Sunday, May 3, 2020

So Much We Don't Know

Google has an interesting tool that allow us to see the effects that social distancing is having on people in various countries, states and counties. Google complies this data based on location information they receive from people's smartphones.

For example, here is the Community Mobility Report for the United States for the period March 15-April 26 for Retail & Recreation, Grocery & Pharmacy and Parks.




Here it is for Spain.





Here is is for Sweden.




Looking at the Google Mobility data for these three countries it is clear that Spain has been most successful at social distancing followed by the United States. Sweden has not closed schools, restaurants or bars but they have asked people to be responsible and social distance where possible.

We hear so much about how important social distancing is to curbing the spread of Covid-19. Looking at this mobility data you would think that Spain would have the fewest cases and deaths and Sweden would have the most with the United States in the middle.

These are what the actual numbers are for each country per Worldometers.org as of 5/3/20 at 17:04GMT.

Total Cases/Deaths per 1 million population

Spain          5,285/1M         540/1M

USA           3,353/1M         205/1M

Sweden      2,210/1M          265/1M


Sweden's cases are not much different than the United States despite no economic lockdown. Sweden's lower number of cases is probably explained by the fact that it they have only tested about half of what the United States has on a per capita basis.

Spain, which has seen the biggest use of social distancing, has had the worst experience.

In looking at the Google Mobility data I noticed a similar pattern in looking at individual states in the United States.

48% of the deaths and 38% of all the confirmed cases of Covid-19 in the United States are in New York and New Jersey.

This is Google Mobility data for New York.



This is the data for New Jersey.




Notice that the social distancing taking place in New York and New Jersey is much higher than the United States as a whole. In fact, if you look at all the states, it shows larger reductions in visits to all of these locations than any other state.

Compare New York and New Jersey to Florida on Google Mobility.

This is the Florida data.



There is less social distancing going on in Florida than in either New York or New Jersey.

Now compare the cases and death from Covid-19 in the three states.

Florida               1,752/1M         67/1M

New York         16,457/1M    1,256/1M

New Jersey       14,270/1M       886/1M


New York has almost 10 times the cases and 20 times the deaths as Florida on a per capita basis.

This would seem to indicate that other factors beyond simple social distancing are in play regarding the spread and prevention of the virus in these states.

If that was the absolute key would we also not expect to see the number of cases dropping faster than they have in New York and New Jersey after over six weeks of very stringent social distancing taking place?

I do not pretend to know what all of this means but I do know it means that we don't know enough about what is truly effective and what is not when it comes to limiting the impact of Covid-19.

I am very interested in what we will see now that different states are taking different approaches as we enter the next phase of dealing with Covid-19.

We are being told that the Governors in states like Georgia and Texas are being irresponsible in opening up parts of their economy while states like Virginia and California are doubling down.

Governor Northam of Virginia has extended the stay-at-home order until June 10.

Governor Newsom of California has closed the beaches in addition to extending the state-at-home order until May 31.

I will be keeping a close eye on the numbers to see if it tells us anything.

In the meantime, I also find it interesting that we hear so little about where the new cases are coming from after more than six weeks of lockdowns.

In my home state of Ohio, we are continuing to see about 500-600 new cases per day. This is after more than six weeks of stay-at-home orders with a virus that has an average incubation period of around 5 days.




The number of daily cases are actually about double what they were in the early April when we were just over three weeks into the stay-at-home order.

Where are the new cases coming from?

Are they among workers at essential businesses who never closed?

Customers who went out briefly to buy essential supplies at the grocery store?

Are they among health care workers?

Are they among family members of health care workers or others who were working in essential businesses?

Nursing home residents?

Prisoners?

Or is this just a function of more testing?

I consider this important information to share with the public in order that we all might be able to better assess the risks to ourselves and others.

Why do we know so little about something that affects our lives so much?

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