One Vote Away From Pure Madness

Right after a nursing home, the place you would least like to be in the Covid-19 world we live in right now is in a prison.

More positive cases are being found in prisons than anywhere else. The good news is that most prisoners are younger than those in nursing homes so the virus is not as fatal.

In Ohio's Marion Correctional Institution, 2,011 of the inmates--80% of the prison population-- have tested positive for Covid-19.

However, the death count in Marion County, where the prison is located, only numbers four at this point. That is only .2%, about the same fatality rate as the seasonal flu.

Another prison in Ohio, Pickaway Correctional Institution, has seen more than 1,500 inmates and 81 staff members with confirmed cases.

A prison in Arkansas is reporting 850 prisoners and 10 staff members with the virus at one facility. All in all, 38% of all Covid-19 cases in the state are at that single prison.

You can find similar stories at state prisons in New York, Massachusetts, Tennessee, North Carolina as well as within the federal prison system.

The high level of risk for infections has led many state Governors to grant early release to some prisoners. Most of these prisoners have been near the end of their sentence, older in age or imprisoned for lesser crimes.

However, in the state of Washington a liberal legal activist group filed a petition arguing that the lives of thousands of prisoners in the state's prisons were being endangered by being incarcerated and should be released. The petition argued that leaving failing to release the prisoners violated the "cruel punishment" clause of the state's constitution.

That group argued in its petition before the state's Supreme Court that all inmates over the age of 50, those with early release dates, or with serious risk or harm from Covid-19 due to underlying medical conditions, should be released .

It didn't matter that some of the inmates were serving time for serious crimes such as assault, rape and murder.

Among the group that the legal activists argued should be freed was infamous serial killer Gary Ridgeway.

Ridgeway, also known as “the Green River Killer,” was sentenced to 500 years in prison in 2003 after being convicted of murdering 49 women, many of whom were prostitutes, in the 1980s and 1990s. He later confessed to murdering upward of 80 women.

This is a description of the kind of acts that put Ridgeway, age 71, behind bars for 500 years. It seems to me it might have been too light a sentence.


He would take the women and girls, have sex with them, and then strangle them, watching the light go out of their eyes as he squeezed the life out of them. Sometimes he’d use a rope and sometimes he’d use his bare hands. He’d pose their bodies and sometimes come back and have sex with the corpses. His first victims were found in the Green River, giving the monster his moniker. 


All in all, the petitioners sought to have 2/3 of all of the prisoners in the state prison system, released into the community.

The Attorney General’s Office placed the number of inmates in those categories where release was requested at 11,715 including 5,272 who have committed serious violent offenses such as murder, assault, and rape.

To their credit, the Governor and Attorney General opposed the petition for release.

You might think there would be no chance that any court anywhere would grant such an outlandish petition.

You would be wrong.

This petition was narrowly denied in a 5-4 vote of the Washington Supreme Court. A mere one vote among the justices of the court kept Gary Ridgeway and other serial killers, murderers and rapists from walking free into the community.

Let's put all of this in context.

Gary Ridgeway confessed to the murder of upwards of 80 women. That is why he was sentenced to 500 years in prison.

Can you guess how many women under the age of 60 have died because of Covid-19 in Washington state thus far?

Less than 40.

In other words, Gary Ridgeway confessed to killing twice as many women as have died from Covid-19  under the age of 60 since the epidemic started in the state.

However, legal activists wanted to release Ridgeway from prison because of a threat or harm to him from Covid-19?

Who knows how many other lives were ended or altered forever by the other 11,714 prisoners that the four justices wanted to release?

Is this pure madness?

Almost.

Pure madness is the fact that the state of Washington was just one vote away from actually doing it.

Here are the nine justices of the Washington Supreme Court.

Justices Gonzalez, McCloud, Yu and Montoya-Lewis were the four votes favoring release of the inmates.

(Hat tip to BeeLine reader JWA for making me aware of this decision.)

What Is Going On?

The implementation of social distancing measures and the shutdown of our economy was originally  justified as necessary to insure that our hospital systems were not overwhelmed.

For example, on April 5 the IMHE model was projecting that the United States would be short 36,654 hospital beds, 16,323 ICU beds and 24,828 ventilators on April 15.

We are now two weeks after April 15 and we know that none of this was remotely close to being accurate in the United States as a whole. The New York City metro area saw enormous pressure on its system but even that area did not run short of beds, ICU capacity or ventilators.

Some say that it is due to the fact that strong social distancing protocols were implemented in almost every state. However, the models from mid-March forward assumed full social distancing would be in effect through May, 2020.

We are now facing a harsh reality that is a consequence of the reliance on those models by government policy makers.

We have not seen overwhelmed hospitals. The reality is that we are seeing nearly empty hospitals from coast to coast.

Consider this headline from yesterday concerning the world-famous Mayo Clinic.

The Mayo Clinic's flagship hospital in Rochester, Minnesota is currently at about 35% of capacity. Mayo's surgery services at its three locations (Minnesota, Arizona, Florida) is at about 25%.

The action is being taken to attempt to mitigate a projected $3 billion loss for the year. Many employees are being asked to take extended furloughs until there is increased demand for health services. The pay cuts include 20% to top executives, 10% for all physicians and 7% for salaried employees and will be in effect for the rest of the year. Even with all of these actions, Mayo is expected to lose over $1 billion for the year.

What is going on when 30,000 employees at one of the most well-regarded hospital system in the entire world are being furloughed and have their pay cut in the middle of a global pandemic?

Let's look at the confirmed cases and reported Covid-19 deaths in the three states where the Mayo Clinic has facilities.

Data from WorldoMeters.info as 4/28/20, 14:14GMT.

Arizona

Total Cases      6,716        (967/million)   .000967 of the population

Total Deaths       275        (40/million)      .00004 of the population


Florida

Total Cases      32,318       (1,560/million)  .00156 of the population

Total Deaths      1,088        (53/million)      .000053 of the population



Minnesota

Total Cases         3,816       (690/million)   .00069 of the population

Total Death           286        (52/million)     .000052 of the population

For additional context regarding the Minnesota numbers, 223 (78%) of the deaths have been of people who lived in senior long-term care facilities. That means that there have only been 63 deaths out of everyone else in a state of almost 6 million people.


As of now, Democrat Governor Tim Walz of Minnesota has still not decided whether he will remove or extend the stay-at-home order for the state that is currently set to expire on May 4.

If all of this is not enough, consider the most recent data from HealthWeather.US which tracks readings from smart thermometers around the country. This is helpful information which allows for the high-level surveillance of fever-based seasonal illnesses such as influenza and Covid-19 in the United States.

The chart below shows the % of thermometer readings that are higher than normal. You can see that  fever-based illnesses were following a typical seasonal path until the beginning of March when we began to see atypical experience. That is when Covid-19  started to take hold in the country.

The variance reached a peak on March 16 with about 5.1% of the population showing signs of illness compared to an expected 4.2%. Interestingly, this is also the exact time that many states started social distancing rules.

Where are we now?

In a nation of 325 million people, the number of people with a fever is almost imperceptible. That has also been the case for almost two weeks.

It as if we have practically wiped out all fever-related illness in the United States.

Considering all of the facts above, it would not seem that a decision on opening the economy (and hospitals) should be a difficult one in many parts of the country.

The Mayo Clinic is also hardly alone as a hospital that finds itself with few patients during this pandemic.

Beckers Hospital Review is keeping track of all of the hospitals in the United States that have furloughed workers in response to Covid-19.

This is the list of hospitals that announced furloughs on April 27 alone.


April 27


1. Citing a revenue loss due to the COVID-19 pandemic, Jackson-based West Tennessee Healthcare has furloughed 1,100 individuals of its 7,000-person workforce. The health system said it lost $18 million in March due to the statewide ban on elective procedures that went into effect March 23. To comply with the order, the health system temporarily shut down some hospital departments as well as its outpatient surgery center.


2. Annapolis, Md.-based Anne Arundel Medical Center has furloughed 1,000 employees due to low patient volume and other financial challenges brought by the COVID-19 pandemic. All furloughed employees received 80 hours of pay and are able to retain their benefits through June 30. The medical center said it plans to redeploy some of the furloughed workers to support an anticipated COVID-19 surge.


3. Lexington, Ky.-based UK Healthcare has furloughed 1,500 employees to help offset a COVID-19-related revenue loss, according to Kentucky.com. The health system said it has seen a drop in the number of services offered after elective procedures were canceled statewide in March. The health system said earlier in April it planned to place some employees on unpaid leave after April 25 if the pandemic continued to affect operations.


4. St. Joseph Hospital in Nashua, N.H., has furloughed 300 employees due to the COVID-19 pandemic, according to WMUR. The furloughs affect about 20 percent of the hospital's employees. In March, the hospital said it lost $3.6 million in revenue, a number expected to double by the end of April.


5. Citing a financial hit from the COVID-19 pandemic, Fresno, Calif.-based St. Agnes Medical Center has furloughed 175 employees, according to ABC affiliate KFSN. The hospital said it has seen a large drop in the number of elective surgeries and emergency room visits during the pandemic. Affected employees are able to retain healthcare benefits.


6. Pikeville (Ky.) Medical Center has furloughed more than 200 employees amid mounting financial pressure due to the COVID-19 pandemic, according to WCHS TV. The medical center said that the furloughs are necessary because it is predicting a "significant historical financial loss for April." The furloughs took effect April 26.


7. In an effort to offset financial losses due to the COVID-19 pandemic, Cody (Wyo.) Regional Health said it is furloughing a portion of its nonclinical staff, according to The Cody Enterprise. The health system said the furloughs will last at least two months. Since the crisis began, Cody Regional Health's revenue has been down 60 percent, according to the report.


8. Citing a decrease in patient volume and revenue, Mobile, Ala.-based Infirmary Health has furloughed a portion of its staff, according to NBC 15. Affected employees will retain their healthcare benefits.


9. Show Low, Ariz.-based Summit Healthcare, projecting a revenue decrease of 40 percent to 50 percent due to COVID-19, is asking employees to voluntarily take furloughs, according to the White Mountain Independent. The hospital system said that the state ban on elective surgeries has significantly reduced workloads and volumes. The voluntary furloughs would begin May 2 and last 90 days.

"Furloughing allows us to retain talent while providing limited benefits," Summit Healthcare CEO Ron McArthur told the publication.


10. Dalles, Ore.-based Mid-Columbia Medical Center plans to furlough employees beginning May 3 in an effort to help offset losses attributed to the COVID-19 pandemic, according to The Dalles Chronicle. The furloughs will affect departments that are not seeing a high patient volume.


11. Due to a revenue loss from the COVID-19 pandemic, Stanford (Calif.) Health Care employees have the option to take a 20 percent pay cut, using paid time off, or taking a furlough, according to the San Francisco Chronicle. Employees must use one of those options between April 27 and July 4.



Who cannot see absurdity in the fact that we shutdown the economy in order to keep from overwhelming the hospital system only to find that we have accomplished the opposite?

I was clear from as far back as January that Covid-19 was something that should be taken very seriously. The early reports out of China gave me serious concerns. In addition, since so much was unknown it made sense to be overly cautious in our initial reactions.


I wrote this in January.

The bottom line is this. Potential pandemics are nothing to trifle with.

There is a reason that China has acted so aggressively in responding to the virus.

I did not disagree with the early actions in shutting schools, bars and restaurants. In fact, I argued that flights from Europe should have been banned earlier. I also argued that the New York metro area should be quarantined from the rest of the country when I saw the emerging cases there.

However, I also predicted early on that the economic contagion in dealing with the virus would very likely be worse than the disease itself.

It would seem that the hard facts that surround us now should be driving the decision making of our public officials rather than the numbers in a predictive model that have already been proven to be so far off the mark.

It used to said that the healthcare industry was recession-proof.

Unfortunately for its workers, it does not appear to be pandemic-proof.

What is going on?

What have we done?

Disorder Coming To State and Local Governments

The response to Covid-19 has resulted in the closing of schools, restaurants, bars and what are called non-essential businesses. Those employees who can work from home in other businesses have been ordered to do so.

You get a sense of the effects of Covid-19 on various economic sectors in this chart of electricity usage between the first week and fourth week of March.

Source: https://www.axios.com/where-coronavirus-is-fueling-more-and-less-energy-use-a6cccb4d-bc15-430a-8133-009ada2bb582.html

However, the change in electricity consumption as a result of the economic shutdown is merely a first order effect.

My concern with what has been done is that many other effects will cascade through the economy in the months (and years) to come.

There will be no larger first, second and third order effects than what these shutdowns will have done to state and local government budgets.

Let's consider a few.

The car dealership that has no sales means that sales tax on new car sales is not being paid to the state.

The car salesman who is not getting any commissions is not paying any income taxes. Since he has no income he is also not buying as much and the retailer is not collecting sales tax on those purchases (if the retailer is even open for business).

The restaurant owner who had to close her restaurant has no money to pay the rent. This then means her landlord also no longer has any income to the mortgage on the property and does not have the cash to pay the property taxes that are due.

Next year, after many restaurants have closed, there likely will be a glut of commercial properties for rent. Rents will decline as will the values of the underlying properties. Property taxes will decline across the board due to the lower real estate values.

Added to this is the fact that almost all state and local governments cannot legally run a deficit. They have to balance their budget each year. They cannot borrow for operating needs. They cannot spend more than they take in.

To cover shortfalls they need to either reduce costs or increase taxes. Reducing costs means cutting services and/or employees. Increasing taxes means asking the private sector (which have had 26 million people file for unemployment in the last month) to pay more.

It is not a pretty picture and we have not even begun to see the effects that are about to cascade through state and local governments from the response to Covid-19.

That is why we are going to see unprecedented pressure put on the federal government to provide billions (if not trillions) of dollars in bailout money to state and local governments.

If you have been paying attention you have seen that it has already begun despite the fact that $150 billion in federal assistance was already made available in the CARES Act that was passed in early April.

Here are a couple of examples from a recent news story on the subject.

“Without (additional) relief, states will be confronted with the prospect of cuts to essential services,” Maryland Gov. Larry Hogan and New York Gov. Andrew Cuomo -- who lead the National Governors Association -- said in a joint statement last week, in which they called for $500 billion in federal assistance to states. 

 New Jersey Gov. Phil Murphy claimed in a Wednesday briefing that he will have to make “draconian cuts” without federal assistance.

“I also cannot be clearer that the choices we will have to make – absent federal assistance – are dire for our state and our recovery,” Murphy said, adding that “without substantial and direct financial assistance from the federal government, the programs we care deeply about and which we will lean on will be at risk.”

The problem is that a number of state and local governments were not on very firm financial ground, despite the robust economy, even before Covid-19 appeared on the scene.

This is why Senate Majority Leader Mitch McConnell has stated he is in favor of a more measured approach at looking at additional state and local assistance.

McConnell suggested that it might first make sense to allow states to file for bankruptcy which local governments can use but which states are currently prohibited from utilizing under the law.

Senate Majority Leader Mitch McConnell, R-Ky., suggested Wednesday on “The Hugh Hewitt Show” that states strapped for cash should be allowed to declare bankruptcy instead of getting federal bailouts to help them deal with financial problems.

"Yeah, I would certainly be in favor of allowing states to use the bankruptcy route. It saves some cities," McConnell said. "And there’s no good reason for it not to be available."

McConnell noted, however, that states are likely to agree that bankruptcy shouldn't be the first option.

"My guess is their first choice would be for the federal government to borrow money from future generations to send it down to them now so they don’t have to do that," he said. "That’s not something I’m going to be in favor of.

Predictably, Democrat Governors, Senators and House members attacked this suggestion. However, let's put this issue in some context.

Every state and local government should have been putting money away for a rainy day. This most certainly should have been the case during the unprecedented economic boom we were enjoying the last few years.

However, there is a wide disparity in what states have put into their "rainy day" reserve funds as this chart demonstrates.

You may notice that a few of the states at the bottom of that list are also states that have been particularly hard hit by Covid-19 including Illinois, New Jersey and New York. These are also deep blue Democrat-run states.

In fact, New York was facing a $6 billion deficit for the current fiscal year ending June 30, 2020 before the first case of Covid-19 was even identified in the state.

Some type of federal aid package is probably warranted. The states can't print money. The problem is that the Democrats never want a good crisis to go to waste. You can be sure that they are looking for an aid package that will go beyond bailing them out for their Covid-19 financial problems. They are looking for a bailout of their prior bad decisions as well.

At the top of that list are the costly public sector pension programs that many states and local governments continue to use despite the fact that they were abandoned by most private sector employers long ago.

These plans have been especially dangerous in the hands of politicians who found it easy to buy labor peace with public sector unions in the short-term without taking the long-term responsibility to fund the promised benefits which may not come due for years in the future. However, the liabilities just keep get bigger and bigger with the fiscal neglect.

This chart shows the staggering cost of those pension costs at the state level as it has grown through the years.

Which states have the biggest pension funding shortfalls according to the most recent survey by Pew Charitable Trusts?

Kentucky's pension plans are only 34% funded.

New Jersey  36%

Illinois   38%

Connecticut  46%

Again, three of these four states have been particularly hard hit by Covid-19.

States like New Jersey and Illinois were insolvent before Covid-19 arrived even if most people did not realize it. Does it make sense to delay the inevitable now that the effects of Covid-19 makes that clear to everyone? Is it not time to clean up the mess rather than push it further down the road?

I must also admit that I have been disappointed that more state and local governments have not been as aggressive in mitigating their operating expenses as they have been at attempting to mitigate the spread of Covid-19.

How many public sector employees have been furloughed or laid off even if they no longer were performing their regular work activities when the Covid-19 shutdowns began?

DMV's are closed. Libraries are closed. Schools are closed.  Online instruction is being conducted but how does this apply to a physical education teacher, an art teacher or the Assistant Principal who normally is dealing with discipline issues? How does it apply to the high school History teacher who has 4 sections of U.S. History but who records one class session for the students in all four classes to view? What about the school nurse and the cafeteria workers?

I don't want to see anyone lose their job but government seems to take for granted that the tax money is always going to be there. There is no such luxury in the private sector. How many of the 26 million people who have filed for unemployment have been public sector employees?

Short of being laid off or furloughed, why couldn't some of these public sector employees have been redeployed to other jobs serving the public? Why couldn't they have been tasked to help restock grocery store shelves? Why couldn't they be sent to retail and restaurants as we reopen to clean and disinfect door handles and other surfaces? Why couldn't they be assigned to deliver food or prescriptions to senior citizens so they can stay at home? Why couldn't they be assigned to the public health department to assist in the army of people that will be needed to do contact tracing?

Yes, I know that is not the job they were hired to do. However, we don't need them to do that job right now. However, we have other pressing public needs. These are not normal times. It requires thinking beyond simple solutions such as getting the federal government to bail us out or raising taxes next year to cover the revenue shortfalls.

Could any of this happen? Not a chance, for the simple reason that the public sector unions that represent these government workers would not allow it. The same public sector unions that have also been a big part of the reason that state and local government have the unaffordable pension plans they do today.

Make no mistake, it appears that some very hard times and hard decisions are looming on the horizon for state and local governments. These decisions will be made even harder by public sector unions who have no interest in serving the public. They have only one interest---protecting their turf---and the Democrat party is unwilling to challenge those unions because it relies on them for money and votes.

It is important to remember that there is no real legal or economic reason for the very existence of a public sector union in the first place. In fact, liberal luminaries in the 1930's such as Franklin D. Roosevelt and Fiorello LaGuardia were opposed to public sector collective bargaining for the simple reason that it threatened the broad needs of the citizenry. That is why it was illegal for most government employees to unionize until well into the 1970's.

Credit: https://showmeinstitute.org/blog/government-unions/what-was-fdr%e2%80%99s-stance-government-unions

The historical basis for unions in the private sector is based on insuring a balance of power to insure that workers receive a reasonable share of profits and work in safe and sanitary conditions. Governments doesn't make profits to share. They only levy taxes. In addition, has anyone ever heard of a government worker toiling in a sweat shop? They also work in a monopoly situation meaning that if they provide poor service, no service, or they strike, there is no corresponding power by the consumer to go elsewhere as there is with a private sector business that is unionized.

In addition, in the private sector, unions are balanced against managers who have a natural incentive to push back on union demands. In the public sector no such tensions exists. More often than not the elected officials on the other side of the bargaining table are incentivized to give in to the unions for their own political survival. Those politicians often know that they would not have been elected (nor will they be reelected) without that public sector union money flowing into their campaign coffers.

We have not even begun to see the effects that Covid-19 is going to have on state and local governments.

It is safe to say that anyone or anything associated with these governments is not safe.

First order, second order, third order effects. There is going to be a lot of things in play.

Things have been set in motion that many state and local governments are ill-equipped to deal with and for which we have no idea what the final consequences will be.

The only thing that is certain is that the old order will be seriously challenged as the full damage of Covid-19 is calculated.

The Indefatigable Iconoclast

One of the most popular blog posts I wrote last year was entitled "The Indefatigable Donald Trump".

Indefatigable is one of my favorite words.

If there is one word that should be used to describe Donald Trump it is indefatigable.

Trump doesn't tire. He doesn't quit. He is persistent and unrelenting in pursuing his goals.

Watching the Coronavirus Task Force press conferences it has occurred to me there is another word  that also describes Donald Trump. I like this word as well. I have written about it before. However, when I wrote about that word back in 2012 Donald Trump was far from my mind.

This is that word.

Iconoclast

Donald Trump is not afraid to challenge conventional wisdom. He is not afraid to attack and callout institutions like the WHO, NATO and the WTO when he thinks they have not served the interests of the United States of America. He is not satisfied with the status quo.

He is not even afraid to challenge scientists and doctors to ask if there may not be a better way.

Of course, this drives the media crazy and they immediately attempt to paint Trump as unbalanced, insane or ill-informed.

One example is Trump suggesting trying hydroxychoriquine as a treatment for Covid-19 given its proven history of safely treating malaria and lupus and evidence from some doctors that it shows promise in helping some patients  recover from the virus. Another is his early questioning of why a N95 mask could not be disinfected and reused. (Both are now being done)

Yesterday saw the White House press corps go further off the rails when Trump, upon seeing evidence that Covid-19 quickly dies when exposed to heat, humidity, sunlight and disinfectant, asked the question of the experts whether it was possible to use UV light or something like an injection cleaning to kill the virus internally.

This is the transcript documenting  exactly what Trump said at the press conference which I watched live.

The media jumped on this and said that Trump was telling people to inject Lysol into their bodies or that he was claiming that going out into sunlight would cure someone of Covid-19.

As shown above, he said nothing of the sort. He said these things might be worth researching with medical doctors. He said these were interesting topics for further research.. He said it would be powerful if it would work.

He was merely raising the question of whether further research could be done to see whether those things that kill the virus outside the body could somehow be modified to impede the virus inside the body.

Is that "out there"?

Yes, it is. However, that is what an iconoclast does. They challenge traditional or conventional ideas. Most progress in the world has come from someone challenging the status quo or asking whether there might be another, or better, way.

Soon after I saw Trump suggest the use of UV rays inside the body to kill the virus I came across this YouTube video.

What are doctors and researchers at Cedars Sinai Hospital in LA working on? They have developed what they call a Healight that does exactly what Trump asked about.

Is Donald Trump crazy or is he just an iconoclast that is two steps ahead of most everyone else?

I don't know about you but I want a President who is not afraid to ask these two questions with regard to almost any issue presented to them.

Why?

Why not?

Read what I wrote about iconoclasts in 2012 and my wish that one day soon we would get a few in Washington.

Eight years later, we actually may have one.

Iconoclast
(originally published January 5, 2012)

I`con`o`clast/ n / A person who does something that others say can't be done.

Iconoclast is my most favorite word for 2012.  We need more inconoclasts.  We need them in business.  We need them in education.  We need them in science. We most certainly need them in government.  We need people who will challenge the status quo and can bring fresh thinking and ideas to solve problems.  I like Albert Einstein's quote in this regard.

"We can't solve problems by using the same kind of thinking we used when we created them."

I am currently reading a book titled "Iconoclast" by Gregory Berns who is a Professor of Neuroeconomics at Emory University.  Berns delves into the reasons that iconoclasts are so creative and successful.  He also explains how we can all become more iconoclastic by learning to see things clearly for what they are and not being influenced by other people's opinions.  By not letting fear rule our decisions and by learning the necessary social networking skills so that other people will eventually come to see things the same way as the iconoclast.

Berns introduces the book with a story about Howard Armstrong.  That is a name I was not familiar with but he was quite a man, and quite an iconoclast.

More than any other person, Armstrong was responsible for the three basic technologies that make radio and television possible.  In addition to his first discovery, called regeneration, which is the technique that allows radio signals to be amplified, Armstrong invented the superhetererodyne receiver, which transforms high-frequency waves into audible sound waves.  But his crowning achievement, and his ultimate undoing, was the creation of FM radio-a technology that the entire radio industry had dismissed as inferior.

We all know now that the sound quality of FM radio is vastly superior to that of AM radio.  However, Armstrong was alone in his belief of the superiority of FM in the 1930's when he developed the first FM receiver.  He was discredited and disparaged by the AM adherents who only knew what they knew.  He ultimately took his own life in 1954 not knowing that his iconoclastic views would eventually be fully accepted after his death.

I have been thinking a lot about iconoclasts this year which led me to an interesting article in today's Wall Street Journal about 13-year old Aidan Dwyer from Northport, NY.  This young man looks to me like a budding iconoclast.

This past summer, Aidan won a national science competition with what seemed to be a bright idea: His research appeared to show that solar panels arrayed like the leaves on a tree collect sunlight more efficiently than traditional setups.

Many people on the Web called the Long Island teenager a "genius" who had achieved a true "breakthrough" in solar power. Others praised him for proving that nature's own designs are superior to man's.

But there was one little problem: To prove his hypothesis, Aidan had measured the wrong thing. 

As readers figured out the mistake, the Internet went supernova. Commenters and bloggers attacked Aidan with vitriol usually saved for political enemies and the Kardashians. Blogs decried his experiment as "bad science" and "impossible nonsense." Someone called him "an alien—a cool one, though."

Aidan and his family watched in amazement as strangers around the world debated his intelligence and abilities, as well as his opinion of subjects generally beyond the scope of a suburban boy his age: politics, evolution and the state of modern society, for example.

Does that sound somewhat similar to the experience of others like Howard Armstrong who advance a new and novel idea?  How did Aidan see something new and what got him cross-wise with so many others?

On a recent afternoon, Aidan and his parents admitted they were somewhat baffled by the attention for a project that began two years ago on a winter hiking trip through the Catskill Mountains.

Aidan, then 11, stared at the tree branches denuded of leaves and noticed they looked alike; he wondered why. Back home, his parents encouraged him to research the subject. Google searches uncovered that a mathematical concept called the Fibonacci number sequence underlies the structure of tree branches. 

His parents had been hoping to install solar panels on their Long Island house, but their yard was too small and their roof wasn't suitable. There was, however, enough room for a tree. Perhaps, Aidan postulated, trees arranged their branches to improve the collection of sunlight. If he used the Fibonacci sequence to imitate that design with solar panels replacing leaves, maybe the structure could fit his family's limited space, look pretty—and power the house.

He did chores to earn the money to buy about $75 worth of materials. With help from his father—and after many mistakes—Aidan ended up with two models: a traditional flat-panel array and a tree-shaped solar collector designed to mimic the branch sequence of an oak tree. Over the course of months he compared measurements. To his delight, the tree structure's numbers were higher. 

Exuberantly, he submitted the results to the Young Naturalist Awards, a national contest run by the American Museum of Natural History. Of 700 entries, his was picked as one of 12 winners.

"Then," Aidan said with a slight smile, "things got out of hand."

As the report went viral, attacked and championed in hundreds of comments, museum officials became worried. "We do think it's really important that information that we put forth is scientifically accurate," said Rosamond Kinzler, senior director of science education at the museum. They were also concerned for Aidan, she said.

Critics had a point: Aidan had recorded voltage, when he needed to calculate power. It is a serious flaw, explained Jan Kleissl, an assistant professor of environmental engineering at the University of California, San Diego.

Imagine a water pipe, he said. Voltage is equivalent to water pressure. Current is the size of the pipe. Power is equal to the flow of water out of the pipe, which depends on both variables.

Aidan has not been deterred.  He has listened to the constructive advice he got, ignored the critics and the vitriol, and gotten back to work.  A true iconoclast.

On a recent afternoon, Aidan showed a visitor his newest model, tweaked to respond to his critics: a towering seven-foot tree form adorned with solar panels and painted green. He is now measuring current and power. So far, he said, the tree continues to outperform the traditional panel. "I'm thinking that it could actually change the world."

Aidan may or may not be proven right in the end.  However, it is people like Aidan, Florence Nightingale, Henry Ford, Walt Disney, Jackie Robinson and Steve Jobs that move us forward as a society.  My fervent wish for 2012 is that we will send some iconoclasts to Washington.  We need them so that people like Aidan can pursue their dreams and ideas for the betterment of us all.

The Covid-19 Puzzle

I have written extensively about Covid-19 over the last two months. It is an interesting subject to write about as it involves a great deal of data and yet there is still much that is unknown about the virus and the appropriateness of our response to it.

It is like to trying to put together a 1000 piece puzzle but you have no idea what you are assembling as you pick up each piece and try to put it together. As you work, you are not sure where any piece fits and you also are not sure what you are going to have when you are done.

There is no better example of that than when I learned earlier this week that in my home state of Ohio over 4,000 cases of Covid-19 have been confirmed among prisoners and staff at Ohio's prisons.

As of Tuesday, when the latest prison numbers were released, that represented about 30% of all the Covid-19 cases in the state.

One facility, the Marion Correctional Institution had 2,011 inmates test positive. That is 80% of the prison's population. It is now the largest source of infections of any place in the United States.

That is a great example of one of those puzzle pieces.

An 80% infection rate in one facility shows how contagious this virus can be. However, if there is any place that is about as locked down as it can be it is a prison. How did the virus get into the prison? I assume the prison had stopped allowing visitors but staff still came and went. It shows the limitations of any lockdown unless it is total and complete.

Nursing homes have also been a hot spot for the virus in Ohio and elsewhere. You don't see it mentioned at Governor Cuomo's press conferences but 25% of all deaths in New York have been nursing home residents. Part of that seems to have resulted from a questionable state policy of requiring nursing homes to admit or readmit patients who had tested positive for Covid-19 thereby putting other residents at risk.

The Ohio Department of Heath reported on Monday that 1,200 confirmed cases have been reported in Ohio long-term care facilities. These are also generally locales from which residents are not circulating much in the community. These seniors mostly were stay-at-home before stay-at-home became a state order. Visitors were banned from nursing homes in Ohio in mid-March. Nevertheless, staff go in and out even though I know all Ohio nursing homes have been doing temperature checks of everyone entering their facilities since the same time in mid-March.

If you take prisons and nursing homes together, there are over 5,200 confirmed cases in Ohio out of what is reported as slightly more than 14,000 total confirmed cases.  Therefore, almost 40% of all cases are in populations that were essentially locked down before we even locked down a good part of the other 11.7 million people in Ohio.  

Compared to the dire forecasts of public health models at the outset of the virus, it can be argued that the mitigation strategy has been an enormous success. The politicians who took these actions are arguing that vociferously right now. That includes President Trump. What else can they do?

However, it has come at an enormous economic cost. Job losses in Ohio are at almost 1 million. The state is projecting at least a $5.4 billion budget shortfall for the fiscal year that ends in June. (To put that in context, the state budgeted for the collection of about $ 9 billion per year in personal income taxes before the Covid-19 hit). Ohio was expecting to end the year in surplus six weeks ago.

We still don't know what the final costs will be to local government and school budgets. It seem certain that all of us will be living with the economic consequences of the lockdown for years and years to come.

That is another piece of the puzzle. Is the economic cost and disruption to society worth it? This takes on an added dimension as it is now known that almost 40% of Ohio cases are in prisons and nursing homes. If this is the result, even after instituting a stay-at-home order for the rest of the state, it raises more questions and makes the puzzle even more puzzling.

Short of requiring the guards at state prisons and the staff of nursing homes to lock themselves in with the prisoners and patients and never go home, could any of this have been prevented anyway?

The models first estimated that almost 200,000 people could die in Ohio due to Covid-19. Based on those forecast models Governor Mike Dewine made Ohio one of the first states to ban mass gatherings, close schools, bars and restaurants and implement a stay-at-home order.

Despite those actions, on April 2, over two weeks into locking down the economy, the IMHE model was projecting that at the peak of the crisis on April 19 that Ohio would have 6,716 hospitalized of which 1,238 patients would need ICU care. 

This is a screenshot of that projection that was made on April 2. Bear in mind, these projections in the model were made with assumptions that included social distancing and stay-at-home orders in place.

These are the actual numbers for Ohio as of April 19.

Hospitalized    2,565 (38% of forecast)

ICU                    765 (62% of forecast)

It must also be considered that Ohio only reports cumulative hospitalizations and ICU admissions in its data. Therefore, the Ohio numbers above are overstated compared to the IMHE model that is focused on hospital resource availability at a point in time.

Here is another piece of the puzzle.

There were 349 Covid-19 deaths in Ohio for the two weeks ended April 18.

That is not insignificant. However, the average deaths from all causes for that two week period over the last three years in Ohio is 4,780 deaths. Those 349 deaths would represent about 7.3% of all deaths in the state for the last two weeks based on the average of all deaths over the last 3 years.

To put that in perspective, that is about the same percentage of deaths that would be expected from an average flu season as seen in this chart from the CDC that shows pneumonia and influenza deaths as a percent of all deaths in the state of Ohio since 2015.

Source: CDC FluView Mortality Data

So many puzzle pieces.

So little known on how they all fit together.

And nothing is at all known on what all of this looks like when (and if) it can be put back together.

We are about to begin looking at another piece of the puzzle when various states begin to gradually open up for business.

Some alarmists argue that this is ill-advised and will inevitably result in a substantial increase in additional cases.

Others point to the economic effects and the additional harm that is being done to the nation's physical and mental health as a result of putting so many people out of work.

26 million people have now filed for unemployment since mid-March. This suggests the unemployment rate is close to 20% nationally. It was 3.5% in early March.

Who is right? What is right?

The Covid-19 puzzle. Nothing has been more puzzling in my lifetime.

Does New York City "Work" In a Covid-19 World?

As I have studied the data from Covid-19 it is impossible to not see the enormous disparity between the cases (and deaths) in the New York City metro area compared to the rest of the United States.

For example, look at this graphic that Dr. Birx showed at the Saturday briefing that compared the New York City metro area to all other major metro areas in the United States.

The New York City metro area has over 10 times as many cases as the next highest metro area.

You can also see how New York City impacts the state of New York and New Jersey from this slide that Dr. Birx also shared at the briefing.

Why is this?

One answer is population density.

New York City has the highest population density of any major city in the United States and two other cities in the metro area (Jersey City, NJ and Newark, NJ are also in the top 10).

Credit: US Census Bureau via Cleveland.com

The large number of international travelers into the major New York City gateway hub airports (JFK and Newark) also made the area more vulnerable to other metro areas than other cities initially.

However, as I study the data it seems inescapable to me that a large reason for the spread of the virus in the New York metro area is the large use of public transit by the population.

For example, here is public transit usage in the New York City metro area compared to other major metro areas in the Unites States.

U.S. cities with the largest metro systems in 2019, by ridership (in million unlinked transit passenger trips)*
Credit: Statista.com

The New York City metro area has more than ten times as many passenger trips on public transit as the next largest city. In fact, it has more public transit trips than all of other cities combined on this chart.

The reality is that most who work in New York City get to their jobs by public transit. They take the subway or the bus in the city. It they live in New Jersey, Westchester, Long Island or Connecticut, and work in the city, they are most likely commuting into the city on a train.

For example, the New York City subway system alone had about 5 million turnstile entries on a typical weekday before the Covid-19 outbreak.

Of course, each of those trains or buses is a vector for transmission of the virus. They are crowded and people are contained in a tight, constrained space.

Why does the New York metro area have half of the cases and deaths in the United States?

Could it be because half of all the public transit trips in the country are also in the New York City metro area?

My thesis seems to also be supported by a recent paper from an MIT economist who has just published a paper entitled "The Subways Seeded the Massive Coronavirus Epidemic in New York City".

This is the abstract of that paper.

New York City’s multitentacled subway system was a major disseminator – if not the principal transmission vehicle – of coronavirus infection during the initial takeoff of the massive epidemic that became evident throughout the city during March 2020. The near shutoff of subway ridership in Manhattan – down by over 90 percent at the end of March – correlates strongly with the substantial increase in the doubling time of new cases in this borough.

           Maps of subway station turnstile entries, superimposed upon zip code-level maps             of reported coronavirus incidence, are strongly consistent with subway-facilitated             disease propagation. Local train lines appear to have a higher propensity to                     transmit infection than express lines. Reciprocal seeding of infection appears to               be the best explanation for the emergence of a single hotspot in Midtown West in               Manhattan.

 Bus hubs may have served as secondary transmission routes out to the   periphery of the city.

In that people in the New York metro area rely on public transit to get to their jobs how does New York City "work" in the Covid-19 world?

How will New York City truly get back to work if the major method they use to do that could be the major transmitter of the virus in the community?

It appears to me that New York City metro is facing an enormous challenge in getting back to anything close to normal considering the transportation model that the area relies on.

Credit: Powerline.com

The proximity that New York City has provided for business, finance, entertainment, media and other sectors of the economy has always been an asset to that metro area. However, in an era of social distancing, proximity has become a huge liability.

What good does social distancing do at work, in a restaurant or at another venue if you first need to travel there by public transportation?

How does social distancing work with public transit?

The only answer would appear to be more trains and buses, limits on passengers per train or bus, and extensive and continual disinfection procedures of subway cars, turnstiles and buses to limit the risk of virus transmission.

However, this will cost enormous sums of money. That is something that the New York MTA did not have a lot of even before Covid-19. One observer called the MTA's fiscal condition "precarious" two months ago.

Ridership is down 90% since then and the New York Times recently reported that the MTA faces revenue losses of $8.5 billion by the end of the year.

This quote in the same New York Times story really says it all.

“The MTA is the economic engine of the entire region; the economy is built around the spine of the subway, buses and commuter rails,” said Lisa Daglian, executive director of the Permanent Citizens Advisory Committee to the MTA, a watchdog group.

“You can’t reopen the economy without the transit system in New York.”

So very true.

It is very hard for me to see how New York City "works" in a Covid-19 world since the transit system is extricably tied to the economic system.

New York City has had more to deal with in responding to Covid-19 than anywhere else in the United States.

The path forward for New Yorkers in returning to work and a sense of normalcy might prove to be even more difficult due to their reliance on public transit.

Is it a National Crisis or a New York Crisis?

One of the big questions that I think most people have about Covid-19 is whether all of this has really been necessary?

We were told that we had to flatten the curve. If we did not do that our hospitals would be overwhelmed and hundreds of thousands might die due to lack of care.

Of course, flattening the curve does not mean any fewer people will get the virus. It just spreads out the time period over which people get infected. It also does not decrease the numbers who will naturally die from the virus. It only prevents those who would die who could have otherwise been saved with hospital intervention if those resources were not overwhelmed.

You can see this in the graph from the CovidActNow.org model for Ohio that I shared in a previous blog post in late March. The area under the green curve is the same as the pink curve. This was the model as of March 27.

These were the predicted outcomes that could be expected after 3 months according to the model at that time. Even with 3 months with a shelter in place policy it was projected there would be 7,000 to 174,000 deaths in Ohio.

Credit: CovidActNow.org, 3/27/20

As of today, Ohio has 471 deaths. 49% of deaths have been of those over age 80. 75% for those over age 70. The median age is 79.

Credit: Ohio Department of Health

Massachusetts also just released their summary data on deaths for the last two weeks by age groupings. 59% were over the age of 80. 85% over age 70.

These are actual counts rather than percentages.


Under age 40     0
40's                    1
50's                    7
60's                   17
70's                   44
80's                   56
90's                   42
100's                  1


Looking at the data, the obvious question is what is the "excess mortality" of this disease? In other words, when we put everything together how many deaths can really be said to be above and beyond what we would have expected otherwise?

The CDC has historically tracked pneumonia and flu as part of its surveillance system. In fact, this surveillance system is being used by the President's Coronavirus Task Force to monitor states and counties as they move towards opening up. They are going to rely on this surveillance system to tell them if a state or county needs to go back to stricter mitigation standards.

The surveillance system monitors visits to medical providers for flu-like symptoms as well as tracking deaths from the flu and pneumonia (P&I) as a percentage of total deaths.

This data can be very useful in answering the question of what the excess mortality is of Covid-19 when all is said and done. It is a little more difficult in getting absolute answers today because of lags in the reporting of the data.

This chart shows deaths from P&I as a percent of all deaths for the previous 5 years before the 2019/20 flu season.

Credit: CDC

You can see that 2014/15 and 2017/18 saw much higher P&I deaths than normal. However, those deaths typically spiked in weeks 1 to 10 of the year (January 1-March 15). Those spikes also usually resulted in about 11% of deaths from all causes. Deaths in a normal year usually spiked at about 7-8% of all deaths.

This is the chart of 2019/20 from the CDC. Notice that up until week 10 there was nothing out of the ordinary going on with deaths from P&I nationally. However, it exploded upwards starting about that time. That has to be the result of Covid-19. Deaths in week 14 were 12.9% of all deaths.

Credit:CDC

This would seem to suggest excess mortality is present. However, what about the fact that deaths earlier in the year were much less than other heavy flu seasons? Considering the age of most of the victims could it not be argued that had we had a tougher flu season in January-February some of those individuals might have succumbed earlier to seasonal flu?

In reviewing the CDC data I was also interested in seeing what "total deaths" have typically been over the years since these charts only compare P&I deaths as a percent of total deaths. What do we typically expect "total deaths" to be and how does that compare to what we are seeing right now?

Here is a chart that shows average "total deaths" from all causes for the last four years for weeks 9-14 according to the CDC. I have compared it to "total" deaths reported from all causes for the same period from the CDC for the current year. These are all the weeks that the CDC considers to be 100% complete for data purposes. That is data through April 3.

Total deaths from all causes is actually less this year than the average of the previous four years.

How is that possible with what we hear on the news each night?

How is that possible considering what we have done to our economy?

My guess is that some of this is due to a lag in reporting. The CDC data is incomplete even though its website claims the data is 100% complete for weeks 14 and prior as shown in this screen shot.

Credit; CDC
https://gis.cdc.gov/grasp/fluview/mortality.html

I do not believe that is true so in the chart below I have adjusted the current year deaths upwards on the assumption that we will eventually find that the CDC data is not complete right now. I adjusted deaths in week 9 upwards by 1.02x and increased the adjustment by .02x for every week until I made a 1.12x adjustment for week 14. That suggests that week 14 data is only 88% complete.

Even with this adjustment, this data does not show any excess mortality in the aggregate for this six week period in 2020 compared to the average of the previous 4 years. In total, this year is about 1,600 deaths short of the four year average.

This is not to say that this will not change. Deaths lag Covid-19 cases and we will definitely see some excess mortality in April (weeks 15-18) where we normally see lower overall death counts as the seasonal flu season has run its course. The daily death totals we have seen in April should guarantee that. In addition, total deaths usually decrease by 2,000 per week in April compared to March which should also push excess mortality totals higher.

There is also no question that we have seen excess mortality in New York City in the data already.

Here is the CDC chart for New York City. In week 14, P&I deaths made up 31.5% of all deaths according to the CDC data. Last year it was 8.6% in the same week.

Credit:CDC

For additional perspective, New York City usually averages about 1,100 deaths per week in March.

In week 13 the CDC data shows that NYC had 2,474 total deaths.

In week 14 the data shows 4,408 total deaths.

I know there are some who are questioning whether all of the Covid-19 deaths being reported are really due to the virus.

When you see total deaths running as high as four times normal in New York City there is little doubt that there is a lot of excess mortality taking place and Covid-19 is the cause.

However, the same is not evident in looking at the national numbers. That seems even more true when you consider the New York City numbers are included in the national numbers.

If the national numbers show no excess mortality over the last six weeks, even though New York City has had so much, that has to mean that deaths are actually down even more in the rest of the country compared to what we would normally expect.

I intend to closely monitor the CDC FluView surveillance website in the weeks ahead to see if it provides some further perspective on all of the questions that are out there.

We should also learn a lot from the CDC surveillance data on what occurs when some of the mitigation policies in the various states are lifted. Will we see an immediate increase in cases as the CovidActNow and other models suggest? Or will warmer weather and a lower R0 help keep the lid on the contagion?

However, looking at the data as of now I have to ask...

Is this a national crisis or is it a New York crisis?

Stay tuned.

Context Around Covid-19

Regular readers of BeeLine know I am a big believer in providing context around an issue.

As I often say, context is everything when assessing anything.

There is no subject that requires more context when assessing anything than most information you hear about Covid-19. It is almost impossible to wrap your mind around all of the numbers and economic implications.

A little context around Covid-19 that I recently have found interesting.

Over 50% of deaths in Europe are from residents of nursing homes

We often hear that Covid-19 is more deadly to those that are older. It is not just their age. It is also where they have been living. Here is a little context on that issue that shows how many deaths in major European countries have come from people living in nursing homes.

Over half of the combined deaths in these countries are from residents of nursing homes.

Credit: https://ltccovid.org/wp-content/uploads/2020/04/Mortality-associated-with-COVID-12-April-3.pdf

The two big hot spots in Europe ---57% in Spain. 53% in Italy.

Deaths in Sweden are declining even though economy was never totally shutdown

Sweden has gotten a lot of attention around the world by not closing its schools and shutting down its economy as many countries have done. Many have argued that Sweden will regret that decision. However, let's put that argument into context. 

Recent data from Sweden suggests that deaths have already peaked and are now declining in that country.

Time Series: Deaths per day
https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa

Sweden has about the same population as the state of Georgia in the USA. (approx. 10 million).

Here is the graph of deaths in Georgia by date. Sweden's death rate per capita is about double that of Georgia but the slopes of the graphs are remarkably similar going up, peaking and heading down on a similar timeline. 

https://dph.georgia.gov/covid-19-daily-status-report

I thought it was also interesting to see the age distribution of deaths in Sweden.

23% of all deaths in Sweden have been from people age 90 or older.

64% of deaths have been age 80 or older.

Deaths from those under age 50 almost do not show up on the graph.

Deaths per age group
https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa

For context, here is the most recent data from Florida. Note that the age distribution of deaths in Florida is very similar to Sweden.

Also of note is the fact that Florida's deaths per capita are 1/4 of that in Sweden. Recall that Governor DeSantis was heavily criticized for not instituting a stay-at-home order for the entire state until April 1. That was at least two weeks after most other major states took that action.

Credit: https://twitter.com/AlexBerenson/status/1250888639418163205

Unemployment claims in the last month almost equal to all job gains over the last decade

An additional 5.2 million unemployment claims were filed for last week in the United States. 22 million people have now filed for unemployment in the last four weeks.

Let's put that in context.

That is about the same number of jobs that have been created in the last 10 years in the United States.

In other words, what it took a decade to create has been demolished in one month.

Credit: ZeroHedge

 Effects of Economic Impacts of Covid-19 by Age

Everyone has been affected by the economic effects of Covid-19. However, this survey by Data for Progress shows that younger voters have been hit especially hard. 33% of all voters say they have lost their job, been placed on leave or had their work hours cut. However, 52% of those under age 45 have been affected in this way. It is only 26% for those age 45 or older.

How much time would it take to test everyone in the USA for Covid-19?

Some are saying that the United States should not open the economy until everyone can be tested for Covid-19. 

How long would that take?

Let's look at some numbers assuming one test is administered every second of the day, 24 hours a day, 7 days a week until everyone has gotten tested.

1 test per minute

60 tests in one minute

3,600 tests in one hour

86,400 tests in one day

2,592,000 tests in one month

31,536,000 tests in one year

There are an estimated 328 million people in the United States.

At one test per second it would take over 10 years to test everyone in the United States.

Can we wait 10 years to open up the country? 

Even at 10 tests per second it would take one year. That would mean conducting 864,000 tests per day. That is over 5 times that number we are doing per day right now.

These numbers also provide context on the incredible progress in testing in the United States over the last month.

Tests administered as of 4/16    3,401,064 

Tests administered as of 3/16         42,286

People are really staying at home

Why have oil prices gone into free fall? All cruise ships are sitting idle. Air travel is down 96% from last year. Miles driven by personal vehicles since February 2 looks like this.

 Things are not quite as bad as you might think if you own stocks

Most people don't even want to look at their stock values or 401(k) balances with all the bad news they hear each day about the economy.

One thing we all should be thankful for is that this Covid-19 crisis did not occur in 2008/2009. We had some margin to provide some cushion for the economic shock. That also applies to the employment numbers.

A few pieces of good news that most people are not aware of.

NASDAQ stock average is actually higher today than it was 6 months ago.

S&P 500 is higher than it was on June 3 of last year.

These factoids would normally be good cocktail conversation to share with friends this weekend.

Not this weekend.

I guess your best option is to forward this information to a friend. 

Stay safe.