Coronavirus Newsletter - The Simplicity

 

The Simplicity / General Update / Comparing Countries / The Anti Hype

I think that over the past few weeks, I've been writing super long newsletters as I think I've gotten overexcited about a new home for these newsletters. Previously I had been doing them on Facebook, but here they are now ... permanently for all to see. And it appears that I felt to restate much of what I had already said over on Facebook, just to have summaries all in one place.

So, from here on I'm going to work back to doing shorter articles.

Today, I'm talking about simplicity.

The Simplicity

If I had to condense all of epidemiology into one goal it would be this:

To get R(t) less than 1.0.

This is mathematically equivalent to saying: To get active cases to drop.

If you've already seen my newsletter on Herd Immunity, then you already know what R(t) is and how it is different from R(0). As a reminder, R(0) = the initial rate of spread of a disease at the beginning of an outbreak. (This coronavirus is estimated to be between 2.0 and 6.0.) And R(t) is the current rate of spread, which can be achieved through artificial means.

What happens if you get R(t) under 1.0? It means that the virus starts dying out, and is eventually eradicated.

All the complexities that you keep hearing about ... the masks, the lockdowns, the social distancing strategies, and the contact tracing are all working toward that one simple goal: R(t) < 1.0.

If you haven't seen this video simulating epidemic math (which I've shared a million times already), I strongly recommend you watch it now ... the best 20 minutes you'll ever spend if you truly want to understand how a sickness spreads. This guy is funny, clear, and finds simple ways to explain complex topics, and from it all, you can gain a better understanding as to why R(t) < 1.0 is the proper goal.

General Update

You'll note how I started with the "simplicity" first, because that's what I want to drive home today ... once you understand this, EVERYTHING else falls into place.

And now, more than ever, this is important because our numbers in the US (and also other places in the world) are threatening to rise again. The Dakotas are still exploding. Wisconsin and Utah also went ballistic this past week. I know Utah is mainly because of where my kids are at school ... BYU, and the neighboring Utah Valley University.

At least the south appears to be chilling now. Hurray for me!

As usual, you can check out the NY Times hotspot map here. (May require a free subscription.)

Comparing Countries

And the update continues as we explore different countries and study their Active Cases profile. Which countries are getting that R(t) less than 1.0?

We'll start with China where it all began. Above, you can see that cases ramped up quickly starting in late January. New cases peaked in early February, but it took people a couple more weeks to start recovering, which then caused active cases to go down near the end of February. This is when R(t) went below 1.0. Then further recoveries brought down Active cases very close to 0. If you look closely, you'll see little tiny bumps ... a few resurgences where R(t) briefly went above 1.0, but quickly came back down. China's got this.

Last week we talked about South Korea's active profile. To put it shortly, there were two big outbreaks and one little one in the middle. And see how fast Korea got those numbers back down?

All China and Korea had to do was to get R(t) below 1.0, and the virus started to disappear on its own. They achieved this mainly from wearing masks and extensive contact tracing.

One more from Asia:

Japan is doing pretty well, though two outbreaks larger than South Korea's. The recoveries are mainly from wearing masks and generally good social distancing and hygiene techniques.

Here are a couple from Europe:

They both had outbreaks, got it under control, and are now seeing the beginnings of a second wave. Most European countries are using some kind of mask wearing, and use of the Google/Apple contract tracing app technology.

And another random one ... Chile:

They've had a lot of death (#6 in deaths per capita), but they've been getting those active counts down ... slowing down further deaths.

And finally, let's look again at the US graph (where Trump claims he's doing an A+ job) ...

Compared to all the graphs above, it's like the US isn't even trying. We've gotten R(t) < 1.0 for perhaps 3 weeks total, but other than that, our Active base continues to increase. Now Actives are practically level with recoveries canceling out the rising new cases over the past week. In other words, R(t) is very close to 1.0.

But it still needs to get below 1.0! That seems to be the goal elsewhere, and should be the goal in the US as well. If we are to start to see a third wave now with our base this high, that would set the stage for deaths at a level not yet seen this entire pandemic. And we shouldn't want this.

Before continuing on, let me show you four countries that appear to have stopped tracking Active Cases -- all in Europe.

See the four N/A's for Active Cases? These four countries (Spain, the UK, Netherlands, Sweden) are all doing terribly ... all four of them experiencing noticeable increases in their new case counts over this past couple of weeks.

I point out these 4 rogue countries, because if you're not tracking Active cases, then how can you calculate R(t)? How can these countries even think to meet the main goal of epidemiology? If I were to give the US a grade of D, these four countries should get an F for not understanding epidemiology 101.

The Anti Hype

And finally it comes to this ... if one isn't trying to meet the main goal: R(t) < 1.0, then one is allowing the virus to spread unchecked. Anything that works to spread the virus goes against the main goal, and thus I call the negative reactions to this goal the "Anti Hype."

This is by far my biggest complaint about the virus in my country and Trump's handling of it. To me, the goal is simple to understand and very achievable as demonstrated by other countries, even in some cases through very simple and cheap methods (while keeping most of the economy open). But there are so many bad actors in our nation who do not understand epidemiology, who think they are smarter, who come up with the craziest nonsense, which actually works to spread the virus rather than help the situation.

This Anti Hype comes in the form of resisting mask wearing, talking up bogus science, aiming for herd immunity to get it over with, and just plain apathy -- not wanting to do their patriotic duty to do simple things to end this pandemic much more quickly.

Because of this Anti Hype, we're still in this situation with a high Active base. I still can't roam around free because of my propensity to catch bronchitis with any respiratory disease. I'm also facing the real possibility that my chances of avoiding the virus is near zero ... thanks to people who refuse to work together to end this thing.

And what would it take for us to end this most quickly? What has proven to get R(t) < 1.0?

1) Mask wearing -- works better than you think.

2) Contact tracing -- you really should cooperate with human tracers so we can end this -- and please consider using a tracing app if one is available. See my earlier discussion for much more info.

3) Testing -- if we can't identify, we can't quarantine fast enough.

Don't be Anti ... be a patriot, and remember the goal: R(t) < 1.0.