Category Archives: Healthcare

Healthcare, Public Health/Coronavirus

This is not going to work right: CDC would like to test “virtually everyone”

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The false positives will overwhelm the true positives – how will they detect this?

Testing has so far been used in the United States mostly to diagnose people who are sick or have been exposed to someone with a confirmed Covid-19 case. Screening would test virtually everyone in a given community, looking for potentially infectious people.

Source: CDC is developing new coronavirus testing guidance for screening at schools, businesses

Here’s the problem.

  • We test everyone.
  • The actual prevalence of the disease in the community is 1 in 500 people (as an example).
  • Our screening test is 99% accurate (in reality, the full test process may have a much higher error rate).
  • We test 500 people and find 1 person who actually has Covid-19, plus we find 1% of the 500 or 5 people who are tagged as false positives.
  • We’ve now found six people testing positive but only 1 of the six actually has the disease; the other five are false positives.
  • Public health authorities tell us that six people tested positive and “new coronavirus cases” go up by six.
  • The community, however, has a population of  50,000 people.
  • Our testing “virtually everyone” finds 100 actual new cases (1/500 x 50,000) and 500 false positives (5 for every 500 or 10 for every 1,000, times 50 or 500).
  • Public health tells us there are 600 new cases (100 actual + 500 false positives).
  • 500 people are placed in two week quarantines unnecessarily.
  • Because we are testing everyone and because of this problem, we can never “flatten the epicurve” – we will always have a large number of false positives when we test everyone while the prevalence of the disease is low. Even a high accuracy test – or high specificity – still results in this problem. No test – including lab and handling – is 100% accurate.

And oh, the actual test they are proposing to use has a false positive rate of 3% – three times worse than the 1% I used above.

What am I missing? This sounds like insanity – unless your goal is purposely maintain high numbers.

Update: Based on data for my county, it appears the prevalence may be 1 in 800. And the actual false positive rate is 3%, not 1%, as in my example, above.  This means if they greatly expand testing, nearly all of the positive results will be false positives in this County. Unless they take measures to address this (such as double testing all positive results, and not using too many cycles in the PCR process), this is another disaster in the making.

To illustrate 3% of 800 is 24 false positives for each actual case they find. In a 50,000 person community, that is 63 actual cases and 1,500 false positives if they test everyone. I asked OHA about this and they have not answered; another person tells me he has asked OHA also and they have not answered.

Healthcare, Public Health/Coronavirus, Uncategorized

Most people likely won’t get a coronavirus vaccine until the middle of 2021

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I have been expecting a general roll out in Q2 of 2021 and am still sticking with that. We will hear much positive news on vaccines from now well into October and the first non-test phase recipients will receive vaccinations at some point during the last two months of the year (but very limited distribution).

Most Americans likely won’t get immunized with a coronavirus vaccine until the middle of next year, U.S. officials and public health experts say, even as the federal government asks states to prepare to distribute a vaccine as soon as November.

Source: Most people likely won’t get a coronavirus vaccine until the middle of 2021

I think we will see “herd effects” occurring from this point on ward, and especially by late this year. But I am an idiot with no health expertise so my comments are for Entertainment Purposes Only.

Of interest, the annual winter time influenza in the southern hemisphere has been so mild as to be almost non-existent; that is great news. No one knows why but some suggest may be because of social isolation, hand washing – and their favorite super hero, face masks. Regarding the latter, the University Washington published new  disease model projections (theirs have been mostly worthless) that surprising implies face masks do not work (but they did not seem to notice they had said that!)

The Institute for Health Metrics and Evaluation at the University of Washington’s School of Medicine is  predicting more than 410,000 deaths by January if mask usage stays at current rates. If governments  continue relaxing social distancing requirements, that number could increase.

Source:  Coronavirus live updates: Model predicts 410K US deaths by January; Labor Day weekend brings risk; South Dakota stages state fair

That is a more than doubling of deaths in the U.S. in the next 3 1/2 months – versus the past 5 months. And this occurs while face masks are now mandatory throughout most of the country and in all of the highly populated areas. National surveys indicate  face mask wearing is common and widespread in populated areas.; Newsweek reports that 95% of Americans are wearing face masks as required.

But the UW IHME is saying we will see a  more than doubling of deaths in the next 3 1/2 months – versus the past 5 months. They are saying – without realizing it – that face masks are  not working at all. We have high compliance but the death rate, per their estimate, will more than double in just over half the time as previous deaths occur.

This is a shocking finding – there are about 110 days between now and January. The CDC reports 186,153 deaths as of today. To reach 410,000 means an average of over 2,000 new deaths per day between now and January. As of today, the U.S. is averaging about 900 deaths per day.

Official CDC Chart as of 9/4/2020. To meet the UW IHME projection, the dropping death must not only reverse, but needs to double almost immediately to leaves not seen since last spring. Does this make any sense? 

To rise from 900 to 2,000 deaths per day means public health mitigation steps are not working. It means the U.S. would revert back to the peak deaths period that occurred in the spring.

That is a stunning conclusion from the UW’s IHME and apparently they did not notice what they just said.

A LOT of experts have said the IHME’s random number generation program is worthless and this new projection seems to reinforce what other experts are saying. Disease modeling is 21st century astrology and just as reliable.

Update: When will we resume having public events again? I am planning to attend a comic con event in early March 2021 but I am convinced it will be canceled. My guess is for vaccines to start rolling out in Q1 2021 but might not be available to the general population until Q2 2021. Then, it will take months to get the vaccine administered to millions of people.

Public health authoritarians will not reduce restrictions until some as yet unspecified metrics are achieved. For example, perhaps a positive Covid-19 test rate of 0.25% or something. Who knows what they will require?

This might happen in Q2 – or may be, like some of them have been saying in the media, we will face restrictions for the next 1 to 3 years. I doubt the public will agree with that – as the authors of the 2006 paper on public health mitigation note, pandemics end when herd effects take over, vaccines are available, the virus mutates to a less infectious or virulent form – or the public just gives up and gets on with life.

Healthcare, Public Health/Coronavirus

Bill and Melinda Gates donate $1/2 Billion to accelerate manufacturing of Covid-19 vaccines

This batch of manufactured vaccines will be targeted at low-income countries.

Since February, the foundation has donated more than $350 million to support the global response to the Covid-19 pandemic. This includes a $100 million commitment to Gavi’s Covid-19 Vaccine Advance Market Commitment (COVAX AMC), in which Gavi guarantees the price of Covid-19 vaccines once they have been developed.

The additional $150-million, at-risk funding will help SII manufacture candidate vaccines from two pharmaceutical companies, AstraZeneca and Novavax. About 100 million doses of vaccines are expected to be made available to 92 countries at a maximum price of US$3 per dose.

Source: The Gates Foundation Commits Another $150 Million to Accelerate Covid-19 Vaccines – Barron’s

Gates’ previously announced funding for 7 vaccine manufacturing lines.

The effort might cost him billions of dollars and end without a viable vaccine. But Gates thinks it’s something that needs to be done as soon as possible, and that it’s time that we can’t afford to waste.

Healthcare, Policy, Public Health/Coronavirus

Are Face Masks really just “making a political statement”?

 Below is a list of counties that made face masks mandatory as far back as early to mid-April. All of these counties, as of July, are seeing an out of control spread of Covid-19. It appears that mandatory face masks have not resulted in solving the problem.  Several of these counties are now re-closing businesses.  Why are face masks not working? (See below for a lengthy list.)

Similarly, by late August, Hawaii has seen an explosion in new cases; Oahu has been placed back on lock down. Hawaii has had a face mask mandatory Order in effect since April, has had very tough travel restrictions not only to the Islands, but between the Islands, mandatory quarantines of travelers – even arresting those who violate the quarantine Orders. Yet none of this has worked. Why?

The media is spinning a controversy over face masks as a left versus right issue because the media is incapable of seeing other perspectives. In their spin, the left wears face masks and the right objects. And that is the end of the story. And they could not be more wrong.

Not everyone can wear a face mask, and if they can, it may depend on the type of face mask.

Recently published evidence for use of face masks was tortured by the media in to saying that “new study proves face masks work” when that was not the conclusion of the study – at all.  I summarize the full study here   and reproduce my summary conclusions here:

  • N95 respirators are valuable in reducing the spread of Covid-19
  • A 12-16 layer cotton mask appears to also be valuable.
  • No one is wearing 12-16 layer cotton masks. See if you can breath through 6-8 t-shirts placed in front of your face. Other studies found it is difficult to breathe using more than about 4 layers in a homemade face mask.
  • There is no current evidence to support the use of randomly designed, random materials, assembled by persons of unknown skill, home made face masks.
  • There is no evidence what so ever that wearing homemade face masks in outdoor setting has any impact what so ever on reducing the spread of Covid-19.
  • The study documents risks of wearing face masks (most studies did not have people wearing face masks full time, which is now required for many workers.)

The Occupational Safety and Hazard Administration (OHSA) has guidelines for evaluating an employees ability to use an N95 respirator type mask. These problems are already well known.

Employers are to take the following into consideration:

C. Medical Factors and Conditions

….

The medical evaluation is designed to identify general medical conditions that place employees who use respirators at risk of serious medical consequences. Medical conditions known to compromise an employee’s ability to tolerate respirator-, job-, and workplace-related physiological stress include: cardiovascular and respiratory diseases (e.g., a history of high blood pressure, angina, heart attack, cardiac arrhythmias, stroke, asthma, chronic bronchitis, emphysema); reduced pulmonary function caused by other factors (e.g., smoking or prior exposure to respiratory hazards); neurological or musculoskeletal disorders (e.g., ringing in the ears, epilepsy, lower back pain); impaired sensory function (e.g., perforated ear drums, reduced or absent ability to smell); and psychological disorders (e.g., claustrophobia and severe anxiety).

Source: OSHA Technical Manual (OTM) | Section VIII: Chapter 2: Respiratory Protection | Occupational Safety and Health Administration

As you can see, there are numerous medical and behavioral health conditions that make it difficult, if not dangerous, for many to cover their faces and airway. But from the media’s perspective, it comes down to left versus right politics … thus, if you have a medical or behavioral health condition that precludes mask wearing, the media insists you must be on the right. And if you are wearing a mask, you are obviously on the left.

The media’s spin translates to the world of social media insta-experts. Social media idiots publicly shame everyone who is not wearing a face mask, accusing them of everything from having the wrong politics to wanting to murder people.

Personal comments

I have suffered six traumatic brain injuries and experience “ringing in the ears” as well as generalized anxiety. I also have high blood pressure and exercise induced asthma since I was a teen. That’s 4 of the items on the OSHA list. Not until 2018 was the TBI connection recognized and I received treatment (over the years I experienced about a dozen and half effects of TBI).

Because of these personal challenges, I have been practicing – or training – to wear different types of masks while at home.

Continue reading Are Face Masks really just “making a political statement”? →

Healthcare, Policy, Public Health/Coronavirus, Smart Phones

Smartphone tracking apps lose favor: “What happened to all the coronavirus tracking apps? – CNN”

Last week, Singapore pulled the plug on its own Bluetooth-based smart phone contact tracing app:

Covid-19 tracking apps were hailed as a way to help countries out of lockdown. Instead many have been delayed, and those that are out are not being downloaded at the rates experts say are needed to have a major effect.

Source: What happened to all the coronavirus tracking apps? – CNN

The apps cannot work unless nearly everyone in the country has a smart phone and installs the app. Furthermore, they are incapable of tracking contacts across time (scenario: sit on bus, cough, get up, leave, next person sits in seat, contacts viral load – apps miss this completely).

Lots more here on why Bluetooth-based, smart phone tracking apps are very unlikely to work well.

The U.K. is testing their own Bluetooth-based app on the Isle of Wight and news reports suggest the test is not going well. The NHS is being secretive about what they are learning. The app was originally to have been rolled out nationwide about 3 weeks ago… but for now, there are no updates on the test. Another problem is the U.K.’s system is a privacy nightmare.

Healthcare

Does brain damage lead to people becoming “sudden geniuses”?

Don’t think it worked for me:

There’s mounting evidence that brain damage has the power to unlock extraordinary creative talents. What can this teach us about how geniuses are made?

Source: The Mystery of Why Some People Become Sudden Geniuses

Having had 5 mild TBI and one moderate TBI, it’s hard to think about this 🙂 Also, I do not recommend injuring your brain as an approach to becoming smarter.

While my life turned out well, many opportunities went missing due to dealing with gremlins of past brain injuries that were not diagnosed and treated until about 18 months ago.

#IOT Internet of Things, Emerging Technology, Healthcare, Policy, Privacy, Public Health/Coronavirus, Smart Phones

Covid tracking apps summarized

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When people mention “Covid tracking apps” it would be useful to first define what is meant by “Covid tracking app”. There are many approaches in use and many that are proposed. The various methods are remarkably different. When you hear that “Country X used a tracking app and they have fewer cases”, this does not mean they used a tracking app like you have in mind.

Most apps use location data provided by the cellular network itself or on GPS/Wi-Fi position fixes stored on the phone and shared directly with public health authorities.  Some use the data for contact tracing, coupled with free Covid-19 testing, while others use location data to enforce strict geo-fenced quarantine procedures that if violated, may result in arrest and imprisonment. Few existing apps use  close contact tracing based on Bluetooth.

Contact tracing apps, by themselves, appear to provide little value. As we will see, to be useful there needs to be supporting infrastructure outside the app – such as Korea offering Covid-19 testing to those in close contact. And the app must be installed by nearly all smart phone users (and this will miss about 15% of phones that are not smart phones). Most countries are not using  phone-based apps to track location – they are using the phone network to report locations on 100% of phones in use, which is very different than voluntary installation of a tracking  app.

Consequently, when you hear someone refer to “contact tracing app”, you need to ask them to define what they mean by “contact tracing app”.

What follows is a review of various “contact tracing” apps used in different countries.

Continue reading Covid tracking apps summarized →

Emerging Technology, Healthcare

App-based Covid tracking in Iceland does not work well

“The technology is more or less … I wouldn’t say useless,” says Gestur Pálmason, a detective inspector with the Icelandic Police Service who is overseeing contact tracing efforts. “But it’s the integration of the two that gives you results. I would say it [Rakning] has proven useful in a few cases, but it wasn’t a game changer for us.”

….

He says there have been instances where the data was useful, but that the impact of automated tracing has been exaggerated by people eager to find technological solutions to the pandemic.

Source: Nearly 40% of Icelanders are using a covid app—and it hasn’t helped much | MIT Technology Review

Continue reading App-based Covid tracking in Iceland does not work well →

Business, Economic Growth, Healthcare

A look at travel issues over the next 12-24 months

Mandatory physical distancing measures, temperature checks and filling out medical history questionnaires prior to airplane flights, possible Covid-19 testing before boarding, limited or non-existent meal and beverage service on airlines, no more free hot breakfasts at hotels, restaurants allowed to use only 25-50% of their seats, mandatory face mask wearing at all times … and higher prices. Airlines can not keep flying idled seats – someone has to pay for it.. Hotels, restaurants and car rental agencies will have to charge more to fewer customers in order to cover their fixed costs.

Source: What travel will look like for the next year or two – SFGate

What does this mean for travel? It means recreational travel will be limited until a vaccine is widely distributed and people have confidence in its effectiveness. Many will choose to avoid the “new normal” hassles of travel during this time.

Continue reading A look at travel issues over the next 12-24 months →