COVID Trends and Flu Cases

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Writing about COVID as a respite from election madness is very cold comfort, but here goes….

COVID deaths in the U.S. still haven’t shown the kind of upward trend this fall that many had feared. It could happen, but it hasn’t yet. In the chart above, new cases are shown in brown (along with the rolling seven-day average), while deaths (on the right axis) are shown in blue. It’s been over six weeks since new case counts began to rise, but deaths have risen for about two weeks, and it’s been gradual relative to the first two waves. Either the average lag between diagnosis and death is much longer than earlier in the year, or the current “casedemic” is much less deadly, or perhaps both. It could change. And granted, this is national data; states in the midwest have had the strongest trends in cases, especially the upper midwest, as well as stronger trends in hospitalizations and deaths. Most of those areas had milder experiences with the virus in the spring and summer.

Lagged Reporting

What’s tricky about this is that both case reports and death reports in the chart above are significantly lagged. A COVID test might not take place until several days after infection (if at all), and sometimes not until hospitalization or death. Then the test result might not be known for several days. However, the greater availability of tests and faster turnaround time have almost certainly shortened that lag.

Deaths are reported with an even a greater delay, though you wouldn’t know it from listening to the media or some of the organizations that track these statistics, such as Johns Hopkins University and the COVID Tracking Project. Thus far, they only tell you what’s reported on a given day. This article from Rational Ground does a good job of explaining the issue and the distortion it causes in discerning trends.

Deaths by actual date-of-death

I’ve reported on the issue of lagged COVID deaths myself. The following graph from Justin Hart is a clear presentation of the reporting delays.

Reported deaths for the most recent week (10/24) are shown in dark blue, and those deaths were spread over a number of prior weeks. Actual deaths in a given week are represented by a “stack” of deaths reported later, in subsequent weeks. One word of caution: actual deaths in the most recent weeks are “provisional”, and more will be added in subsequent reporting weeks. Hence the steep drop off for the 10/17 and 10/24 reporting weeks.

Going back three or four weeks, it’s clear that actual deaths continued to decline into October. Unfortunately, that doesn’t tell us much about the recent trend or whether actual deaths have started to rise given the increase in new cases. I have seen a new weekly update with the deaths by actual date of death, but it is not “stacked” by reporting week. However, it does show a slight increase in the week of 10/10, the first weekly increase since the end of June. So perhaps we’ll see an uptick more in-line with the earlier lags between diagnosis and death, but that’s far from certain.

Another important point is that the number of deaths each week, and each day, are not as high as reported by the media and the popular tracking sites. How often have you heard “more than 1,000 people a day are dying”. That’s high even for weekly averages of reported deaths. As of three weeks ago, actual daily deaths were running at about 560. That’s still very high, but based on seroprevalence estimates (the actual number of infections from the presence of antibodies), the infection fatality keeps dropping toward levels that are comparable to the flu at ages less than 65.

Where is the flu?

Speaking of the flu, this chart from the World Health Organization is revealing: the flu appears to have virtually disappeared in 2020:

It’s still very early in the northern flu season, but the case count was very light this summer in the Southern Hemisphere. There are several possible explanations. One favored by the “lockdown crowd” is that mitigation efforts, including masks and social distancing, have curtailed the flu bug. Not just curtailed … quashed! If that’s true, it’s more than a little odd because the same measures have been so unsuccessful in curtailing COVID, which is transmitted the same way! Also, these measures vary widely around the globe, which weakens the explanation.

There are other, more likely explanations: perhaps the flu is being undercounted because COVID is being overcounted. False positive COVID tests might override the reporting of a few flu cases, but not all diagnoses are made via testing. Other respiratory diseases can be mistaken for the flu and vice versus, and they are now more likely to be diagnosed as COVID absent a test — and as the joke goes, the flu is now illegal! And another partial explanation: it is rare to be infected with two viruses at once. Thus, COVID is said to be “crowding out” the flu.

Waiting for data

There is other good news about transmission, treatment, and immunity, but I’ll devote another post to that, and I’ll wait for more data. For now, the “third wave” appears to be geographically distinct from the first two, as was the second wave from the first. This suggests a sort of herd immunity in areas that were hit more severely in earlier waves. But the best news is that COVID deaths, thus far this fall, are not showing much if any upward movement, and estimates of infection fatality rates continue to fall.

Biden Brainstorm: Nationwide Lockdown, Mask Mandate

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Ah, so Mayor Pete Buttigieg of South Bend, Indiana, one of garbling Joe Biden’s campaign surrogates, says Biden will indeed consider a national lockdown if elected. Oh, fine. And Biden accused Trump of destroying the economy? These dumb-asses must think people have memory spans of about a second.

There are several gigantic problems with foggy Joe’s idea: first, it’s not within a president’s power to impose a nationwide lockdown, as the chorus of experts reminded us last spring when Trump mentioned it. Second, the evidence suggests that lockdowns don’t work to eliminate the virus; they delay its spread at best. Third, as we’ve witnessed, lockdowns themselves have enormous public health consequences, leading to a variety of severe maladies, despondency, and excess non-COVID deaths. That’s simply unacceptable. Finally, the economic damage imposed by lockdowns is horrific and often permanent. We’re talking about destroying the independent livelihoods of people. Permanently! Lockdowns are especially hard on those at the bottom of the economic ladder, who are disproportionately minorities. That’s so obvious, and yet very difficult for elites to gather in.

Here’s another one: today Biden said he would impose a “national mandate” on masks and social distancing on Day One of his presidency. Like lockdowns, evidence is accumulating that masks do not work to contain the virus, and in fact they might be counter-productive (also see here, here, here, and here). Biden’s people will probably also insist on a mandating a government-approved contact-tracing app on your cell phone. Not if I can help it! But don’t get me wrong… I wear a mask in public buildings as an act of voluntary cooperation and to be polite. I also hold out some hope that it will keep the viral load minimal should anything float my way, but whatever lands on the mask might stick with it … and me!

Measures like those Biden contemplates are major assaults on our liberty. And the thing is, if any of it comes to pass, the restrictions might never go away. We’ll be asked to do this every flu season, or perhaps permanently to protect each other from “germs”. This is an authoritarian move, one that we should all resist, even if you’re freaked out by the virus. The best way to resist right now is to vote for Donald Trump.

And please, don’t give me any bullshit about our “responsibility” to lock down, and how mandatory masks are necessary to protect the vulnerable. Is poverty now a “responsibility”? The most highly vulnerable can be protected without masks, and maybe better. Beyond that, people must be free to determine their own level of risk tolerance, just as they have for millennia with respect to a broad spectrum of serious risks, pathogens or otherwise. That’s a dimension of freedom about which no one should be so cavalier.

The Biden Family Influence Racket

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If you’ve heard the Biden family’s long-time influence peddling racket is “fake news”, and you believe it, you’ve been manipulated. It’s certainly not a new story, in and of itself. There are certain mainstream media outlets that wouldn’t dream of reporting it now that not long ago were calling out the Bidens over this issue. It’s easy to be suspicious, given Hunter Biden’s lucrative association with the scandal-plagued Ukrainian energy firm Burisma. His contract with Burisma was executed around the time his dad Joe, the Vice President at the time, became heavily involved in President Obama’s diplomatic efforts in the Ukraine. Joe actually bragged publicly that he’d threatened to withhold U.S. loan guarantees unless a certain prosecutor was fired, a man who just happened to be investigating Burisma!

Then there were Hunter Biden’s manuevers in China, another country in which father Joe had been assigned as point man for the Obama Administration’s diplomatic efforts. The father and son travelled together, and it was well known that Hunter made a very profitable business deal with a billionaire owner of a Chinese energy firm, one with important connections to the Chinese Communist Part (CCP). Suspicious, to be sure.

But let’s review what’s happened more recently:

  • Earlier this month, the New York Post reported that the owner of a computer repair shop in Delaware came forward with a copy of a hard drive from a laptop. The owner claimed the laptop had been left with him by a besotted Hunter Biden in April 2019. Biden never picked it up, even after a reminder, so ownership of the laptop reverted to the shop. The owner said it contained compromising material on the Bidens.
  • The owner had turned over the laptop to the FBI almost a year ago because he feared that its possession might expose him to danger, given its contents. Apparently, the FBI did not follow up with him. This motivated the shop owner to go public with the help of Rudy Guiliani.
  • As disturbing as that may be, the larger story involves the trove of emails and texts on the laptop between Hunter Biden and his business associates. The messages indicate that Hunter Biden and his uncle, Jim Biden, were involved in a heavy influence peddling operation.
  • The materials offer fairly strong evidence that Joe Biden was a financial beneficiary of the deals cut by Hunter and his team. These are deals that would have compromised Joe Biden in his dealings with foreign nations, and in particular the Ukraine and China.
  • Subsequently, two of Hunter Biden’s business associates confirmed the authenticity of the controversial communications made public. One of them, an investor and ex-naval officer named Tony Bobulinski, was brought in by the Bidens as CEO of their partnership with the Chinese. Bobulinski says he met with Joe Biden twice regarding the Chinese business deal for which Hunter solicited his support, and he calls Joe Biden a liar. Bubolinsky has been interviewed by the FBI and has provided documents to the Senate Homeland Security Committee and the Senate Finance Committee.
  • Until a few days ago, no one in the Biden family, nor the Biden campaign, had denied that the laptop belonged to Hunter. But Joe Biden gave a blunt denial this week, saying of the whole story: “There is no controversy about my son. That’s a hell of a lie! That’s a flat lie because the president has nothing else to run on.” Alright Joe, so this whole thing is politically motivated. You might be right about the timing, but that certainly doesn’t vindicate your family of the corruption evident in these messages and the accounts offered by your son’s associates.
  • Now, there is documented proof of an earlier favor bestowed on the Chinese by Hunter Biden, his associates, and members of the Obama Administration, including Joe Biden. This was in 2011, when a group called the China Entrepreneur Club (CEC) arranged through Hunter’s associates to tour the White House and meet with Joe Biden and other officials. The group included CCP and Chinese government officials as well as influential Chinese businessmen. It also resulted in some lucrative deals for Hunter Biden and his partners. The purpose of the meetings was put thusly by a Hunter Biden contact who helped arrange it, as quoted at the last link: “… CEC’s ‘mandate’ was ‘to let the U.S. know that the Chinese “private sector” [scare quotes in original] is ready and willing to invest in America.’ He thus observed the opportunity to leverage government policy and lucrative business: Cultivating the CEC would be ‘a soft diplomacy play that could be very effective.’” Specific deals for Hunter Biden’s team were also discussed by the partners in connection with the CEC visit.

It’s no surprise that Joe Biden is a liar: his history as a plagiarist is well known. He also falsely claimed the truck driver involved in the accident that killed his first wife was driving drunk. But these recent revelations are pretty damning. As president, any dealings Joe Biden might have with the Chinese would be severely compromised. He sold out his country to build his family’s wealth. It’s also been disturbing to witness the media’s effort to provide cover for the Bidens. This is not the work of journalists; it’s the work of propagandists in the tank for a candidate.

Four More Years to MAGAA

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As a “practical” libertarian, my primary test for any candidate for public office is whether he or she supports less government dominance over private decisions than the status quo. When it comes to Joe Biden and his pack of ventriloquists, the answer is a resounding NO! That should clinch it, right? Probably, but Donald Trump is more complicated….

I’ve always viewed Trump as a corporatist at heart, one who, as a private businessman, didn’t give a thought to free market integrity when he saw rent-seeking opportunities. Now, as a public servant, his laudable desire to “get things done” can also manifest to the advantage of cronyists, which he probably thinks is no big deal. Unfortunately, that is often the way of government, as the Biden family knows all too well. On balance, however, Trump generally stands against big government, as some of the points below will demonstrate.

Trump’s spoken “stream of consciousness” can be maddening. He tends to be inarticulate in discussing policy issues, but at times I enjoy hearing him wonder aloud about policy; at other times, it sounds like an exercise in self-rationalization. He seldom prevaricates when his mind is made up, however.

Not that Biden is such a great orator. He needs cheat sheets, and his cadence and pitch often sound like a weak, repeating loop. In fairness, however, he manages to break it up a bit with an occasional “C’mon, man!”, or “Here’s the deal.”

I have mixed feelings about Trump’s bumptiousness. For example, his verbal treatment of leftists is usually well-deserved and entertaining. Then there are his jokes and sarcasm, for which one apparently must have an ear. He can amuse me, but then he can grate on me. There are times when he’s far too defensive. He tweets just a bit too much. But he talks like a tough, New York working man, which is basically in his DNA. He keeps an insane schedule, and I believe this is true: nobody works harder.

With that mixed bag, I’ll now get on to policy:

Deregulation: Trump has sought to reduce federal regulation and has succeeded to an impressive extent, eliminating about five old regulations for every new federal rule-making. This ranges from rolling back the EPA’s authority to regulate certain “waters” under the Clean Water Act, to liberalized future mileage standards on car manufacturers, to ending destructive efforts to enforce so-called net neutrality. By minimizing opportunities for over-reach by federal regulators, resources can be conserved and managed more efficiently, paving the way for greater productivity and lower costs.

And now, look! Trump has signed a new executive order making federal workers employees-at-will! Yes, let’s “deconstruct the administrative state”. And another new executive order prohibits critical race theory training both in the federal bureaucracy and by federal contractors. End the ridiculous struggle sessions!

Judicial Appointments: Bravo! Neil Gorsuch, Brett Kavanaugh, Amy Coney Barrett, and over 200 federal judges have been placed on the bench by Trump in a single term. I like constitutional originalism and I believe a “living constitution” is a corrupt judicial philosophy. The founding document is as relevant today as it was at its original drafting and at the time of every amendment. I think Trump understands this.

Corporate Taxes: Trump’s reductions in corporate tax rates have promoted economic growth and higher labor income. In 2017, I noted that labor shares the burden of the corporate income tax, so a reversal of those cuts would be counterproductive for labor and capital.

At the same time, the 2017 tax package was a mixed blessing for many so-called “pass-through” businesses (proprietors, partnerships, and S corporations). It wasn’t exactly a simplification, nor was it uniformly a tax cut.

Individual Income Taxes: Rates were reduced for many taxpayers, but not for all, and taxes were certainly not simplified in a meaningful way. The link in the last paragraph provides a few more details.

I am not a big fan of Trump’s proposed payroll tax cut. Such a temporary move will not be of any direct help to those who are unemployed, and it’s unlikely to stimulate much spending from those who are employed. Moreover, without significant reform, payroll tax cuts will directly accelerate the coming insolvency of the Social Security and Medicare Trust Funds.

Nonetheless, I believe permanent tax cuts are stimulative to the economy in ways that increased government spending is not: they improve incentives for effort, capital investment, and innovation, thus increasing the nation’s productive capacity. Trump seems to agree.

Upward Mobility: Here’s Joel Kotkin on the gains enjoyed by minorities under the Trump Administration. The credit goes to strong private economic growth, pre-pandemic, as opposed to government aid programs.

Foreign Policy: Peace in the Middle East is shaping up as a real possibility under the Abraham Accords. While the issue of coexisting, sovereign Palestinian and Zionist homelands remains unsettled, it now seems achievable. Progress like this has eluded diplomatic efforts for well over five decades, and Trump deserves a peace prize for getting this far with it.

Iran is a thorn, and the regime is a terrorist actor. I support a tough approach with respect to the ayatollahs, which a Trump has delivered. He’s also pushed for troop withdrawals in various parts of the world. He has moved U.S. troops out of Germany and into Poland, where they represent a greater deterrent to Russian expansionism. Trump has pushed our NATO allies to take responsibility for more of their own defense needs, all to the better. Trump has successfully managed North Korean intransigence, though it is an ongoing problem. We are at odds with the leadership in mainland China, but the regime is adversarial, expansionist, and genocidal, so I believe it’s best to take a tough approach with them. At the UN, some of our international “partners” have successfully manipulated the organization in ways that make continued participation by the U.S. of questionable value. Like me, Trump is no fan of UN governance as it is currently practiced.

Gun Rights: Trump is far more likely to stand for Second Amendment rights than Joe Biden. Especially now, given the riots in many cities and calls to “defund police”, it is vitally important that people have a means of self-defense. See this excellent piece by David E. Bernstein on that point.

National Defense: a pure public good; I’m sympathetic to the argument that much of our “defense capital” has deteriorated. Therefore, Trump’s effort to rebuild was overdue. The improved deterrent value of these assets reduces the chance they will ever have to be used against adversaries. Of course, this investment makes budget balance a much more difficult proposition, but a strong national defense is a priority, as long as we avoid the role of the world’s policeman.

Energy Policy: The Trump Administration has made efforts to encourage U.S. energy independence with a series of deregulatory moves. This has succeeded to the extent the U.S. is now a net energy exporter. At the same time, Trump has sought to eliminate subsidies for wasteful renewable energy projects. Unfortunately, ethanol is still favored by energy policy, which might reflect Trump’s desire to assuage the farm lobby.

Climate Policy: Trump kept us out of the costly Paris Climate Accord, which would have cost the U.S. trillions of dollars in lost GDP and subsidies to other nations. Trump saw through the accord as a scam under which leading carbon-emitting nations (such as China) face few real obligations. Meanwhile, the U.S. has led the world in reductions in carbon emissions during Trump’s term, even pre-pandemic. That’s partly a consequence of increased reliance on natural gas relative to other fossil fuels. Trump has also supported efforts to develop more nuclear energy capacity, which is the ultimate green fuel.

COVID-19 Response: As I’ve written several times, in the midst of a distracting and fraudulent impeachment attempt, Trump took swift action to halt inbound flights from China. He marshaled resources to obtain PPE, equipment, and extra hospital space in hot spots, and he kick-started the rapid development of vaccines. He followed the advice of his sometimes fickle medical experts early in the pandemic, which was not always a good thing. In general, his policy stance honored federalist principles by allowing lower levels of government to address local pandemic conditions on appropriate terms. If the pandemic has you in economic straits, you probably have your governor or local officials to thank. As for the most recent efforts to pass federal COVID relief, Nancy Pelosi and House Democrats have insisted on loading up the legislation with non-COVID spending provisions. They have otherwise refused to negotiate pre-election, as if to blame the delay on Trump.

Immigration: My libertarian leanings often put me at odds with nationalists, but I do believe in national sovereignty and the obligation of the federal government to control our borders. Trump is obviously on board with that. My qualms with the border wall are its cost and the availability of cheaper alternatives leveraging technological surveillance. I might differ with Trump in my belief in liberalizing legal immigration. I more strongly differ with his opposition to granting permanent legal residency to so-called Dreamers, individuals who arrived in the U.S. as minors with parents who entered illegally. However, Trump did offer a legal path to citizenship for Dreamers in exchange for funding of the border wall, a deal refused by congressional Democrats.

Health Care: No more penalty (tax?) to enforce the individual mandate, and the mandate itself is likely to be struck down by the Supreme Court as beyond legislative intent. Trump also oversaw a liberalization of insurance offerings and competition by authorizing short-term coverage of up to a year and enabling small businesses to pool their employees with others in order to obtain better rates, among other reforms. Trump seems to have deferred work on a full-fledged plan to replace the Affordable Care Act because there’s been little chance of an acceptable deal with congressional Democrats. That’s unfortunate, but I count it as a concession to political reality.

Foreign Trade: I’m generally a free-trader, so I’m not wholeheartedly behind Trump’s approach to trade. However, our trade deals of the past have hardly constituted “free trade” in action, so tough negotiation has its place. It’s also true that foreign governments regularly apply tariffs and subsidize their home industries to place them at a competitive advantage vis-a-vis the U.S. As the COVID pandemic has shown, there are valid national security arguments to be made for protecting domestic industries. But make no mistake: ultimately consumers pay the price of tariffs and quotas on foreign goods. I cut Trump some slack here, but this is an area about which I have concerns.

Executive Action: Barack Obama boasted that he had a pen and a phone, his euphemism for exercising authority over the executive branch within the scope of existing law. Trump is taking full advantage of his authority when he deems it necessary. It’s unfortunate that legislation must be so general as to allow significant leeway for executive-branch interpretation and rule-making. But there are times when the proper boundaries for these executive actions are debatable.

Presidents have increasingly pressed their authority to extremes over the years, and sometimes Trump seems eager to push the limits. Part of this is born out of his frustration with the legislative process, but I’m uncomfortable with the notion of unchecked executive authority.

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Of course I’ll vote for Trump! I had greater misgivings about voting for him in 2016, when I couldn’t be sure what we’d get once he took office. After all, his politics had been all over the map over preceding decades. But in many ways I’ve been pleasantly surprised. I’m much more confident now that he is our best presidential bet for peace, prosperity, and liberty.

Portents of Harris-Biden Nation

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Joe Biden is a weak figurehead, a one-time moderate faltering over a coalition of leftists. If you wonder why Nancy Pelosi floated legislation to establish a committee on “presidential capacity,” don’t think so much about her loathing for Donald Trump; think about poor Joe Biden. He might be shunted aside just as soon as the power grab isn’t too obvious. They know well how Barack Obama famously said, “Don’t underestimate Joe’s ability to f*ck things up.” But whether Joe Biden is in control of anything, think about who he stands with:

The Violent Left: Marxist Antifa and Marxist BLM; opposed to law and order; burning cities; spewing eliminationist rhetoric; hissing n*g**r at black cops;

Police Defunders: won’t acknowledge good policing is needed more than ever, especially in minority communities;

“Ministers of Truth”: social media platforms exerting control over what we say and what we see;

Re-Educators: democrats push for a “Truth and Reconciliation Commission” to address the “issue” of Trump supporters;

Critical Race Theorists: a Marxist front whereby every word and action is viewed in the context of racial bias and victimization; they want reparations; on your knees.

The Scientistic: who labor under the delusion that “science” should guide all administrative and political decisions. Or someone’s version of science. The very idea is antithetical to the scientific domain, which deals only with falsifiable hypotheses. Few matters of value can be addressed using the tools of science exclusively, nor can they address matters of ethics.

Fear Mongers: would rule by precaution; risks are always worth exaggerating to existential proportions;

Lockdown Tyrants: refuse to acknowledge the steep public health costs of lockdowns; stripping individual liberties indefinitely, including the right to contract, free practice of religion, and assembly;

Insurrectionists: who fabricated a Russian collusion hoax to subvert the 2016 election, and later to overthrow a sitting president;

Gun Confiscators: they will if we let them;

Abortionists: would use federal tax dollars to fund the murder of millions of babies late into pregnancy, primarily black babies;

Fluid-Genderists: insist that children should be encouraged to explore transgenderism;

Taxers: won’t stop with punitive taxes on the wealthy and employers; it’s just not easy to milk high earners in a way that’s sufficient to pay for the fiscal debauchery demanded by the Biden-Harris constituency. Joe says he will raise taxes by $3.4 trillion.

Spenders: $2 trillion of new federal education outlays, including universal pre-K and free community college; the Green New Deal (see below). After all, the democrats are the party that can’t tell the difference between a cut in spending and a reduction in spending growth. If you think Trump is a big spender, their plans are astonishing;

Green New Dealers: would spend trillions to restrict energy choices, transfer U.S. wealth overseas in the name of international carbon reduction, and reduce our standard of living;

Redistributionists: would tax job creators not simply for the benefit of supporting the needy, but for anyone regardless of need (see UBI); this extends to plans to bail out blue states and cities with insolvent public employee pension funds;

Interventionists: would regulate all phases of life, including straws, sugary drinks, and your fireplace; they will burden private initiative; create artificial, politically-favored winners skilled at manipulating regulatory rules for competitive reasons; and create losers who are typically too small to handle the burden;

Medical Socialists: will strip your private health insurance, dictate the care you may receive, fix prices, and regulate physicians and other providers. You’ll love the care abroad, if you can afford to get out when your sick.

Public School Monopolists: poorly performing, beholden to teachers’ unions, unresponsive to taxpayers and often parents; they would happily revoke school choice;

Federal Suburb Rezoners: demanding low-income housing in every community;

Court Packers: to destroy the independent judiciary;

Iran Apologists: give them cash on the tarmac, let them develop their “peaceful” nuclear program; alienate the rest of the Middle East;

Grifters: marketing their influence as public servants for private gain; never exclusive to one side of the aisle, but the Biden family has certainly traded on Joe to enrich themselves;

Smear Merchants: fabricated allegations against Brett Kavanaugh; impugned Amy Coney Barrett’s religious faith;

Perverts: Harvey Weinstein, Anthony Weiner, Jeffrey Toobin, Hunter Biden, and Bill Clinton, to name just a few; even Joe has his #MeToo accusers;

I could go on and on, but Harris-Biden voters should get a strong taste of their compatriots from the list above. It reflects the overriding prescriptive, bullying, and sometimes violent nature of the Left. They’d have you think all material goods can be free. Presto! They presume to have the knowledge and wisdom to plan the economy and your life better than you, Better than free markets and free people. What they’ll need is a lot of magic, or it won’t go well. You’ll get poverty and tears. I’m not sure Joe has the desire or the wherewithal to rein in his coalition of idiots.

The Favored Cause of Death

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The CDC changed its guidelines on completion of death certificates on April 5th of this year, and only for COVID-19 (C19), just as infections and presumed C19 deaths were ramping up. The substance of the change was to broaden the definition under which death should be attributed to C19. This ran counter to CDC guidelines followed over the previous 17 years, and the change not only makes the C19 death counts suspect: it also makes comparisons of C19 deaths to other causes of death unreliable, since only C19 is subject to the new CDC guidance. That’s true for concurrent and historical comparisons. The distortions are especially bad relative to other respiratory diseases, but also relative to other conditions that are common in mortality data.

The change in the CDC guidelines was noted in a recent report prepared for the Florida House of Representatives. It was brought to my attention by a retweet by Justin Hart linked to this piece on Andrew Bostom’s site. Death certificates are divided into two parts: Part 1 provides four lines in which causes of death are listed in reverse clinical order of events leading to death. Thus, the first line is the final clinical condition precipitating death. Prior clinical events are to be listed below that. The example shown above indicates that an auto accident, listed on the fourth line, initiated the sequence of events. Part 2 of the certificate is available for physicians or examiners to list contributing factors that might have played a role in the death that were not part of the sequence of clinical events leading to death.

The CDC’s change in guidelines for C19, and C19 only, made the criteria for inclusion in Part 1 less specific, and it essentially eliminated the distinction between Parts 1 and 2. The following appears under “Vital Records Criteria”:

A death certificate that lists COVID-19 disease or SARS-CoV-2 as a cause of death or a significant condition contributing to death.”

How much difference does this make? For one thing, it opens the door to C19-attributed deaths in cases of false-positive PCR tests. When large cohorts are subject to testing — for example, all patients admitted to hospitals — there will always be a significant number of false positives even when test specificity is as high as 98 – 99%.

The elimination of any distinction between Parts 1 and 2 causes other distortions. A review of the Florida report is illustrative. The House staff reviewed almost 14,000 certificates for C19-19 attributed deaths. Over 9% of those did not list C19 among the clinical conditions leading to death. Instead, in those cases, C19 was listed as a contributing factor. Under the CDC’s previous guidelines, those would not have been counted as C19 deaths. The Florida House report is conservative in concluding that the new CDC guidelines inflated C19 deaths by only those 9% of the records examined.

There are reasons to think that the exaggeration was much greater, however. First, the Florida House report noted that nearly 60% of the certificates contained information “recorded in a manner inconsistent with state and national guidance”. In addition, almost another 10% of the fatalities were among patients already in hospice! Do we really believe the deaths of all those patients whose diseases had reached such an advanced stage should be classified as C19 fatalities? And another 1-2% listed non-C19 conditions as the immediate and underlying causes.

Finally, more than 20% of the certificates listed C19 alone as a cause of death despite a range of other contributing conditions or co-morbidities. This in itself may have been prompted by the change in the CDC’s guidelines, as the normal standards often involve a “comorbidity” as the initial reason for hospitalization — in that case a clinical event ordinarily listed in Part 1. The high rate of errors and the fact that roughly two-thirds of the deaths reviewed occurred in the hospital, where patients are all tested and often multiple times, raises the specter that up to 20% more of the C19 deaths were either erroneous and/or misclassified due to false positives.

(An exception may have occurred in New York, where an order issued in March by Governor Andrew Cuomo to return C19-positive residents of nursing homes (including suspected C19 cases) back to those homes, The order was made before the change in CDC guidelines and wasn’t rescinded until later in April. There is reason to believe that some of the C19 deaths among nursing home residents in New York were undercounted.)

All told, in the Florida data we have potential misclassification of deaths of 9% + 9% + 2% + 20% = 40%, or inflation relative to actual C19 deaths of up to 40%/60% = 67%! I strongly doubt it’s that high, but I would not consider a range of 25% – 50% exaggeration to be unreasonable.

We know that reports of C19 deaths lag actual dates of death by anywhere from 1 to 8 weeks, sometimes even more. This is misleading when no effort is made to explain that difference, which I’ve never heard out of a single journalist. We also know that false positive tests inflate C19 deaths. The Florida report gives us a sense of how large that exaggeration might be. In addition, the Florida data show that the CDC guidelines inflate C19 deaths in other ways: as a mere contributing factor, it can now be listed as the cause of death, unlike the treatment of pneumonia as a contributing factor, for instance. The same kind of distortion occurs when patients contract C19 (or have a false positive test) while in hospice.

There is no doubt that C19 led to “excess deaths” relative to all-cause mortality. However, many of these fatalities are misclassified, and it’s likely that a large share were and are lockdown deaths as opposed to C19 deaths. That’s tragic. The CDC has done the country a massive disservice by creating “special rules” for attributing cause-of-death to C19. If reported C19 fatality rates reflected the same rules applied to other conditions, our approach to managing the pandemic surely would have inflicted far less damage to health and economic well being.

Fall Coronavirus Season

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We’ve known for some times that COVID-19 (C19) follows seasonal patterns typical of the flu, though without the flu’s frequent antigenic drift. Now that we’re moving well into autumn, we’ve seen a surge in new C19 case counts in Europe and in a number of U.S. states, especially along the northern tier of the country.

The new case surge began in early to mid-September, depending on the state, and it’s been coincident with another surge in tests. From late July through early October, we had a near doubling in the number of tests per positive in the U.S. An increase in tests also accompanied the previous surge during the summer, which claimed far fewer lives than the initial wave in the early spring. In the summer, infections were much more prevalent among younger people than in the spring. Vitamin D levels were almost certainly higher during the summer months, our ability to treat the virus had also improved, and immunities imparted by prior infections left fewer susceptible individuals in the population. We have many of those advantages now, but D levels will fade as the fall progresses.

As for the new surge in cases, another qualification is that false positives are still a major testing problem; they inflate both case counts and C19-attributed deaths. In the absence of any improvement in test specificity, of which there is no evidence, the exaggeration caused by false positives grows larger as testing increases and positivity rates fall. So take all the numbers with that as a caveat.

How deadly will the virus be this fall? So far in Europe, the trends look very promising. Kyle Lamb provided the following charts from WHO on Twitter yesterday. (We should all be grateful that Twitter hasn’t censored Kyle yet, because he’s been a force in exposing alarmism in the mainstream media and among the public health establishment.) Take a look at these charts, and note particularly the lag between the first wave of infections and deaths, as well as the low counts of deaths now:

If the lag between diagnosis and death is similar now to the spring, Europe should have seen a strong upward trend in deaths by now, yet it’s hardly discernible in most of those countries. The fatality rates are low as well:

As Lamb notes, the IFRs in the last column look about like the flu, though again, the reporting of deaths and their causes are often subject to lags.

What about the U.S.? Nationwide, C19 cases and attributed death reports declined after July. See the chart below. More recently, reported deaths have stabilized at under 700 per day. Note again the relatively short lags between turns in cases and deaths in both the spring and summer waves.

Clearly, there has been no acceleration in C19 deaths corresponding to the recent trend in new cases. Northeastern states that had elevated death rates in the spring saw no resurgence in the summer; southern states that experienced a surge in the summer have now enjoyed taperings of both cases and deaths. But with each season, the virus seems to roll to regions that have been relatively unscathed to that point. Now, cases are surging in the upper Midwest and upper mountain states, though some of these states are lightly populated and their data are thin.

A few state charts are shown below, but trends in deaths are very difficult to tease out in some cases. First, here are new cases and reported deaths in Michigan, Wisconsin, and Minnesota. There is a clear uptrend in cases in these states along with a very slight rise in deaths, but reported deaths are very low.

Next are Idaho, Montana, North Dakota, and South Dakota. A slight uptrend in cases began as early as August. Idaho and Montana have had few deaths, so they are not plotted in the second chart. The Dakotas have had days with higher reported deaths, and while the data are thin and volatile, the visual impression is definitely of an uptrend in deaths.

The following states are somewhat more central in latitude: Colorado, Illinois, and Ohio. There is a slight upward trend in new cases, but not deaths. Illinois is experiencing its own second wave in cases.

Out of curiosity, I also plotted Massachusetts, Pennsylvania, and New Jersey, all of which suffered in the first wave during the spring. They are now experiencing uptrends in cases, especially Massachusetts, but deaths have been restrained thus far.

The upshot is that states having little previous exposure to the virus are seeing an uptrend in deaths this fall. The same does not seem to be happening in states with significant prior exposure, at least not yet.

There are major questions about the reasons for the lingering death counts in the U.S.. But consider the following: first, the infection fatality rate (IFR) keeps falling, despite the stubborn level of daily reported deaths. Second, deaths reported have increasingly been pulled forward from deaths that actually occurred in the more distant past. This sort of “laundering” lends the appearance of greater persistence in deaths than is real. Third, again, false positives exaggerate not just cases, but also C19 deaths. Hospitals test everyone admitted, and patients who test positive for C19 are reimbursed at higher rates under the CARES Act; Medicare reimburses at a higher rates for C19 patients as well.

We’re definitely seeing a seasonal upswing in C19 infections in the US., now going on five weeks. In Europe, the surge in cases began slightly earlier. However, in both Europe and the U.S., these new cases have not yet been associated with a meaningful surge in deaths. The exceptions in the U.S. are the low-density upper mountain states, which have had little prior exposure to the virus. The lag between cases and deaths in the spring and summer was just two to three weeks, and while it’s too early to draw conclusions, the absence of a surge in deaths thus far bodes well for the IFR going forward. If we’re so fortunate, we can thank a combination of factors: a younger set of infecteds, earlier detection, better treatment and therapeutics, lower viral loads, and a subset of individuals who have already gained immunity.

Lockdowns Subvert Public Health and Life Itself

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Acceptance of risk is a necessary part of a good life, and extreme efforts to avoid it are your own business. Government has no power to guarantee absolute safety, nor should we presume to have such a right. Ongoing COVID lockdowns are an implicit assertion of exactly that kind of government power, despite the impotence of those efforts, and they constitute a rejection of more fundamental rights.

Lockdowns have had destructive effects on health and economic well being while conferring little if any benefit in mitigating harm from the virus. The lockdowns were originally sold as a way to “flatten the curve”, that is, to avoid a spike in cases and an overburdened health care system. However, this arguably well-qualified rationale later expanded in scope to encompass the mitigation of smaller and much less deadly outbreaks among younger cohorts, and then to the very idea of extinguishing the virus altogether. It’s become painfully obvious that such measures are not capable of achieving those goals.

In the U.S., the ongoing lockdowns have been a cause célèbre largely on the interventionist Left, and they have been prolonged mainly by Democrats at various levels of government. In a way, this is not unlike many other policies championed by the Left, often ostensibly designed to help members of the underclasses: instead, those policies often destroy or wrongly obviate incentives and promote dependency on the state. In this case, the plunge into dependency is a reality the Left would very much like to ignore, or to blame on someone else. You know who.

The lockdowns have been largely unsuccessful in mitigating the spread of the virus. At the same time, they have been used as a pretext to deny constitutional rights such as the free practice of religion, assembly, and a broad range of unenumerated rights under the “penumbra” of the Bill of Rights and the Ninth Amendment. What’s more, the severity of the economic blow caused by lockdowns has been borne disproportionately by the working poor and the small businesses who employ so many of them.

Lockdowns are deadly. It’s not clear that they’ve saved any lives, but they have massively disrupted the operation of the health care system with major consequences for those with chronic and undiagnosed conditions. The lockdowns have also led to spikes in mental health issues, alcoholism, drug abuse, and deaths of despair. A recent study found that over 26% of the excess deaths during the pandemic were non-COVID deaths. Those deaths were avoidable or accelerated, whereas the lockdowns have failed to meaningfully curtail COVID deaths. Don’t tell me about reduced traffic fatalities: that reduction is relatively small relative to the increase in non-COVID excess deaths (see below).

What proof do we have that lockdowns cause excess deaths? See this study in The Lancet on cancer deaths due to lockdown-induced delays in diagnoses. See this study on UK school closures. See this Oxfam International report on lockdown-induced starvation. Other reports from the UK suggests that lockdown deaths are widespread, having taken nearly 2,800 per week early in the pandemic, and many other deaths yet to occur have been made inevitable by lockdowns. Doctors in the U.S. have warned that lockdowns are a “mass casualty incident”, and a German government study warned of the same.

The Ethical Skeptic (TES) on Twitter has been tracking a measure of lockdown deaths for some time now. The following graphic provides a breakdown of excess non-COVID deaths since the start of the pandemic. The total “pie” shows almost 320,000 excess deaths through September 26th (avoiding less complete counts in recent weeks), as reported by the CDC. COVID accounted for 202,000 of those deaths, based on state-level reporting. Of the remaining 117,000 excess deaths, TES uses CDC data to allocate roughly 85,000 to various causes, the largest (more than half) being “Suicide, Addiction, Abandonment, and Abuse”. Other large categories include Cardio/Diabetes, Stroke, premature Alzheimers/Dementia death, and Cancer Access. Nearly 32,000 excess deaths remain as a “backlog”, not yet reported with a cause by states.

Also of interest in the graphic are estimates of life-years lost. The vast bulk of COVID victims are elderly, of course, which means that any estimate of lost years per victim must be relatively low. On the other hand, most non-COVID, lockdown-related deaths are among younger victims, with correspondingly greater life-years lost. TES’s aggregate estimate is that lockdown-related excess deaths involve double the life-years lost of COVID deaths. Of course, that is an estimate, but even granting some latitude for error, the reality is horrifying!

John Tierney in City Journal cites several recent studies concluding that lockdowns have been largely ineffective in Europe and in the U.S. While Tierney doesn’t rule out the possibility that lockdowns have produced some benefits, they have carried excessive costs and risks to public health going forward, such as lingering issues for those having deferred important health care decisions as well as disruption in future economic prospects. Ultimately, lockdowns don’t accomplish anything:

While the economic and social costs have been enormous, it’s not clear that the lockdowns have brought significant health benefits beyond what was achieved by people’s voluntary social distancing and other actions.

Tierney also discusses the costs and benefits of lockdowns in terms of life years: quality-adjusted life-years (QALY), which is a widely-used measure for evaluating of the use of health care resources:

By the QALY measure, the lockdowns must be the most costly—and cost-ineffective—medical intervention in history because most of the beneficiaries are so near the end of life. Covid-19 disproportionately affects people over 65, who have accounted for nearly 80 percent of the deaths in the United States. The vast majority suffered from other ailments, and more than 40 percent of the victims were living in nursing homes, where the median life expectancy after admission is just five months. In Britain, a study led by the Imperial College economist David Miles concluded that even if you gave the lockdown full credit for averting the most unrealistic worst-case scenario (the projection of 500,000 British deaths, more than ten times the current toll), it would still flunk even the most lenient QALY cost-benefit test.”

We can now count the World Health Organization among the detractors of lockdowns. According to WHO’s Dr. David Nabarro:

Lockdowns just have one consequence that you must never ever belittle, and that is making poor people an awful lot poorer…. Look what’s happened to smallholder farmers all over the world. … Look what’s happening to poverty levels. It seems that we may well have a doubling of world poverty by next year. We may well have at least a doubling of child malnutrition.

In another condemnation of the public health consequences of lockdowns, number of distinguished epidemiologists have signed off on a statement known as The Great Barrington Declaration. The declaration advocates a focused approach of protecting the most vulnerable from the virus, while allowing those at low risk to proceed with their lives in whatever way they deem acceptable. Those at low risk of severe disease can acquire immunity, which ultimately inures to the benefit of the most vulnerable. With few, brief, and local exceptions, this is how we have always dealt with pandemics in the past. That’s real life!

COVID, Trump, and Tyrants

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I’ve said this before, but it bears repeating: allegations of the White House’s “poor leadership” and preparedness for COVID-19 (C19) are a matter of selective memory. At the link above, I “graded” Trump’s pandemic job performance through May. Among other things, I said:

Many have criticized the Trump Administration for not being ‘ready’ for a pandemic. I assign no grade on that basis because absolutely no one was ready, at least not in the West, so there is no sound premise for judgement. I also view the very general charge that Trump did not provide “leadership” as code for either ‘I don’t like him’, or ‘he refused to impose more authoritarian measures’, like a full-scale nationwide lockdown. Such is the over-prescriptive instinct of the Left.”

The President of the United States does not have the constitutional authority to impose a national lockdown, though Trump himself seemed confused at times as to whether he had that power. However, on this basis at least, the ad nauseam denigration of his “leadership” is vapid. At this point, the course of the pandemic in the U.S. is less severe than in several other industrialized countries who didn’t even have Andrew Cuomo around to exacerbate the toll, and it’s still not as deadly in per capita terms as the Asian Flu of 1957-58.

Who exactly was “ready” for C19? Perhaps critics are thinking of South Korea, or parts of South Asia. Those countries might have been “ready” to the extent that they had significant prior exposure to SARS viruses. There was already some degree of immunological protection. Those countries also were exposed to an earlier genetic variant of C19 that was much less severe than the strain that hit most of the western world. These are hardly reasons to blame Trump for a lack of “readiness”.

A related charge I hear all the time is that Trump “ignored the advice of medical experts“, or that he “ignored the science“. Presumably, those “experts” include the darling of the Prescriptive Class, Dr. Anthony Fauci. On February 28, Dr Fauci said:

Right now, at this moment, there’s no need to change anything you’re doing on a day by day basis.

All-righty then! So this was the advice Trump “should” have followed. Oh, wait… he did! And Fauci, on March 9, said there was no reason for young, healthy people to avoid cruise ships.

Likewise, Dr. Robert Redfield, Director of the Centers for Disease Control, said the following on February 27:

The risk to the American public is low. We have an aggressive containment strategy that really has worked up to this time, 15 cases in the United States. Until the last case that we just had in Sacramento we hadn’t had a new case in two weeks.”

Then there is the World Health Organization, which downplayed the virus in January and February, and giving a convincing impression that it servied as a mouthpiece for the CCP.

In fact, the American people were badly harmed by wrongheaded decisions made by the “experts” at the CDC in January and February, when the agency insisted that testing could not proceed until a test of their own design was ready. Then, the first version it approved was discovered to be flawed! This set the testing effort back by well over a month, a delay that proved critical. It’s no exaggeration to say this bureaucratic overreach denied the whole country, and Trump, the information needed to properly assess the spread of the virus.

But let’s think about actual policy once it became clear that the virus was getting to be a serious matter in parts of the U.S. Here’s another excerpt from my post in May:

Trump cannot be accused of ignoring expert advice through the episode. He was obviously on-board with Fauci, Dr. Deborah Birx, Dr. Robert Redfield, and other health care advisors on the ‘15 Days to Slow the Spread‘ guidelines issued on March 16. His messaging wavered during those 15 days, expressing a desire to fully reopen the nation by Easter, which Vice President Michael Pence later described as “aspirational”. Before the end of March, however, Trump went along with a 30-day extension of the guidelines. Finally, by mid-April, the White House released guidelines for ‘Opening Up America Again‘, which was a collaboration between Trump’s health care experts and the economic team. Trump agreed that the timeline for reopening should be governed by ‘the data’.” 

We should give Trump credit for shutting down flights into the U.S. from China, where the virus originated, late in January. That was an undeniably prescient move. Let’s also not forget that the original intent of the “15 Days” was to prevent hospitals and other medical resources from being overwhelmed. Today, the data show a strong seasonal tendency to the spread of the virus, but medical resources are not close to being overwhelmed, our ability to treat the virus has vastly improved, and its consequences are much less deadly than in the spring. That’s good progress, whatever the President’s detractors may say.

More than anything else, what Trump’s COVID critics fail to understand is that the executive leader of a republic is not possessed of monarchical powers. And in the U.S., the Constitution provides an additional layer of sovereignty for member states of the Union, a manifestation of the federalist principals without which the Union would not have been possible. The 15-day guidelines produced by the White House, and the guidelines for reopening, were consistent with this framework. The states have adapted their own policies to actual conditions and, if their leaders haven’t worn out their goodwill among voters, internal political realities. Those adaptations were often bad from my perspective, or even tyrannical, but sometimes good. That is exactly how our federalist system was designed to work.

Joe’s “Boom”: Mendacity or Memory Loss?

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Joe Biden has claimed that he and Barack Obama had left Donald Trump with a “booming” economy to start his term in office. Of course, if he had anything to do with economic performance during the Obama Administration, it may have been his oversight of the mismanaged and ineffective “shovel-ready” stimulus program of 2009, For his sake, one might hope (and suspect) his oversight was nominal. In any case, his characterization of the Obama economy is not really accurate, as this editorial at Issues and Insights demonstrates. I could argue with a few of their points, but the thrust of it is correct. The economy weakened in 2015 and 2016, and expectations were for continued slow growth or possibly a recession in 2017 or after. At that point, many economists thought the aging expansion might be on its last legs. But economic growth exceeded expectations after Trump took office. As for job growth, economists predicted relatively sluggish growth in 2017-2019, but actual job growth exceeded those projections by more than three times.

Finally, Biden’s assertion that “Trump caused the recession” was laughable, especially when the punchline is his willingness to “shut down the economy“! He insists “I would listen to the scientists”, presumably the same knuckleheads who don’t understand the public health tradeoffs between the pandemic itself and lockdown risks (and who don’t understand the Constitution). Biden might not understand that the President lacks constitutional powers to demand a nationwide shutdown. Trump was quite sensibly persuaded to leave non-pharmaceutical interventions in the hands of the private sector as well as state and local governments, with guidance from federal health authorities. That some state and local leaders instituted draconian policies, which were largely ineffective and often damaging. was and is a terrible misfortune. The more sensible approach is to  protect the most vulnerable and allow others to gauge their own risks, as we always have in earlier pandemics.