Month: May 2020

How many of you understand what “flattening the curve” actually means? We have been told for months that “we must flatten the curve,” and Newsom, the governor of California is still insisting on a very very slow and delayed opening of the California economy – keeping basic stuff, like schools, restaurants, bars, barber shops, beaches, etc closed, so that we can continue to “flatten the curve.”

Now even though I live in California, as I have said before, California voters are basically dumb. It is a safe bet that when asked, most in this state would not know what “flatten the curve” means.

I am going to assume that most, like myself, had thought that “flatten the curve” meant that we were enduring all of these lockdowns, etc. to lessen the number of cases of the coronavirus . . . but that answer is only partially true. This “flattening the curve,” basically means lessening the number of cases over the short term, but not over the long term; the number of new cases are being delayed, but not avoided completely. Those whose lives have been saved over the short term by “flattening the curve” will not be saved over the long term . . . unless a vaccine becomes available, and becomes available soon.

Is the wrecking of the lives of innumerable people by the destroying of the economy worth it? Remember, we are not talking about permanently protecting, but rather delaying.

As Jan Albert, a professor of microbiology in Sweden said, “strict lockdowns only serve to flatten the curve ,and flattening the curve doesn’t mean that cases disappear – they are just moved in time.”

Initially “flattening of the curve” was supposed to delay cases of Covid-19 so that our hospitals would not be overwhelmed with I.C.U. cases as what happened in New York. Remarkably, in Sweden, despite no lockdowns and few social isolation controls, the Swedish hospital system never experienced anything like what happened in Italy and Spain.

There are a gazillion models out there, and caution dictates that we should recall that is was a mistaken broken model that caused all of the panic in the first place. Nonetheless, for what it’s worth, a Harvard model projects that a 60% suppression of the disease because of lockdowns, will result in a higher peak later on and a higher number of total deaths compared to a strategy similar to what Sweden has been using. 

This is basically the same thing that I said earlier, namely that “ flattening the curve” could be worse over the long run. Perhaps the message should be: “strive to achieve herd immunity while the vulnerable are protected”

I just read a Facebook post from an E.R. physician at Rush Medical Center on the near west side of Chicago. (Yes that same west side of Chicago that had a recent video depicting a large house party with supposedly a hundred or so guests, the alcohol flowing freely, and no face masks in sight.)

But more to the point, the gist of this E.R. M.Ds epistle can be basically summarized as follows:

“How can you out there complain about the inconveniences of this shutdown when people are dying daily, especially here at Rush Medical Center. Nightly I am seeing not only patients, but also families being devastated by this Covid-19 virus. Those of you who are protesting and complaining should show more love and compassion for your fellow man.”

As was obvious from his diatribe, he is trapped in a horrible situation. I have only the most admiration for what he is doing . . . but not for his opinion or his air of moral superiority. Certainly one’s position in this pandemic will alter one’s views. Just like the Picasso statue in downtown Chicago – what you see and what you think the statue means often depends on where you stand when you view that work of art. 

E.R M.D. refers to the tragic consequences of this lockdown, such as losing one’s job, losing one’s business, or losing one’s savings as “inconveniences!”

Now granted these “inconveniences” do not involve being on a ventilator, or being in the I.C.U. But, wake up, E.R.M.D.! Losing one’s job or one’s savings is not just an “inconvenience”!

Moreover, some of the social problems that have increased because of these lockdowns are certainly more than “inconveniences” for many! Suicides are up. Alcoholism and it’s consequences – up. Drug abuse – up. Spousal abuse and child abuse – up. Depression – up. Does E.R. M.D. consider all of these personal tragedies as mere “inconveniences?” 

Has he spoken to any patients, especially seniors who cannot get their “elective surgery” done? Granted those who are suffering with daily pain because they cannot get their hip replaced, their knee replaced, or their rotator cuff tear fixed are not in his bailiwick. He is probably not seeing them in his E.R., but they are patients nonetheless, and their suffering is being aggravated and prolonged by this lockdown. Has he asked them about their painful “inconveniences?”

Likewise, mammograms are way down, as are outpatient biopsies. Medications are not being refilled because some are fearful of leaving their home. Does this mean that the incidence of breast cancer, as well as other cancers is down? Has Covid cured hypertension and diabetes? Not likely, and not probable.

If after looking at the Picasso from a different viewpoint, he still thinks that everyone who disagrees with his lockdown strategy is a baseless immoral person, perhaps he should take some time off, away from his E.R., and see what the hoi-polloi is experiencing.

Today for the first time in over fifty days, I went to one of my favorite places – Costco. I had been told that things at Costco were fine, so I got into the “old farts” special time line. I managed to find a spot in the parking lot that was  within walking distance of the store. Because I was in the higher risk age group, I was able to go to the front of the line . . . the long line. Because Costco was limiting the numbers of people they were letting in, I was expecting plenty of wide open spaces . . . wrong!
It was pretty crowded! Now granted, it wasn’t holiday weekend crowded, but six foot clear spaces were few and far between.
Were those inside the store wearing masks? Absolutely, as you needed a face-mask to get in the store! However, the positioning of the masks on the faces was another story altogether . . . some under the chin, some up over the chin, some under the nose, some covering the nose. 

The line to get out was anything but short . .. at least a thirty minute wait . . . all the while keeping the suggested six foot safety distance ? Hardly! 

Again as stated before, I love Costco . . . usually!

Now while I can go into that store with the rest of the herd, I cannot get my hair cut, even though the safety factor in a barber shop is eons above that today at Costco. Again, remember . . . I love Costco! But, this is nuts? Does anybody, other than me, suspect that our Governor has never been to either a Costco or to a neighborhood barbershop.

Furthermore, the longer this goes on the more nuts it is! 

As I have questioned before, what is the end game here? 

For each individual, there appears to be limited options:

-Stay inside . . . protected from outside contact until . . . ? Until you die from old age, or until a vaccine (of dubious effectiveness) is available. Semi-miserable  the whole time.

-Go about your normal business, and take your chances. With this option, at some point you are likely to be exposed to and get infected by the coronavirus. This could happen tomorrow, next month, or never! If you do get this virus, the chance of dying is much less than 5%, while the chance that you will be asymptomatic or minimally symptomatic is much, much higher than 5%, and then consequently there is the very high probability that from then on, you will be immune.

Which option do I choose? 

This is nuts!
Easy! Let me get my hair cut! I will take my chances!

 Is This a Perfect World ?

What is the  Right Thing to Do?

Another unforeseen consequence for those who think that shutting down everything was the right thing to do . . . What is the right thing do about rents for those who have lost their jobs? 

Is this a perfect world? 

Is continuing to shut everything down, now the right thing to do ?

At this point many of those who are now unemployed may or may not be getting unemployment benefits. Actually my heart goes out to those, especially those with families, who now cannot afford to pay their rent. Whether those individuals are legal or illegal, black, white, or brown , gay or straight . . . it makes no difference. If I was caught in the conundrum of whether my family should eat or I should pay my rent, the choice becomes pretty easy. 

“Let’s have a rent strike,” say something activists. Before jumping into the deep end of promoting “free housing for everybody” or even “free housing for those who can no longer afford to pay rent,” what happens to the landlord who still has bills to pay. He still has to pay his mortgage, and his property taxes, and his insurance. In some rentals the owner even has to continue to pay some of the utilities. What if the rental needs a new roof or needs some dangerous tree branch cut down? What should we suggest that he do? Not pay his insurance or his property taxes? Perish the thought! The point is that everybody has expenses. The world is not perfect.

Prior to this coronavirus pandemic, in the U.S, a relatively large percentage of individuals did not have enough in savings to deal with an unexpected $500 emergency! Now with little or no money coming in because their job has vanished, of course they cannot pay their rent. 

Okay, maybe the answer is to let them live free for now and then to let them make up all of the missed rent payments over the next year or so. 

“What are you drinkin’?” You are a dreamer if you think that those who have little or no savings could then make up two, three, or even four months of back rent over the next year. Theoretically possible? Perhaps for some, but get real!

Unfortunately the shutting down of everything, which has undoubtedly saved some lives over the short run, is responsible for many, many other problems – problems whose answers are elusive, even in a perfect world. However, at this time, this is not a perfect world! The reality is that people have to eat, and have to have somewhere to live. From my perspective the only reasonable answer is to open everything up . . . Now! 

Will we see an increase in the incidence of coronavirus infections? . . . Yes!

Will some of those newly infected individuals die? . . .Unfortunately, yes.

Is this a perfect world where everything is rosy and bright ? . . . No!

I just listened to Anders Tegnell, chief epidemiologist at Sweden’s Public Health Agency – the nation’s top infectious disease official and architect of Sweden’s coronavirus response.

Sweden has taken an approach that is in contrast to almost every other country. They are using the common sense wearing of masks and handwashing, but not much more. Grade schools, high schools, and daycare never closed. Restaurants, bars, and shops have remained open. They have attempted to shelter those most vulnerable, and by Tegnell’s own admission that part of their countrywide plan has not worked very well, as one-third of the deaths in Sweden have been in nursing home patients. (To compare, about half of the coronavirus death in San Diego County have been in nursing home patients.)

At this time, the death rate in Sweden is higher than that of their neighboring Scandinavian neighbors, but this was not unforeseen because of Sweden’s gamble. Sweden is gambling that in the long run they will be better off by allowing some sort of herd immunity to develop among its Swedish citizens. For those not attuned to “herd immunity,” the concept is that if a certain percent of the population gets infected and thus gets antibodies to that same infection, those, who are still susceptible in the society, will then be “protected” by the herd. With an illness, like the coronavirus, in which one person will on the average spread the virus to 2.5 others, about 60% of the general populace needs to have antibodies( get infected) in order for “herd immunity” to be a significant player. In the long run the gamble is that less damage will be done by letting nature take its course early on. The gamble is that over the long run the death rate will be approximately the same or less and the economic ravages will be much less. Will the Swedish gambit payoff? . . . Too early to know!

To me the most interesting part of Anders Tegnell’s interview was his response to the question as to whether or not getting the coronavirus infection will then prevent one from getting it again? The questioner pushed on: “Do we know for sure if allowing all of the Swedish people to get the virus will for sure protect them from getting it again?”

To paraphrase, Tegnell’s answer basically was basically brilliant: “Do we know for sure? No. But if immunity to a subsequent infection as a result of the same prior infection follows the same pattern as has happened with other past viral infections, this is what will happen. However, if in fact getting the infection does not prevent one from getting that same infection again, then why are we . . . why is just about every nation in the world, trying to get a vaccine for this coronavirus. For you see if getting the virus does not prevent one from getting the same virus again, then . . . then a vaccine against this same coronavirus will be useless.”

Think about that logic for a bit! If one believes that a vaccine will be successful, then one must believe that herd immunity will also be successful.

However, by extension, if one does not believe that herd immunity will be successful, then one must believe that a vaccine will also not be successful.

If this is so, and one believes in latter, then “carpe-diem,” as we are all doomed!

I think that a lot of mistakes have been made with this Covid-19 pandemic in the U.S.A. Now I am not trying to point fingers at anybody in particular, but rather at what seems to be a more general sort of problem.

At the beginning, basing everything on a theoretical model that turned out to be way off, was in retrospect, a mistake. However, remember that everyone was dealing with an unknown here so it’s hard to fault those decisions . . . in the beginning.

The problem that I see has absolutely nothing to do with politics, but rather  it has to do with the concept of generalization versus individualization.

Let’s take the U.S. first. The U.S. is a very big place, and obviously many of its different parts, although, still within the confines of its boundaries, some spots bear little resemblance to each other. Would anyone suggest that New York is the same as South Dakota is the same as Oklahoma? Obviously not . . . so as far as Covid, it makes no sense to treat the people who live in these states, the same. Should the rules for social distancing and the wearing of masks be the same in New York City as it is in Sioux Falls, South Dakota? No! But yet if the governor of X does things different than the governor of Y, the press is not hesitant to throw stones.

Next the same principle applies to every state. Does it make sense to have the same rules and diktats for those that live in Newark, as those who live down by Princeton? I say no. Likewise does it make sense for the governor of Illinois to extend the lockdown the same for those who live on the West side of Chicago and those who live downstate in Carbondale? No, again. Similarly L.A. County versus Placer County up near Lake Tahoe . . . No, no, a thousand times, “No!” So why are we doing it?

We can even continue this down the individual counties in California. In San Diego County, should the rules for social distancing and masks be the same in the neighborhood of Hillcrest in the city, with a high population density, and Julian, a small country town in the mountains. With the risk of being redundant and repetitive . . . No!

Has Covid-29 effected the judgement-making capabilities of those in charge? Whiplash!