powerlineblog--2020-04-03--Coronavirus in one state (3)

Coronavirus in one state (3)

Minnesota Governor Tim Walz promulgated his first shutdown order on March 17 before broadening and extending it a week later .
The governor promulgated his current shutdown order on the basis of a model that projected in excess of 74,000 deaths due to the Wuhan virus .
We have questioned the projection and asked what model it is based on .
Today the Star Tribune finally gets around to taking a look — an extremely clouded look — at Walz ’ s in Jeremy Olson ’ s story “ Disease data modeling , in Minnesota and elsewhere , varies greatly.
@ @ @ @ @ @ @ Minnesota Department of Health and the University of Minnesota directly informed Gov .
Tim Walz and guided his stay-at-home order.
” What is Walz ’ s model ?
How many lives will the current , extremely destructive shutdown save , if any ?
Let us extract the references to Walz ’ s model : Modeling by the Minnesota Department of Health and the University of Minnesota persuaded Gov .
Tim Walz to announce the current stay-at-home order .
The modeling is conservative , perhaps pessimistic , about the course of the outbreak , @ @ @ @ @ @ @ , but the Washington model may be optimistic and overlooking risk factors in the United States that could make the outbreak worse .
“ Saying that the Washington approach is optimistic is not saying that we think we ’ re right , ” he said .
“ Some of our assumptions might have turned out to be unusually conservative .
In fact , we ’ ve been saying this from the beginning .
We will continue to test our assumptions and change them.
” The Minnesota modeling wasn ’ t designed to forecast @ @ @ @ @ @ @ decline under social distancing restrictions .
Gildemeister and colleagues concluded that deaths could decline by one-third under the current stay-at-home strategy — primarily by delaying the surge of cases so that hospitals have more time to prepare .
When it comes to the death numbers , any change in assumptions makes a dramatic difference .
The Minnesota researchers used hospitalization and death rates that increase with age and were first used by colleagues at Imperial College .
We have adverted several times to the Imperial College model and related problems .
Olson alludes @ @ @ @ @ @ @ researchers also used a so-called R-naught estimate that one Minnesotan carrying the coronavirus would spread it on average to 2.5 people , whereas initial global estimates were only 2.2 .
In the world of R-naughts , tenths can make a substantial difference in estimating how rapidly a virus can spread , said Dr. Frank Rhame , a virologist for Allina Health .
“ Over a couple of months , 2.2 and 2.5 is a big difference.
” With no interventions at all , the Minnesota model estimated 74,000 deaths in the state .
@ @ @ @ @ @ @ estimated around 50,000 .
However , Rhame said the reduced face-to-face contact in Minnesota could be reducing the R-naught , which in turn would reduce infections and deaths .
The addition of ventilators could help as well , as the Minnesota model predicts local hospitals will run out before the COVID-19 outbreak peaks .
Globally , only around 5 % of COVID-19 cases have needed hospital intensive care , and fewer yet have needed ventilators to compensate for the severe respiratory symptoms that can occur .
But death risks increase dramatically when people @ @ @ @ @ @ @ needed .
The Minnesota model also assumed that people with COVID-19 needing intensive care would remain in hospital ICU units on average for 23 days .
The actual length of stay could be shorter , which would mean more availability of beds and ventilators .
The length of stay “ affects available resources , and that affects the timing of when we reach overcapacity , and that affects [ the rate of ] mortality , ” Gildemeister said .
When it comes to saving some 24,00 lives at the costs imposed by the @ @ @ @ @ @ @ we are walking in a wonderland of bovine excrement ?
Analyze this : But then there is this : One concern about the Washington model is that it doesn ’ t directly account for the high level of obesity and chronic disease in the U.S. , which could result in more severe illnesses and deaths than in China or other countries , Gildemeister said .
The Minnesota model was based on prior studies that demonstrated that people with chronic diseases were 7.6 times more likely to die from a COVID-19 illness than people @ @ @ @ @ @ @ predicted only a delayed peak in COVID-19 cases and hospitalizations because of the mitigation strategies , and not a reduction of cases , but updated analysis may show differently , Gildemeister said .
Does anyone seriously believe that we will save 24,000 lives in Minnesota by preserving the availability of health care resources that would otherwise be lacking ?
I doubt it , but Olson lets the question escape unasked .
The question of costs versus benefits is beyond Olson , or beyond the scope of his story .
Reading Olson ’ s @ @ @ @ @ @ @ it solely on its own terms , I assess that we are at substantial risk of inflicting enormous damage on the Minnesota economy with literally no benefit in lives saved .
I ’ m not saying this is the case .
I don ’ t know .
I ’ m saying it is a reasonable inference from Olson ’ s story .
NOTE : See also Kevin Roche ’ s Healthy Skeptic post “ Be Extremely Cautious About Anything You See Based on a Model .
”

Minnesota Governor Tim Walz promulgated his first shutdown order on March 17 before broadening and extending it a week later. The governor promulgated his current shutdown order on the basis of a model that projected in excess of 74,000 deaths due to the Wuhan virus. We have questioned the projection and asked what model it is based on.
Today the Star Tribune finally gets around to taking a look — an extremely clouded look — at Walz’s in Jeremy Olson’s story “Disease data modeling, in Minnesota and elsewhere, varies greatly.” Subhead: “Modeling by the Minnesota Department of Health and the University of Minnesota directly informed Gov. Tim Walz and guided his stay-at-home order.”
What is Walz’s model? How many lives will the current, extremely destructive shutdown save, if any? Let us extract the references to Walz’s model:
Modeling by the Minnesota Department of Health and the University of Minnesota persuaded Gov. Tim Walz to announce the current stay-at-home order. The modeling is conservative, perhaps pessimistic, about the course of the outbreak, said Stefan Gildemeister, state health economist, but the Washington model may be optimistic and overlooking risk factors in the United States that could make the outbreak worse. “Saying that the Washington approach is optimistic is not saying that we think we’re right,” he said. “Some of our assumptions might have turned out to be unusually conservative. In fact, we’ve been saying this from the beginning. We will continue to test our assumptions and change them.” The Minnesota modeling wasn’t designed to forecast deaths but rather how much they would decline under social distancing restrictions. Gildemeister and colleagues concluded that deaths could decline by one-third under the current stay-at-home strategy — primarily by delaying the surge of cases so that hospitals have more time to prepare. When it comes to the death numbers, any change in assumptions makes a dramatic difference. The Minnesota researchers used hospitalization and death rates that increase with age and were first used by colleagues at Imperial College.
We have adverted several times to the Imperial College model and related problems. Olson alludes to none of this.
Olson continues:
The local researchers also used a so-called R-naught estimate that one Minnesotan carrying the coronavirus would spread it on average to 2.5 people, whereas initial global estimates were only 2.2. In the world of R-naughts, tenths can make a substantial difference in estimating how rapidly a virus can spread, said Dr. Frank Rhame, a virologist for Allina Health. “Over a couple of months, 2.2 and 2.5 is a big difference.” With no interventions at all, the Minnesota model estimated 74,000 deaths in the state. Under the current stay-at-home strategy, it estimated around 50,000. However, Rhame said the reduced face-to-face contact in Minnesota could be reducing the R-naught, which in turn would reduce infections and deaths. The addition of ventilators could help as well, as the Minnesota model predicts local hospitals will run out before the COVID-19 outbreak peaks. Globally, only around 5% of COVID-19 cases have needed hospital intensive care, and fewer yet have needed ventilators to compensate for the severe respiratory symptoms that can occur. But death risks increase dramatically when people don’t have ventilators available when needed. The Minnesota model also assumed that people with COVID-19 needing intensive care would remain in hospital ICU units on average for 23 days. The actual length of stay could be shorter, which would mean more availability of beds and ventilators. The length of stay “affects available resources, and that affects the timing of when we reach overcapacity, and that affects [the rate of] mortality,” Gildemeister said.
When it comes to saving some 24,00 lives at the costs imposed by the current shutdown, does anyone sense that we are walking in a wonderland of bovine excrement? Analyze this:
The Washington model suggests an improving situation in Minnesota. It predicted a death toll of more than 2,000 in the state a week ago but only 932 as of Wednesday because of the apparent impact of Walz’s stay-at-home order.
But then there is this:
One concern about the Washington model is that it doesn’t directly account for the high level of obesity and chronic disease in the U.S., which could result in more severe illnesses and deaths than in China or other countries, Gildemeister said. The Minnesota model was based on prior studies that demonstrated that people with chronic diseases were 7.6 times more likely to die from a COVID-19 illness than people without those conditions. Minnesota modeling has predicted only a delayed peak in COVID-19 cases and hospitalizations because of the mitigation strategies, and not a reduction of cases, but updated analysis may show differently, Gildemeister said.
Does anyone seriously believe that we will save 24,000 lives in Minnesota by preserving the availability of health care resources that would otherwise be lacking? I doubt it, but Olson lets the question escape unasked.
The question of costs versus benefits is beyond Olson, or beyond the scope of his story. Reading Olson’s story closely, however, and taking it solely on its own terms, I assess that we are at substantial risk of inflicting enormous damage on the Minnesota economy with literally no benefit in lives saved.
I’m not saying this is the case. I don’t know. I’m saying it is a reasonable inference from Olson’s story.
NOTE: See also Kevin Roche’s Healthy Skeptic post “Be Extremely Cautious About Anything You See Based on a Model.”


Pelosi barks

Nancy Pelosi is Exhibit A in Kim Strassel ’ s Wall Street Journal Potomac Watch column “ Pols Face a Coronavirus Test.
” Subhead : “ Who ’ s leading and who ’ s seeking political advantage ?
Here are the answers.
” Pelosi is the leading example of what not to do : Crises have a way of separating the leaderlike wheat from the opportunistic chaff .
Coronavirus is the crisis of our time , and the political winnowing is something to behold .
Example : The Trump administration spent this week distributing ventilators , standing up small-business loans @ @ @ @ @ @ @ care facilities , explaining virus modeling , revamping regulations to keep truckers on the road , and plastering the airwaves with information about hygiene and social distancing .
Speaker Nancy Pelosi spent this week setting up a new House committee to investigate Donald Trump .
After citing Governors Cuomo and Newsom as counterexamples , Strassel returns to Pelosi : Contrast this with Mrs. Pelosi , who seems to view the pandemic as one big political opportunity .
She held up last week ’ s relief bill for days , attempting to cram into @ @ @ @ @ @ @ She used a Sunday CNN appearance to accuse Mr. Trump of killing Americans .
This week she announced a new special House committee that will “ examine all aspects of the federal response to the coronavirus ” and will have subpoena power .
This is yet the latest Democratic machinery for investigating Trump and ginning up scandals .
“ The little dogs and all , ” King Lear complains as he struggles to hold it together in Shakespeare ’ s great play .
“ Tray , Blanch , and Sweet-heart , see , @ @ @ @ @ @ @ to be seeing things , but Pelosi is unfortunately for real .
The little dogs bark but the caravan moves on .

Nancy Pelosi is Exhibit A in Kim Strassel’s Wall Street Journal Potomac Watch column “Pols Face a Coronavirus Test.” Subhead: “Who’s leading and who’s seeking political advantage? Here are the answers.” Pelosi is the leading example of what not to do:
Crises have a way of separating the leaderlike wheat from the opportunistic chaff. Coronavirus is the crisis of our time, and the political winnowing is something to behold. Example: The Trump administration spent this week distributing ventilators, standing up small-business loans, dispatching hospital ships, erecting alternate care facilities, explaining virus modeling, revamping regulations to keep truckers on the road, and plastering the airwaves with information about hygiene and social distancing. Speaker Nancy Pelosi spent this week setting up a new House committee to investigate Donald Trump.
After citing Governors Cuomo and Newsom as counterexamples, Strassel returns to Pelosi:
Contrast this with Mrs. Pelosi, who seems to view the pandemic as one big political opportunity. She held up last week’s relief bill for days, attempting to cram into it unrelated election and climate provisions. She used a Sunday CNN appearance to accuse Mr. Trump of killing Americans. This week she announced a new special House committee that will “examine all aspects of the federal response to the coronavirus” and will have subpoena power. This is yet the latest Democratic machinery for investigating Trump and ginning up scandals.
“The little dogs and all,” King Lear complains as he struggles to hold it together in Shakespeare’s great play. “Tray, Blanch, and Sweet-heart, see, they bark at me.” Lear seems to be seeing things, but Pelosi is unfortunately for real. The little dogs bark but the caravan moves on.


powerlineblog--2020-04-04--Trump nominates 37 year-old Kentucky judge for D.C. Circuit

President Trump has nominated Judge Justin Walker for the U.S. Court of Appeals for the District of Columbia , the nation ’ s second most important court .
Walker , age 37 , serves on the U.S. District Court for the Western District of Kentucky .
He has been on that court for about half a year .
The American Bar Association rated Walker “ unqualified ” when he was nominated for the district court position .
To the extent , if any , that the ABA wasn ’ t engaged in raw partisanship , its rating presumably was based @ @ @ @ @ @ @ tried a case .
Trial experience is relevant in considering a nominee for a trial court .
However , it has little bearing on the qualifications of an appeals court judge — the position Walker now has been tapped for .
In any event , Walker has now presided over federal trials .
Walker is a graduate of Harvard Law School , where he served on the law review .
He clerked for Brett Kavanaugh on the D.C Circuit ( a reminder of how “ newly minted ” Walker is ) and for @ @ @ @ @ @ @ After his clerkships , Walker worked for a top law firm in D.C. ( Gibson Dunn ) , maintained a solo practice in Louisville , and then joined the faculty of the University of Louisville Law School .
Walker ’ s conservative credentials include substantial contributions to the Federal Society .
He served on the executive board of the Harvard chapter as a student and on the executive board of the Louisville chapter before becoming a judge .
Walker has the strong backing of Senate Majority Leader McConnell .
Reportedly , McConnell has @ @ @ @ @ @ @ for his high school newspaper .
I assume it was through McConnell ’ s influence that Walker jumped to the head of the line for the coveted spot on the D.C .
Circuit .
Walker is qualified for the job ( whatever the ABA ends up saying ) and he ’ s a solid conservative , as noted .
However , Trump could have nominated someone with more appellate experience , greater familiarity with the issues the D.C .
Circuit tends to hear , and a longer conservative track record .
But Walker @ @ @ @ @ @ @ qualified .
Absent unexpected revelations ( and I don ’ t mean unsubstantiated claims about a high school party ) , the Senate should confirm Walker .

President Trump has nominated Judge Justin Walker for the U.S. Court of Appeals for the District of Columbia, the nation’s second most important court. Walker, age 37, serves on the U.S. District Court for the Western District of Kentucky. He has been on that court for about half a year.
The American Bar Association rated Walker “unqualified” when he was nominated for the district court position. To the extent, if any, that the ABA wasn’t engaged in raw partisanship, its rating presumably was based on the fact that Walker had never tried a case.
Trial experience is relevant in considering a nominee for a trial court. However, it has little bearing on the qualifications of an appeals court judge — the position Walker now has been tapped for. In any event, Walker has now presided over federal trials.
Walker is a graduate of Harvard Law School, where he served on the law review. He clerked for Brett Kavanaugh on the D.C Circuit (a reminder of how “newly minted” Walker is) and for Justice Kennedy on the Supreme Court.
After his clerkships, Walker worked for a top law firm in D.C. (Gibson Dunn), maintained a solo practice in Louisville, and then joined the faculty of the University of Louisville Law School. Walker’s conservative credentials include substantial contributions to the Federalist Society. He served on the executive board of the Harvard chapter as a student and on the executive board of the Louisville chapter before becoming a judge.
Walker has the strong backing of Senate Majority Leader McConnell. Reportedly, McConnell has known Walker since he interviewed the Senator for his high school newspaper.
I assume it was through McConnell’s influence that Walker jumped to the head of the line for the coveted spot on the D.C. Circuit. Walker is qualified for the job (whatever the ABA ends up saying) and he’s a solid conservative, as noted. However, Trump could have nominated someone with more appellate experience, greater familiarity with the issues the D.C. Circuit tends to hear, and a longer conservative track record.
But Walker is the nominee and he’s qualified. Absent unexpected revelations (and I don’t mean unsubstantiated claims about a high school party), the Senate should confirm Walker.


powerlineblog--2020-04-03--Has COVID-19 Peaked In the U.S.?

Has COVID-19 Peaked In the U.S.?

The Centers for Disease Control web site says there have been around 240,000 identified cases of the Wuhan virus in the U.S. , and , as of today , 5,543 deaths .
I have generally not paid much attention to data on cases , because the number of cases reported obviously depends in large part on the number of tests being carried out .
More tests will generate more cases .
Still , this chart suggests that the epidemic may be peaking in the U.S .
It tracks the daily number of cases by date of onset .
Click to @ @ @ @ @ @ @ side of the chart will of course rise higher as more cases come in .
But putting that aside , if these numbers are representative , the peak in terms of new cases may already have been reached .
I believe some models predict that deaths will peak around mid-April , which I think would be consistent , as deaths obviously lag onset of illness .
One reason why I am reluctant to assign too much significance to this chart is that it includes just a little over one-fourth of the total number @ @ @ @ @ @ @ because in many instances , the date of onset is unknown or not reported .
If the one-quarter represented in the chart are a random sample , the trend should be accurate .
But I don ’ t know that that is true .
In any event , like all of the other data on COVID-19 currently swirling around , you can take it for what it is worth and draw your own conclusions .

The Centers for Disease Control web site says there have been around 240,000 identified cases of the Wuhan virus in the U.S., and, as of today, 5,543 deaths. I have generally not paid much attention to data on cases, because the number of cases reported obviously depends in large part on the number of tests being carried out. More tests will generate more cases. Still, this chart suggests that the epidemic may be peaking in the U.S.
It tracks the daily number of cases by date of onset. Click to enlarge:
The bars on the right side of the chart will of course rise higher as more cases come in. But putting that aside, if these numbers are representative, the peak in terms of new cases may already have been reached. I believe some models predict that deaths will peak around mid-April, which I think would be consistent, as deaths obviously lag onset of illness.
One reason why I am reluctant to assign too much significance to this chart is that it includes just a little over one-fourth of the total number of cases. I assume that is because in many instances, the date of onset is unknown or not reported. If the one-quarter represented in the chart are a random sample, the trend should be accurate. But I don’t know that that is true.
In any event, like all of the other data on COVID-19 currently swirling around, you can take it for what it is worth and draw your own conclusions.


powerlineblog--2020-04-03--Bill Withers dies at 81

Bill Withers dies at 81

I am sorry to pass on the news that Bill Withers died on Monday at the age of 81 .
The cause , according to his family , was heart complications .
The news will break the hearts of anyone who leaned on his music to get through sad times or celebrate happy occasions .
Where were you the first time you heard “ Ain ’ t No Sunshine ” in 1971 ?
If you were around at the time , I bet you remember .
It was a heckuva single , one of those buried treasures discovered by deejays @ @ @ @ @ @ @ side ( “ Harlem ” ) to find it .
The rest of us took it from there .
I should add that that this single and the first album were produced by Booker T. Jones with the Stax rhythm section and a few other guests backing Withers .
Stephen Stills sat in on guitar for “ Ain ’ t No Sunshine.
” The estimable Booker T. added the string arrangement .
Withers ’ s background and personality seemed to me to ooze from the grooves of his records .
That ’ s @ @ @ @ @ @ @ s Hands , ” anyway .
I think the same applies to “ Use Me.
” This just pops out at you .
Born in Slab Fork , West Virginia , Withers joined the Navy at age 17 .
He put in 9 years as an aircraft mechanic before he punched out .
I learn from the Times obituary that “ [ a ] visit to a club to see Lou Rawls perform was a catalyst for changing his life.
” It wasn ’ t just Rawls ’ s singing that lit Withers @ @ @ @ @ @ @ babe magnet aspect of the vocation .
You can hear it oozing from the grooves of “ Use Me.
” Withers was his own man .
When his original label went bust , Withers signed with Columbia .
The suits at Columbia wouldn ’ t let him be .
The Times obit also plucks this quotable quote from a Rolling Stone interview in 2015 when he was inducted into the Rock & Roll Hall of Fame : “ I wouldn ’ t know a pop chart from a Pop-Tart.
” RIP .

I am sorry to pass on the news that Bill Withers died on Monday at the age of 81. The cause, according to his family, was heart complications. The news will break the hearts of anyone who leaned on his music to get through sad times or celebrate happy occasions.
Where were you the first time you heard “Ain’t No Sunshine” in 1971? If you were around at the time, I bet you remember. It was a heckuva single, one of those buried treasures discovered by deejays who had to flip over the A side (“Harlem”) to find it. The rest of us took it from there.
I should add that that this single and the first album were produced by Booker T. Jones with the Stax rhythm section and a few other guests backing Withers. Stephen Stills sat in on guitar for “Ain’t No Sunshine.” The estimable Booker T. added the string arrangement.
Withers’s background and personality seemed to me to ooze from the grooves of his records. That’s what I hear in “Grandma’s Hands,” anyway.
I think the same applies to “Use Me.” This just pops out at you.
Born in Slab Fork, West Virginia, Withers joined the Navy at age 17. He put in 9 years as an aircraft mechanic before he punched out. I learn from the Times obituary that “[a] visit to a club to see Lou Rawls perform was a catalyst for changing his life.” It wasn’t just Rawls’s singing that lit Withers up, either. It was the babe magnet aspect of the vocation. You can hear it oozing from the grooves of “Use Me.”
Withers was his own man. When his original label went bust, Withers signed with Columbia. The suits at Columbia wouldn’t let him be. The Times obit also plucks this quotable quote from a Rolling Stone interview in 2015 when he was inducted into the Rock & Roll Hall of Fame: “I wouldn’t know a pop chart from a Pop-Tart.” RIP.