[April 20, 2020]
Bread lines. Mandated curfews. The lack of services due to the deliberate shutdown of the efficiencies of capitalism. And, my favorite, the socially-enforced spurious practices of wearing cloth masks.
You know what? I’m going to reverse the order of that list.
Medical masks, particularly high quality ones, work by two principles. (1) The slowing of diffusion by particles of 100-1000 nanometers , which it can only get through the mask by winding through the microscopic fibers, (2) the electrostatic attraction between the fibers of the mask and particles. This principles go out the window if the seal around the bottom of your chin, your face, and the metal support around your nose isn’t airtight. In infectious disease wards, sometimes, we would even put masking tape on to make sure of this. Basically, if it’s not hard to breathe, you’re doing it wrong.
Trust me, I used to be a doctor. And I have a degree in biophysics (the physics of biological molecules). But I haven’t really been following this stuff super closely — I’m just here to rant about how grocery shopping has become even more annoying.
Cloth masks, knit of wool, poly-whatevers, and cotton, obviously are going to have bigger gaps far greater than 1000 nanometers, or one micron (sometimes even visible — hold it up to the light and see for yourself). I wore an N-95 a few times dealing with tuberculosis patients which is a bacterium with roughly a diameter of 250–500 nanometers.
A virus can be as small as 20 nanometers.
But let’s go ahead and slap on our little tribal flags over our mouths. Maybe we can get them designed with hammer and sickles (or swastikas, depending on which way the politicization of this dumb game goes).
At first, even I was mostly neutral about this. Confused at the magnitude of the reaction (perhaps, like you) but fine with it. I mostly keep to myself. I worked remotely already in the Before Times (B.T.) as an “expert knowledge worker.” And I liked the great new cautious distance everyone kept from me at the store and cafes (I’m a big guy tentative about not accidentally brushing into someone and knocking them over, and a lot people with limited attention can walk into you. For some reason, small elderly woman love to position themselves in the resting position of my arm when I reach to receive something from the deli or at the butcher counter. It can be stressful sometimes to dodge them which is why I suppose they, particularly older people, don’t even bother trying or being stressed out about it.).
Then I saw the annoying ‘total cases’ metric breathlessly reported by the media. OK, whatever. I assume they dropped out of high school and became interns in media and that’s why they don’t understand why that number is less than useless. But then I heard about the models a week or two back, which you may have heard deferential references to. These ticked me off. “Models.” The great modern divination crystal ball of the new class of priests in our culture stripped of religion, pagan rituals, and druidic superstition, replaced by mathemagics, artificial intelligence, and hypothesis-testing.
Trust me, I worked as a scientist. I have an annoying PhD. I’ve been ‘the math brains’ on an NIH project working for an annoying administrator-level scientist who barely understands an ANOVA interaction. I’ve dressed up models and simulations before and painstakingly held a room of other scientists captive for 45 minutes while I shotgun them with technical jargon and convince them, not only am I some kind of genius, but, yes, even though I don’t do any physical work in the laboratory like collecting data or dealing with the equipment, I’ve been hard at work for the last 6 months. I swear. I mean look at these complicated colored plots. “Models.” “Simulations.” “Computerized math games.”
The world’s most uninspired game designers. Except with layers of linear math — just layered up to fake complexity. Sometimes a random number generator to fake a Philospher’s Stone level grasp of probability.
Did I say game designers? No — we are Dumbledore, Gandalf, and the Oracle. We are wizards peeling back the flimsy shroud of space and time to reveal All Things To Come. The lady presenting the models at the national press conferences (I have nothing against her specifically) literally wears robes over her shoulders as she attempts to connect the language of us mere mortals with the conversation she had from the Gods.
Mere mortal: “IS ANYTHING WE’RE DOING WORKING?”
Expert: “Yes. Doing what we tell you to do, is the correct thing to do. According to me. No, not me. The models. The MODELS say we are right. Not me.”
“YEAH, BUT SPECIFICALLY, IS THIS PRISON STATE HELPING — “
“You mean, social distancing — “
“WELL SOCIAL DISTANCING IS A WEIRD COMBINATION OF WORDS. I MEAN, LIKE, I CAN CALL PEOPLE ON THE PHONE, I VIDEO CHAT PEOPLE AT WORK… I’M NOT REALLY DISTANCING SOCIALLY. IN FACT, WITH THE GOVERNMENT-FORCED ANTISOCIALISM, I ACTUALLY FIND MYSELF SOCIALIZING MORE THAN I DID BEFORE, WHICH IS A LITTLE ANNOYING, PERSONALLY. WHAT YOU MEAN TO SAY IS YOU’RE PHYSICALLY RESTRAINING US, NOT SOCIALLY DISTANCING. BUT THAT SOUNDS PRISON-LIKE.
“Good point. They’re called mitigation measures. The experts just came up with that phrase, but now we’re going to correct you with a slightly disdainful school-teacher look as if this is a term used in our society for decades, known even by our youngest children.”
“THAT’S PRETTY GOOD. MITIGATION MEASURES. IT ALSO EXPANDS THE SCOPE FROM SIMPLY RESTRICTING US TO SOLITARY CONFINEMENT TO MORE BROAD MEASURES. LIKE CLOSING ALL THE GROCERY STORES AT 5 PM. OR PERMANENTLY SHUTTING DOWN THE COMMUNITY GRILL AT MY APARTMENT SPACE EVEN THOUGH I’VE LITERALLY NEVER HOSTED A PARTY OR GRILLED WITH ANOTHER PERSON WITHIN 30 FEET NEAR ME IN OVER A YEAR.”
“Sounds like a personal problem.”
“PERHAPS. BUT ARE MITIGATION MEASURES SAVING LIVES?”
“Well, I would have to bring the new data back up to the Divine Pantheon…er…I mean, adjust the models ….and then we could see in a few days.”
I will avoid railing on economic models, climate models, and all other mathematical tinker-toy projects whereby we attempt to replicate the success of Newton and modern physics to use math to predict simple things like a thrown baseball or a thrown electron to millions of insanely complex creatures interacting in insanely complex ways, inside insanely complex environments. I will keep today’s coffee-fueled rampage focused on the COVID-19 modelling disaster.
I will just say this: models and simulations fill in the void where better-designed metrics are supposed to be.
In this case, to see actual death and hospitalization impact, there should be statistically-competent people who are also experts in this domain (epidemiology) who could simply construct sensitive metrics. The reason you need a dual-specialist (or, honestly, a non-expert that’s at least critically thoughtful) is a non-epidemological statistician might miss that perhaps, you don’t want to just report ‘positive COVID-19 tests’ because it just reflects how many tests have been deployed. Or only report the growing numbers of people showing up to the hospitals and getting a government-subsidized diagnosis.
You certainly don’t want to be building ‘models’ and projecting numbers off of that data.
I literally copy-and-pasted and plotted this data out myself back in March (in Microsoft Excel) by simply using some subtraction and division. Just fourth-grade math. I mean, I used ‘reverse non-linear multiplication’ which applies a ‘correction’ and ‘normalizes’ the ‘observables’ by ‘generating forecastable patterns’). You can grab this data and do this in under 10 minutes (covidtracking.com).
Don’t just grab today’s data — grab the daily history for the last several weeks. Subtract the daily total cases so you can actually see what’s new-per-day. Get some kind of useable rate by dividing the new hospitalizations (not total hospitalizations) by the new positive tests (not total tests). Then you can see, very very roughly, what percent of positively tested people are getting a hospital admission (presumably because they’re sick enough).
You can repeat this by dividing deaths by hospitalizations to see the survival rate of the sickest infected people (not all infected people).
You should be looking at percentages, not raw numbers. There should be no inferring of ‘flattening of curves’ by trying to eyeball second-level derivatives in aggregate data. Just use some difference scores, for Math God’s sake.
Two days before the Grand Wizard Models returned to our realm with adjusted models to announce a successful flattening of the curve (following acolyte sacrifices in the statistician offices at the NIH), I had already seen in Excel that there was a smaller daily percentage the last couple days.
Keep in mind, even if you look at the data corrected, there’s gigantic cloth-sized-mask-hole caveats. Say, for instance, the disease has already penetrated 30–60% of the population, say already back in February (I totally had some kind of runny nose thing around then). Say the vast majority of people are asymptomatic to barely symptomatic. Say these people won’t even test positive on IgM antibodies anymore (the antibody test to see if you were previously infected) which they haven’t rolled out yet in the US.
Maybe you don’t believe this could be true. I remember back in mid-March, roughly half a dozen NBA players tested positive. 30 NBA teams, 15 players on the roster each — 450 players. Assuming all were tested, that is a minimum of already 1.5% penetration: 5 million cases in the US already. Assuming some got sick before and are over it (and, thus, wouldn’t test positive), 1.5% currently sick, with easily another 3–6% previously sick: tens of millions of cases already in the US. Assume only a handful of teams got tested, the tests were flawed, or most of them that have ever been sick were already over it, and these numbers shoot up to 15%, 30%, or more population penetration back in early March.
But throw out all those assumptions, and just consider this: How sick were any of those NBA players? They didn’t even know they had it.
Now, with that observable, assume every time you test a mortally-ill person with this new test, not only might the test itself have large false positives, not only do, maybe, 1000 other people have it asymptomatically for each positive test… consider this doesn’t even rule out that 35 other microorganisms didn’t make that person’s lungs its new habitat because they are mortally ill inside a disease-infected hospital. Maybe COVID-19 was the last runty kid to show up to an already-ongoing pick-up basketball game, inside this person’s already sick respiratory organs, standing on the sidelines.
I may have credibility-dropped this already in this article, but I used to be a doctor. I have caught so many bugs despite being careful, including converting my tuberculosis test, catching an antibiotic-resistant bacterium, and countless viruses from little pediatric snotbags. I was not mortally sick, nor elderly, nor fat. I wore medical masks. I got sick a bunch.
If you look at the data, on the 26th of March there’s a massive spike in admissions. The two days before, we were admitting 11.6% and 14% of all positive COVID-19 patients (with symptoms). On the 26th, we admitted a whopping 23.8% suddenly. Some weird epidemological spike? Perhaps.
Or perhaps the news of increased measures that day, combined with the massive fallibility of admitting physicians, PAs and other medical professionals in the middle of a very socially-spotlighted workplace, compounding with people all over the city over-reporting to the hospital for anything including the many people who have been living for years with underlying conditions.
Consider that two days, three days and four days later, we were back down to 15%, 14.4%, and 12% admissions.**
**I burned out on this drama in March, so I haven’t checked it this month. I’m into other mentally unhealthy hobbies now.
My point being: these numbers, even if you look at them carefully, still aren’t even that great for figuring out what’s going on. They might just be reflecting mass hysteria.
Now take all these caveats, imagining a swirling mess of thousands of unidentified viruses and microorganisms, hitting us in waves not only annually, but seasonally. Every year for thousands of years. But we have the ability to identify one. Like, as of February of this year.
(Of course we can identify some other viruses but we probably aren’t even running any of those tests right now. Can you imagine? As a physician, surrounded by other medical people, a patient laying in a hospital room probably from a heart attack earlier that day — you’d check that COVID test box, probably automatically checkboxed on the patient chart, by protocol now. As if that makes it better.)
Say, this is now all compounded by some kind of weird mass hysteria, amplified by the media and the divine experts who are always, like neglected children, desperate for relevance. And relevance only has like three flavors, the best of which is: we’re-all-gonna-die.
Unless, give-us-some-public-money is on the menu. Then give me that one instead.
Is this the one where I can order both? Mmmm, #$%* yeah. I chose the right PhD. Time for my media circuit tour, my book, and my appearance on cable news and/or podcasts.
Speaking of which, the doctors on the news media…how do I even put this? It’s like some kind of incredibly-designed sieve for the most weird, melodramatic health professionals I have ever seen. I truly wonder if some these doctors have only taken care of runny noses in a beach-side clinic (good on them, that’s a victory as far as a position in the human sewer system that is the healthcare system). I wonder if a producer managed to find these creatures by finding their histrionic tweets on Twitter. Real gems like, “This is our generation’s Hiroshima [serious face emoji]” encasing another tweet from a medical worker complaining about the lack of beds or supplies.
(By the way, did I mention I was a doctor? I practiced, in a large city in this country over a decade ago, in the Before Times. There were shortages of beds, even then. They too, even then, instructed us to keep our N-95’s in a baggie in the OR Locker Room because they were expensive. Our city hospital required bailouts by the state every year to keep operating.)
I’m imagining this ambitiously lazy producer, then, following up on the one doctor that said the correct things in their phone conversation… well now I’m repeating myself, but in case you forgot: (1) We’re all gonna die, (2) Give us money and/or attention.
But what really motivates these amateur media tryouts is the third flavor of attention. The flavor most vaunted but containing the least nutrition: (3) Look-upon-my-TV-appearance-my-high-school-acquaintances-on-my-Facebook-feed-I’m-on-TV-being-important-and-you’re-just-an-average-loser. The key to this third flavor is to do it with a frowny face. Signal that you’re socially important for intrinsic reasons. Not just because you think you’re one of the most important people to society. No, because you also care about society and society cares about you. But most of the doctors, the media-naive idiots they are, screw it up with an irrepressible grin as they talk about their personal Hiroshima (seriously, look for it).
Except Sanjay Gupta. He’s a practiced media expert. He knows how to look obscure things up on wikipedia and say them with a gravitas face, never letting his self-satisfied smile break the facade, pretending all the while that as a former neurosurgeon, he’s seen a single person with any kind of respiratory symptoms in the last thirty years.
Oh yeah, and a point on the media. Of course they’re pro-shutdown. I mean, they have a captive mega-nation-audience now. Hundreds of millions of forced stay-at-home people with nothing to do except TV and Internet. The media’s glee is palpable.
I’m looking back up at my title I wrote and I feel like I had other rants in the chamber. But I think my coffee is wearing off, so I’ll just leave it to you to infer what I probably meant.
Until next time, stay safe. Maybe take up meditation or something you wouldn’t normally do. I’ve taken up unprofessional ranting.
Omar Claflin 