Tuesday, June 30, 2020

A Face-Saving Proposal for Donald Trump

There is one piece of good news on the COVID front.  As the disease is increasingly spreading in red states, many Republican leaders are starting to endorse wearing masks.  Their numbers include Senate Majority Leader Mitch McConnell, House Minority Leader Kevin McCarthy, and even Sean Hannity and Steve Doocey on Fox News. 

And, after all, wearing masks makes sense, particularly from a Republican perspective.  Do you hate shutdowns?  Do you want businesses to be free to operate and make profit.  Good news!  We can curb the virus without shutting down -- by wearing masks.  Do you hate government interference in your life?  Well good news!  In countries like Japan and Hong Kong, government as been inactive and the initiative of private citizens has beaten back the virus -- by wearing masks.  Masks can truly be seen as the less intrusive and disruptive alternative to a shutdown.  So what is the problem?

The problem seems to be that Donald Trump has made masks a culture war issue and refusal to wear masks a test of loyalty.  It is hard to say why.  Maybe he thinks he looks foolish in a mask.  Maybe he just can't admit something really bad is happening on his watch.  Maybe division and polarization are so vital to him that just can't give up the habit.  Maybe:
Trump is literally incapable of admitting error, even implicitly, which means he will never go on TV and declare that everyone should wear a mask. Quite the contrary: he’s more likely to double down and declare that mask wearing is ridiculous and useless. He’s probably the only person in America who could effectively deliver the mask message to the people who really need it, but he refuses to do so.
What are the chances that Donald Trump will yield to pressure, if not from Congressional Republicans, then at least from commentators on Fox News?  I have no idea.  He has been known to yield to pressure before -- to admit that Russia hacked the DNC, for instance, or to condemn neo-Nazis at Charlotteville -- but invariably he seems to snap back. 

But have no fears.  I have a face-saving out for him.

Face shields.  Think of the advantages.  They give protection against COVID, but they aren't masks.  They are more comfortable and easier to breath in than masks.  They allow people to see your face, which seems to be a big issue for some mask opponents.  They allow Trump to show his face and avoid his fears of looking foolish in a mask.

But above all, face shield allow you to protect against COVID while still making a culture war issue of it.  Donald Trump can denounce masks as the work of the devil and praise face shields to the sky.  Can anyone doubt that Republican opinion leaders from Congress to Fox will promptly fall in line and make face shields the new test of party loyalty.  Suddenly you can make a political statement, not by whether you wear a mask or not, but by whether you wear a mask or a face shield.  Culture wars can continue to rage, even as everyone takes measures to beat back the disease. 

Hell, I would even urge liberals to get irate about face shields if it will just convince Trumpsters to wear them.

Sunday, June 28, 2020

Joe Biden's Pitch

Honestly, we have gotten to the point that Joe Biden's election pitch doesn't require much more than, "Hi, I'm Joe Biden, a normal person with an ordinary capacity for compassion and empathy.  I know you can't cure virus by shining a flashlight up your nose, and I'll never ask anyone to drink bleach.  I am known to say things that are dumb or even offensive, but when I do, I admit I was wrong.  If that is what you want in a President, then vote for me."

Sunday, June 21, 2020

On Statue Toppling

And just for the record, I do not condone these crowds -- mobs, really -- that have been toppling statues.  Yes, it is preferable to mobs smashing windows and looting, but toppling statutes ought not to be confused for peaceful protests.  Toppling statues is still mob action, and a low-level form of riot.

And yes, some of these statues deserve to be taken down.  But taking down statues should be done through official action, following public debate.  Condoning toppling statues is capitulating to mob rule, and mob rule is never good.

And, incidentally, as our moral guardians are increasingly treating any criticism of the protesters as out of bounds, I am beginning to fear the we are succumbing to a sort of intellectual mob rule as well.

PS:  And it should go without saying, but none of this is to deny that police brutality and institutionalized racism are serious issues that should be addressed. I would just prefer a more rational and deliberative pace.  Haste is apt to lead to ill-considered actions.  A backlash is inevitable and must be endured, but ill-considered actions will give the backlash legitimate grievances that I would rather it not have.

COVID in New Mexico

I live in New Mexico, a state that has been ahead of the curve in COVID testing.  We have had some of the best testing from early on during the outbreak, and have now reached the point of having enough tests for anyone who wants one.  Our state posts daily statistics, which I have been closely following and eventually started a spreadsheet on. 

A few comments on what I have observed.

Our number of tests performed has been increasing at an impressive rate.  When I started the spreadsheet (May 9), we had slightly under 100,000 tests done.  The number is now nearing 300,000.  In a population of 2.1 million, that will amount to one test per seven people.  (Although some people may be tested more than once).  In the time I have been keeping track, the number of people being tested has typically risen by something more than 4,000 people per day.  In the meantime, the typical number of positive tests has been rising by around 100 to 150 per day.  On good days, we have had less than 100 positive tests and on bad days more than 150, but I have seen only very few days with increases over 200 and only two with increases over 300.

The effect has been that our rate of positive tests have fallen, even as the number of positives continues to rise at a fairly steady rate.  The rate of positive tests was nearly five percent (4.92%) when I started my spreadsheet and has since fallen below for percent (3.6% today).  The positivity rate in new tests has been noisy, but consistently less than the total positive rate, so the cumulative positive rate continues to fall.

That being said, I do not believe that our increase in testing is uncovering a lot of mild or asymptomatic cases that were going undiagnosed at the beginning.  The reason I think that is that if we were uncovering more mild or asymptomatic cases than before, one would expect the mortality rate or hospitalization rate (as a percentage of infected people) to go down.  Instead, the mortality rate has been holding steady at about 4.5% of infected people and the hospitalization rate has been holding steady at about 17% of infected people.*

The infection rate has been unequal across the state.  Unsurprisingly, Bernalillo County, the county that includes Albuquerque, and by far the most populous county in New Mexico, has counted for a considerable share of the infections, but less than its share of the population.  With approximately 30% of the population of New Mexico, Bernalillo County's share of the total infections has fallen from 23% on May 23 to 17% today.  Positivity rate has fallen from about 3.5% to under three percent.  There does not appear to be any significant increase following the protests, but I am still warily watching.

Dona Ana County is New Mexico's second most populous with about 10% of the population.  Although Dona Ana County originally appeared to be doing well, it had a recent outbreak among its colonias (roughly rural slums).  I am not fully confident that the outbreak is behind us, but at least it does not appear to be running out of control.  The total positive rate in Dona Ana County is now below 3%, with the positive rate among new tests noisy, but rarely above 5%.

Santa Fe County, with a population of about 150,000, has had over 18,000 tests and only 196 positives, for a rate slightly over 1%.  Santa Fe County is doing fine.

The hardest-hit counties in New Mexico have not been its urban areas, but San Juan County (population 124,000) and McKinley County (population 72,000), two counties in the northwest of the state with large Navajo populations.  Both have greater absolute numbers of cases than the much more populous Bernalillo County.  Positive test rates have run as high as 15% in San Juan County and perhaps even 19% in McKinley.  It should also be noted that McKinley County, despite its smaller population, has had more tests done than San Juan County -- the number exceeds 20,000, or about 28% of the population.  There is some sign that the worst may have passed in San Juan County; positivity is noisy but has fallen to single digits for something over a week.  But McKinley County continues to have positive rates in double digits.

Sandoval County also deserves mention.  Home to many Indian Pueblos, it looked alarming early on during the outbreak.  It was showing positive cases far in excess of its population (slightly smaller than Santa Fe County), with a rate of about 7%.  There are now only a handful of new cases per day, and the positive rate fell below 3% for the first time today.  I don't know what the pueblos have done, but it appears to have worked.

The other (mostly rural) counties are doing well.  And, incidentally, not all Native American populations have been hit hard.  Rio Arriba County has the Jicarilla Apaches and Otero County has the Mescalero Apaches and both are doing fine.

Deaths and recoveries are also interesting, although the recovery rate comes with the warning that the number of recoveries may be understated because not everyone who has recovered informs the Health Department.  Recovery rate is useful, because it tells us when the worst is past.  The recovery rate for the state as a whole is currently 44.34%.  For Bernalillo County the rate is 62.88%.  The overall death rate has consistently been around 4.5%.  That rate has not gone down with increased testing, suggesting that increased testing has not uncovered a lot of mild or asymptomatic cases that were being missed. 

San Juan County's mortality rate has been 7%, which seems excessive.  I thought this might be a sign that we were missing cases in that state, but the positivity rate is going down, and the recovery rate is up to 52/4%.  These are signs that the worst may be passed, yet the mortality rate remains high.  McKinley County's death rate is edging up and now exceeds 5%.  Nor is the worst over.  Positivity remains high in new tests, despite extremely widespread testing.  And, worse, only 35.5% of all people diagnosed with the disease are known to have recovered.

Meanwhile, Dona Ana County's mortality rate remains anomalously low, at less than one percent, or six deaths out of 718 total cases.  When the outbreak began there, I waited for a upsurge in deaths, but so far it has not materialized.  And a little over half the people diagnosed in Dona Ana County have now recovered.  This would seem like a hopeful sign, that we have become more effective in treating this disease, except that death rates continue to rise in San Juan and McKinley Counties.

There has definitely been a recent upsurge in cases in New Mexico, focused on a prison in Otero County, though without apparent spread to the general community.  There have been 828 positive tests in a very short period of time.  Only six people have died so far, but only ten have recovered.  Today the prison diagnoses were 30% of total new cases and 15% of all active cases. 

Finally, although 1,746 people have been hospitalized for COVID in New Mexico, there have never been more than 223 active hospitalizations at a time, which is manageable.  The number of active hospitalizations peaked on May 15 and has been steadily declining since June 10.  But I expect an increase soon as a result of the prison outbreak.

Stay tuned.

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*There has been a recent drop in the hospitalization rate to 16.53% of infected people, but i suspect that is because of a recent surge in cases at a prison, with hospitalizations still lagging diagnoses.