus pandemic, issuing more than 17,500 loans valued at $5.4 billion.
HUD announced it is making $200 million in Indian housing block grants for Indian Tribes under the CARES Act.
EPA Administrator Wheeler held a call with retailers and marketplace platforms to discuss ways to protect consumers from fake disinfectants.
April 4: President Trump announced that 1,000 members of the Defense Department’s Medical Corps will be deployed to New York to assist in the fight against coronavirus.
President Trump urged PM Modi of India to allow Hydroxychloroquine to be shipped to the United States.
April 5: President Trump announced that have deployed to New York, New Jersey, and Connecticut to assist in the coronavirus response effort.
April 5: President Trump announced that the Trump Administration will be sending New York 600,000 N95 masks.
April 5: President Trump announced that the Administration will send:
– 300 ventilators to Michigan
– 200 ventilators to Louisiana
– 600 ventilators to Illinois
– 100 ventilators to Massachusetts
– 500 ventilators to New Jersey
President Trump announced that 1.67 million coronavirus tests have been completed.
President Trump announced that the government has stockpiled 29 million doses of Hydroxychloroquine
Dr. Birx announced that testing in the New York metro area, New Jersey, Louisiana, and Washington has exceeded the testing rate of Spain and Italy
Adm. Polowczyk announced that three Project Airbridge flights of medical supplies landed across the US today carrying:
– 1 million gowns
– 2.8 million surgical masks
– 11.8 million gloves
April 6: President Trump announced an agreement with 3M to produce and import 55.5 million N95 masks each month for the next three months.
President Trump announced that 2 million coronavirus tests have been completed.
President Trump announced that CVS will open two ew drive-thru coronavirus testing sites in Georgia and Rhode Island. Both will use Abbott’s rapid coronavirus test.
President Trump announced that the FDA authorized Inovio’s potential coronavirus vaccine for a clinical trial, with another 10 potential coronavirus therapeutic agents in active trials.
President Trump announced that The Army Corps of Engineers is building 22 field hospitals and alternative care sites in 18 states.
HHS announced an additional $186 million in CDC funding for state and local jurisdictions combatting the coronavirus.
HHS announced it will be purchasing 15 minute coronavirus tests from Abbott for state, territorial, and tribal labs and for the Strategic National Stockpile.
The DoE announced a streamlined process making it easier for states to use federal education funding for distance learning during the coronavirus outbreak.
April 7: President Trump announced the SBA has processed “more than $70 billion” in loans to help small businesses as part of the Paycheck Protection Program.
President Trump announced that the federal government will be acquiring 110,000 ventilators in the next three months to be distributed to states in need.
President Trump announced his intent to ask Congress for an additional $250 billion for the Paycheck Protection Program to loan to small businesses.
CMS Administrator Verma announced that CMS will make available an additional $30 billion in grants this week for health care organizations with increased operating costs due to the coronavirus.
The State Department announced an additional $225 million in health, humanitarian, and economic assistance to reduce the transmission of the coronavirus around the world.
As part of Project Airbridge, UPS and FEMA began shipments of 25 flights with more than three million pounds of medical supplies.
April 8: HHS announced a $646M contract with Philips to produce 2,500 ventilators for the Strategic National Stockpile by the end of May, and a total of 43,000 by December.
April 8: Vice President Pence announced $98B in forgivable loans were disbursed through the Paycheck Protection Program
Customs and Borders Protection announced with FEMA that it will detain shipments of PPE in order to keep critical medical supplies within the U.S. for domestic use.
HHS announced an agreement with DuPont and FedEx to rapidly manufacture and deliver 2.25M new Tyvek Protective Suits to the Strategic National Stockpile over the next five weeks.
HHS expanded telehealth services for Native Americans through The Indian Health Service.
HHS authorized pharmacists to order and administer coronavirus tests, further expanding the availability of testing.
HHS awarded $1.3B from the CARES Act to 1,387 health centers in all 50 states, 8 territories, and the District of Columbia to fight coronavirus.
CMS issued updated guidance based on CDC guidelines to protect patients and health care workers in hospitals from the coronavirus.
April 9: President Trump announced that there are currently 19 potential coronavirus therapies being tested and another 26 potential therapies in active planning for clinical trials.
President Trump announced that, to date, over 2 million coronavirus tests have been completed.
Vice President Pence announced that $125B in Paycheck Protection Program forgivable loans has been approved to date.
Vice President Pence announced that a total of 29,000 National Guard service members have been activated across the country to assist in the coronavirus response.
Vice President Pence announced that to date 4,100 military medical personnel have been deployed to New York, New Jersey, and Connecticut.
The Treasury Department announced that it extended over 300 tax filing, payment, and administrative deadlines to give relief to taxpayers.
The Federal Reserve announced new lending programs providing up to $2.3T in loans to businesses and state & local governments.
Secretary of Education DeVos announced that $6.3B in CARES Act funding will be immediately distributed to colleges and universities to provide cash grants to students affected by the coronavirus.
April 9: The USDA announced relief for farmers across the country by giving borrowers 12 months to repay marketing assistance loans (MAL), helping protect farmers from being forced to sell crops to make loan payments.
April 10: President Trump announced that 60 mask sterilization systems, with the ability to clean over 80,000 masks will be sent to 10 cities.
President Trump announced that his administration is working to bring blood-based serology tests to market “as quickly as possible” so Americans can determine if they have had the coronavirus.
President Trump signed a Presidential Memorandum to facilitate the supply of medical equipment and other humanitarian relief to Italy.
April 10: HHS began delivering $30B in relief funding to health care providers, part of the $100B allocated to health care providers by the CARES Act.
The FDA approved an emergency authorization for a blood purification device to treat coronavirus patients.
April 10: Transportation Secretary Elaine Chao announced $1B for Amtrak to continue rail service and respond to the spread of the coronavirus.
April 11: The DoD announced it is using The Defense Production Act to get the private sector to produce 39 million N95 masks within 90 days, a $133M investment.
The DoJ announced it is monitoring state and local social distancing regulations to ensure religious organizations are not unfairly targeted.
CMS expanded the requirements that private health insurers provide free coronavirus testing.
April 12: The FDA issued an emergency authorization to devices from Advanced Sterilization Products, which can decontaminate approximately 4 million N95 respirators each day.
April 13: President Trump announced that 3 million coronavirus tests have been completed.
The U.S. government now has 28 million doses of hydroxychloroquine stockpiled.
The Treasury Department announced that 80 million Americans will receive economic impact payments in their bank accounts within the week.
April 14: President Trump announced the Dynamic Ventilator Reserve, a public-private partnership to help hospitals with surplus loan them to hospitals in need.
President Trump met with coronavirus survivors at the White House to discuss their treatment and condition.
President Trump extended an order for the federal government to cover the costs of all National Guard operations to states with recently approved disaster declarations.
April 14: HHS announced it was distributing the $3.5 billion in child care and development block grant funding included in the CARES act.
FEMA confirmed it send out 19.1 million doses of hydroxychloroquine to cities across the country.
The EPA announced that it has temporarily waived certain approvals for manufacturers producing disinfectants for use against the coronavirus.
The Department of Education Announced $3 billion in education block grants for states to help schools, students, and educators at all levels.
GM began mass production on an order of 30,000 Ventec ventilators, 600 ventilators are expected to be shipped this month and the full order will be completed by August.
April 15: President Trump announced that more than 3.3 million coronavirus tests have been completed.
CMS announced Medicare will nearly double payments for “high-throughput” coronavirus tests, incentivizing health care providers to increase the supply and speed of testing.
The Department of Labor awarded more than $131 million in dislocated worker grants to help workers impacted by the coronavirus outbreak.
April 16: Under the DPA, HHS announced a $336 million contract with GE for 50,000 ventilators to be produced by July 13.
April 16: The FDA encouraged Americans who have recovered from coronavirus to donate their plasma for the development of new treatments and therapies.
April 17: President Trump and Secretary Perdue announced a $19 billion relief package for ranchers and farmers impacted by the coronavirus.
April 18: President Trump announced that over 4 million coronavirus tests have been completed to date, double the number of tests done by any other country.
President Trump announced that 1.6 million small businesses have participated in the paycheck protection program and reiterated his request that Congress replenish funding for the program.
April 18: President Trump offered to send ventilators to Iran, if the Iranian government accepted the assistance.
April 19: President Trump announced that 4.18 million coronavirus tests have been completed to date – more tests than France, The U.K., South Korea, Japan, Singapore, India, Austria, Australia, Sweden, and Canada combined.
April 19: President Trump announced his administration is working on using the DPA to increase the production of testing swabs.
April 20: President Trump announced that HHS has distributed the $30 billion in relief funding to health care providers under the CARES act.
President Trump announced that there are currently 72 active trials for coronavirus therapies, with 211 additional therapies in the planning stages for active trials.
April 20: Chief of the Army Corps of Engineers Gen. Todd Semonite announced that USACE has, to date, executed the construction of 32 facilities across the country, creating approximately 16,000 more beds.
The Trump Administration announced its helping increase testing swab production by 30M per month – assisting an Ohio manufacturer to convert production lines to produce 10M swabs a month & using the DPA to help Puritan Medical Products produce 20M testing swabs a month.
CMS announced that 650,000 infrared thermometers have been secured by the federal government in anticipation of future demand for these devices as states re-open.
Vice President Pence announced that all DoD and federal labs will be made available for states to use in order to increase testing capacity.
The VA announced it acquired a 470,000 sq. ft. facility in Texas to help provide overflow bed capacity to treat coronavirus cases, which will eventually serve as an outpatients and specialty care clinic for veterans.
Acting DHS Secretary Wolf announced that US, Canada, and Mexico had extended non-essential travel restrictions for an additional 30 days.
The Justice Department announced it cleared antitrust barriers which could have blocked the drug distribution company AmerisourceBergen from distributing medicine and supplies as part of the coronavirus response, including hydroxychloroquine.
CMS announced it is incentivizing Medicare health care providers to report more coronavirus data to help treat and fight the spread of the disease.
April 21: After negotiations with the Trump Administration, the Senate passed the Paycheck Protection Program and Health Care Enhancement Act, which includes an additional $382B for the PPP, $75B for hospitals, and $25B for coronavirus testing efforts.
April 21: President Trump announced that the FDA has now authorized more than 50 coronavirus diagnostic tests and four antibody tests.
HHS announced $995 million in CARES Act grants for older adults and the disabled.
April 21: The FDA issued an emergency approval for the first coronavirus test where a sample can be collected at home.
April 22: President Trump signed a Presidential Proclamation suspending immigration in the U.S. for 60 days due to “the impact of foreign workers on the United States labor market, particularly in an environment of high domestic unemployment’.
President Trump announced the Administration has to date directed more than $7 billion in funding towards coronavirus treatments, diagnostics, and therapies.
HHS awarded nearly $165 million in funding to fight the coronavirus in rural communities, providing CARES Act funding to 1,779 small rural hospitals and 14 HRSA-Funded telehealth resource centers.
HHS announced an additional $20 billion in CARES Act funding for health care providers would be disbursed this week.
FEMA published a final rule defining certain PPE as ”scarce” to combat hoarding and price gouging of these materials.
April 22: The USDA announced it has successfully increased monthly SNAP benefits by 40% during the coronavirus outbreak.
April 23: President Trump announced that to date 750 million pieces of PPE have been delivered to the US through Project Airbridge.
April 23: Acting DHS Undersecretary for Science & Technology William Bryan announced findings of a study indicating that heat, humidity, and UV rays can slow and kill the coronavirus.
HHS announced $631 million in CARES Act funding for public health departments across the country for testing, contact tracing, and containment of the coronavirus.
April 24: President Trump signed the Paycheck Protection Program and Health Care Enhancement Act into law, providing $321B in new funding for the PPP, $75B for health care providers, and $25B for coronavirus testing.
April 24: FDA Administrator Dr. Hahn announced the FDA granted emergency approvals to 63 coronavirus diagnostic and serological tests to date.
=========================================
Now, believe it or not, this is about 25% of the actions this administration has taken that anyone without an agenda could easily find with a simple internet search…..as long as you are willing to get past the first 5-6 pages of ORANGE MAN BAD articles.
Paul Plante says
Why are you cherry-picking data here, Mr. Otton?
Scanning your extraordinarily long list, I notice you failed to include January 8, 2020, which is the date the CDC put out the HAN-alert on COVID which was distributed to state and local health officers, state and local epidemiologists, state and local laboratory directors, public information officers, HAN coordinators, and clinician organizations in the United States of America, which alert should have triggered our COVID response, but failed to do so.
Which raises the question of why you omitted that notice from your extensive list.
Graham says
I will aim for one of the shortest replies on this site
Government 0, virus 1
Ray Otton says
Say here’s a question from a non-epidemiologist, non-Vietnam vet, non-engineer, non-expert in any of this.
Any computer models out there on the health effects of a worldwide economic depression?
I’d bet you’d find you would need more zeros on the tail end of those death numbers.
Ray Otton says
So, while Paul and Graham simultaneously pursue their dick measuring contest while blinding us with their brilliance ( or baffling us with bullshit ), those of us in the bleacher seats have some questions:
Why can’t you have elective surgery but you can have an abortion?
Why are we staying inside when we know heat, humidity and sunlight kills viruses.
Why is it OK for governors to get haircuts but not citizens in their states?
Why are people forced to wear masks at golf courses?
Why are people forbidden to fish from their own boats?
Why are coroners questioning the cause of death in so many cases?
What makes one person’s job essential but others not?
Why the fear when the death rate for this virus is comparable to all the other viral epidemics of the past?
Where has the flu gone?
Why does the homeless population have such low infection rates?
If masks work why are we still in quarantine and if they don’t work why are we forced to wear them?
Why are we not concerned with the mental and physical heath of our citizens suffering from the economic downturn?
Why are we not concerned with the increase in cancer and heart disease deaths due to canceled diagnostic tests?
Why are hospitals paid more for virus caused deaths than deaths from other causes?
Why are they including deaths from drug overdoses and car accidents in the virus related death tallies?
Why did the Obama administration give $334 million to the Whuan lab?
Why did the Obama administration fail to resupply the N95 mask inventory after the H1N1 outbreak of 2009?
Why are non-virus related spending efforts included in virus relief packages?
Why don’t people realize these are rules, not laws, and they have not gone through our legislative process?
Why are so many police departments enforcing lockdown rules with no regard as to their constitutionality?
Why are we releasing criminals from jail and jailing law abiding citizens for violating rules, NOT laws?
Why are media outlets putting words in the president’s mouth that he clearly did not say?
Why are they discussing mandatory vaccinations for a virus that comparable to the flu?
Why are they discussing “health certificates” so you can prove you are virus free?
And finally
Why are you putting up with this?
Graham says
Reply 6
Hi Ray, I will do my best to answer your questions and baffle you with the size of my dick 😀
Why can’t you have elective surgery but you can have an abortion?
Several reasons:
General Hospitals are germ factories. At present, despite best hygiene practice they are covid -19 incubators. Many of the early victims of covid – 19 were people in hospital for other reasons.
Hospitals needed to free up space for treating covid -19 patients. This is an emergency, the risks of not performing elective surgery in timely fashion are far less than the risks of not treating covid -19 patients (more people will die). Human discomfort is not a part of risk calculations.
Abortion clinics are stand alone enterprises that cannot be easily be re purposed for treating covid-19 cases. The risks of not treating women needing abortions are high. As you will probably understand from the previous history in the States, backstreet abortions killed hundreds of thousands each year. In addition some abortions are performed to save the life of the mother. Moral perspectives have little place in the management of risk.
Why are we staying inside when we know heat, humidity and sunlight kills viruses.
Yes fresh air and sunlight is generally beneficial to health. The rules are an unintended consequence of social distancing rules. The vital necessity is to control spread of the virus.
Why is it OK for governors to get haircuts but not citizens in their states?
Haha, one rule for us, one rule for politicians. We should quite rightly condemn those politicians who do not follow the rules they try to get the rest of us to follow. Start with Trump & Pence & work down ☺
Why are people forced to wear masks at golf courses?
To protect your fellow humans! Airborne droplets are the most significant mode of transmission after fomites ( surfaces everyone touches)
Why are people forbidden to fish from their own boats?
Why are coroners questioning the cause of death in so many cases?
Coroners have a legal responsibility to ensure that the cause of death is accurately stated. Accurate information on causes of deaths is important for all kinds of decision making.
What makes one person’s job essential but others not?
Ask your politicians for their definition of essential.
Why the fear when the death rate for this virus is comparable to all the other viral epidemics of the past?
Are you referring to polio or smallpox? People did live in fear of these viruses. From what we can establish their fear was far greater.
Where has the flu gone?
People are still catching & dying of Flu. The flu season trails off in spring. Social distancing has slowed the transmission of the flu virus. Vaccination prevents most flu infections.
Why does the homeless population have such low infection rates?
They are not being tested and are largely ignored. If a homeless person dies on the streets, few care. Those few who have died and have been tested indicates that they have a higher rate of covid-19 infection and mortality than over 70’s
If masks work why are we still in quarantine and if they don’t work why are we forced to wear them?
They don’t work 100% to prevent infection. In a non hospital settings they are more effective in ensuring others do not transmit the virus.
Why are we not concerned with the mental and physical heath of our citizens suffering from the economic downturn?
Governments are. It is just that controlling the spread of covid-19 is more urgent at the moment. I can’t speak about the selfish political model in the states but in the UK measures have been put in place to ameliorate this issue.
Why are we not concerned with the increase in cancer and heart disease deaths due to canceled diagnostic tests?
The medical community is deeply concerned. Again I can’t speak about the US, but in the UK efforts are being made to use isolated hospitals for this sole purpose.
Why are hospitals paid more for virus caused deaths than deaths from other causes?
Because covid – 19 treatment needs on average, more resources.
Why are they including deaths from drug overdoses and car accidents in the virus related death tallies?
Source? To my knowledge they are not. These figures are important for balancing the cost in lives from the lock down.
Why did the Obama administration give $334 million to the Whuan lab?
This is known as international co-operation motivated by the desire to prevent a pandemic In the future. Call it insurance or forward planning.
Why did the Obama administration fail to resupply the N95 mask inventory after the H1N1 outbreak of 2009?
Ask the people responsible for managing the stockpile. In the UK they allowed the stockpile to go out of date. I do not blame the prime minister at the time for this.
Why are non-virus related spending efforts included in virus relief packages?
Because those who implement them believe that they are the best way to support the economy. Personally I doubt this, but hey I am not an economist.
Why don’t people realize these are rules, not laws, and they have not gone through our legislative process?
From what I have seen they do. In the UK we are not as selfishly individualistic as in the USA. We know & we recognize the necessity.
Why are so many police departments enforcing lockdown rules with no regard as to their constitutionality?
That is a question for an American.
Why are we releasing criminals from jail and jailing law abiding citizens for violating rules, NOT laws?
Jails are covid-19 breeding grounds. In the land of the “sue everyone & everything” I am surprised that people are jailed without breaking laws be they local or state level.
Why are media outlets putting words in the president’s mouth that he clearly did not say?
Because he cannot speak a coherent sentence? Evidence? Source?
Why are they discussing mandatory vaccinations for a virus that comparable to the flu?
It is not the same as the flu. Covid is more infectious and more than 10 times more lethal. Mandatory vaccinations should be compulsory for public health reasons.
Why are they discussing “health certificates” so you can prove you are virus free?
So they can ease social distancing restrictions and get people back to work without fear of the epidemic culling millions of Americans.
And finally
Why are you putting up with this?
Because I care about the health of my family?Because I care about my fellow human beings?
Stuart Bell says
‘and baffle you with the size of my dick’ WTF???
Why is your dick on your mind when responding to another Man?
You are a sick individual. Get your sh1t together.
Julie Brown says
Men that brag about the size of their penis, usually have a very small one.
Paul Plante says
Raymond is old, Julie Brown, and like many older men, Raymond has become fixated with his “gun,” as he likes to call it, and he likes to think of it as a hog-leg .357-magnum, when the reality is more like a Daisy bee-bee pistol, so we simply humor him when he gets going on about it.
Why get the dude all upset about something he really has no control over, afterall.
Let him think what he thinks because in the end, it’s of little consequence to any of us what the real size of Raymond’s “gun” is, especially in a thread about COVID, not genitalia.
It’s like a variation on the theme expressed by Bruce Springsteen in his song about “Glory Days”:
I had a friend was a big baseball player
Back in high school
He could throw that speedball by you
Make you look like a fool boy
Saw him the other night at this roadside bar
I was walking in, he was walking out
We went back inside sat down had a few drinks
But all he kept talking about was
Glory days well they’ll pass you by
Glory days in the wink of a young girl’s eye
Glory days, glory days
Ray Otton says
Hi Ray, I will do my best to answer your questions and baffle you with the size of my dick.
Yeah, not actually baffled, Tiny.
“General Hospitals are germ factories. At present, despite best hygiene practice they are covid -19 incubators. Many of the early victims of covid – 19 were people in hospital for other reasons.
Hospitals needed to free up space for treating covid -19 patients. This is an emergency, the risks of not performing elective surgery in timely fashion are far less than the risks of not treating covid -19 patients (more people will die).
Well, we know now that there was never a risk to the hospital system. Maybe when the prediction was 2.5 million but that number has been memory holed.
And how about all the diagnostic services that were suspended? Mamograms, pap smears, heart monitoring, chemo treatments? Just going to chalk all those cancer deaths 2-3 years from now to human discomfort?
“Abortion clinics are stand alone enterprises that cannot be easily be re purposed for treating covid-19 cases. The risks of not treating women needing abortions are high. As you will probably understand from the previous history in the States, backstreet abortions killed hundreds of thousands each year. In addition some abortions are performed to save the life of the mother. Moral perspectives have little place in the management of risk.”
At most, 6% of abortions are medically necessary, thus the question stands unanswered…..And sorry but moral perspectives have EVERYTHING to do with management of risk, else why would doctors be told to “First do no harm”?
“Yes fresh air and sunlight is generally beneficial to health. The rules are an unintended consequence of social distancing rules. The vital necessity is to control spread of the virus.”
Your answer makes no sense. If we know these environmental conditions are lethal to the virus why are we told to stay at home? Shouldn’t we be encouraging people to go out side? Isn’t it true that 66% of the infections in NYC came from people who were at home with their families?
I asked – “Why are people forced to wear masks at golf courses?”
Your answer – “To protect your fellow humans!’
Oh for God’s sake! ( Gotta love those exclamation marks for making your point, huh?) Golf is about the most socially distancing activity imaginable, other than fishing from your own boat. Banning both these activities was simple muscle flexing by petty tyrants.
“Coroners have a legal responsibility to ensure that the cause of death is accurately stated. Accurate information on causes of deaths is important for all kinds of decision making.”
Again, didn’t answer the question or maybe I wasn’t clear. Why are so many coroners finding out that the cause of death isn’t the same as what was written on the death certificate? FWIW, Colorado just reduced their viral death count by 25% due to this.
“Are you referring to polio or smallpox? People did live in fear of these viruses. From what we can establish their fear was far greater.”
WTH? How did you get from the flu to smallpox?
“People are still catching & dying of Flu. The flu season trails off in spring. Social distancing has slowed the transmission of the flu virus. Vaccination prevents most flu infections.”
1 – And why wouldn’t the COVID virus fall off in the spring?
2 – Don’t know about the old country but most of our flu vaccinations aren’t that effective., in the area of 37 to 50%. Plus we haven’t developed a vaccine against the 1919 Spanish Flu nor the 1968 Hong Kong flu, thus where is the rational for keeping the country locked down until there is a cure for this virus? Remember, herd immunity, which we reach when 60% of us are infected, is the only way to beat this thing. Why are we delaying it?
“They are not being tested and are largely ignored. If a homeless person dies on the streets, few care.”
You’re kidding right now. If the homeless were dying in droves the media would be all over Mr. Trump.
“They don’t work 100% to prevent infection. In a non hospital settings they are more effective in ensuring others do not transmit the virus.”
Didn’t answer the second 1/2 of the question. If they work, even less than 100%, why is the country still shut down? ( Some places, blue states generally, worse than others )
“Governments are. It is just that controlling the spread of covid-19 is more urgent at the moment. I can’t speak about the selfish political model in the states but in the UK measures have been put in place to ameliorate this issue.”
What you call selfish, we call liberty. Combine that with personal responsibility and you have the perfect formula for fighting, well, just about everything from this virus to socialism.
“Because those who implement them believe that they are the best way to support the economy. Personally I doubt this, but hey I am not an economist.”
Our Left hand party is attempting to “fundamentally change the country” because of this virus. Don’t go by me, go look up their comments. Hence, they packed the various relief bills with all sorts of non-virus related things that help advance their ideology. The silver lining to this crisis is that many Americans are finally seeing that the Left in this country doesn’t care one whit about them and will sacrifice many lives to get back into power.
“From what I have seen they do. In the UK we are not as selfishly individualistic as in the USA. We know & we recognize the necessity.”
Yeah, well our selfish individualism kicked you out about 250 years ago for this very same morally superior attitude and we haven’t looked back. Well except save your sorry asses in WWI and WWII, but I digress………… Again, our sense of liberty combined with personal responsibility are the character traits that will see Americans though this crisis.
“Jails are covid-19 breeding grounds. In the land of the “sue everyone & everything” I am surprised that people are jailed without breaking laws be they local or state level.”
And that is my point. We USED to have faith that our LEO’s and military would side with those of us who support the Constitution but after this we’re not too sure.
Me – Why are media outlets putting words in the president’s mouth that he clearly did not say?
You – Because he cannot speak a coherent sentence? Evidence? Source?
I will grant you than the man is hard to listen to. However, we’re tired of being lied to eloquently and much prefer the truth spoken roughly. See Boris Johnson for a local reference.
Source? Go look up the “drinking bleach” controversy of a week ago, then get back to me.
“Why are they discussing “health certificates” so you can prove you are virus free?”
Right there, the crux of it all. We are a free people and we will not agree to carrying “papers” to prove we are safe. FWIW, totalitarian regimes do not tell their citizenry they are taking away their lawful rights, they tell them they are suspending them for their safety…….and they never get them back without a bloody revolution.
“Because I care about the health of my family? Because I care about my fellow human beings?”
And by inference, I don’t? FU,
Here’s my final thought.
My civil rights do not end where your fears begin.
Paul Plante says
Ray, let me say that when it comes to mastering the art of thinking not only small, but very small, that you are master’s master!
You are able to take any subject under the sun as you have done here, and reduce it down to something having to do with your genitalia, which is something that would fascinate both Freud and Jung if they were still around today to study your various emanations in here.
And you don’t need to be a Viet Nam veteran to understand any of this, nor do you need more than a very basic high school education, because there is nothing at all complicated here, despite your efforts to have it be so, for some reason that would be known only to yourself.
It is a communicable disease.
You don’t need the Ph.D. in rocket science to understand that, Ray.
It’s like measles, which is actually quite a bit more transmissible than COVID – you know, something transferred readily from person to person like all those icky STD’s that were being passed around back in the Free Love days.
Another day in the life of America, Ray, that’s all this is, and so, you should not make yourself so upset and scared and afraid of what really is a boogie-man of your own creation – its the worst thing in the world you can do to your immune system.
And Ray, reel in your paranoia, dude, there is no contest of any sort between myself and Graham – there is not even commonality, which is to say that his issues in this thread are not my issues, at all, I’m not worried about my academic research becoming unfunded by the government because I am not doing any, nor taking government money to do research, while he is in England, rightfully worried about his future, which country is predicted to have the highest COVID toll in all of Europe, having surpassed Italy to take that crown, so you surely can see, Ray, that we are talking around each other, not to each other, and hence, there is no contest to see if our genitalia are as big as yours.
So you can rest easy on that score, Ray.
Yours is still the biggest, and you are still THE CHAMP!
Graham says
What should have been the correct response to corona virus?
Only five factors need to be considered
1) Corona virus is a contagious disease
2) The growth rate of the disease is greater than one
3) The disease spreads by direct and indirect human contact
4) There is no vaccine
5) There is no effective treatment
In medical and epidemiological terms there is only one solution to stopping the spread of an epidemic or pandemic. Strict Quarantine.
Isolate the area, stop ALL travel in and out of that area. Wait until everyone has had the infection or died, disinfect the area. Problem solved.
Sadly quarantine has rarely been effective throughout history. Firstly there are the people desperate to escape their fate crossing the zone border. Secondly there are those who have what they think is a compelling reason to move through the zone border; lovers desperate for a tryst, merchants anxious that they are being stopped from making their next million fast enough.
You are probably going to observe to me that this is very harsh. Indeed it is. You are also going to observe that individual freedoms are curtailed. Indeed they are. You have to make a choice. A small population suffering or everyone suffering.
Now inevitably quarantine will be broken. What are the next logical steps? Inside the country in question there needs to be rigorous test track & trace. Identify the cases before they infect others and quarantine those cases and their contacts.
To prevent a pandemic (as we have now). There is only one solution. Stop ALL travel between countries.
Note we are talking about ALL travel in and out of the country. Partial travel bans do not stop anything with a contagious virus that can ravel around the world with speed.
Is this an inconvenience? Yes. Does this curtail individual rights? Yes. Will this do economic damage? Yes. What are the effects of not doing this, or only partially doing this? Greater curtailment of individual rights and greater economic damage at the next stage.
Now if you have a facility such as North Brother island, you can allow travel, but every incoming traveler has to undergo a quarantine period equivalent to the incubation plus infectious period of the disease. No exceptions. Is this an inconvenience? Yes. Does this curtail individual rights? Yes.
The next scenario is that an outbreak occurs in the country. Eventually one infected person slips through. The tried and tested solution to this is test, track, trace. Every individual case has to be identified by testing and placed in quarantine so that they cannot infect others. Every contact of that individual has to be placed in quarantine. This should contain the spread of the virus.
In New Zealand a prompt travel ban combined with quarantine, followed by strict isolation enabled them to erradicate corona virus. Now they are in the happy state of the economy back to a more normal state. Their income from tourism is about zero now, but most of their population are still alive.
In South Korea, quarantine of travelers combined with test track & trace has suppressed the initial outbreak.
The next stage. Assume that you have a government so utterly inept that they allow cases to enter the country and to spread in the wild . They only identify people once they have an advanced stage of the disease. Now the strategy must be containment. In essence, stop the virus spreading so fast. To do this, rules must be put in place to stop people interacting by either quarantining or social distancing. Social distancing can either be light (interact but only 2 meters apart, wear a face mask at all times) or it can be strict (you are not allowed to go out of your house). Does this cause economic damage? Yes, devastating. Does this curtail individual freedoms? Yes. Does this inconvenience everybody? Yes.
So why containment?
If containment is effective, you buy yourself the time to develop a vaccine or an effective treatment, before too many people die.
If containment is effective you buy yourself the time to build the resources necessary to put an eradication strategy in place.
If containment is effective it is less economically damaging than the final stage
The final stage: An endemic disease,
This is when the disease is present in the population in a way that cannot be
controlled. I could write an essay here. I will just say look up the history of smallpox or polio or Tuberculosis in your country. We have had the luxury of not living in fear of serious infectious disease epidemics for at least 50 years.
My overall point is that at every logical stage of dealing with an epidemic or pandemic you have economic damage and curtailment of individual freedoms. These costs get greater at every stage. Ultimately, they lead to the greatest loss of freedom and wealth of all. Death for a significant proportion of the population.
My discussion with Paul has been all around the issue of the data. What does the data actually tell us about the death rate from covid–19? What do the data and the models tell us about the risk of contagion? How many asymptomatic cases are there? These are all essential questions governments need answers to, so as to evaluate the necessity of decisions and their effectiveness.
The scientifically honest response to these questions is to say we do not yet fully know the answers. Indeed we do not have sufficient data to draw firm conclusions. What we do have, is partial unrealiable data. This is sufficient for those of us whose profession is dealing with numbers to draw tentative conclusions.
The process of decision making is not helped by political ideologues who flatly assert deliberate and mendacious lies such as; covid-19 is only as lethal as the flu. Covid -19 is just the flu. Covid -19 is only a risk for people over 70 or with underlying health conditions.
Then there are the half truths. The cure costs more than the disease. It is most effective to allow the virus to spread through the population. Covid -19 is killed by bleach. Covid-19 is killed by sunlight. Individual freedoms are more important than lock down. More people will die from economic damage than covid -19.
All these are used mendaciously with political intent to obnubliate the central questions that need to be focused on to produce an effective resolution to this disease.
Ultimately we will only emerge from this crisis when we have effective and pragmatic leadership and action from those who govern us. Political persuasion should serve no input in this decision making process, for it is there that we depart from the rationality and effectiveness that is needed.
Paul Plante says
Graham, I am curious as to why you think we provincials over in here in the colonies need a Cockaigne from the Mother Country to teach us how to suck eggs, as that saying goes?
Do you think that our public health infrastructure here in the colonies hasn’t advanced any since George III was in charge here?
We actually have had epidemics of communicable diseases, over here, afterall, and in all our history, we have never had everybody in America die of an epidemic.
In another thread in here (see, Freedom, If You Can Keep It, May 10, 2020 http://www.capecharlesmirror.com/news/freedom-if-you-can-keep-it/ ) I took pains to post from actual records from the 1918-1919 period in the Commonwealth when the flu was rampant to illustrate what was actually done then to illustrate how a functional public health infrastructure in both a major city (Richmond, Va) and two rural counties dealt with that epidemic, which was worse than COVID.
If you would consult our CDC on the subject of the 1918 flu, this is what you would find, to wit:
The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919. In the United States, it was first identified in military personnel in spring 1918.
It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States. Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic.
While the 1918 H1N1 virus has been synthesized and evaluated, the properties that made it so devastating are not well understood. With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly.
If you bothered to read my reply in the thread “Opinion: The COVID-19 Information Campaign–Who’s on First?” on May 17, 2020 ( http://www.capecharlesmirror.com/news/opinion-the-covid-19-information-campaign-whos-on-first/ ), you would see that on paper, assuming we were a nation of rule by law, we actually have in place an elegant, decentralized public health system here in the colonies that was put in place expressly for public health threats like COVID.
So we really don’t need to be lectured by the Mother County on the subject of how to deal with communicable diseases as if we were unlettered savages trying to deal with the spread of a communicable disease by dancing around with feathers on while shouting incantations and shaking a turtle-shell rattle.
Just saying.
So the real question or issue for those of us over here in the colonies as opposed to London town, where Boris Johnson and the Queen Mum live, is why, if we have such a good system on paper to deal with emerging public health threats like COVID, didn’t it work as it was designed to do?
And no, Graham, you do not lock down 326 million people over an area of 3.797 million mi² (area of England=50,346 mi²) because there is a communicable disease in an east-coast city.
Graham says
Hi Paul, you misunderstand my intent. Many of your compatriots crying about freedom seem to have forgotten that we are dealing with a deadly contagious disease. What it is necessary to do medically, should always be stated clearly, so that the needed actions are clear and not contaminated by political bias or flavour. Once the necessary goals are clearly established one can then have debates about the pragmatics of implementation or varieties thereof.
Apologies if it came across as condescending. I was just trying to establish clear foundations for discussion. It is easy to lose sight of the goals when discussing numbers & their meaning.
Graham says
“So the real question or issue for those of us over here in the colonies as opposed to London town, where Boris Johnson and the Queen Mum live, is why, if we have such a good system on paper to deal with emerging public health threats like COVID, didn’t it work as it was designed to do?”
It is exactly the same in the UK. We have a well designed public health system. Admittedly a little diminished by years worshiping the false god of austerity.
“And no, Graham, you do not lock down 326 million people over an area of 3.797 million mi² (area of England=50,346 mi²) because there is a communicable disease in an east-coast city.”
Yes you can, and you are going to have to do this. There is only one known way of dealing with a deadly contagious disease. Quarantine & isolate (everything else including vaccination and social distancing is just a less effective variant). You either choose to do this on a local and small scale to start, or you do it on a large scale later. At each step up in scale, the costs increase. Your choice.
Ray Otton says
Not a contest?
Psssht, this thread has been nothing BUT a contest between a couple of BLOWHARDS who are very impressed with themselves. No one else is, but BLOWHARDS wouldn’t notice that.
So, the question remains, did you guys figure out the winner?
The community is on the edge of it’s collective seat here anticipating the results.
The reigning champ of dicks from upstate NY, by way of VIETNAM, vs the new comer from across the pond.
Don’t forget, no raw numbers, because you’re measuring in micro-inches and Graham in millimeters.
FWIW, I’m betting on you to “hold” your title.
Paul Plante says
Raymond, you’re getting hysterical, dude!
Chronic hysteria lowers your immunity.
By being hysterical, therefore, you make yourself susceptible to COVID, and a lot of other things too, because nature is ravenous, Raymond, and unforgiving of weakness and ignorance.
So why do you do that to yourself, get yourself all worked up over other men’s genitalia?
What is the cause of this fixation you have with how big the genitalia of the men who comment in here are, as if that could possibly make any difference to anything?
It’s actually more than a bit creepy, Raymond.
Just saying, dude.
Slide Easy says
THINK ABOUT THE FOLLOWING: When the State commands you to stay at home, and even threatens you with arrest and jail if you don’t comply, as it allows illegal aliens to flood freely into your land and live off of your hard-earned tax dollars, it’s not about protecting your health. When the State shuts down millions of private businesses, but doesn’t lay off a single government employee, it’s not about protecting your health. When the State forbids you from visiting your dentist, but deems abortion visits safe, it’s not about protecting your health. When the State prevents you from buying tomato and cucumber seeds to plant for food, but allows in-person lottery ticket sales, it’s not about protecting your health. When the State tells you that it’s “too dangerous” to go golfing, boating, surfing, etc., while the Governor gets her stage make up and hair done for numerous TV appearances, it’s not about protecting your health. When the State puts you in jail for opening your small business so that you can feed and support your family as it releases dangerous criminals onto the streets, it’s not about protecting your health. When the State closes your church, but it deems liquor stores “essential,” it’s not about protecting your health. When the State allow you go out and buy marijuana while it tells you that we must have “Mail-In Voting” because it’s “too dangerous” to allow people to go out and vote . . . . WAKE THE F’ UP!
Paul Plante says
Speaking of conundrums that simply boggle the mind, Slide, consider this and try to make a lick of sense out of it, if you can.
First off, the people of the Commonwealth went to all the trouble creating a Constitution to limit and define the powers of the “state,” as you call it, and then inserting into Article I, the Bill of Rights of the Constitution of the Commonwealth Section 2, titled “People the source of power,” which section of the organic law of the Commonwealth states thusly:
That all power is vested in, and consequently derived from, the people, that magistrates are their trustees and servants, and at all times amenable to them.
end quotes
As a further check on the powers of the “state,” in section 3 of the Virginia Bill of Rights, the people stated thusly:
Section 3. Government instituted for common benefit
That government is, or ought to be, instituted for the common benefit, protection, and security of the people, nation, or community; of all the various modes and forms of government, that is best which is capable of producing the greatest degree of happiness and safety, and is most effectually secured against the danger of maladministration; and, whenever any government shall be found inadequate or contrary to these purposes, a majority of the community hath an indubitable, inalienable, and indefeasible right to reform, alter, or abolish it, in such manner as shall be judged most conducive to the public weal.
end quotes
And going beyond that safeguard, the people of Virginia added Section 7, “Laws should not be suspended,” to the Bill of Rights, as follows:
That all power of suspending laws, or the execution of laws, by any authority, without consent of the representatives of the people, is injurious to their rights, and ought not to be exercised.
end quotes
Further defining the “state” they wished to create in the Commonwealth, the people added Section 15, “Qualities necessary to preservation of free government,” to the Bill of Rights, to wit:
That no free government, nor the blessings of liberty, can be preserved to any people, but by a firm adherence to justice, moderation, temperance, frugality, and virtue; by frequent recurrence to fundamental principles; and by the recognition by all citizens that they have duties as well as rights, and that such rights cannot be enjoyed save in a society where law is respected and due process is observed.
end quotes
That seems to say what it says without any confusion as to what it means to say without the need for a J.D. from Harvard Law School to suss out the meaning of what those words are saying in plain language.
And to put a Martingale bit, so to speak, in the mouth of governors like “Blackface” Northam, the people enacted Article V. Executive, Section 7. Executive and administrative powers, to wit:
The Governor shall take care that the laws be faithfully executed.
end quotes
And then, he didn’t!
And what did the people of the Commonwealth do when “Blackface” Northam suspended their laws and Constitution?
They did what he told them to do, which to get inside and stay there.
Which raises the question, Slide, of why bother to have a Constitution and laws when they clearly do not limit the power of the “state” to simply ignore them?
Brett says
Graham says: “Human discomfort is not a part of risk calculations.” Well, I would say, “Thus the inherent problem with such models/simulations when attempting to use them to make decisions regarding very consequential policies with a complicated human species.”
Graham says
It is always a good idea to separate what needs to be done from the pragmatics and politics of implementing it. Otherwise you lose sight of the goal (which is to prevent transmission). The initial calculations and data on the spread of covid -19 were alarming even at the initial stages. Emergency medical planning needed to allow for a worst case scenario (cf Italy). Social distancing measures worked sufficiently well to prevent the worst case. Now we have to deal with the fallout, the cancelled operations, the broken relationships, the unemployment. Compared with death, they are indeed inconveniences.