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The Numbers Game

COVID-19 is a numbers game. Trouble is, we don’t know what any of the numbers are. Yes, we can tote up test positives and deaths, but that tells us surprisingly little about the things that matter in this case: How contagious is the virus? How many people are infected but don’t know it? How many people had it but thought they had the flu? All of that matters.

None of it is known.

We’ll learn more as new tests are devised, particularly for antibodies. Knowing how many people have caught the virus but threw it off would put a number of things into perspective, especially the critical issue: How close are we to herd immunity? That’s the most important known unknown in a big greasy sack of mixed unknowns.

In the meantime, people worry. I’m one of them. I’ve read others online. The worried ones tend to be older folks. And yeek! It was a little disorienting to internalize that I’m an older folk. I’ll be 68 in two months. I don’t care if 60 is the new 40. We have decent stats on whom the virus is taking out. And that curve heads for the sky at age 60.

As an aside, there’s the complicating factor in that anybody who dies with the virus in their system tends to be counted as a COVID-19 fatality, even if they had heart disease or stage 4 cancer. Sometimes the corpses aren’t even tested for coronavirus. If it looks like the virus, coughs like the virus, or kills like the virus, then…they write COVID-19 on the death certificate. That may be unavoidable in some cases, but it certainly does not help in our current numbers game.

This may all seem obvious, but I’m not done yet. The country has to open up soon. People are burning through their savings trying to keep the lights on and food on the table. (Alas, the people who are keeping us under house arrest never miss any paychecks.) Businesses are failing. My local art supplies store has closed forever. A lot of restaurants are not going to make it. Smithfield closed its ginormous pork-packing plant in Sioux Falls, SD, and the firm is supposedly working with the CDC to determine how and when the plant will reopen. Too much of that and we’ll have food shortages.

We’re not there yet. My local groceries have fresh meat again, at least. My hunch is that the hoarders have already filled their chest freezers, at least those hoarders who can find their chest freezers behind the mountains of toilet paper piled up in their basements.

I recognize that there will be a cost in letting people go back to work, particularly in monster cities like New York and Chicago where getting around is mostly done on jam-packed buses and subway/commuter trains. More people will be infected. Additional people will die. Those numbers can’t be known yet. (Computer models riddled with unknown parameters are utterly worthless.) Being my ever-hopeful self, it looks like the numbers won’t be nearly as bad as early models suggested. The big upside is rarely mentioned: Herd immunity happens because people catch the virus, develop antibodies, and throw off the virus. Some of that has happened already. It’s happening. More needs to.

We’re a ways off from a vaccine, though one will happen. In the meantime, we need to consider any drug or drug combo that shows promise through clinical experience. The media seems…peculiarly…opposed to hydroxychloroquine plus zinc and an antibiotic. Still, observational studies are being ramped up as quickly as possible, and early clinical experience looks good. If I suddenly got hit hard, I would ask for that first. When you’re looking death in the eye, you may not be as insistent on bureaucratic niceties.

People like me will probably have to stay home for awhile longer than those younger and not yet retired. I’m willing to do that…to a degree. Carol and I walk in local parks. If we need something at a store, we mask up and go. How effective are the masks? Nobody knows. But it’s worse than that. No matter how much you wear your mask, a virus or seventeen may land in one of your eyes. The mask reduces the likelihood of catching it. But it never reduces the likelihood to zero. The same goes for cleaning surfaces, which is harder now because the hoarders have snapped up all the cleaning supplies. Miss something with that soapy rag (you’d use alcohol if you could find some) and you could pick up the virus. Less likely, but possible. No matter what measures you might take, your chances of catching COVID-19 will never go to zero. And your chances of dying will never go to zero. We do not and cannot and will never know. Carol and I have had our family trust and wills together for awhile. We take whatever protective measures we can. That’s about the best we (or anybody) can do.

Irrepressibly perky gonzo optimist that I am, I do see something to be optimistic about: Evolution is a thing, and it works. Viruses that immobilize/kill their hosts quickly eventually lose out to related strains that infect and cause fewer and less severe symptoms. Over time, newly discovered viruses mutate toward more innocuous forms. It worked that way with HIV. It will work that way with our current coronavirus. It’s already working that way, even if we can’t measure it. How long will it take? No one knows. Get over it.

It comes down to this: Whether you like to gamble or not, you’re damned well gambling, and you will never know the odds. Come May 1, if we don’t begin opening up our economy, the virus could well become the least of our worries. Those odds are greater than zero. Greater, in fact, than you may think.


  1. Jim Fuerstenberg says:

    good observations jeff… btw, everything I read says that soap and water are actually better than alcohol at killing the virus. soap gets through its shell very well…but if you are out and about, carrying alcohol makes sense.

  2. Jonathan O'Neal says:

    > Evolution is a thing, and it works.

    The pessimistic view of that statement is what’s got me bothered. This study (to the best of my knowledge, not yet peer-reviewed) contains a good-news/bad-news message: SARS-CoV-2 only mutates at about half the rate the seasonal flu does, but they’ve already spotted a mutation that changes the way the spike protein binds with the ACE2 receptor – which, because that binding is the focus of many prospective vaccines, may make finding a truly useful vaccine rather difficult.

    We also still know almost nothing about the degree or duration of immunity conferred by recovering from the virus. South Korea’s KCDC is reporting a surprising number of cases of “recovered” patients testing positive again, some with symptoms, some asymptomatic; it’s currently unclear if any of them are contagious. It’s entirely possible that SARS-CoV-2 will end up like the common cold, with many variants, limited immunity, and no practical means of immunization – “herd immunity” may not be achievable. We’d then be at the mercy of viral evolution, waiting for “newly discovered viruses [to] mutate toward more innocuous forms.” (Time to invest in surgical mask and nitrile glove companies.) On the other hand, all of the “re-infection” data could just be a simple testing issue (and therefore a non-issue).

    There really are just too many unknowns, and policy-makers (along with the rest of us) are in a “damned if you do, damned if you don’t” position. Assuming we manage to have an election this fall, the mud-slinging seems likely to be even more nauseating than usual.

    (Sorry for the umbral reaction to your sunny post – it’s just been that sort of day.)

    1. Sunny? I thought it was one of my near-bummers. So it goes. My overall point stands, and it supports what you’re saying: We simply don’t know enough yet to make reasonable policy. The vulnerable may need to stay home. The less vulnerable may have to take their chances. Collapsing the economy would be worse.

  3. John Norman says:

    Thank you so very much. “Irrepressibly perky gonzo optimist”… love it.

    Take precautions as best you can determine. I’m in my ‘younger 60s’ in a small town, and have changed my daily routine very little. I’m lucky in that I see few people in my office, and it’s a regular, reliable group. I can’t abide our elected officials leaving subways open while threatening church goers. Data or no data, it’s time to stop killing ourselves and the small business people that we love like family and upon whom we’ve chosen to become co-dependent.

    Take care, and God bless.

    1. We’re doing our best; thanks. I keep thinking we’re not getting the whole story, while another part of me answers back that there is no story yet. I can see both sides.

      There will come a time, and soon, when keeping the country shut down will cost more lives than opening up the economy and letting people get back to work. Our healthcare industry is now almost entirely focused on the coronavirus, and other aspects of healthcare, like cancer care, are being shorted to make sure there’s room for all the COVID-19 patients. Some hospitals in some places are jammed (think NYC) while other hospitals elsewhere are mostly empty due to governor-imposed restrictions on what may be done in hospitals.

      Opening up? Messy. NYC is in a bad spot: The city simply doesn’t work without its subways. This is true of Chicago to a lesser extent. But if the big cities don’t get back to work, there will be unrest, and perhaps rioting when the supply chain can’t do its job anymore. At some point we will just have to face the fact that we can’t all sit around at home and wait for the damned thing to go away. It won’t.

  4. Robert Flanagan says:

    Your comment “Computer models riddled with unknown parameters are utterly worthless.” seems to indicate your lack of confidence (or understanding) about the underlying science. Science, Jeff, is all about models. The fact that the data are showing a more optimistic outcome when compared to the model shows that social distancing works, not that the model is “nonsense.”

    1. I know a few things about models. I also know that science uses models but is not “all about models.”

      I stick by my major point: We know so little about the virus at this time that attempting to model its behavior would be an exercise in self-deception. Maybe next year, or five years down the road. Right now? No.

  5. Keith says:

    I read an article over the weekend written by a vaccine researcher (from Australia, if I remember correctly) who said that he believes we are unlikely to develop a vaccine. His reason is that we have never been able create a vaccine for a virus that attacks the upper respiratory system, and there is a fundamental reason for that.

    He explains that the lining of the upper respiratory system is basically skin (it is like the surface of the body, even though it is tucked away in the nose and throat), and our immune system is not set up to detect and block viruses on the skin.

    I don’t believe he said this, but I think that explains why we don’t develop immunity from colds after having one. So I guess we probably won’t develop immunity to the Covid-19 virus after recovering from an infection by it.

    My conclusion from reading the article was that we should put a lot more effort into understanding exactly what effects of the virus are responsible for the very severe and fatal symptoms, and figure out what we can do to block the virus from doing those things, or what we can do to most effectively help our bodies recover from those things. We should continue trying to develop a vaccine, too, in case this particular virus is one for which a vaccine can be created, but that probably should not be our primary effort.

    Unless the testing of hydrochloroquine and zinc, or any of the other drugs that are already in use for other diseases, proves to be effective in keeping a Covid-19 case from progressing to the severe stage, it probably will take a long time to understand Covid-19 well enough that we can treat it well. So unless we are lucky with an existing drug, I believe we are going to be reduced to reopening the economy slowly and carefully, with careful monitoring and adjusting to keep the number of cases small enough that we can handle them, and managing the deaths that will be inescapable on that course. Unpleasant, but I believe we don’t have another choice.

  6. Keith says:

    One other point: About a week ago, or a little more, I saw one article that said that the Covid-19 cases bore a lot of similarity to altitude sickness, and the writer wondered whether it might be that one of the effects of the Covid-19 virus was to attack the oxygen-carrying ability of the red blood cells.

    I don’t know whether that could be the primary way the virus causes harm, and the symptoms in the lungs are a consequence of that, or the virus has two ways it attacks. Or maybe it looks like altitude sickness only because attacking the lungs the way it does makes the level of oxygen that can reach the red blood cells too low, leading to the same symptoms as altitude sickness because of that.

    It seemed like an observation that deserved to be followed up, but I saw only that one article about it. Maybe it was looked into and was just a wrong idea, but I don’t know. I hope it isn’t an important point that has been ignored.

    1. I’ve read a few articles that indicate that the virus attacks hemoglobin function, and a couple that state the opposite. The vehemence of the argument suggests a political dimension, but in truth we just don’t know the facts yet. Studies are underway.

  7. Roy Harvey says:

    Regarding masks… my understanding is that they help a bit to keep the masked person from catching it, but they helps a LOT to keep a masked infected person from passing it around. So beyond wearing our own, we should stay away from people not wearing theirs. And since it can take days before one shows symptoms, and some never do, but can be spreading it all that time, getting everyone to just wear the damned masks is a Really Good Idea.

  8. Keith says:

    An article today in the New York Post tells about a study that claims to show that treatment with hydroxychloroquine does not help Covid-19 patients. Here is the article:

    If you look at the report they are talking about:

    you’ll see that the treatment used hydroxychloroquine alone, or in combination with azithromycin, but did not include zinc.

    The Post did not mention that the treatment was lacking that critical component of zinc, which is what actually stops the virus replication (the hydroxychloroquine gets the zinc into the cells where the replication is done).

    I don’t know whether the reporter did not know enough to notice that important deficiency in the treatment, or intentionally left out that fact.

    As for the researchers who did the study, kind of makes you wonder whether they wanted to make it fail, doesn’t it?

    1. None of the studies that get waved in my face indicating that HCQ (hydroxychloroquine) is ineffective or deadly include zinc in the study treatment protocol. I want to see a study that includes the whole cocktail: HCQ, Z-Pak, and zinc. That’s what the Orthodox MD was using. That’s what I want tested. You’re right about one thing: There is indeed a political reason for all the slandering of HCQ, and although I won’t discuss it here, anyone with any Google-fu can figure it out in a spare nanosecond or two. I suspect you’ve already figured it out.

  9. Keith says:

    Another possible effect of the Covid-19 virus: excessive blood clotting.

    First I’ve heard of that. Here is where I saw it:

    Although it is an article in an Indian newspaper, it is about some doctors in New York.

  10. Keith says:

    I believe this article, though long, is well worth reading.

    It is by an ER doctor who believes he has identified an oversight in the current treatment of the Covid-19 disease. The pneumonia caused by Covid-19 is not typical, causes very low blood oxygen levels without the typical symptoms, and so it is not recognized and treatment is not started until very late.

    People with this not typical pneumonia compensate unconsciously by breathing faster and deeper, which is one way to recognize it. Using a fingertip blood oxygen meter, if available, would be another way to recognize it.

    If this pneumonia is caught and treated early, use of a ventilator can be avoided in many cases.

    But don’t trust my summary; read the article:

  11. Wile E Coyote says:

    Hi Jeff

    Wondering if you’ve seen this? I know nothing of this guy’s credentials but his analysis seems to make sense (and also is consistent with your “we don’t know what we don’t know” theme)

  12. Keith says:

    Yet another hydroxychloroquine-bashing study that does not include zinc is being touted today.

  13. Spencer Arnold says:

    Very astutely observed, Jeff. There is a trade-off that needs to be made with COVID-19, in the economy vs peoples lives. In my mind, it comes down to what is defensible in the media, the person who died or the business owner who went broke.

    I remember talk of Vietnam being the first War that was fought on TV. This COVID-19 pandemic appears to be the first War fought with statistics. Each night the government reports on the current figures in an attempt to bring the population around to agreeing with their strategy (containment, herd immunity, elimination, whatever).

    And one observation made to me by a friend who was a nurse, was that most of the deaths in New Zealand here are from Nursing Homes where people are suffering from dementia or terminal illnesses. All that COVID-19 has done is bring their death forward 6-12 months (Medical professionals can be annoyingly pragmatic sometimes).

  14. Rosemary D'Andrea says:

    It seems that the activities my husband and I are working on during this Stay- at – Home phase brings me to an article of yours from 2018 regarding an exploding Lafayette Wireless Intercom. Clearing out stored boxes, we found that very intercom. After searching the internet for a value, we came upon your experience. We thought we would at least try the unit. So we plugged one intercom upstairs and one in the kitchen. There was lots of buzzing and no voice transmission.
    In less than 3 minutes, as happened to your wife, the thing exploded!
    It’s in the trash now and we are still laughing.

    As for the post of 4/20, we also live in a small town on the NC coast dependent on tourism and outer banks weekend/ summer homes. We’ve had 27 cases of the Wuhan virus and 4 deaths-all very old folks with diabetes and high blood pressure in a county one hundred miles long. However the young and middle aged folks who own the small shops, restaurants, rental units, hotels have been bankrupted. These are businesses with small margins and will not recover. The cure is certainly worse than the disease. We followed the same models as the Climate Change fanatics. I have much less faith in this brand of “science”.

    1. This is an old, old problem with old, old tube-based electronics. I bought a Heath Comanche receiver at a hamfest back in the late 1990s, plugged it in, and one of the filter electrolytics blew up. Fortunately, after I replaced all the electrolytics in the little box, it ran just fine. The intercom not so much: The coil that imposed signal on the power line was fried, and that’s the very definition of unobtanium. I gave them to electronics recycling before we moved back to Arizona in 2015.

  15. Olli says:

    “Vitamin D levels appear to play role in COVID-19 mortality rates”

    Maybe not an issue in Arizona, but my mornings start with a tablet of Vitamin D3 (100μg). 

    1. Maybe not as necessary in AZ as elsewhere, but as I read the reports, being a little over the typical recommended level is a good thing. It is true that enough D is toxic and at a certain (yuge) dose can be fatal, but we’re not eating polar bear livers by the pound–especially not in AZ. Carol and I take a 2500 IU gel (62.5 ug) every morning. At some point during the day, even if we’re fiercely busy inside, we go out in the backyard and hit the pool. We stay in the shade to cool off, but we try to be in bright sunlight for at least 8-10 minutes. We take a quercetin supplement daily and a zinc supplement 3X a week. Beyond that there’s not much that people in our age cohort can do beyond stay home a lot.

  16. Keith says:

    100 micrograms (4000 IU) vitamin D3 is usually a reasonable dose, but people vary widely on how well they absorb vitamin D from their diet and how much they get from sun exposure. It is possible to get too much vitamin D and get into some toxicity, but in most cases, you have to take an awful lot of vitamin D supplements to be in danger of that.

    Still, occasional testing to monitor is prudent. The 25(OH) test (sometimes called 25-hydroxy) is the one to get, not 1,25(OH). Results between 50 and 70 ng/ml (125 to 175 nmol/liter) are usually good enough, though up to 100 ng/ml (250 nmol/liter) are safe. Many labs still flag results over 50 ng/ml as high, but they are using older guidelines.

    Adequate vitamin K2 levels are needed to properly use vitamin D. People vary a lot in how much vitamin K they get, and there aren’t very good tests for it. A daily 150 microgram K2 supplement is usually suitable for many people, though those taking anticoagulants need to be careful about K2 supplementation.

    Of course, Covid-19 is so new that nobody knows any details about how the above levels affect the progress of it. There are some indications that people low in vitamin D have poorer outcome from Covid-19, so getting adequate vitamin D probably would be worthwhile, and at least will help your health in other ways.

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