Lockdown Meltdown – EOH 08/11

As we get closer to the end of the summer, the calls for a new lockdown have come in full force with new voices such as Minneapolis Fed leader Neel Kashkari advocating for a 2nd lockdown in the United States. The calls for a new lockdown are contrasted in the end Sweden ended up okay without a lockdown and that the so called “hotspot” states were not so hot. Clamoring for a new lockdown is not only a American issue, but one that is being debated across the world. From the United Kingdom to Australia, arguments of a new lockdown, or even if the old lockdown was a good idea continue in full force. Despite GDP plummeting due to lockdowns, as seen with the UK’s steep decline vs Sweden’s minor fall, it seems the debate over lockdowns is more about peoples priors versus the actual facts on the ground. 


We Need a Principled Anti-Lockdown Movement


“Shell-shocked is a good way to describe the mood in the U.S. for a good part of the Spring of 2020. Most of us never thought it could happen here. I certainly did not, even though I’ve been writing about pandemic lockdown plans for 15 years. I knew the plans were on the shelf, which is egregious, but I always thought something would stop it from happening. The courts. Public opinion. Bill of Rights. Tradition. The core rowdiness of American culture. Political squeamishness. The availability of information.  Something would prevent it. So I believed. So most of us believed. Still it happened, all in a matter of days, March 12-16, 2020, and boom; it was over! We were locked down. Schools shut. Bars and restaurants closed. No international visitors. Theaters shuttered. Conferences forcibly ended. Sports stopped. We were told to stay home and watch movies…for two weeks to flatten the curve. Then two weeks stretched to five months. How lucky for those who lived in the states that resisted the pressure and stayed open, but even for them, they couldn’t visit relatives in other states due to quarantine restrictions and so on.”

Garret Talks To Data Analyst: AZ Virus Testing Rate Is Lower Than Reported


“This data analyst is on twitter @Hold2LLC and is part of the group of data analysts putting out great information about COVID. He points out how Arizona just changed how new cases are reported and it shows our COVID positive rate is lower than the media is reporting because they just don’t understand the numbers. This is a game changer!”

A National Lockdown Could Be The Economy’s Best Hope, Says Minneapolis Fed President


Note: As Aaron pointed out, this point of view is wrong on the face of it considering in the United States, states that had lockdowns currently suffer from higher rates of unemployment then states that never enacted a lockdown. One can also look to Europe and see how the UK’s economy is doing worse than Sweden’s economy, where the former had a lockdown and the latter didn’t. 

“The United States has now surpassed five million confirmed cases of COVID-19 and 160,000 deaths from the virus as tens of millions of Americans file for unemployment, causing experts to debate how the nation should respond. Neel Kashkari, the president of the Federal Reserve Bank of Minneapolis, says the answer should be a return to mandated lockdowns in every state for up to six weeks in an effort to save both lives and the economy. “If we aren’t willing to take this action, millions more cases with many more deaths are likely before a vaccine might be available,” Kashkari wrote in a New York Times op-ed on Friday alongside Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.”


COVID-19 in children and the role of school settings in COVID-19 transmission


“A small proportion (<5%) of overall COVID-19 cases reported in the EU/EEA and the UK are among children (those aged 18 years and under). When diagnosed with COVID-19, children are much less likely to be hospitalised or have fatal outcomes than adults. Children are more likely to have a mild or asymptomatic infection, meaning that the infection may go undetected or undiagnosed. When symptomatic, children shed virus in similar quantities to adults and can infect others in a similar way to adults. It is unknown how infectious asymptomatic children are.

While very few significant outbreaks of COVID-19 in schools have been documented, they do occur, and may be difficult to detect due to the relative lack of symptoms in children.”

Virtual Care and the Pandemic: Are We Reaching All Patients?


“Faced with the rapid spread of a new, highly contagious virus, the Veterans Health Administration (VHA) was well positioned to provide virtual care at scale. The VHA’s legacy in telehealth combined with newly enacted legislation easing the provision of services across state lines enabled the nation’s largest integrated health care system to pivot quickly. In their article, Baum and colleagues (1) document the VHA’s experience by comparing the number of face-to-face appointments provided in 2016 to 2019 with the number provided during the initial 10 weeks of the coronavirus disease 2019 (COVID-19) pandemic. Their findings confirm a swift expansion of virtual care, including telephone and video visits, and a parallel decrease of in-person visits. Their research also adds to the body of literature on expansion of virtual care in the U.S. Department of Veterans Affairs (VA) and other organizations during the COVID-19 pandemic (2–4). On balance, the study found a decrease of 30% in 2020 appointments compared with 2016 to 2019. The authors note that these findings prompt important questions about the potential effect of delayed access to in-person care on patient-level outcomes.”

Association of Nursing Home Ratings on Health Inspections, Quality of Care, and Nurse Staffing With COVID-19 Cases


“In the US, approximately 27% of deaths due to coronavirus disease 2019 (COVID-19) have occurred among residents of nursing homes (NHs). However, why some facilities have been more successful at limiting the spread of infection than others is unclear. For example, those with greater staffing or higher performance on quality measures may be better at containing the spread of COVID-19 among staff and residents. We evaluated whether NHs rated highly by the Centers for Medicare & Medicaid Services (CMS) across unique domains—health inspections, quality measures, and nurse staffing—had lower COVID-19 cases than facilities with lower ratings.”

KDHE doctored a COVID case chart to justify mask mandates

Note: Below are the two charts so you can see for yourself. What the person did was manipulate the axis of the charts to make mask look better then no masks, which was not the case.

“DHE Secretary Lee Norman shared a COVID case chart with the media this week, which he said shows the counties that abided by Governor Kelly’s mask mandate are ‘winning the battle.’ But he deceptively doctored the chart to justify mask mandates. At about the 15-minute mark of the recording, a reporter asks (according to Norman’s restatement of the hard-to-hear question, “If the no-mask counties would start masking, would it (blue line) drop, and would it dip down below the mask counties.””

Incorrect Chart

Chart with proper axis

Charts and Graphics

UK GDP is expected to fall further than any other G7 nation in Q2 2020

Compared to G7 countries, The United Kingdom’s economy has been affected the worst by COVID-19, having dropped by -21% vs the best G7 country, Japan, only dropping by -7.6% in Q2. This can be attributed somewhat to the poor job the government did in controlling what economic activity could go on at the time. 

Brazzillan States COVID-19 Deaths % of Population (7 Day Ma- data deaths reported) ordered by latitude 

Brazil, much like the rest of the world, eventually hit a wave in COVID-19 cases, but as seen below, some waves are smaller than others. As seen below, infrastructure, density, and temperature all play a role in what regions got hit with larger waves. The well governed Sul region of Brazil which is more temperate then the rest of the country got a small wave, while the dense southeast region and isolated north region got hit with more cases. 

CA – COVID-19 – Positive Patient Hospitalizations by County and Date

COVID-19 cases in Los Angeles at the moment are mainly focused in Los Angeles, with other major urban areas in Southern California not getting hit with as many cases. By not as many cases, the other countries have around 90% less cases when each is compared to Los Angeles county. Additionally, the “2nd wave” is represented, but as seen for all the counties below, the wave already passed its peak. 

USA COVID Seasonality

COVID-19, much like other viruses, has a seasonality and regionality component to it as well, affecting how it spreads. One of the reasons that the northeast got hit so hard was that the northeast had a similar climate profile to Europe, while other regions in the United States have different climates and norms that are conducive to having less cases of COVID-19. Ivor Cummins @FatEmperorTwo minutes to reveal USA corona regional/seasonal impact patterns People keep asking me about this; need to understand it’s not just about transmission during the rise (a lot of this has far more subtle drivers). Hope-Simpson’s incredible book here: dropbox.com/s/4yda40j4hf9n…

July 28th 2020391 Retweets605 Likes

Comparing Projected Covid19 Deaths IGME to Actual Covid19 Deaths

Despite our reliance on statistical modeling at the start of the pandemic, sometimes the models end up being wildly inaccurate. In this case, the IHME model predicted a large amount of COVID-19 deaths in Sweden that would occur during the Summer, which did not happen. In practice, Sweden only had the first wave and a gradual decline in cases after that. 

ICU Census vs Fatality Moving Averages – US

While fatalities are going up again, the amount of people in the ICU  has decreased in August in comparison to earlier in the spring. While fatalities are up, that fewer people are in ICU units is a good sign because at the start of the pandemic, especially in NYC, being in a ICU unit with COVID-19 was a death sentence. 

Estimated total lifetime QALYs for Categories A, C and D

The Office of National Statistics in the UK did an analysis of the impact the lockdown had on COVID-19 deaths. As seen below, the lockdown in the UK was responsible for hundreds of thousands of deaths due to increased deprivation & increasing loneliness. 

COVID Deaths (Per Million)

Again, the so-called “2nd wave” ended up being smaller than the first wave of cases that occurred in Europe and in states in the American Northeast. Arizona, Florida, and Texas each have fewer deaths than the states that got hit with the first wave, New York and New Jersey. Texas is even doing better than some European countries that managed the pandemic well, such as the Netherlands or Sweden. 

Spanish Second Wave Monitoring 

The Spanish government has been worrying about a 2nd wave in cases due to the opening up of some borders and tourists traveling to Spain who may or may not have COVID-19. In practice, this “2nd wave” is tiny in comparison to the original wave, and the “2nd wave” has already passed in Spain. 

Nationwide COVID-19 Metrics. 7-Day Average Lines

Some key nationwide statistics regarding COVID-19 cases. After the so-called “2nd wave” which hit states in the Sunbelt, the amount of cases and hospitalizations is finally declining. 

International News

Germany’s populist revolt against the lockdown


“Tens of thousands gathered in Berlin last weekend to proclaim ‘Freedom Day and the end of the pandemic’. The event couldn’t have been more controversial. One side (the vast majority of commentators and politicians) referred to the demo as a ‘dangerous development’. The protesters were labelled as reckless government-haters who posed a risk to other people’s health. The word Covidiots came up again and again (including in a tweet by the leader of the Social Democrats, Saskia Esken). Government minister Peter Altmeier demanded harsher penalties for those violating social-distancing rules. The protesters, on the other hand, saw themselves as ‘freedom fighters’ against ‘dictatorship’ and ‘single-party rule’. Disagreement arose even with regard to the size of the demonstration. Were there 20,000 participants, as reported by the police? Or were there up to one million, as the alternative, left-liberal media platform Rubicon (the ‘magazine for the critical masses’, as it calls itself) claimed?”

New Zealand’s ongoing self-siege is not at all a COVID-19 ‘Success Story’


“New Zealand has now taken on the mantle of the model coronavirus response nation, according to the latest prevailing wisdom, following Australia’s implosion as the media and “public health experts’” previous favorite COVID-19 “success story.” On Sunday, New Zealand marked 100 days without any detected community spread of the novel coronavirus that originated in Wuhan, China. The media, government bureaucrats, and politicians worldwide congratulated Wellington for its “success” in keeping its people free (temporarily) from infection. The chattering classes took to social media, discussing how “lucky” New Zealand was to have its apparent capable and wise leadership in their government.”

Australia’s Victoria reports deadliest day of COVID-19 pandemic


“Australia’s second-most populous state, Victoria, reported its deadliest day of the COVID-19 outbreak on Sunday, with 17 people dying, as police thwarted a planned anti-mask rally in the capital of Melbourne. Victoria, at the centre of a second wave of infections in Australia, reported 394 cases of the novel coronavirus in the past 24 hours, compared with a daily average of 400-500 over the past week. The new deaths bring the state’s total to 210. The southeastern state, with infections concentrated in Melbourne, accounts for a lion’s share of the national tally of more than 21,000 and 295 deaths. In an effort to slow the spread of coronavirus, Victoria has imposed a night curfew, tightened restrictions on people’s daily movements and ordered large parts of the economy to close.”

Lockdown supporters cannot bear the thought that Sweden has got it right


“Sweden has fulfilled the same role during the Covid-19 crisis as Argentina fulfils in every World Cup. It’s the team which everyone – apart from the natives themselves, naturally – wants to get beaten. This has been especially true in the liberal US press, which has taken time off from berating Donald Trump to publish lengthy pieces on the supposed failure of the Swedish approach. “The Swedish government didn’t enforce social distancing,” began the Washington Monthly, for example, in May when Sweden briefly had the world’s highest death rate from the disease. “It’s now paying the price – in lives and GDP.” Even neighbouring Nordic countries – normally peas in a pod – have taken against Sweden. When Denmark and Norway re-opened their borders to the world they initially left out Sweden. Sweden’s chief epidemiologist, Anders Tegnell, who has acquired a rock star image among some of his countrymen, is seen as a maverick by many abroad….”

Madness in Melbourne

“Melbourne, that glorious city in the state of Victoria in Australia, granted me some of the best travel days of my life during two separate trips each lasting a full week.  A happy, civilized, highly educated people are here living amidst modern architecture, inspiring bridges, and natural beauty, a place where even the police are kind, and when you ask them for directions they reply with a smile, and when you say thank you, they say “No worries.” Now there are big worries in Melbourne.  The Premier has imposed a vicious police state without precedent in this country’s history. His name is Dan Andrews (a sweet-sounding name that masks the tyrant he has become), and he tweets out pictures of empty streets to brag about what he has achieved in the name of suppressing a virus. Tacitus’s line about the Roman empire comes to mind: “Where they make a desert, they call it peace.” Australia is the only country in the world that has a law that people can’t be mean to each other. Now it is host to one of the world’s meanest governments.”

New national lockdown ruled out in Poland despite rising COVID-19 cases


“Poland reported 809 new COVID-19 cases on Friday, the sixth record daily rise in two weeks, but Deputy Prime Minister Jacek Sasin ruled out a new nationwide lockdown. According to the Health Ministry’s Twitter account, most of the cases were in and around big cities including the capital Warsaw, Katowice and Krakow. It said 259 of the new infections were in the Silesia coal mining region, where the main city is Katowice. As of Friday 1,279 coal miners were now infected, mostly in state-run coal producer PGG, data cited by state news agency PAP showed. The increase in new infections was faster and higher than predicted by Health Minister Lukasz Szumowski on Thursday, when he saw the daily tally rising to up to 700 during and after the weekend.”

Surprise, Lockdown in New Zealand!

After New Zealand was being lauded as a success story in fighting COVID-19, the city of Auckland is returning under lockdown because a family all managed to catch COVID-19. Despite only having four new cases, the city is on lockdown. Wouldn’t it make more sense just to quarantine the people who had it, instead of disrupting the social and economic life of Auckland? It should not be that difficult to control four cases. Again, lockdowns are being used as a disproportionate response to a small number of cases. 



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