Month: May 2020

Let me first warn you, that even though this piece may be informative, the author is possibly probably Moronic, Idiotic, Demented! (i.e. M.I.D.!)

When the term M.I.D. is used, in today’s world we are speaking about Covid-19. I would surmise that only a few of you know what M.I.D. stands for or what it means in the real world.

M.I.D. stands for Minimal Infectious Dose, and it refers to the amount of virus needed to establish a Covid-19 infection. In practical everyday lingo it means that not every single exposure to the virus will result in an infection. In general, it is felt that one’s meaningful exposure is a product of the amount of virus one is exposed to, and the length of the exposure. That is why it is thought that those who work in grocery stores catch the virus . . . exposure to a small amount of the virus over the course of many hours attains that M.I.D. and the worker gets the virus infection. Whereas those of us who are shoppers in that same store are potentially exposed to the same amount of the virus “floating” around in the air, but we are in the store for perhaps 20 minutes, and thus do not attain the M.I.D., and thus do not come down with the clinical disease. The same logic applies as to why meatpackers are coming down with the disease . . . prolonged exposure in a confined area to a certain amount of “floating” viral particles in that meatpacking plant. ( In addition these meatpacking plants are extremely noisy, and so that is a lot of shouting is necessary; shouting increases the virus that is expelled , and so more “floating” viral particles.) 

Likewise it has been demonstrated that a clusters of Covid are likely to occur in households . . . prolonged exposure to a small amount of “floating” viral particles will likely attain the M.I.D. Similarly a one second exposure to a passing walker or jogger is not likely to lead to a clinical infection, whether the jogger/ walker/ runner is wearing a mask or not.

Now that everyone understands what M.I.D. means, and it’s practical implications, that leads me to the real purpose of this piece. In general, the optimum situation for each individual adult would be to get Covid, and it’s subsequent antibodies, but be asymptomatic or minimally symptomatic and at the same time not expose those at higher risk to our disease. 

One of the big mysteries with this Wuhan virus is “why are there many infected individuals who are asymptomatic or minimally symptomatic?” (Estimates run as high as 25-30%.) Could it be that these individuals obviously were exposed (they had to catch it from somebody or somewhere), but perhaps were not exposed to the M.I.D.? Could it be that these sub-M.I.D. exposed individuals might be a clue as to how to prevent the spread of this viral disease? Now granted at this moment in time, no one seems to know what the M.I.D. is for Covid-19, or furthermore how to measure the M.I.D. in certain situations. 

But let’s fantasize for a second . . . what if church services would provide an environment with X number of “floating” particles, but only for a relatively short period of time – let’s say one hour. If the M.I.D. is not achieved, would we, could we, get some asymptomatic or minimally symptomatic people as a result? In the long run would this be good or bad? . . . keeping in mind that asymptomatic individuals can still spread the disease. Perhaps after a church gathering, those in attendance should quarantine themselves for two weeks? This quarantining, however, would only be of value if at least one person attending that church service were positive for Covid. If no one at the church service were positive, then there would be a lot of useless quarantining!

And what about “let’s get Covid” parties where a group of people would purposely get exposed to a minimally symptomatic, but Covid positive individual. Here, as opposed to a church service, everyone attending this party would know for sure that he/she had been exposed before self-quarantining for two weeks.

Again, like I said before . . . M.I.D. = Moronic, Idiotic, Demented!

I just finished reading a very informative and enlightening revue of Covid in China outside the Hubei province where Wuhan is located. To emphasize, this was not about the initial infections, etc. in Wuhan, but was rather about the spread into other cities and provinces in China (in 320 municipalities in China). This spread to different parts of China was undoubtedly exacerbated by Chinese New Year (CNY), which in mainland China encompassed 1/24 – 1/30, and the extensive travel associated with CNY. 

The purpose of this study was to demonstrate when and how this virus is transmitted. Since I cannot pronounce nor will I attempt to spell the names of these municipalities, most of this info will be in generalities, not related to specific municipalities.

First, some definitions:

A cluster is 3 or more cases linked to some infection venue (e.g. apartment, train, school, plane, car) during a sufficiently close period of time.

An outbreak is a cluster with a common index point. These common index points were divided into six categories (e.g. homes, transport, restaurants, entertainment, shopping, and miscellaneous). [bear with me, as I needed to demonstrate how detailed this study was!]

This paper involved 318 outbreaks and 1245 infections. Of these 318 outbreaks, 129 involved family members, 133 family relatives, and only 53 involved other contacts, both social and non-social. In other words over 80% involved relatives and family members. (Most likely the family relatives were involved in some kind of CNY festivities.)

Of the 318 outbreaks 253 involved apartments with an average of 3.4 people involved in each of the 253. Most  families in China have only one child, and the parents often live with them. This implies that again about 80% involved a single apartment with an average of 3.4 people living within the apartment. Only 108 of the 318 outbreaks involved the category of “transportation,” (which included train, private car, bus, plane, taxi, cruise ship) and these involved an average of 3.8 each. The remainder of the cases were related to restaurants, entertainment, shopping, and miscellaneous.

The common denominator in these top two categories seemed to be confinement in a relatively small space. In addition, the most remarkable thing about this comprehensive study is that all outbreaks occurred in indoor environments. 

This article did not draw any conclusions except those relating to outdoors and indoors. I hope that governors who had banned just about all activities in outdoor places, (e.g. parks, and are still banning most beach activities) will be cognizant that being outdoors is much safer.

Also the likelihood of transmission by contaminated surfaces although still possible, as people in the same apartment or on the same train or bus all touch similar things, is deemed an infrequent cause of spread.

In 6 months, or 12 months, or 18 months, when what I am about to describe happens, I want you to remember where you heard it first … right here!

I am talking about what is going to happen when we have a Covid-19 vaccine. My question is who is going to be given priority to get vaccinated first? Who will demand that they go to the top of the list. Who is going to make that decision? When is that decision going to be made. Now here I am not only talking about in the U.S.A., but also in the world.

First, before we get into the nitty-gritty, let’s assume that an effective vaccine is made, and let’s assume that it has minimal significant side-effects. Let’s also hope that multiple effective vaccines are made by multiple companies. The population of the world in 2019 is over 7.5 billion (7,577,130,400), while the population of Europe is over 513 million (513,500,000). Furthermore the population of the U.S.A. in 2019 was over 328,500,000 (328.5 million).

Let’s assume that a single drug company (company A) is able to produce one million doses a day. Which country should get those million doses? A second drug company (company B) is also able to produce one million doses a day. If we (whoever “we” is) allocates the one million doses a day from company B to Europe, it would take about 513 days to vaccinate all of Europe. Russia has about 143 million people, and this is peanuts compared to Africa and China, each of which has over one billion people.

Furthermore, let’s assume that 10 million vaccine doses per day can somehow be made. That means that it would about two years to vaccinate everybody in the world.

Are you beginning to see the problem. How is this vaccine going to be allocated and by whom? Should it be given to the poorer countries first because they are less well equipped as far as medical care is concerned? In Europe should it be given to Italy and Spain first, because these countries have suffered the most?

I guess we should just let Europe decide on its own.(BTW: Would Great Britain still be considered as Europe after Brexit?) 

Next let’s discuss the vaccine in the U.S.A where everyone is very open to discuss what is fair!!! For the sake of discussion, let’s give the U.S.A. two million doses a day, because the U.S.A. has financed many of the vaccine makers’s research. Again here in the U.S., who gets first dibs? There could potentially be a number of possible ways to prioritize who gets it first . . . after those in the medical profession and the first responders, should it be the oldest, or the youngest? Cuomo will argue that New York should get it first as they were the hardest hit, whereas Newsom will argue for California because it has the highest population, etc. etc. Illegals? Red states first? Blue states first?

Are you beginning to see the problem?

So far the best suggestion that I have heard, is to have a National Lottery, perhaps similar to the draft lottery back in the sixties, which was based on birthdays. However I am still looking for a better answer, and I think a have one . . . perhaps because the virus is called Covid, those whose last names begin with C should get the vaccine first!

I usually like to avoid big words in my titles because I suspect that these types of words will lead to many not reading this at all. While I often will vaguely demean one political party, right up front, I want to say that I am not hinting that a certain demographic will not get the meaning of such words . . . err, actually, perhaps, I am!

Now that the implausible deniability factor has been addressed, I want to start with a great quote that I read this morning.

“Homogenous intervention in the face of heterogenous risk is just cruelty passed off as equality.”

Read that again slowly and think about it with regard to the coronavirus situation, and more precisely the one size fits all response that is occurring most everywhere. To me with regard to the present situation we’re in, this quote is brilliant!

Why are we treating everybody the same (homogenous intervention) when the risks for different age groups is vastly different (heterogenous risk)?  For instance, why are all age groups being treated the same when the risk is vastly different  depending on age? To make a point, let’s take the extreme  . . . why in this lockdown, are school children being treated the same as the older folk (homogenous intervention) when the risks for children and those in their seventies and eighties are DRAMATICALLY different (heterogenous risk)? 

Why are individuals of different incomes all being locked out of their jobs (homogenous intervention) when the effects are DRAMATICALLY different – those who earn more are much, much, much more likely to be able to work from home, whereas those who work in the service industry cannot (heterogenous risk). And in the guise of treating everybody equally (equality), aren’t those of lower socioeconomic status being treated cruelly (cruelty)?

A second part of the same homogenous/heterogenous quote goes like this:

“Just because no one’s risk is non-zero doesn’t mean everyone’s risk is the same.” Again brilliant! To keep children sequestered at home (MINIMAL risk) is nonsense as even though their risk is non-zero, it is NOT THE SAME as the general population!

Hmmm, I wonder if I could take credit for both of these brilliant quotes, as I doubt that the one who uttered both of them, Newman Nahas, reads my blog!

Just one word to describe the situation with California schools . . . Chaos!

With the lockdown winding down in California, someone needs to come out with a unified plan first on the when, then on the how, and finally the why (“we are doing it this way because . . . and then state the scientific reasons). 

Like I said, instead of this we have “chaos!” But although it may sound as if I am ragging specifically on California, there are two words to describe the situation with schools in general across the U.S. and Covid-19 . . . Innuendo Rules!

On 5/21/20 there was an editorial titled “The Evidence on Kids and Covid.” (If you do not get the WSJ, this single editorial is worth the price of a six month subscription.)

First the general summary from this editorial and then the specifics:

In general, the summary is the last line of this piece . . . “nobody wants to endanger children. But the risks to children are not not enough to justify the continuing destruction of the lockdowns.”

Some facts, from this WSJ editorial:

• “The CDC reported last week that 15 children under the age of 15 in the U.S. have died of Covid-19 since February compared to about 200 who have died of the flu and pneumonia. Children represent 0.02% of virus fatalities in the U.S., and very few have been hospitalized.”
• During the last three weeks of March, 2020 only 48 children in the U.S. were admitted to 14 Pediatric I.C.U.s, and 83% had an underlying condition. (The I.C.U. mortality rates for children is only 5% compared to 50-62% for adults admitted to I.C.U. with Covid.)
• A study from Spain found that younger children appear to be at lower risk of infection based on population antibody studies . . . only 3% between ages 5-9, 3.9% between ages 10-19, compared to a prevalence of 6% in those above 60 years. Why younger children appear to get this virus less, no one knows.

     -Unlike other respiratory viruses, children do not appear to be large  spreaders. A study from Australia studied “Covid-19 cases for six weeks at 25 schools. At the onset 18 individuals were infected. After 6 weeks only two of their 863 close contacts at the school had become infected.”
And most importantly . . . there were NO cases of the students passing the virus to teachers!

     -Children are >120 times more likely to die in accidents than from Covid-19.

So why are parents and those who are in charge of sending children back to school so hesitant to act?

Three things:

Mainstream media

Innuendo

Lack of the facts

If I were asked by Governor Newsom what should be done about schools (and I won’t be, even though I have nine grandchildren under sixteen), I would recommend the following:

Initially, probably for the first year, the parents would have the choice of whether to send their children back to schools or not. If they delay at first for whatever reason, that would be okay, but when a child were to finally start back, he/she would start at whatever grade level he/she was in as of 3/1/20.

Start all el-hi California students back to school on Monday, June 15th at the same grade level with the same teacher as before the lockdown. No spacing, no masks,no gloves, no change in class sizes or starting schedules. The hope would be that some herd immunity would be gotten at minimal cost in this very, very low risk group.

Continue at same grade level till August 14th, then break till Labor Day.

Start back after Labor Day at the next grade level with a new teacher. Go through Thanksgiving, and restart after the first of the year.

If any of you have an in with Gov. Newsom, please tell him that he can call me any time.

Let me present a dilemma. 

What would you do in the following situation?

Let’s assume that your mother is eighty and is residing in a nursing home. You suspect that within the week Covid-19 patients are going to be transferred from a nearby hospital to your mother’s nursing home. Would you try to get her out of that nursing home, and move her to your home or to a hotel?

I would assume that most of you would answer “yes” as this is only a temporary solution, and not a forever solution.

To make the dilemma a bit more difficult, let’s assume that your good friend was the Director of Health for that region, and she had said to you, “This is confidential. Do not tell anyone, but that nursing home that your mom is in right now is going to be receiving some Covid-19 patients from the hospital in a few days. Remember, this is all hush-hush.” 

Would you move your mother to a safer location?

Again, even though this is similar to “inside trading,” which is illegal, I am going to surmise that most of you would move her, because if she catches the coronavirus at age eighty while in the nursing home, there is a significant likelihood that she will die.

Let’s make the decision even tougher. Let’s assume that you are the Director of Health for the area, and because of your position you have learned that the Governor is going to order that Covid-19 patients be transferred into your mother’s nursing home in a day or so. This time you did not hear this from any friend, but rather you have direct inside info, and it was expected that you would not tell anybody about the upcoming transfers. 

Would you move you mother? A much tougher decision. Move her and even though you have not told anyone else, you have, in essence, betrayed the confidence of the person that told you.

Again I am going to guess that most of you would, after some serious consternation, move her.

Finally, let’s assume that you are the Director of Health, and you are the one making the decision to move the Covid-19 patients out of the hospital and into your mother’s nursing home. This decision to move them is yours . . . and only yours. Would you move her? In other words, are you doing a similar thing to inside trading? Would you buy that stock solely because you had the inside info? Would you move your mother?

I think that the decision would be extremely tough!  

Move her, and you will likely lose your position as the Director of Health.

Do not move her, and she may well get infected with Covid-19 and die!

I am interested in what your decision would be.

After you have thought this over and made your decision, I want you to know this actually happened in Pennsylvania where Ms. Levin moved her mother out of her nursing home into a hotel the day before the coronavirus patients were transferred in from the hospital, and for sure she knew these transfers were about to happen.

Was she morally right or wrong?

As of this moment, she has not been forced to resign, but I expect that she will be forced to resign in the next few days.

 Masks – what are they good for? 

Before you all chant about the benefits of masks in preventing the spread of the coronavirus, yes, I have seen the slow motion videos of the spray generated from a single sneeze. It is actually an amazing video, and with color enhancement, no less. Certainly a mask would protect an innocent bystander from this sort of sneeze-spray . . . if the mask is worn properly or worn at all. Usually when a sneeze comes, it comes FAST, and so the mask is of little help if not properly positioned.

The other day on the front page of the paper there were four pictures of four different people. #1 = no mask. #2 = mask tied around the neck, but being worn totally under the chin. #3 = mask being worn over mouth, but not over the nose. #4 = mask being worn properly over both nose and mouth. In general, how many #4s do you see?

Yesterday, I saw a sign that said: “Protect yourself, wear a mask.” Apparently the person who made that sign had never been in an operating room, where the surgeons wear masks . . . not to protect themselves, but to protect the patient. In keeping with the true purpose of a mask, only those with Covid-19 should be wearing masks, to protect not themselves, but to protect others.

I think the latest is for everyone to be wearing a mask when outside. Over the weekend I went to the my local park twice, to walk. (Yes, they have finally opened up the park so that the healthy children and adults can walk, bike, or play soccer . . . but the play-structures for the little tykes are still verboten. . . . “Stay off that slide, mister, or else!” & “Don’t you dare go near those swings, missie!”) Anyway, among the hundred or so people I observed in that park over a two day period, maybe three were wearing masks, and one was me! Yes, I have always been a rule follower even when those making the rules are OTL! . . . Well perhaps, not always.

Today for some exercise, my wife and I went to beach to walk. Yes, they have finally opened up the beach, so that healthy children and adults can go near the water. (However, don’t you dare put down a towel or a chair to sit on . . . “Get up off your arse, buddy, or I’ll write you up!”) Interestingly, very very few had a mask in sight on the beach . . . I guess there is no need to “protect yourself” in that part of the city. The one person that I saw two different times wearing a mask properly was a homeless guy, but in full compliance with the rules, actually wearing his mask properly!. . . Of note, he did not even attempt to sit down, possibly because he could not take a chance of getting a citation.

But do not get me wrong, I am all for the wearing of masks in certain places, for example, like in the grocery store. It would not be good form to have someone sneezing all over the canned peas or the gallons of milk. However, for the remainder of day-to-day activities, all the masks really do for sure . . .  is fog up my glasses!

Certainly there have been and will continue to be mistakes made in the management of this Wuhan virus epidemic here in the U.S., mostly because there is no past experiences to guide anybody. The models upon which many of the decisions have been made have been more wrong than right, and often these decisions seem to be rather arbitrary.(“don’t wear masks . . . oops . . .”everybody should be wearing a mask” . . . Huh?) Instead of arbitrary decisions becoming less frequent, they are seemingly continuing, all the while, seemingly without much factual basis. For example, in Wisconsin, the entire state is in lockdown despite the fact that some counties have just one or even zero cases of Covid-19! Huh? Absurd!

To me one of the biggest examples of arbitrary “economic pin-the-tail-on-the-donkey” is that of “essential” vs. “non-essential.” Who decided that elective surgery should be non-essential, while marijuana and alcohol were deemed essential? 

Huh? . . . Nonsense! 

Some of my friends, neighbors, and family have had their jobs deemed “essential” – whether they are actually essential or not, I don’t care. However, I do care that someone who probably knows little about . . . pick something . . . let’s say hairdressers, somehow decides they are non-essential. Huh! . . . Absurd.

I have been intrigued here lately by Elon Musk. Yes, that same Elon Musk, who is the Tesla guy. He has had enough of these arbitrary decisions made by ?? “officials.” Somebody in the Alameda County chain of command decided that he could not re-open his Tesla factory. I searched for, but could not come up with the person who was responsible for this somewhat arbitrary decision. What makes Musk’s decision to defy Alameda’s power play and reopen his factory is the potential economic impact for California. For you see, Elon is pissed, and has threatened to move his Tesla factories and their 10,000 jobs out of state, and more specifically to a state income tax free state, like Texas or Nevada.

Oops, suddenly this is a lot different than a hair salon owner opening her shop in defiance of arbitrary lockdown orders in Texas. This is not a single hair salon and a few jobs, but rather 10,000 jobs!! The lost tax revenue from the loss of 10,000 jobs is no small bag of potatoes! 

Will we soon be hearing, “Perhaps, your Tesla factory is a lot more essential than someone initially thought. Maybe on second thought we should reconsider and arbitrarily change it from “non-essential” to “essential.”    Huh! . . . Classic, duck and run!

As time goes on Elon Musk may well be remembered as the guy who said, “Give me liberty, or give me Texas !”

I have a new hero . . . err, actually I have two new heroes one male and one female. One recently stood up for what she believed . . . in American Revolution-like language, “she stood firm again tyranny!”

Her name is Shelley Luther, the hairdresser in Dallas who had re-opened her hair salon in defiance of the lockdown. She did it, because she had a family to feed as did her employees. In addition she publicly ripped up a cease-and-desist from a county judge and ignored a temporary restraining order from a district judge. She then was brought before that district judge. She refused to recant or apologize for “trying to feed her family.” She had always been a law-abiding American who felt responsible for all of her employees who also had families to feed. When she had re-opened she had abided by the other rules, like the wearing of masks, and limiting how many people could be inside. The district judge fined her and sentenced her to seven days in jail.

Good for Shelley Luther for standing up for her principles!

“Booo, hiss!” for that district judge.

My second hero is Greg Abbott, the governor of Texas, who then issued a revised executive order, which allowed Shelley Luther to get out of jail. 

He said, “Throwing Texans in jail who have had their businesses shut down through no fault of their own is nonsensical, and I will not allow it to happen!”

Wow! A government official who uses common sense. 

Hooray for the Texas Governor, Greg Abbott!

It is amazing to me that so much of what is being done with Covid-19 seems to be presented to the general population as “fact,” and is actually far from being proven fact.

First of all, apparently  the “proof” that masks do anything is mainly based on one study, and not the best study, from Hong Kong. Furthermore, in the beginning we were told not to wear masks! If anyone has some good data on the benefit of wearing masks, I would like to know about it. Now granted I don’t mind wearing a mask . . . but does it do anything? Is there any proof?

Next, is there any evidence that the closing of beaches is beneficial? At this point it is unclear whether heat and sunlight are bad for this virus. For many of other past viruses, the incidence of infection goes way down in the summer. Will this be the same for Covid? Certainly at this time, there is no proof as best I can tell. If heat and sunlight are bad for the coronavirus, and good for us, then perhaps the beach might be the best place to be! 

In addition, wind dissipates the concentration of the smaller particles that are produced by coughing, sneezing, etc. In the 40 years that I have lived in San Diego, I do not recall ever going to the beach and there being zero wind. I am told that very early in the morning there can be little if any wind, but who goes to the beach at 7a.m., other than surfers, and they are in the water, not sitting around on the beach! I am sure that zero wind days do happen at the beach, but . . . again, the beach might be one of the better places to be! Proof . . . No proof ?!

Finally when families go to the beach why is it now “unlawful” to put down a towel and just sit and sunbathe? These same families have been cooped up in the same house for weeks, and now they can’t sit together on a towel or in chairs at at the beach! Again at the risk of being like an echo chamber . . . Proof ? . . . Nonsense!

This morning I have read two different articles about children and Covid. The amazing thing here is that the proof(anecdotal for the most part) is that children and Covid is an entirely different ballgame from adults (>17 y/o) and Covid. First of all, < 2% of reported cases in China, Italy, and the U.S have been in children! Now perhaps that could be related to the fact that children are only rarely tested for this virus. Why is that?  – probably because they typically have few if any symptoms. 

And to boot, there is little proof that children pass this infection onto adults! Adasdar Munro, a pediatric infectious disease expert at the University Hospital in Southampton, U.K recently stated that children are not responsible for the majority of transmissions, and that data supports the opening of schools.

There are other retrospective anecdotal studies from Australia and Europe that basically say something very similar . . . So why are schools closed? Certainly not because of any proof that closing schools is the right thing to do!

Now for sure someone is going to mention Kawasaki’s disease that can occur in children as a result of Covid. I am not surprised much by the few cases in children, but here again we do not have any info on the incidence of this with Covid. Frequent? or . . . Infrequent. No proof either way. But these isolated cases cannot be a reason to keep schools closed, can it?