Wednesday, April 15, 2020

A Reasonable Demand

April 15, 2020

 [Government Elected Official name and address]

 [Your Address]

 I’m writing today as constituent and concerned citizen. Over the last several weeks the combination of media hyperbole and “expert” predictions have been not merely incorrect, but disastrously wrong. Our country is currently in a state of induced coma. Our churches, schools, museums, libraries, and nonprofits are deemed “non-essential” and are ordered closed. Tens of thousands of people cannot work remotely and are without employment. Hundreds of thousands of others are on the brink of economic disaster.

Meanwhile, fatalities directly caused by COVID-19 are nowhere near projections. Models (with margin of error variabilities exceeding 400%) are adjusted daily without any reference to baselines which would immediately demonstrate the poor predictive capabilities of these same models. Comorbidities are ignored, while risk populations remain unclear, and transmission rates, viral loads, and susceptibility are deemed unimportant.

The Models Have Been Poor Predictors

At the end of March, we were warned of "2.2 million US Deaths" from COVID-19. A week later the estimate was revised to "200,000 fatalities." The latest claim is "60,000 by August." Not a single model used as impetus for emergency mandates has been correct. (The British Medical Journal concluded: “[The] proposed models are poorly reported, at high risk of bias, and their reported performance is probably optimistic.” See https://www.bmj.com/content/369/bmj.m1328)

Yet, even these numbers are skewed, as the figures only count people who seek medical care. COVID-19 displays a wide range of presentations from asymptomatic to a mild cold to severe pneumonia. In addition, CDC guidance has been that mild cases should stay home. Thus, many cases are never tested and thus never counted.

Suspect Infection Rates

We’ve been told otherwise healthy people coming within six feet of a COVID-19 asymptomatic person will likely be infected. Yet there were over 4,000 passengers and crew on the cruise ships Rotterdam and Zaandam that docked in Miami on April 2. There was a grand total of nine confirmed COVID-19 cases. Over the course of the cruise, 97 passengers and 136 crew presented with influenza-like symptoms that were not assessed as COVID-19 (see https://www.miamiherald.com/news/business/tourism-cruises/article241740696.html). Four people died of COVID-19, yet we still don’t know the age, sex, or other underlying conditions of those who perished. Nevertheless, these enclosed, floating involuntary test sites suggest the transmission rates are nowhere near the worst-case claims.

Suspect Input Data

Limited testing and inconsistencies in the attribution of the cause of death means that the COVID-19 fatality rate is not accurate. How can we continue to impose the most crushing (and unconstitutional) mandates in history based on flawed data?

Data Inconsistency

The COVID-19 fatality rates of confirmed cases run from a low of 0.96% (SD) to 5.8% (MI). Nationwide the average is now 3.8% with the majority of states 2% or less. New Jersey reports 99.54% of all COVID-19 as “tested positive,” while the average in the US is 15^, and the range drops as low as 2.6%. How can these wildly variable numbers be used to assess anything? Is New Jersey testing people who are already known to be positive? Then why test? Or is the test protocol so broad that anyone exhibiting any symptoms (which are common for a wide range of maladies) decreed as “positive for COVID-19”? This variance makes no sense -- unless the input data is inconsistent (which is the most likely explanation -- see Occam's razor).

The CDC’s Reporting Guidelines require hospitals to categorize as “HOSPITALIZED” all “Patients currently hospitalized in an inpatient bed who have suspected or confirmed COVID-19.” Fatalities are reported for those “Patients with suspected or confirmed COVID-19 who died in the hospital, ED, or any overflow location on the date for which you are reporting (see: https://www.cdc.gov/nhsn/pdfs/covid19/facilityqrg-508.pdf)

The problem here is a COVID-19 fatality using this definition does NOT ascertain whether a person died from the virus – instead, the data comingles confirmed and suspected COVID-19 infection with every other cause of death. Therefore, a person who suffers a heart attack after years of hypertension is listed as a COVID-19 fatality. Since the input data is flawed, the resulting statistics are skewed.

The Pennsylvania Department of Health recently commented that “Most people recover from the coronavirus but the health department does not offer statistics on how many recover.” Why not? Wouldn’t this be an essential metric to determine the danger posed by this particular virus strain? Or are we to be subject to draconian (and I would argue unconstitutional) restrictions based on flawed, incomplete, and ignored data?

Hospital Capacity

There are 931,203 staffed beds in 6,210 hospitals in the USA (data from 2019. See: https://www.aha.org/statistics/2020-01-07-archived-fast-facts-us-hospitals-2019). There are currently 562,506 known COVID-19 cases in the US (13APR2019. See: https://www.bing.com/covid/local/unitedstates) Only between 5 and 15% will require hospitalization. In fact, current guidance from both Federal and Commonwealth authorities is to stay home if symptoms manifest that are “not life threatening.”

Yet, even if every person who tested positive during the “peak” were to be hospitalized, that would leave a buffer of 40% capacity. If we use 10% of the total cases number as requiring hospitalization, that’s only 6% of all available hospital beds (this does not include emergency hospital beds such as those provided by the US Army and Navy and charitable organizations such as Samaritans’ Purse in NYC).

The Quarantine Orders are Too Broad

The CDC’s Recent study on hospitalization rates of COVID-19 patients states: “Most of the hospitalized patients had underlying conditions, some of which are recognized to be associated with severe COVID-19 disease, including chronic lung disease, cardiovascular disease, diabetes mellitus.” (See https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm)

This means there are identifiable vulnerable subgroups who most certainly should be protected from infection using a variety of protocols. But there is no justification for treating the entire population as  susceptible or even infected when there is very little data to support such an assertion.

The State’s Definitions of “Essential” and ‘Non Essential” are Arbitrary and Pointless

Ever since the Governor’s list was issued (and revised several times), not one official has been able to explain the criteria used to determine “essential” or “non-essential” other than broad brush categorizations that are ambiguous to the point of futility.[1] The most egregious example is the final line in the Governor’s List (“Private Households: May Continue Physical Operations: No”).

The “Shelter in Place” orders are Useless and have Extended too Long

First, the exception provisions are so broad no one was truly quarantined. All a citizen need state is that he or she was “gathering essential supplies” or “caring for a minor or elderly person” and an exception would apply.

Second, we are long past the incubation periods where asymptomatic carriers were potential virus time-bombs. In a study on 181 confirmed cases, COVID-19 had an estimated incubation period of approx. 5.1 days (95% confidence interval is 4.5 to 5.8 days) (Lauer et al.). This analysis shows 97.5% of those who develop symptoms will do so in 11.5 days (95% confidence interval is 8.2 to 15.6 days). If this is the case, why are we extending this order more than two weeks?

Finally, doesn’t it make sense to focus amelioration protocols on susceptible populations rather than the entire population?

False Choices

In 2017, 647,457 Americans died from heart disease, 169,936 died from accidents, 160,201 died from Chronic respiratory disease, 146, 383 died from stroke, 121,404 died from Alzheimer’s disease, 83,564 died from diabetes, 55,672 died from influenzas and pneumonia, and 47,173 deaths were self-inflicted suicide. In 2018 there were 67,367 Drug Overdose deaths in this country. Divided by 365 that’s 185 deaths every day of the year. (see https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_06-508.pdf)

The fatality rate of all humans remains 100%, with time the only variable. It is a false dichotomy to suggest it’s “people dying or the economy.” Humans are defined by the pursuit and sustainment of life which REQUIRES “economic” activity. The reductionist "lives or the economy" claim ignores the impact a faltering economy has to health in the short, mid, and long term. Unemployment has jump from 3.5% to 4.5% in a month. 401k gains over the last two years have been wiped out. World markets have lost $25 trillion in value. The CARES act has added $2 trillion dollars to the national debt. Thousands of businesses will not survive the shutdown. Meanwhile hospitals are far under capacity and proposed emergency field hospitals have been cancelled. (see https://www.cbsnews.com/news/new-york-cathedral-coronavirus-patients-st-john-the-divine-canceled-today-2020-04-10/)

We’ve established that the data have been sloppy, undependable, suspect, and in far too many cases completely absent. Should a national and state emergency exist with this level of sloppy reporting, variable assessment, unclear mitigation, and dubious transmission modalities? We're supposed to keep guessing or will there be some hard, actionable data at some point? The prevailing “Safety First” mindset is trite an indefensible. Life is filled with risks. Every person faces risks each and every day. Those who live long quickly become adept at assessing and mitigating those risks and then moving on with life in the face of varying odds. So be it – this is life on Earth. No one expects (or should expect) Government at any level to allay all fears and mitigate all risks. Therefore, I vigorously urge you to remove the restrictions, restore the foundational freedoms Americans have defended, suffered, and died to keep, and defer to the will of your true overlords, the American people.

A concerned citizen, taxpayer, and voter,

[your name]



[1] The Governor’s own cabinet making business is deemed essential, however, as it’s critical that lifesaving Corian be installed to help stem the tide of Grim Death (see https://www.inquirer.com/business/spl/pennsylvania-coronavirus-wolf-home-products-essential-business-life-sustaining-20200330.html)


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