NedNotes (not blog): 18dec20 weekly COVIData sweep

In remembrance of five Americans struck down this week by the vicious virus, Three women, two men. A Native American Elder and one nun.  From thirty-seven to eighty-six years old. Two artists, a pastoral care provider for children, a church builder, and a journalist. Average age of fifty-seven and median of seventy-three. Ranging from Michigan to the Dakotas. 🙏

B.L.U.F. (bottom-line, up-front): another adverse week for the United States, with accelerating penetration and more deaths, tracking with University of Washington estimates. AGAIN and ALWAYS: lethality lies primarily in transmission rather than mortality run rates. Otherwise, modest improvements in positivity rates.

NOTE: my beloved Tunisia fared well in the first wave but is struggling in this second wave as more patients strain the two-tiered health system placing her with the second highest fatality rate relative to population in Africa. The problems are similar to those of the United States during her second wave. 🙏😷💔

INTRODUCTION
This week has witnessed the momentum of infections at a time when a mutation may be making the coronavirus more transmissible in the U.K. A significant gap between states’ and people’s expectations for vaccine deliveries has opened, leading to (conspiracy) speculation that planning on the distribution and related funding by the Federal government (U.S.G.) is inadequate by prior design or deception. Some evidence may suggest diminished data integrity and why.

This week’s info-sweep focusses in part on the impact of the American epidemic upon the arts. The performing arts are receiving attention as Congress negotiates a new coronavirus relief package. The fine arts rely more on the big foundations with household names. Lastly, incongruities with data, particularly around recovery rates, have emerged, raising potential uncertainty with data integrity. 

OVERVIEW
Sexion summary. Deaths rising fast enough for total death toll to double by the date when these dismissive missives end (i.e., 05mar21, mercifully). Problems are being aggravated by political maneuvers or leadership incompetence.

The world has slogged through yet another difficult week; the United States added almost eighteen thousand deaths, more than 2,500 per day on daily new cases of some 225,000 per day. The pattern seen in the past of a slower first few days in the week followed by acceleration in the latter days has continued. One bright note: deaths, critical care patients, and hospitalizations did slow modestly at the end of the week.

 

At this pace, the death toll will surpass my projection forecast in April 2020 by year’s end. This acceleration should not be so pronounced. In fact, we have understood the mitigants required for a century. Trump's checking out two months ago is aggravating the stresses already imposed by the first lock-down as states enter their second rounds of restrictions. In fairness to Trump, he did recognize this problem of impacts on social development and mental health; sadly he did little about it.

 

In addition to cultural divides throughout the country, evidence of politicization may make the analysis of the U.S.G.’s data – as now collected by the Trump-compliant Department of Heath and Human Services – more challenging. A good source for tracking this political dimension of the pandemic is the series of essays – six each week – penned by Dr Heather Cox Richardson titled ‘Letters from an American’.

Please note that Dr Richardson takes a progressive view toward history. As a conservative, I am fine with that because the good professor is transparent and her research is meticulous. One can simply read the strong case she typically makes through his or her personal lens. As a former Republican, I often disagree with Dr Richardson, but her insights never fail to enrich my perspective.

One must not lapse into a feeling of normality with respect to this week's numbers notwithstanding improving positivity rates. Assuming nothing changes from this week's 'improved' fatality growth rate of 6%, overall deaths in the United States would climb to 575-580,000 souls by 01Mar20 (i.e., the end of the one year time horizon for this series of sweeps). 

This week, only D.C., Hawaii, and Vermont have tested below 5% positivity rates (i.e., the level deemed safe to re-open when maintained for two weeks). Half a dozen states in the Northeast and the Pacific Northwest came close to cracking that World Health Organization threshold. Seven states most urgently to watch include:

• Arizona for her increasing weekly growth rate in fatalities, high positivity, poor testing penetration, and shrinking intensive / critical care unit (I.C.U.) availability;
• California for her population, quickening fatality and infection rates, over-crowded hospitals in the more heavily populated southern half, and high positivity rates;
• The Dakotas for their high positivity rates, accelerating death tolls, and poor testing capacity;
• Michigan for her population, continuing high weekly mortality growth, high positivity, and strained I.C.U. capacity;
• Pennsylvania for her population, rapidly growing death tolls, poor performance in testing, etc., very high positivity rates; as well as,
• Tejas for her population, proximity to México, increasingly strained I.C.U. availability, high case growth rates, poor testing régime, as well as worsening yet already high positivity rates.

BLIND DATA GETTING LOST (or TOSSED)
Sexion summary. The premier data manager for this epidemic has dropped a key datum, suggesting problems of data integrity or lack of standard metrics. Furthermore, deaths appear to be rising faster than recoveries, including asymptomatics.

Two disturbing things have appeared this week with the data. First, the worldwide static pool mortality rates (i.e., deaths divided by the sum of deaths + recoveries) have risen noticeably (i.e., 6%+) for the first time that I can recall. That is difficult to explain without an intimate knowledge of how other countries are doing. One or both of two things is going on.

1. Deaths in recent days have accelerated relative to recoveries, a disturbing possibility as testing is expanding across the world and a with new mutations constantly discovered; and / or,
2. The calculations have been changed; there is no discussion of this assertion readily available in the press.

Deaths may be accelerating faster than recoveries due to re-openings in India and elsewhere; COVID is now penetrating across the world rapidly. The calculations – most likely around the definition of a recovery – may be changing. That possibility leads to the second data-nerd nervous break-down for the week.

In the middle of the week, Johns Hopkins ceased publishing the datum for national recoveries across the United States without identifying a reason transparently. Substituting a proxy datum from Microsoft / BING, that change has reduced the value of U.S. static pool rates to make align them with the 3.4% global average. This change lends itself to at least two troubling possible explanations.

1. Johns Hopkins has lost control of some of its data.
2. There is a problem with data integrity, showing up first with the fuzziest datum of all (i.e., recoveries).

Of course, that static pool rates are not declining nearly as fast as mortality run rates (i.e., cumulative deaths to total confirmed cases) points to a disturbing up-tick ahead since these two data eventually must converge upon attainment of herd immunity when the coronavirus is no longer so 'novel'. Losing control of the data remains a real possibility, since different jurisdictions may have different notions of what comprises a recovery. 

That issue of defining a recovery turns on a central question of whether to include people testing positive for anti-bodies, implying a previously asymptomatic infection. Complicating this question of passive carriers, the Trump régime has pursued a herd immunity strategy by maximizing infections among less vulnerable groups. Though one can argue in favor of such a policy, it is not working as the virus jumps generations, often from gown-to-town, and, now, younger adults are beginning to die in higher numbers than usual.

This strategy pursued by the Trump Admin. overlooks the latent legacy of the virus for asymptomatics, as indicated by younger-aged 'long-haulers'. There is ample evidence of data integrity challenges as Trump may have politicized the pandemic possibly by over-promising on vaccine deliveries and timing as well as reportedly compromising the reporting coming out of the Centers for Disease Control. Though sobering, President Biden’s cautious outlook actually helps.

HERE COMES THE CAVALRY . . . umm . . . erm . . . ¡whhuuuppps!

Sexion Summary. One week into vaccinations and recriminations have started over unmet expectations of vaccine availability. Back-end distribution channels are not yet in place and states are not yet seeing the funding needed to implement the vaccination program. A second vaccine granted emergency use authorization (E.U.A.) by the U.S. Food and Drug Administration (F.D.A.). 

The F.D.A. has cleared the way for the second vaccine to begin distribution under the E.U.A. protocol. Together with Pfizer, the Moderna vaccine can inoculate almost 5.5 million people. Like so many other developments during this epidemic, the quality of information from Trump and his loyalists looks to be overly optimistic. The Western states endorse the Pfizer vaccine’s safety.

 

To me, the information appears to be a little confusing since various data conflict among news sources. The Trump Administration hopes to vaccinate some twenty million Americans, primarily elder-care residents and medical first responders, by year’s end. Nevertheless, states struggling in this second wave are complaining of “steep cuts” of the Pfizer vaccine for the balance of the year by some 35%.

 

The Trump Admin. and Pfizer blame each other, with the former claiming that Pfizer has a production problem and the latter gainsaying that assertion, claiming that no one is picking up delivery for the U.S.G. As it is, the initial 5.9 million complete vaccinations – good to inoculate 2,950,000 people -- looks to be distributed based on populations of the states. The twenty million vaccinations by 01jan21 strikes me as a stretch.

 

The distribution from lab to state is planned; distribution from the those state hubs to people’s biceps remains a challenge with funding and programming set to run out just after President Biden is sworn into office. Like so many other aspects of this coronavirus contagion, one must simply wait and see what happens once Trump departs. The first shipments expect to cover about a third of the most vulnerable populations. Some states have plans short on funds but visible in eye-candy (e.g., South Dakota's infographic below).

FEATURE: CREATIVE CRISIS ON THE EVE OF DESTRUCTION

Sexion summary. The arts, most noticeably the live performing arts (e.g., plays, operas, rodeos, concerts, circuses), have suffered an estimated $15 billion financial loss among non-profits to date. Due to constituent pressures, Congress is paying attention to the performing arts; the fine arts (e.g., paintings, sculptures) are not as visible but are securing support from N.G.O.s.

 

The coronavirus contagion has affected every part of American life, few more than the arts that rely upon social interaction and group settings, frequently indoors, not to mention nine-to-ten million back-up personnel, either to promote the fine arts or to stage the performing arts. This challenge remains a commonplace, even in ‘post-COVID’ (sic) nations like China or secondary regions within stricken countries.

 

While Ireland has acted more decisively in favor of her artists and creative communities than the United States, the dozen-plus issues of lost work, revenues, etc. are universal. This ‘creative crunch’ respects no borders as solutions emerge with time. On the business side in the United States, Robert Sweibel arts consultancy in N.Y.C. catalogues an thorough list of digital arts information and resources for artisans across the U.S.

 

Following Canada’s albeit smaller lead, the United States Congress is haggling toward $10-17 billion for the arts in the proposed coronavirus relief bill. Led by Senators Klobuchar (D-MN) and Cornyn (R-TX), the relief will supplement other subsidies (e.g., the Payroll Protection Program) though these have expired. Any sum within that range should suffice to cover the amount of lost revenues in the performing arts.

 

In surveying several, far from all, arts hubs around the country – New York, Boston, Chicago, San Francisco, and Los Angeles – the flurry of private and public sector coordinated initiatives may remind one of the Great Society with its notion of creative federalism and its push into the arts. Sadly, there is a New Year’s Eve funding cliff in the offing for many of these efforts.

 

Approaches to mitigate the COVID crisis in the arts vary widely, reflecting resources available and the ‘quantifiability’ of need. Since performing arts and professional crafts have business models, one can project financial losses reasonably. Some institutions with business interruption insurance have sought reimbursement of lost income. Unfortunately, insurers are disputing these claims, on solid but lamentable grounds.

 

These constraints have induced creatively diverse approaches, ranging from assistance for pre-paid rental fees to secure future space (now unused) to literally out-sourcing some performing arts to the great outdoors. While Broadway is shuttered for another nine months at least, its absence on the road has hurt many medium-sized cities like Denver and Pittsburgh. Yet the arts remain important to American culture and their absence continues to be keenly felt.

The fine arts have a harder row to hoe with a utility function not as easily measured in money.  Nevertheless, these museums, perhaps auction houses and galleries, end up following the regulations laid down for their performing peers. Smaller local governments find it difficult to manage the dollar drought for the arts; most such programs strike one as trying to bail out the S.S. Titanic with a soup spoon. Large charitable trusts, already known for their support for the fine arts, are pooling resources.

(FAMILY) CLUSTER FACTS

Baltimore-Annapolis (general info-link). Push-back from restauranteurs against partial lock-down in Baltimore and adverse ruling in Anne Arundel County. Economy beginning to show life.

 

Boston & Cape Cod (general info-link). Cape Cod already getting vaccines. Republican Governor Baker urging people to stay put during holidays. Democrats want indoor dining formally curtailed.

 

Chicago proper (general info-link). Infection rates and hospitalizations flattening but deaths still high. Teachers’ union denied delay in re-opening schools on 04jan21.

 

Colorado statewide (general info-link). Despite reduced deliveries, medical first responders being vaccinated; lower priority recipients demand clarity on who gets what and when. 16% positivity in Delores County. State stepping up relief efforts, slowly bring contagion under control.

 

Detroit metro (general info-link). Immediate return to class-room for high schools permitted. Legislature passes bill for $465 million for unemployment / small business relief and vaccine distribution.

 

NEW YORK METRO (general info-link). N.J. to distribute vaccine through mega-centers. Connecticut surging capacity. N.Y. relaxing shut-down; using hospitalizations as guide for targeted actions.

 

Philadelphia metro (general info-link). CARES act monies stuck in process.
Pittsburgh metro (general info-link). Western PA hospitals challenged, but PGH metro okay, at least for now.

METHODOLOGY
Since this data sweep serves as a information supplement without very little research, this week provides an opportunity to clean up the presentation through the following changes. For informational purposes, this text will follow the second table on thirty-eight states and five territories in subsequent weeks. For comprehensive explanations on methodology and purpose, please revert to Appendix I. 

1st, the two averages of weekly growth rates for the ten bellwether states are clarified in the Appendix. Essentially, the geometric or compound average growth rate is a smoothed average that allows for growth-on-growth increases (i.e., similar to compounding interest). The time weighted weekly averages are a trend-weighted average of each week's particular growth rates. While the compound rate is theoretically more defensible, comparing the two averages gives one a sense of more recent trends and volatilities.

2nd, in the 3table (of thirty-eight states and five territories), the risk classifications  -- of very low; low; moderate; high; and, very high -- remain the same. The parameters, however, are loosened to reflect nine months of experience. The new parameters center upon the first year base case fatality level of 335,301 souls that I forecast eight months ago, together with the updated projection from the University of Washington of 470,974 deaths. On 04dec20, the old and new parameters are applied to facilitate  transition.

3rd,changes in how positivity rates are presented in the 38+ now align the data with the original intention behind presenting them. The intent here is to show whether positivity is trending up or down and to what degree. The parameters are loosened to match the practical reporting constraints and data lags facing most states. 

States with changed positivity rates of less than 10% up (i.e., worsening) or down (i.e., improving) are deemed unchanged and the information unformatted (i.e., appearing in plain black font). The formatting differentiates deteriorations from improvements in the color of the font between 10-20%. Bold fonts indicate material deteriorations or improvements of more than 20%. 

Keep in mind that these percentage changes are based on percentages; percentages of percentages can attenuate the utility of data.

4th, a refresher on the assessment of a state’s testing capacity, again on the 38+ table. The data pivot off of the tests per million people expressed as a percentage. The symbology uses hand gestures to assessment the degree of testing capability and commitment relative to the national average for the week under review. Colors indicate whether testing is declining (red font) or improving (blue font) when a states results place its commitment to a new category of, specifically:

• 👎👎 meaning a state's testing level materially below the concurrent national benchmark (i.e., > 15 points below);
• 👎 meaning a state's testing is noticeably below the weekly national average (i.e., 5-15 points below);
• 👈 meaning a state's testing activity is slightly lower than average (i.e., < 5 points below);
• 👉👈 meaning a state's testing level is basically equal to that of the nation;
• 👉 meaning a state's testing level is < 5 points above the benchmark;
• 👍 meaning a state's testing activity is 10-15 points above the weekly national level; and,
• 👍👍 meaning a state's testing commitment is > 15 points above the concurrent average.