Category: Health

Undocumented migrant population of U.S. jumps from 11 million to 19 million due to Coronavirus

by philg

For about 20 years, our official media tells us that there are 11 million undocumented residents of the U.S. But last week I was listening to NPR (temporarily bored by a lecture on 11th century Japanese history so tuned into the Channel of the Righteous as a last resort) and they casually used the number “19 million” in the context of how many people should get amnesty for violating U.S. immigration laws so that they would be encouraged to seek treatment for coronavirus and not kill all American natives. The 19 million number isn’t that different from the 22 million that Yale estimated in 2018, so it is not the number that is interesting but the radical jump from 11 million (when telling Americans not to believe Trump) to 19 million (when telling Americans about the risk of Trump policies designed to discourage the undocumented from getting on health care welfare).

Separately, as there is no treatment for coronavirus and hospitals at the time of the interview couldn’t order tests, it is unclear why anyone would want 19 million undocumented Americans to go to their nearest hospital.

(Is a constant number of undocumented plausible? To some extent, it might be. Most migrants arrive and have children in the U.S. Thus, 18 years later, the parents are entitled to a green card via chain migration (each legal immigrant will bring in an average of 3.45 additional migrants). On the other hand, with the recent migrant surge, the constant number over decades seems less plausible.)

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Coronavirus is a national emergency, but let’s not do anything drastic

by philg

Email from the president of Harvard University:

I write to follow up on the message you received Wednesday from HUHS Executive Director Giang Nguyen regarding two members of our community who have been tested for Coronavirus Disease 2019 (COVID-19). One individual received a presumptive positive test and is receiving medical care off campus. We await test results for the second individual. Additionally, a third individual who had close contact with the person who tested positive, is now being tested.

Ensuring the anonymity of these individuals is paramount. If you are aware of their identities, please respect their privacy so that they can focus completely on their health. The last thing they need—or any of us would want for them—is public attention and scrutiny.

So… it is an emergency, but preventing millions of deaths is not as important as keeping the names of the infected anonymous? If we’re in an actual emergency and lives are at stake, wouldn’t it make more sense to abandon the standard procedures and publish the names of the infected so that people who were with them can self-quarantine? Or, if anonymity is actually more important than stopping the spread of coronavirus, should we choose some description softer than “emergency”?

[Follow-up from March 15, after the governor of Massachusetts had declare a State of Emergency, ordered all restaurants and schools closed, etc.: “I write to follow-up on President Bacow’s recent message to the community. While we wait for additional test results, I continue to emphasize that the anonymity of these individuals is paramount. If you know their identities, please respect their privacy so they and their loved ones can focus completely on their health.”]

Similarly, on Friday, March 13, the Boston Public Schools decided to close for six weeks… but not start the closure until the following Tuesday (today, March 17). If the problem is serious enough to require a six-week closure, why open the schools on a single Monday after everyone has had a chance to pick up the virus somewhere over the weekend (if anyone needed to come the school to retrieve an item, that could have been done over a period of days, without gathering everyone together in close quarters for 6+ hours).

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Will the human race be more susceptible to obsessive compulsive disorder going forward?

by philg

What do you call someone who washes his hands 30 times a day? “OCD,” right? As the coronaplague spreads, what do you call someone who washes his hands 30 times a day? “Alive”?

If it turns out that OCD is protective against coronavirus and the virus mutates such that it can kill a significant number of reasonably young people (i.e., not well past their child-producing years), could it be that OCD will become a significantly more common human characteristic?

Even without coronavirus, if the world population expands to 11 billion or more and the trend toward urbanization continues, will the dense living conditions favor those with OCD habits? There are plenty of existing diseases that are transmitted from person to person and that can be stopped with OCD-style hand washing, wearing of obsessively-fitted face masks, etc.

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More from the British on coronavirus

by philg

From three days ago: “If the British are right, everything the U.S. is doing about coronavirus is wrong”. If you’re not like my friends on Facebook who get all of their scientific, technical, and medical information from Donald Trump (and then complain that it isn’t accurate), you might be interested in “Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand” from Imperial College. It seems that the UK government policy is to some extent derived from this research.

It is tough to summarize, but the authors say that both “mitigation” and “suppression” are required. Mitigation is the “flatten the curve” idea that we’ve seen. Suppression is Asian-style crush: “the aim is to reduce the reproduction number (the average number of secondary cases each case generates), R, to below 1 and hence to reduce case numbers to low levels or (as for SARS or Ebola) eliminate human-to-human transmission.”

The optimum strategy seems to be to turn suppression on and off depending on how many ICU beds are occupied. The authors expect this fight to last roughly two years. If everything is done perfectly and the baseline transmission (R0, an assumption) is 2.4, deaths in the U.K. will be cut from a baseline of 510,000 (do nothing but sweep up bodies) to around 30,000. The authors are expecting social distancing policies to be in place for about 2/3rds of the time.

Some unwelcome news for a country that takes 100 years to build a subway line and maybe 1,000 years to build high-speed rail:

Perhaps our most significant conclusion is that mitigation [as opposed to mitigation plus suppression] is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

So a country like China that can throw together and deliver emergency hospitals may be able to get away with comparatively lightweight social distancing measures. But for countries that are mostly paralyzed with red tape and therefore that have to “go to war with the hospitals they have”:

We therefore conclude that epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.

Sobering. The only thing that would potentially save us from these shutdowns is a vaccine, say the authors. But other sources are saying that a vaccine probably won’t work, right? The virus evolves so fast that last month’s vaccine won’t help with next month’s infection.

Even more sobering…

we emphasise that [it] is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time. How populations and societies will respond remains unclear.

Related:

  • The hospital that the Chinese built in 10 days is 645,000 square feet (Business Insider). How big is that? The Blue Origin rocket factory at Cape Canaveral is 750,000 square feet (Florida Today). (anecdote: A program manager at Blue Origin told our aviation group about making a bet with the general who runs the nearby U.S. Air Force base. A base guard shack had been wiped out by a hurricane. Blue Origin was beginning work on their factory as the Air Force was planning the new guard shack. The Blue Origin guy said he’d get his rocket factory built before the Air Force guy had his new guard shack. 18 months later… the Air Force won, but only by a couple of weeks.)
  • “Flattening the Coronavirus Curve Is Not Enough” (MIT Press), by a University of Toronto professor, who says that we need surge capacity like the Chinese that our military and government will deliver it (after all, we mostly won the Afghanistan and Iraq wars in slightly less than 20 years while spending less than $1 trillion per year on our military, right?): “Building out that capacity requires a new mindset and it requires it quickly. The great news is that we — and by we I mean the generation who were adults in World War II — have done this before. Entire economies were shifted over to military production. This was done by abandoning market processes of resource allocation and moving to a planned economy.”
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How to get your money back on a non-refundable hotel

by philg

From a friend, a few days ago:

We were supposed to be in Vienna today for a short vacation, but the city is at high risk and we would have had to be quarantined on the way back.

The hotel refused to refund the payment. I called and asked to extend from 3 nights to 10 nights. When they asked the reason, I replied that I just got back from Italy and am looking for a place to stay until the 14-day quarantine period is over. “I want to stay in one place and not move around,” I told them.

They canceled my reservation immediately.

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Why are climate change alarmists also coronavirus alarmists?

by philg

My Facebook friends who previously posted mournful and/or urgent messages regarding climate change are now posting messages about the calamity of coronavirus (also how it would hardly bother us at all if Obama were still the Great Father in Washington).

One inveterate climate change alarmist posted on Facebook, for example, “We need trillions of dollars to radically change the economics of health care and work in the US in an instant.” (because spending 20 percent of GDP on health care is not enough?)

The 14th century Black Death resulted in significant cooling due to farmland reverting to forest (Wikipedia). Presumably even the most alarmed coronavirus alarmists aren’t expecting a reduction in human population along the same lines as the Black Death, but for folks whose #1 priority is arresting global warming, why is any epidemic fatal disease a cause for constant alarm?

I can understand being a climate change alarmist. I can understand being a coronavirus alarmist. I can’t understand how someone can be simultaneously alarmed about both phenomena.

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Inventor of email is a coronaskeptic

by philg

From “Dr. Shiva Ayyadurai, an MIT scientist and researcher” (also the inventor of email)… “MIT biologist says fear mongering on coronavirus will go down as biggest fraud to manipulate economies”:

Back in October 2009, the H1N1 killed 1,000 people in the United States, including almost 100 children before President Obama later declared national emergency for the virus. At the time, the media hysteria was not as high as it is today.

Separately, the video is a great marketing piece for why everyone should buy a DJI Osmo.

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Foolproof plan to stop the spread of coronavirus

by philg

President Trump can stop new cases of coronavirus from being diagnosed in the United States. All that it would take is a one-line Executive Order: “The U07.1, 2019-nCoV ICD-10 code is non-reimbursable by Medicare, Medicaid, and private insurance.”

Related:

  • “Impact of Policies on the Rise in Sepsis Incidence, 2000–2010” (Clin Infect Dis. 2016 Mar 15; 62(6): 695–703): “Marked rises in sepsis incidence have generated substantial concern and national campaigns to address sepsis. We show that a significant portion of this increase is temporally related to CMS policy changes that affected sepsis coding and reimbursement“
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If the British are right, everything the U.S. is doing about coronavirus is wrong

by philg

From my secret source in Ireland… “Coronavirus: What are the British up to?” (RTE):

The UK scientific and medical advisers do not expect the infection rate to peak for another three months.

They believe that it is too early to take drastic measures, and that if they are taken now, they will have to be held in place longer than most people expect, and because of that they would lose effectiveness just when they were most needed, because people would get bored and stop practising the hard disciplines of “social distancing”.

In a Channel 4 news special programme on the virus shown on Friday night, Professor John Edwards, of the London School of Hygiene and Tropical Medicine, who also advises the British government, said there are two ways to deal with this virus.

Either stamp it out by curing every person in the whole world who is infected, which we are no longer able to do, or managing the spread of the virus until herd immunity is reached. When challenged about a potentially large death toll, he said “there is no way out of this”.

What, he asked, happens when the lockdown is relaxed? The virus will come back and the risk of a sudden, overwhelming peak rises again.

In other words, the U.S. is due for a massive outbreak of coronavirus in the late spring or early summer.

If the U.S. had a universal taxpayer-funded government-run health care system like the NHS (but with welcome mats spelling out “No Human Being is Illegal” in 15 languages) and no Orange Menace in the White House, Americans would all go to the clinic, get tested like the South Koreans do, and this would purge our great nation of this virus (not to say “foreign virus”), right?

Right now, the British government believes that the biggest impact it can make in terms of slowing the spread of the disease is to request that anyone with a persistent cough or fever should self-isolate for seven days, which is the main infectious period, and not bother contacting a GP or even the phone helpline.

The technocrats in England don’t even want people to go to the doctor, much less fire up the PCR testing machines!

Separately, the article shows that microaggression against the Latinx is muy bien:

Boris Johnson, in his inimitable way, described the resulting chart (or curve, as economists like to say) as looking like a sombrero. And he said the aim of public policy is to “squash the sombrero”.

How is the course of an epidemic in any way like the profile of a sombrero? Isn’t it just up and then down? If Mr. Johnson wants a profile with some action on the brim, why not an English bowler hat? Why pick on our neighbors to the south whom our most righteous Hollywood stars celebrate even as they make plans to migrate to Canada rather than Mexico?

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With unlimited paid sick leave for coronavirus symptoms, why will anyone work?

by philg

Friends on Facebook are demanding that the Federal government (i.e., taxpayers) underwrite unlimited paid sick leave in order to stop the coronavirus plague.

This sounds reasonable. We don’t want an infected person coming into work at a restaurant and spreading the infection to 100 customers.

But, on the other hand, especially since our testing capabilities are so limited, wouldn’t this result in 100 percent of people with less-than-fun jobs disappearing from the workforce? Why take the risk of contact with hundreds of customers by working as a supermarket cashier when it is easy to say “I am experiencing some coronavirus symptoms and therefore, out of an abundance of caution, I am staying home to collect my Gov Sick Leave”? (Americans love nothing more than saying “out of an abundance of caution”!).

People who believe themselves to be suffering from a mild cause of COVID-19 aren’t supposed to go to the doctor or hospital, right? So the employer can’t ask for a doctor’s note.

If our policy dreams come true, will the result be a complete shutdown of the typical service business? Or, actually, almost every business. The only thing better than “work from home” is “play Xbox at home and get a 100 percent paycheck”!

Readers: Is there any possible way to design this so that people who do feel well (something no doctor can determine) will continue to work while ensuring that people who don’t feel well will stay home?

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