Wednesday, May 6, 2020

Practical, effective ways to combat the COVID-19 virus


In mid-March, I cited Tomas Pueyo's article "Coronavirus:  Why You Must Act Now".  It was a clarion call to politicians and business leaders to take immediate action to slow the spread of the coronavirus, and listed various measures that would help in that process.

I was interested to learn that a number of experts in their field have since joined with Mr. Pueyo to study the matter further.  They've published four more articles, which I recommend to your attention, and will be publishing more (you can sign up for notifications here).  The articles analyze what's happened around the world, what's worked, and what hasn't.  Those so far published include:







They've also produced a more formal, scientific article titled "Evidence-based, cost-effective interventions to suppress the COVID-19 pandemic: a rapid systematic review".  Click on that link to go to its summary page, then click "Preview PDF" to read the text.

I find these articles interesting in that they're analyzing events "on the ground" and recommending ways to make dealing with the pandemic easier for all of us.  They're not politically motivated, and don't seem to have any particular special-interest agenda to push.  They appear to aim to provide as much useful, practical information as possible.  For example, from their latest article:

Many countries are enduring the Hammer today: a heavy set of social distancing measures that have stopped the economy. Millions have lost their jobs, their income, their savings, their businesses, their freedom. The economic cost is brutal. Countries are desperate to know what they need to do to open up the economy again.

Thankfully, a set of four measures can dramatically reduce the epidemic. They are dirt cheap compared to closing the economy. If many countries are enduring the Hammer today, these measures are the scalpel, carefully extracting the infected rather than hitting everybody at once.

These four measures need each other. They don’t work without one another:

  • With testing, we find out who is infected
  • With isolations, we prevent them from infecting others
  • With contact tracing, we figure out the people with whom they’ve been in contact
  • With quarantines, we prevent these contacts from infecting others
Testing and contact tracing are the intelligence, while isolations and quarantines are the action.

There's much more at the link.

The thing is, of course, that these measures aren't "one-size-fits-all" like the total shutdown of the economy currently being experienced.  They require good judgment, careful administration and constant monitoring of the health care workers in the field doing the work.  That's anathema to bureaucrats, who'd rather use a single mold and force everyone into it, because it's easier to administer that way.  (The bureaucrats will also have to get out of the way of those who can produce solutions - such as, for example, cheap, accurate easy-to-use tests for COVID-19 - rather than micromanage every aspect of the problem.)  Politicians also won't like it, because it demands that they use their heads rather than react with a knee-jerk.  (For an example of the latter, note the number of states whose governors have extended the lock-down, some into July, rather than proactively seek to restart their economies while protecting citizens so far not affected by the virus.)

Kudos to Mr. Pueyo and his team for producing these articles.  It's good to have all the information pulled together and synthesized, to provide a detailed overview of successes, failures, and potential next steps.  I look forward to seeing what they have in mind in future.  Thanks to them and those like them, the rest of us are better informed, and have options to consider - and to recommend to our elected leaders.

Peter

10 comments:

Ominous Cowherd said...

Quarantine is isolating sick people so they don't sicken the healthy. Locking up everyone isn't quarantine, and it is worse than this disease.

Testing to identify the sick and paying those few to stay home for a few weeks would put this behind us in a couple of months. No doubt that's why our Deep State adamantly refused to test until Trump over ruled them.

Aesop said...

And if you look at those four, the lunatic left is dead-set against testing and quarantine, and the retard right is against contact tracing and isolation.

Good luck preaching common sense and rational response to a world full of Gilligans who don't know they're Gilligans.

The only out of this is through it, and that means both sides want to kill as many people as possible, due entirely to thier own prejudices, biases, and blatant stupidity.

Okay, bring it on.
Anything from 100K to million or several less jackholes is bound to be a good start, and it's the only way to shut the morons up on at least one side.

Ray - SoCal said...

Nice "Sanitized" Article. Good for what it is.

Things Missing:

1. Don't trust China. Taiwan does not trust China due to their lies over SARS, and started taking action December 31st.

2. No discussion of what Sweden is doing.

3. No discussion of difference in US states results. Florida vs NY is a great one.

Florida only has 5% of the deaths of NY, why?

Florida focused their efforts on their Elder Care Facilities. And they did not have the insane requirement, that NY, NJ, and CA have that positive patients must be admitted.

https://www.foxnews.com/opinion/coronavirus-response-florida-new-york-results-compare-william-bennett-seth-leibsohn

4. Bureaucracy Kills. Huge issue that Glenn Reynolds noted. Regulation for making hand sanitizer is a personal frustration (I still can't buy). Another is 3D printing of N95 masks - held up by FDA requirements, since it's a medical device.
https://www.usatoday.com/story/opinion/2020/05/06/coronavirus-density-mass-transit-bureacracy-censorship-column/3075550001/

5. Leadership matters. De Blasio and Cuomo have shown that. Blue State deaths are far ahead of Red States. Instapundit link this morning shows difference is 300%:
https://lawliberty.org/virus-deaths-in-democratic-versus-republican-states/

6. NY Metropolitan area has 65% of the US deaths, why? Five Reasons:

a. Subway was a huge vector, and was filthy, disgusting, and only recently have baby steps been taken to clean it up. Homeless were using subways as mobile homes, along with stations. Even defecating in cars.

b. Not requiring wearing of masks from day

c. Hospitals were a nightmare. There are two videos making the rounds that are bad.

https://nypost.com/2020/05/05/coronavirus-nurse-says-negligence-has-patients-dying-at-nyc-hospitals/

https://www.dailymail.co.uk/news/article-8262351/Nurse-New-York-claims-city-killing-COVID-19-patients-putting-ventilators.html

D. Requiring Nursing Homes to admit positive patients.

E. Not having enough PPE, and this was a problem before the Wuhan Virus. Nursing Homes were worse.

7. No mention of how probably 50% of deaths in the US are from Nursing Homes. Major infection Vectors in other countries are hospitals and nursing homes.

8. No mention of what can be done to harden stores, to protect clerks. Latest I saw at a Chinese Market was masks, plus face shields as well as wearing a rain coat.

9. No mention of Hydroxychloroquine. If given early, it seems to have a significant impact on lowering the death rate. Treatment regimes matter a lot.

http://meaninginhistory.blogspot.com/2020/05/some-good-covid-reads.html

https://www.americanthinker.com/blog/2020/04/press_does_the_gotcha_dance_over_trumptouted_nih_hydroxychloroquine_nonrecommendation_flunks_basic_reporting.html

https://spectator.org/a-report-from-the-front/

10. Big question I have in the US. If we are locked down, where are all the infections coming from? My guess is nursing homes are 50%, and another 10% are medical workers.

Aesop said...

The infections are coming from tens of thousands of asymptomatic carriers, blithely wandering about hither and yon, passing this along without a care or clue.

Rob said...

I wondered about Sweden, they are going at this differently so I did the math. Turns out they are doing pretty good...


Death rates from the virus when you include the total population of the country.

Sweden has 2854 deaths from the virus, divided by it's 10,099,265 people the Sweden virus death rate comes to .000282

Italy has 29,315 deaths from the virus, divided by it's 60,461,826 people is the Italian virus comes to a death rate come to .000484

France has 25,537 deaths from the virus, divided by it's 65,273,511 people the French virus death rate comes to .000391

UK has 29,501 deaths from the virus, divided by it's 67,886,011 people UK's virus death rate comes to .000434

USA has 71,078 deaths from the virus, divided by it's 331,002,651 people America's virus death rate comes to .000214


Here is where I got the numbers of dead.
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

I just did a search for the 2020 population of the countries.

Eck! said...


China, do not trust.
Sweden, no info no trust.

Anything FOX is suspect at best. Mostly useless.

item 4, we need people (FDA) to make sure they aren't trying
to sell us poison. But you can make your own anything. Try Colloidal Silver. Let me know how it goes.

NYC has had the vector issue since the 1800s, same problem,
28000 people per square mile.

Homeless issue is not unique to NYC, Austin TX, LA, SFO, Seatac.
Solutions are few if any.

Stores have hardened with plastic shields wher ethey can and adding other as we go.

9) Hydroxychloroquine, I know people that used it for Malaria, it killed one. Its a very old and somewhat unsafe for a lot of people as it has nasty side complications and interactions. That and not one study has proven it effective. However there are drugs that
IL6 inhibitors that are likely more effective and being tested.
That IL6 inhibition is a weak side effect of Hydroxychloroquine
and was why was tried.

10. Big question I have in the US. If we are locked down, where are all the infections coming from? My guess is nursing homes are 50%, and another 10% are medical workers.

since we have no clue how the first person in a Nursing home got it...
Hint it didn;t creap in and bite that person. Likely an Employee or service person and we haven't a clue how they got either so that makes the question of how a good one but the ans is null, no tracking and no data.

We can assume as a an example it was from a college student at
NYU, on spring break visited his grand parents in a home. Ok home has patient 1, someone gets it from there, goes home and passes to family and the visiting sister gets and and brings it to the next new place...

That's how it goes.

Like Peter said, you need a really big picture in your head and
read and sort it all for real information and real vs anecdotal information.

Eck!

Ray - SoCal said...

HK and Taipei have same, or higher density than NYC and don’t have same infection rates.

Good article on Hydroxychloroquine
https://wattsupwiththat.com/2020/05/02/pseudo-science-behind-the-assault-on-hydroxychloroquine/

Interesting how Hydroxychloroquine with over 5 million prescriptions in the us in 2018, and only now are the side effects being focused on. Unfortunately all drugs have side effects. And it’s worse with interactions of multiple drugs for side effects.

FDA is part of reason Wuhan Flu testing was delayed in US. It is not an all or nothing situation, and some of the FDA requirements actually increase deaths due to treatments not being available due to the high cost of approvals. Are all the Fda requirements for hand sanitizer really needed?

Xoph said...

I don't doubt Covid is real, but I'm beginning to think the negatives of our approach outweigh the positives. As the article talks about the cost of social distancing. Why, when masks are very effective did the government down play them early. Cause the sheep might panic, because our corpacracy had outsourced to a global rival who also had issues the ability to manufacture them, because our gubermint in all its wisdom had no stockpiles. News flash, tie a bandanna around your face like a kid playing cops and robbers. Good as a N95, no - but cost effective.

We have moral obligations to one another. We should be wearing masks, not just to protect ourselves but because we have an obligation to not infect others if we are an asymptomatic carrier. People have given away the ability to make such decisions to the government, and the government only knows how to drive nails with a sledge hammer.

And we have to live with some risk. Minimizing risk doesn't mean no risk. We should, as much as possible, let individuals choose their own risk. Still too many people not wearing masks because the social pressure is not there (how many politicians at their new conferences are practicing what they preach?) Just look at the results of letting the government choose our risk response. I get we don't want to overwhelm hospitals, but had we gone masks and hand washing very early we could have slowed this thing down. Quarantining sick or people ID'd by contact tracing, yes that is needed. And most people would cooperate, don't set policy based on the 1%. Set policy as if we are all adults. We didn't try a phased approach, just a 100% approach.

Quarantine the economy - once again government regulations are causing us to overpay for something we can manage mostly without government.

Aesop said...

@Rob,

Thanks for that bit of Math from the Dr. Erickson School of People Who Skipped Statistics, but unfortunately, the rosiest (and least reliable) surveys put the percentage of infection in NYFC at about 20%, and more like far less than <3% for the rest of the country. Not 100%. So you don't get to divide deaths into the entire population of the U.S.

Thus your US infection rate is only off by a few thousand percent.
Details, right?

OTOH, we can do this the other way if you like, using real numbers instead of imaginary ones:
If the US infection rate was the entire population, based on the 20% infection and death rate numbers in NYFC, there would be about 3,420,000 people dead in the U.S.

{I.e., NYFC, with a 20% infection rate (1/5th of the city), has 19K dead, now. NYFC, at 9M people, is about 1/36th of the total US population. 100% infection means (19,000 X 5) = 95,000 (NYFC) X 36 (entire US) = 3,420,000 dead people. Versus the current actual tally around 73,000. That would be a death rate of a shade over 1% of America, IOW about 4600 times worse than what you've miscalculated it to be. Applying actual deaths to NYFC rates X 100% infection, the actual current tally suggests rather inarguably that the current average percentage of people infected in the U.S. is about 0.426%, nationwide, not 100%, not 20%, and not even 3%. (I told you those rosy surveys weren't accurate, didn't I?) And given that NYFC is 1/4-1/3 of all casualties in the country, and thus the rate is certainly higher there, the avg. rate in the country would have to be even lower than 0.426%. Which explains rather quickly and obviously why most people everywhere have no experience with this outbreak, and have few or no casualties, outside the urban hot spots.}

We can quibble about how many have, or may have, actually been infected, or how padded that 73K number is, but it doesn't change the central fact: this thing is in 50 states, yes, but in most places, it's only about 1mm deep. For vast swaths of the country, particularly anywhere outside of major cities, there have been more lightning strikes since March 1st than COVID cases, by a yuuuuuge margin.

That means that if we achieve NYFC-stupid levels of infection, because people get similarly NYFC-cavalier and -stupid, then something up to 99% of your friends and neighbors are going to get it, and the wider it goes, the more people die.

Let me know when the penny drops for you.

PresbyPoet said...

Contact tracing is stupid now that 10% have it. With 80% not knowing they have it, and going on living their lives because no one knows they have it, you would have to be testing on a weekly basis at least 10% of the population. That is 35,000,000 tests a week. The antibody studies indicate an infection rate of 20 to 30 times those who have tested positive. California's idiot governor is talking about hiring 20,000 contact tracers. A billion dollars we don't have. Given how infectious this is in confined spaces, you would end up with everyone having had some kind of contact with a suspect.

About the only somewhat useful thing we could be doing is each week test a random sample of the American population for both antibodies and virus. This would give you a true indication of the spread, how many are likely immune, and if you did this for a month, an actual indication of what the vector is. Now, an increase in the number of people who test positive is only telling you that we increased testing.

An example of the idiocy that results is found in the meat packing plants. There they are testing almost everyone, and finding many who test positive. Most with no symptoms. They are among the 50 to 80%, with mild to no symptoms. So all the testing does is to lead to panic shutting down of critical facilities. If you tested every grocery clerk in the country, you likely will find the same high number of infected, which would lead, on the basis of the panic in the meat packing plants, in shutting down all grocery stores in big cities.

This virus is infectious. It seems slightly more deadly than normal flu, but less lethal than most bad flu epidemics. Based on the ship samples, about 50% get it. Of those 50%, 80% have no symptoms, or just a "bad cold". About 20% get a "bad flu", with about 2% needing hospitalization, and one or two in a thousand dying.

The death rate is variable. Once it gets into a care facility, it kills because those who get it are already vulnerable, and it is the straw that breaks the camel's back. Given that so many who have it do not know it, and show no symptoms, it is easy to see how it happens. The heavy virus load gets dumped on someone who is trapped inside with an infected caregiver. Norovirus which is also infectious without symptoms, kills thousands in care facilities each year.

The cure is way more deadly than the disease. We have more than a million healthcare workers not working. They are not providing care for people who will die of other diseases:
When children are not vaccinated.
Cancer is not tested for.
Blood tests are not taken.
Shots are not given.
Dentists are not providing normal treatments. Teeth will deteriorate, and people die of infections.

This is not a pandemic, this is a panic.

The evil left continues to prevent people from getting treated early with Hydroxycloroquine. They seem to be trying to make this panic as bad as possible. The "study" they use to claim it doesn't work, seems to have been a set up. It is quite easy to create a study designed to fail.

China had to know the infection rate of this virus. They have let us think it has a death rate of 5% rather than a rate of one or two per thousand infections. So we have the models that point to millions dying, when the number is similar to other epidemics where we did not shut down the economy.

The CDC has much to answer for. They helped fund the Chinese study that almost certainly resulted in the virus escaping. They totally screwed up testing in January and February. They did not tell us that they had failed to resupply masks and other PPE 10 years ago after the last major flu epidemic. We did not have to shut down the economy to flatten the curve. The million plus health care workers not working show how dangerous the decision has been.

When a society seems to consider that liquor, MJ, and lottery tix are essential. But church is not essential, our priorities seem way out of wack.