I know it has become fashionable to blame WHO for virtually the entire pandemic as we seem to have a problem examining our own behavior, and now our royal aspirant (“I have total authority”) president wants to cut off all their funding. Apart from that tactic being totally counter-productive, a look at WHO’s history shows their importance to world health.
Given the ease of travel and communication throughout the world any approach to a potential pandemic requires an international approach. We must have a seat at that table. If that means paying dues, then so be it, but the tactic of taking the ball and running home with it if we don’t get our way is childish and ultimately injurious to ourselves.
Let’s look at WHO’s accomplishments and then the timeline of their response to CORVID-19. Their mission goes beyond the mere treatment of physical illness, its stated objective being “the attainment of the highest possible level of health for all people in the world” with health defined as “a state of complete physical, mental and social well-being.” To that end, they eradicated smallpox (by 1977 accomplishing in 20 years what had been attempted for centuries), and have come close to eliminating leprosy and polio, scourges all that killed millions upon millions of people world-wide.
So who does have responsibility for ultimately deciding how to attack a pandemic in this country? Not WHO, surely. The president has at his disposal hundreds of experts and agencies that can be marshaled to deliver quality information. Yet the president’s attack on WHO seems to imply that he looks to them for direction and action. Now WHO was very slow at declaring this a pandemic. Did they make a mistake by taking China at its word? Absolutely. But so did Trump. See his statement on Jan. 24th. This and later comments all echoed what WHO was saying. Yet the U.S. has far more resources and intelligence agencies who were telling the president something else. “Intelligence agencies “have been warning on this since January,” a U.S. official who had access to reports given to Congress and Trump officials told the [Washington] Post. ...“Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it,” the official said. “The system was blinking red.”
So let’s see what was said and when:
2018 John Bolton and the administration reduce funding for the CDC and merge the agencies whose job it was to look for and manage disease outbreaks. “Rear Adm. Timothy Ziemer abruptly departed from his post leading the global health security team on the National Security Council in May 2018 amid a reorganization of the council by then-National Security Advisor John Bolton, and Ziemer’s team was disbanded. Tom Bossert, whom the Washington Post reported “had called for a comprehensive biodefense strategy against pandemics and biological attacks,” had been fired one month prior.” (Snopes. The response has been that Trump and Bolton were simply streamlining the organizations and no staff were reduced.) What is clear is that the administration cut “funding for the CDC’s global disease outbreak prevention efforts had been reduced by 80%, including funding for the agency’s efforts in China.” Whether any of this would have changed the outcome is, of course, speculative. Much of the cuts were made up by other Congressional funding, so probably not.
Dec 19 WHO was informed of a cluster of cases of a new virus in Wuhan China
Jan 21 The president claims to have banned flights from China. This actually never happened as flights continued to arrive from China for weeks after. He did on Jan 31 restrict travel for “foreign nationals who had been in China in the last 14 days.” 430,000 people arrived from China after Jan 1 and 40,000 following the supposed shutdown. It was the airlines themselves beginning with British Airways who stopped flights from China beginning Jan 29. With that many people having come from China it was inevitable that the virus was on US shores in early January. (Washington Times and CRconservative review) Senators Cotton and Hawley had called for a shutdown earlier in January.
Jan. 22: “We have it totally under control. It’s one person coming in from China. We have it under control. It’s going to be just fine.” — Trump in a CNBC interview.
Jan. 23: “The World Health Organization on Thursday decided not to declare the Wuhan coronavirus outbreak a global emergency, despite the spread of the dangerous respiratory infection from China to at least five other countries.” (NYT)
Jan 24 China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi! (Trump tweet.)
Jan 28 According to HHS Secretary Azar, China rejected assistance offer from the CDC made Jan 6. Azar also said the US was a low risk and masks were not necessary. He also said China;s response to Corona was much better than its response to SARS in 2002-2003.(Fox)
Jan 28 CDC raised its travel advisories for China to level 3. (Fox)
Jan 28 WHO congratulates China for its rapid response and transparency. (Fox)
Jan. 30: “We think we have it very well under control. We have very little problem in this country at this moment — five — and those people are all recuperating successfully. But we’re working very closely with China and other countries, and we think it’s going to have a very good ending for us … that I can assure you.” — Trump in a speech in Michigan.
Feb 5 “ WHO said "We are not in a pandemic. We will try to extinguish the transmission in each of these (locations)," …. the agency has enforced sufficient containment measures already to prevent transmissions, however, she admitted the task was challenging due to global travelers.” (Medical Daily)
Feb. 7: “Nothing is easy, but [Chinese President Xi Jinping] … will be successful, especially as the weather starts to warm & the virus hopefully becomes weaker, and then gone.” (Trump tweet)
Feb. 10: “Now, the virus that we’re talking about having to do — you know, a lot of people think that goes away in April with the heat — as the heat comes in. Typically, that will go away in April. We’re in great shape though. We have 12 cases — 11 cases, and many of them are in good shape now.” — Trump at the White House.
Feb. 14: “There’s a theory that, in April, when it gets warm — historically, that has been able to kill the virus. So we don’t know yet; we’re not sure yet. But that’s around the corner.” — Trump in speaking to National Border Patrol Council members.
Feb 20 WHO reports the virus is not yet a pandemic
Feb. 23: “We have it very much under control in this country.” — Trump in speaking to reporters.
Feb. 24: “The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me!” — Trump in a tweet.
Feb. 24 the Trump administration requested $2.5 billion to address the coronavirus outbreak.
Feb. 26: “So we’re at the low level. As they get better, we take them off the list, so that we’re going to be pretty soon at only five people. And we could be at just one or two people over the next short period of time. So we’ve had very good luck.” — Trump at a White House briefing.
Feb. 26: “And again, when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.” — Trump at a press conference. Note that as of this morning (April 15) over 26,000 Americans have died from the virus.
Feb. 26: “I think every aspect of our society should be prepared. I don’t think it’s going to come to that, especially with the fact that we’re going down, not up. We’re going very substantially down, not up.” — Trump at a press conference, when asked if “U.S. schools should be preparing for a coronavirus spreading.”
Feb. 27: “It’s going to disappear. One day — it’s like a miracle — it will disappear.” — Trump at a White House meeting with African American leaders.
Feb. 27: “Only a very small number in U.S., & China numbers look to be going down. All countries working well together!”
Feb. 29: “And I’ve gotten to know these professionals. They’re incredible. And everything is under control. I mean, they’re very, very cool. They’ve done it, and they’ve done it well. Everything is really under control.” — Trump in a speech at the CPAC conference outside Washington, D.C.
March 4: “[W]e have a very small number of people in this country [infected]. We have a big country. The biggest impact we had was when we took the 40-plus people [from a cruise ship]. … We brought them back. We immediately quarantined them. But you add that to the numbers. But if you don’t add that to the numbers, we’re talking about very small numbers in the United States.” — Trump at a White House meeting with airline CEOs.
March 4: “Well, I think the 3.4% is really a false number.” — Trump in an interview on Fox News, referring to the percentage of diagnosed COVID-19 patients worldwide who had died, as reported by the World Health Organization. (See our item “Trump and the Coronavirus Death Rate.”)
March 6 WHO sends rapid response teams to Italy.
March 6: “I think we're doing a really good job in this country at keeping it down... a tremendous job at keeping it down.”
March 6: “Anybody right now, and yesterday, anybody that needs a test gets a test. And the tests are beautiful. They are perfect just like the letter was perfect. The transcription was perfect. Right? This was not as perfect as that but pretty good.”
March 6: "I like this stuff. | really get it. People are surprised that | understand it. Every one of these doctors said, ‘How do you know so much about this?’ Maybe | have a natural ability. Maybe | should have done that instead of running for president.”
March 7: “No, I’m not concerned at all. No, we’ve done a great job with it.” — Trump, when asked by reporters if he was concerned about the arrival of the coronavirus in the Washington, D.C., area.
March 9: “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!” — Trump in a tweet.
March 10: “And we’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away.” — Trump after meeting with Republican senators.
March 11 WHO declares it’s a pandemic. ““We’re deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction,” the WHO’s chief said.” (CNBC)
March 13: National Emergency Declaration
March 17 “This is a pandemic,” President Donald Trump said at a March 17 press conference. “I felt it was a pandemic long before it was called a pandemic.” ( WP Fact checker)
March 22. Italy’s death toll was reaching vast heights, yet flights from Rome continued to arrive at JFK International Airport.
Clearly, by attacking WHO, an organization with zero power to force any country to do anything, wannabe King (“I have authority to do anything, total authority”) Trump has embarked on a campaign to convince people that his lack of reaction to the virus was all the fault of WHO. The evidence suggests otherwise.
Wednesday, April 15, 2020
Sunday, April 12, 2020
Summary of Social Distance Reports
Intro
We are now several months into the Corona Virus pandemic, a point where fingers are pointing every which way, but there seems to be a light at the end of the tunnel. That it may be on oncoming train doesn't seem to be considered by those in power who lack a plan on how to deal with getting us back to normal, other than to say, it will all be good, everything will be back to normal. Do they have a plan? If so, it's not immediately apparent. One person in the know suggested that assorted plans were being considered; problem is that they all have appalling outcomes.
I listen regularly to a Vox podcast called "The Weeds" that discusses assorted items related to culture and the most recent was devoted to plans developed by several think tanks, the American Enterprise Institute, a conservative group; The American Progress Institute, a more liberal learning organization; and analysis of Paul Romer, Nobel prize winning economist and chief economist for the World Bank. (How Does It End?)
I decided to read the papers themselves and try to summarize what I found to be the salient points. I suspect, however, that given the structure of our republic and the fetish of individuality and independence that plague us, few of the recommendations will be even talked about, let alone accepted.
National coronavirus response: A road map to reopening AEI
Scott Gottlieb, MD served as the 23rd commissioner of the Food and Drug Administration (FDA) from 2017 until April 2019. He is presently a resident fellow at the conservative think tank the American Enterprise Institute (AEI). He's also on the board of Pfizer. He was best known for his vigorous attack on the opioid epidemic. He was widely praised and his resignation after only two years in the Trump administration was considered to have left a big hole. [https://www.vox.com/policy-and-politics/2019/3/5/18252139/scott-gottlieb-resigns-fda-opioid-epidemic] Just two months before he has adamantly insisted he was not leaving. He had come under fire from anti-tobacco groups for his stance on vaping and Americans for Tax Reform had argued his policies were inconsistent with the Trump administration's policies. Draw your own conclusions.
In order to move away from social distancing Gottlieb lists three requirements:
-Better data to identify the rate of exposure and immunity. That will require extensive testing.
-Improvements in public health infrastructure at the state and local level and to make sure we have adequate medical supplies
-Development of therapeutic and preventive treatments.
There are the obvious comments about harnessing technology and expanding investments in pharmaceuticals (he does work for Pfizer, after all, but it's logical -- whether those government supported efforts should become profit centers is another matter.)
They divide their plan into phases.
Lock-down is required of all but essential jobs although they make no attempt to define what is essential, a category that reportedly has been widely abused. That's the phase we are in early April. To reduce the number of infections testing of everyone with symptoms and their close contacts will be necessary. Provide support for the current health system. Only then can we move on to Phase II.
Phase II is state-by-state reopening but physical distancing and limitations on group gatherings needs to continue. Older adults will especially need to limit their community time. Deep cleaning of physical spaces. Those ill still need to self-quarantine. They make no effort to define the criteria as to just when a state or county can move to this phase other than to have multiple places where "confirmed cases cannot be traced back to other known cases", i.e. there is no evidence of community spread. My worry will be that the standards will be too loose to be effective. A return to physical distancing would be required if counts begin to double every three or five days or the health system begins to be overwhelmed (seems a bit late in my view.) Note that both Phases 1 and 2 require an enormous amount of testing. One estimate in another report said 7% of the population each day. That means about 24 million tests per day. Their report says that at least 750,000 tests per week would be adequate IF paired with contact tracing. The report also defines what a lockdown should consist of. It's pretty close to what we have here in Illinois. Ensuring an adequate health system capability they define as doubling current capacity to 5-7 ICU beds per 10,000 adults ,and having 5-7 ventilators per 10,000 adults at a minimum.
Physical distancing restrictions can be lifted only when tools are available to mitigate the risk including surveillance (undefined) and therapeutics or an effective vaccine is available. Gottlieb has been quoted as noting that we have never been able to create a vaccine against any coronavirus so assuming we can it may take as long as two years.
Rebuild readiness for the next pandemic
The report details an extensive new system for contact tracing and quarantine enforced by GPS tracking on cell phone apps. Masks should be worn by the public as recommended by WHO but PPE equipment needs to be reserved for health care providers.
A National and State Plan To End the Coronavirus Crisis by Zeke Emmanuel
The piece from the Center for American Progress looks to South Korea as a model for the way to approach the virus, emphasizing the importance of staying at home so much as to recommend a national policy of stay-at-home for 45 days beginning April 5th. Their point is that you can't have economic health without public health. Studies of the 1918 flu showed that cities who intervened earlier and were more aggressive had faster economic growth after the pandemic.
Testing also plays a key role in their plan requiring a test of everyone with a fever and every member of their household has access to a test along with instantaneous contact tracing and isolation of those who had come into contact with positive individuals. They would also place restrictions on mass transit and restrict public gatherings. They emphasize the importance of a national plan for social distancing; individual states should not be allowed to go their own way. The risk to other states is too great. They cite a Unacast study from GPS data showing only a 40-55 percent reduction in average movements of people. (Nowhere do they suggest how such a policy might be enforced; indeed, that's a flaw in all the plans mentioned in this piece.) As in Italy, the U.S. reacted too slowly initially ignoring areas that appeared to no have many cases mistakenly believing they had no exposure. It's imperative to break community transmission which can only be done with vigorous enforcement of social distancing.
The plan suggests that testing is key and needs to be ramped up to about 2.25 million tests during that 45 day window. We are woefully behind South Korea in the level of testing. That needs to be coupled with serological tests that are relatively inexpensive and provide rapid information on the spread of an epidemic to authorities by measuring antibodies present in an individual's system. A worrisome factor is whether individuals can be reinfected. "In theory, serological tests could also prove individuals’ immunity, clearing people to go back to work. The science of whether COVID-19 infection confers full or partial immunity, and for how long, is still unknown. The level of antibodies necessary to prove immunity is also unknown. A number of patients in China and Japan recovered from COVID-19 but were reinfected and became sick again." Current tests cannot always differentiate between normal corona-viruses and COVID-19 but there are hopes to make the test more sensitive to the differences.
This report also promotes the use of instantaneous contact tracing and isolation. Unfortunately as many as half of the transmission of COVOD-19 occur from asymptomatic individuals which makes manual contact tracing very difficult. Technological means using apps and GPS could help break the transmission but would require an enormous sacrifice of privacy and government intrusion unless anonymity could be assured. In my mind that's doubtful. Assurances that the data would be deleted after 45 days and held only by a non-governmental non-profit agency might help to allay those fears.
One of the more controversial proposals in the plan would require virtually shutting down travel On an average day before the virus 34 million people used public transport and 2.5 million people flew. Those mechanisms are virtually incubation tubes for the virus. They suggest special protective equipment for bus operators, TSA agents, required use of contact tracing apps by passengers, physical distancing in airports, (that will be fun in 3-across seating on an airplane) and routine sanitizing. All of this will, of course, require a great deal of funding. No mention is made of just where that is to come from.
The report emphasizes that N95 masks need to be reserved for health care workers but that homemade masks do provide a measure of protection and therefore should be used.
Mortality rates and mutation
Iris Fung, a friend of a cousin of mine, and clearly either a biology or chemistry major, wrote about the frequency of mutation rates of RNA viruses leading me to an article with this paragraph:
RNA viruses have high mutation rates—up to a million times higher than their hosts—and these high rates are correlated with enhanced virulence and evolvability, traits considered beneficial for viruses. However, their mutation rates are almost disastrously high, and a small increase in mutation rate can cause RNA viruses to go locally extinct. Researchers often assume that natural selection has optimized the mutation rate of RNA viruses, but new data shows that, in poliovirus, selection for faster replication is stronger and faster polymerases make more mistakes. The fabled mutation rates of RNA viruses appear to be partially a consequence of selection on another trait, not because such a high mutation rate is optimal in and of itself.
Whether this high mutation rate would make development of a vaccine much harder, I can't say.
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000003
Simulating Covid 19 by Paul Romer
Paul Romer was a joint recipient of the Nobel Prize in Economics and formerly Chief Economics of the World Bank. He has prepared some really interesting models that show the effects of testing on the course of an epidemic. The second paper modeling the difference between isolating at random or isolating based on test results is particularly enlightening. The graphic representation is often clearer than a written one.
https://paulromer.net/covid-sim-part1/
https://paulromer.net/covid-sim-part2/
https://paulromer.net/covid-sim-part3/
Summary
I have added links to all three reports and urge you to read them in their entirety. My summary is merely cursory and each deserves a more thorough reading.
Based on my reading of these reports, it's clear that we were, and remain, woefully unprepared for any resurgence of corona virus or any other pandemic. To reach that stage will require a massive shift in the allocation of resources as well as a huge cultural shift away from a focus on independence to a realization of how inter-dependent we truly are. Travel and sports industries may have to change the way they do business to avoid huge gatherings of people and that would probably include political events, possibly even in the way we vote. Telecommuting and work might have to become the norm rather than the exception and that may change the face of education as well as work.
We are now several months into the Corona Virus pandemic, a point where fingers are pointing every which way, but there seems to be a light at the end of the tunnel. That it may be on oncoming train doesn't seem to be considered by those in power who lack a plan on how to deal with getting us back to normal, other than to say, it will all be good, everything will be back to normal. Do they have a plan? If so, it's not immediately apparent. One person in the know suggested that assorted plans were being considered; problem is that they all have appalling outcomes.
I listen regularly to a Vox podcast called "The Weeds" that discusses assorted items related to culture and the most recent was devoted to plans developed by several think tanks, the American Enterprise Institute, a conservative group; The American Progress Institute, a more liberal learning organization; and analysis of Paul Romer, Nobel prize winning economist and chief economist for the World Bank. (How Does It End?)
I decided to read the papers themselves and try to summarize what I found to be the salient points. I suspect, however, that given the structure of our republic and the fetish of individuality and independence that plague us, few of the recommendations will be even talked about, let alone accepted.
National coronavirus response: A road map to reopening AEI
Scott Gottlieb, MD served as the 23rd commissioner of the Food and Drug Administration (FDA) from 2017 until April 2019. He is presently a resident fellow at the conservative think tank the American Enterprise Institute (AEI). He's also on the board of Pfizer. He was best known for his vigorous attack on the opioid epidemic. He was widely praised and his resignation after only two years in the Trump administration was considered to have left a big hole. [https://www.vox.com/policy-and-politics/2019/3/5/18252139/scott-gottlieb-resigns-fda-opioid-epidemic] Just two months before he has adamantly insisted he was not leaving. He had come under fire from anti-tobacco groups for his stance on vaping and Americans for Tax Reform had argued his policies were inconsistent with the Trump administration's policies. Draw your own conclusions.
In order to move away from social distancing Gottlieb lists three requirements:
-Better data to identify the rate of exposure and immunity. That will require extensive testing.
-Improvements in public health infrastructure at the state and local level and to make sure we have adequate medical supplies
-Development of therapeutic and preventive treatments.
There are the obvious comments about harnessing technology and expanding investments in pharmaceuticals (he does work for Pfizer, after all, but it's logical -- whether those government supported efforts should become profit centers is another matter.)
They divide their plan into phases.
Lock-down is required of all but essential jobs although they make no attempt to define what is essential, a category that reportedly has been widely abused. That's the phase we are in early April. To reduce the number of infections testing of everyone with symptoms and their close contacts will be necessary. Provide support for the current health system. Only then can we move on to Phase II.
Phase II is state-by-state reopening but physical distancing and limitations on group gatherings needs to continue. Older adults will especially need to limit their community time. Deep cleaning of physical spaces. Those ill still need to self-quarantine. They make no effort to define the criteria as to just when a state or county can move to this phase other than to have multiple places where "confirmed cases cannot be traced back to other known cases", i.e. there is no evidence of community spread. My worry will be that the standards will be too loose to be effective. A return to physical distancing would be required if counts begin to double every three or five days or the health system begins to be overwhelmed (seems a bit late in my view.) Note that both Phases 1 and 2 require an enormous amount of testing. One estimate in another report said 7% of the population each day. That means about 24 million tests per day. Their report says that at least 750,000 tests per week would be adequate IF paired with contact tracing. The report also defines what a lockdown should consist of. It's pretty close to what we have here in Illinois. Ensuring an adequate health system capability they define as doubling current capacity to 5-7 ICU beds per 10,000 adults ,and having 5-7 ventilators per 10,000 adults at a minimum.
Physical distancing restrictions can be lifted only when tools are available to mitigate the risk including surveillance (undefined) and therapeutics or an effective vaccine is available. Gottlieb has been quoted as noting that we have never been able to create a vaccine against any coronavirus so assuming we can it may take as long as two years.
Rebuild readiness for the next pandemic
The report details an extensive new system for contact tracing and quarantine enforced by GPS tracking on cell phone apps. Masks should be worn by the public as recommended by WHO but PPE equipment needs to be reserved for health care providers.
A National and State Plan To End the Coronavirus Crisis by Zeke Emmanuel
The piece from the Center for American Progress looks to South Korea as a model for the way to approach the virus, emphasizing the importance of staying at home so much as to recommend a national policy of stay-at-home for 45 days beginning April 5th. Their point is that you can't have economic health without public health. Studies of the 1918 flu showed that cities who intervened earlier and were more aggressive had faster economic growth after the pandemic.
Testing also plays a key role in their plan requiring a test of everyone with a fever and every member of their household has access to a test along with instantaneous contact tracing and isolation of those who had come into contact with positive individuals. They would also place restrictions on mass transit and restrict public gatherings. They emphasize the importance of a national plan for social distancing; individual states should not be allowed to go their own way. The risk to other states is too great. They cite a Unacast study from GPS data showing only a 40-55 percent reduction in average movements of people. (Nowhere do they suggest how such a policy might be enforced; indeed, that's a flaw in all the plans mentioned in this piece.) As in Italy, the U.S. reacted too slowly initially ignoring areas that appeared to no have many cases mistakenly believing they had no exposure. It's imperative to break community transmission which can only be done with vigorous enforcement of social distancing.
The plan suggests that testing is key and needs to be ramped up to about 2.25 million tests during that 45 day window. We are woefully behind South Korea in the level of testing. That needs to be coupled with serological tests that are relatively inexpensive and provide rapid information on the spread of an epidemic to authorities by measuring antibodies present in an individual's system. A worrisome factor is whether individuals can be reinfected. "In theory, serological tests could also prove individuals’ immunity, clearing people to go back to work. The science of whether COVID-19 infection confers full or partial immunity, and for how long, is still unknown. The level of antibodies necessary to prove immunity is also unknown. A number of patients in China and Japan recovered from COVID-19 but were reinfected and became sick again." Current tests cannot always differentiate between normal corona-viruses and COVID-19 but there are hopes to make the test more sensitive to the differences.
This report also promotes the use of instantaneous contact tracing and isolation. Unfortunately as many as half of the transmission of COVOD-19 occur from asymptomatic individuals which makes manual contact tracing very difficult. Technological means using apps and GPS could help break the transmission but would require an enormous sacrifice of privacy and government intrusion unless anonymity could be assured. In my mind that's doubtful. Assurances that the data would be deleted after 45 days and held only by a non-governmental non-profit agency might help to allay those fears.
One of the more controversial proposals in the plan would require virtually shutting down travel On an average day before the virus 34 million people used public transport and 2.5 million people flew. Those mechanisms are virtually incubation tubes for the virus. They suggest special protective equipment for bus operators, TSA agents, required use of contact tracing apps by passengers, physical distancing in airports, (that will be fun in 3-across seating on an airplane) and routine sanitizing. All of this will, of course, require a great deal of funding. No mention is made of just where that is to come from.
The report emphasizes that N95 masks need to be reserved for health care workers but that homemade masks do provide a measure of protection and therefore should be used.
Mortality rates and mutation
Iris Fung, a friend of a cousin of mine, and clearly either a biology or chemistry major, wrote about the frequency of mutation rates of RNA viruses leading me to an article with this paragraph:
RNA viruses have high mutation rates—up to a million times higher than their hosts—and these high rates are correlated with enhanced virulence and evolvability, traits considered beneficial for viruses. However, their mutation rates are almost disastrously high, and a small increase in mutation rate can cause RNA viruses to go locally extinct. Researchers often assume that natural selection has optimized the mutation rate of RNA viruses, but new data shows that, in poliovirus, selection for faster replication is stronger and faster polymerases make more mistakes. The fabled mutation rates of RNA viruses appear to be partially a consequence of selection on another trait, not because such a high mutation rate is optimal in and of itself.
Whether this high mutation rate would make development of a vaccine much harder, I can't say.
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000003
Simulating Covid 19 by Paul Romer
Paul Romer was a joint recipient of the Nobel Prize in Economics and formerly Chief Economics of the World Bank. He has prepared some really interesting models that show the effects of testing on the course of an epidemic. The second paper modeling the difference between isolating at random or isolating based on test results is particularly enlightening. The graphic representation is often clearer than a written one.
https://paulromer.net/covid-sim-part1/
https://paulromer.net/covid-sim-part2/
https://paulromer.net/covid-sim-part3/
Summary
I have added links to all three reports and urge you to read them in their entirety. My summary is merely cursory and each deserves a more thorough reading.
Based on my reading of these reports, it's clear that we were, and remain, woefully unprepared for any resurgence of corona virus or any other pandemic. To reach that stage will require a massive shift in the allocation of resources as well as a huge cultural shift away from a focus on independence to a realization of how inter-dependent we truly are. Travel and sports industries may have to change the way they do business to avoid huge gatherings of people and that would probably include political events, possibly even in the way we vote. Telecommuting and work might have to become the norm rather than the exception and that may change the face of education as well as work.
Saturday, April 11, 2020
Review: Nightfall Berlin by Jack Grimwood
At the end of the war, Berlin was a mess. Children wandered the streets, people were starving, and anything could be had for a cigarette. Add to the mix thousands of soldiers, all of them bored, and you have a recipe for depredation. "‘The ruins turned us all into rats … The self can be pretty vile if let off the leash.’ All those feral children. All that hunger and starvation. It must have been a feeding frenzy for someone like Blackburn. He wouldn’t have been alone either. Men like that recognized each other, hunted in packs, and protected each other. . . It was like stepping into hell. The problem is, some men like hell."
Some of those predators were officers and they turned a lodge into a true den of iniquity, some of them preying on children. But someone else was writing down the names of the worst, and many of those same men went on to high-level careers in government. Throw in those who want to sabotage the glasnost talks about reducing nuclear weapons and you have a rather incendiary mix.
Major Tom Fox is sent to Berlin to bring back a former defector. It was to be a simple mission. He has none of the above information, but soon it's apparent that someone wants the defector dead and Tom, too. But, most of all they want the memoirs the defector had been supposedly writing as he had the list of names. Fox is caught in a vice but has no idea who's turning the screws. When his children is kidnapped to coerce his cooperation, things get desperate.
This book will suck you into it as it races to the conclusion. I have already ordered Grimwood's other book. Superior spy novel.
Some of those predators were officers and they turned a lodge into a true den of iniquity, some of them preying on children. But someone else was writing down the names of the worst, and many of those same men went on to high-level careers in government. Throw in those who want to sabotage the glasnost talks about reducing nuclear weapons and you have a rather incendiary mix.
Major Tom Fox is sent to Berlin to bring back a former defector. It was to be a simple mission. He has none of the above information, but soon it's apparent that someone wants the defector dead and Tom, too. But, most of all they want the memoirs the defector had been supposedly writing as he had the list of names. Fox is caught in a vice but has no idea who's turning the screws. When his children is kidnapped to coerce his cooperation, things get desperate.
This book will suck you into it as it races to the conclusion. I have already ordered Grimwood's other book. Superior spy novel.
Wednesday, April 08, 2020
Review: Fallout by Garry Disher (Wyatt #6)
Good story, if a bit unusual. Raymond, Wyatt's nephew plays a significant role, and we are left hanging as to Wyatt's relationship with Liz Redding, who was involved with the jewelry heist. Raymond has been making a living (and losing most of it at the casino) by pulling off a series of bank heists. He's been reasonably clever at it, but he's also fallen under the spell of a couple of treasure hunters looking for investors to fund collecting gold from a sunken ship near a reef. Raymond falls for their line, tries to enlist his uncle, and things go downhill for him rapidly.
This is a good series and I have read them somewhat haphazardly, suffering no deleterious effects, so you probably don't have to worry too much about reading in order.
This is a good series and I have read them somewhat haphazardly, suffering no deleterious effects, so you probably don't have to worry too much about reading in order.
Thursday, April 02, 2020
Review: The Bomb: Presidents, Generals, and the Secret History of Nuclear War by Fred Kaplan
I read Kaplan's Dark Territory: The Secret History of Cyber War and discovered it to be a very lucid explanation of the technological challenges faced by the security departments around the world. So naturally, I was anxious to check out his most recent book, courtesy Net Galley, for which I am grateful.
It's an immensely enjoyable, if a bit scary, book about the political infighting and territoriality of the armed services and policy development of nuclear weapons. There was a lot of jockeying between the Navy, Army, and Air Force as to who would control "the bomb". and unfortunately much of that in-fighting controlled policy. Curtis LeMay, a brilliant leader in the organization and implementation of the bombing campaigns (read fire-bombing) in Europe and then Japan, as head of the Strategic Air Command was all in favor of a virtual first strike with everything as the SAC bombers were quite vulnerable. (His philosophy was simply to bomb everything.)
The Navy, meanwhile, was eager to get funds for the development of large numbers of ballistic missile equipped Polaris submarines, arguing that if the Russians never knew where you were the deterrent effect was far greater and more valuable. The Army, on the other hand, promoted the use of smaller tactical nukes on the battlefield suggesting that a nuclear counterattack to defend Europe against Russian aggression would lead to a Russian withdrawal and peace discussions. The casual manner in which civilian casualties (not to mention military) were discussed was a bit disheartening.
The man who replaced LeMay at SAC was Thomas Power. Even LeMay thought he was excessive: "There was a cruelty to Power’s zest for bombing cities. Even LeMay privately referred to his protégé as a “sadist.” When Bill Kaufmann briefed him on the Counterforce strategy at SAC headquarters, Power reacted with fury. “Why do you want us to restrain ourselves?” he screamed. “Why are you so concerned with saving their lives? The whole idea is to kill the bastards!” After a bit more of this tirade, Power said, “Look. At the end of the war, if there are two Americans and one Russian, we win!” Kaufmann snapped back, “You’d better make sure that they’re a man and a woman.” Power stormed out of the room. "
One surprising and note-worthy section was on how Cheney, of all people, was instrumental in reducing the huge number of weapons by half. All of the president's since have failed to reject the no-first-strike policy. Trump, himself, in his on-again, off-again relationship with North Korea didn't hesitate to wave the arsenal and threaten its use.
Kaplan describes the abyss that policy makers then and since have become trapped in. The mere idea of how many times cities (people) need to be nuked in order to assure our victory, even as we ourselves are annihilated, inevitably leads to comparisons with Alice in Wonderland.
That about sums up the insanity faced by all the presidents since Hiroshima. The importance of policy discussions and analysis worries me when I read that our current president disdains not just the briefing books, but the idea of analysis, preferring to rely on his "gut feeling" no doubt the most attuned gut in the history of the world. But then he's such a self-described "stable genius."
A good companion book to McNamara's memoir, "In Retrospect" and Ellsberg's "Secrets." Each is ostensibly more about Vietnam but each reveals much a bout how decisions are made in government. Other titles I will have to read are Kaplan's "Wizards of Armaggedon", Ellsberg's "The Doomsday Machine," and Bruce Kuklick's "Kennan to Kissinger" and I'm sure many others, but we only live so long.
It's an immensely enjoyable, if a bit scary, book about the political infighting and territoriality of the armed services and policy development of nuclear weapons. There was a lot of jockeying between the Navy, Army, and Air Force as to who would control "the bomb". and unfortunately much of that in-fighting controlled policy. Curtis LeMay, a brilliant leader in the organization and implementation of the bombing campaigns (read fire-bombing) in Europe and then Japan, as head of the Strategic Air Command was all in favor of a virtual first strike with everything as the SAC bombers were quite vulnerable. (His philosophy was simply to bomb everything.)
The Navy, meanwhile, was eager to get funds for the development of large numbers of ballistic missile equipped Polaris submarines, arguing that if the Russians never knew where you were the deterrent effect was far greater and more valuable. The Army, on the other hand, promoted the use of smaller tactical nukes on the battlefield suggesting that a nuclear counterattack to defend Europe against Russian aggression would lead to a Russian withdrawal and peace discussions. The casual manner in which civilian casualties (not to mention military) were discussed was a bit disheartening.
The man who replaced LeMay at SAC was Thomas Power. Even LeMay thought he was excessive: "There was a cruelty to Power’s zest for bombing cities. Even LeMay privately referred to his protégé as a “sadist.” When Bill Kaufmann briefed him on the Counterforce strategy at SAC headquarters, Power reacted with fury. “Why do you want us to restrain ourselves?” he screamed. “Why are you so concerned with saving their lives? The whole idea is to kill the bastards!” After a bit more of this tirade, Power said, “Look. At the end of the war, if there are two Americans and one Russian, we win!” Kaufmann snapped back, “You’d better make sure that they’re a man and a woman.” Power stormed out of the room. "
One surprising and note-worthy section was on how Cheney, of all people, was instrumental in reducing the huge number of weapons by half. All of the president's since have failed to reject the no-first-strike policy. Trump, himself, in his on-again, off-again relationship with North Korea didn't hesitate to wave the arsenal and threaten its use.
Kaplan describes the abyss that policy makers then and since have become trapped in. The mere idea of how many times cities (people) need to be nuked in order to assure our victory, even as we ourselves are annihilated, inevitably leads to comparisons with Alice in Wonderland.
That about sums up the insanity faced by all the presidents since Hiroshima. The importance of policy discussions and analysis worries me when I read that our current president disdains not just the briefing books, but the idea of analysis, preferring to rely on his "gut feeling" no doubt the most attuned gut in the history of the world. But then he's such a self-described "stable genius."
A good companion book to McNamara's memoir, "In Retrospect" and Ellsberg's "Secrets." Each is ostensibly more about Vietnam but each reveals much a bout how decisions are made in government. Other titles I will have to read are Kaplan's "Wizards of Armaggedon", Ellsberg's "The Doomsday Machine," and Bruce Kuklick's "Kennan to Kissinger" and I'm sure many others, but we only live so long.
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