I don’t recommend going to Sen. Rand Paul for your next checkup

  

There was a very telling exchange at the Senate hearing on Tuesday between Dr. Anthony Fauci and Dr. Rand Paul, a medical doctor who is now a US Senator. To quote from the coverage by Market Watch:

“Fauci was challenged by Paul, a Kentucky Republican who has been a vocal advocate of reopening businesses now. In the hearing, Fauci warned that reopening too soon could lead to more disease outbreaks and unnecessary deaths.

“As much as I respect you, Dr. Fauci, I don’t think you’re the end-all,” Paul said. “I don’t think you’re the one person that gets to make a decision. We can listen to your advice, but there are people on the other side saying there’s not going to be a surge, that we can safely reopen the economy, and the facts will bear this out.

“I don’t give advice about anything other than public health,” Fauci responded, noting that other people make the economic decisions.

“Paul said he does not expect a surge in COVID-19 cases in rural states like his. Kentucky currently has about 6,700 confirmed cases, with more than 300 deaths, according to the Lexington Herald-Leader. Comparatively, Oregon — which has roughly the same population as Kentucky but has had stricter and longer-lasting stay-at-home orders — has about 3,300 cases and 130 deaths, according to state data.

“Paul also said schools should resume, since children appear to be less affected by the virus. Fauci urged caution on that, too.

“We really better be very careful, particularly when it comes to children, because, the more and more we learn, we’re seeing things the virus can do that we didn’t see from the studies in China or in Europe,” he said. “I think we’d better be careful if we are not cavalier in thinking that children are completely immune to the deleterious effects” of COVID-19.

“You’re right, in the numbers that children, in general, do much, much better than adults and the elderly, and particularly those with underlying conditions. But I am very careful and hopefully humble that I don’t know everything about this disease, and that’s why I’m very reserved in making broad predictions,” Fauci said.”

(Tom again)

So here we have Dr. Fauci pointing out that, based on the facts that he sees, it’s very important to be cautious about the effects of reopening, especially when it comes to the effects on children. Yet Rand Paul was implying that the death rate from Covid-19 among children was so low that such worries could be put aside in deciding whether to open schools. And yesterday Donald Trump came down very explicitly (as only he can do!) on Rand Paul’s side, saying that we should be just as willing to accept a small number of deaths of children from Covid-19 as we should from car accidents on the way to school. Of course, this is in spite of the widespread reports that 100 children in NY City (as well as many others in Europe and other parts of the US) have come down with a mysterious syndrome – similar to Kawasaki Syndrome – that has caused three of them to die. And that they all had Covid-19 antibodies in their blood.

I’ll admit: We’ll never reopen schools if we say even a single resulting death of a child is unacceptable. On the other hand, are we going to accept numbers like we seem to be accepting for (mostly) adult deaths now: i.e. 1-2,500 every day? My guess is not. So I go back to the question I asked in this post: What is an acceptable level of child deaths? If we know that, then the research can be done to determine whether it’s acceptable in general for schools to reopen in the fall (of course, I don’t doubt there are a lot of schools in rural areas for which it will be perfectly acceptable for them to reopen, as long as – ahem! – there’s massive testing available, to make sure there aren’t already hot spots of mostly asymptomatic people).

However, I do know that Sen. Paul’s breezy assertion that children don’t catch Covid-19 very much isn’t exactly the sort of research I have in mind. You might wonder, how can he be so cavalier – Dr. Fauci’s word, not mine – with the possibility that he might be wrong and lots of children would end up dying because of schools reopening too quickly?

But that’s an easy question to answer: Sen. Paul has already demonstrated that he’s quite capable of acting in total disregard of the health and lives of others, when it suits his interest. He had the distinction of being the first person in the Senate to test positive for Covid-19, and his fellow Senators were furious at him because he had continued to have lunches with them, exercise in the Senate gym and swim in the Senate pool, after learning he might have been exposed to the virus at a black tie event in Louisville, KY two weeks earlier.

You’ve got to admire his consistency.

The numbers

These numbers are updated every day, based on reported US Covid-19 deaths the day before (taken from the Worldometers.info site, where I’ve been getting my numbers all along). No other variables go into these numbers – they are all projections based on yesterday’s 7-day rate of increase in total Covid-19 deaths, which was 14%.

Note that the “accuracy” of the projected numbers diminishes greatly after 3-4 weeks. This is because, up until 3-4 weeks, deaths could in theory be predicted very accurately, if one knew the real number of cases. In other words, the people who are going to die in the next 3-4 weeks of Covid-19 are already sick with the disease, even though they may not know it yet. But this means that the trend in deaths should be some indicator of the level of infection 3-4 weeks previous.

However, once we get beyond 3-4 weeks, deaths become more and more dependent on policies and practices that are put in place – or removed, as is more the case nowadays - after today (as well as other factors like the widespread availability of an effective treatment, if not a real “cure”). Yet I still think there’s value in just trending out the current rate of increase in deaths, since it gives some indication of what will happen in the near term if there are no intervening changes.

However, it’s 100% certain that deaths won’t stop at the end of June! They might decline some more this summer, but Drs. Redfield (CDC head) and Fauci both predict there will be a new wave of the virus in the fall, and one noted study said there was a good probability the fall wave would be greater than the one we’re in now, as happened in the 1918 pandemic.

Week ending	Deaths reported during week/month	Avg. deaths per day during week/month	Pct. Change from previous month
March 7	18	3
March 14	38	5
March 21	244	35
March 28	1,928	275
Month of March	4,058	131
April 4	6,225	889
April 11	12,126	1,732
April 18	18,434	2,633
April 25	15,251	2,179
Month of April	59,812	1,994 (= 1 death every 44 seconds)	1,474%
May 2	13,183	1,883
May 9	12,592	1,799
May 16	11,127	1,590
May 23	12,673	1,810
May 30	14,435	2,062
Month of May	55,508	1,791 (= 1 death every 48 seconds)	93%
June 6	16,442	2,349
June 13	18,727	2,675
June 20	21,331	3,047
June 27	24,296	3,471
Month of June	88,111	2,937 (= 1 death every 29 seconds)	159%
Total March - June	207,488

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 85,197

Increase in deaths since previous day: 1,772 (vs. 1,629 yesterday)

Percent increase in deaths since previous day: 2% (vs. 2% yesterday)

Yesterday’s 7-day rate of increase in total deaths: 14% (This number is used to project deaths in the table above)

II. Total reported cases

I no longer pay any attention to the reported case number. It is a huge underestimate of actual cases, which is at least 5-10 times what’s reported. This is because of the huge shortage of testing capacity. For reported cases to be anywhere near actual cases, we would need to be doing millions of tests a day. I believe the US has done fewer than 7 million tests since the start of the pandemic.

Total US reported cases: 1,430,348

Increase in reported cases since previous day: 21,712

Percent increase in reported cases since yesterday: 2%

Percent increase in reported cases since 7 days previous: 13%

III. Deaths as a percentage of closed cases so far in the US:

Total Recoveries in US as of yesterday: 310,259

Total Deaths as of yesterday: 85,197

Deaths so far as percentage of closed cases (=deaths + recoveries): 22% (vs. 22% yesterday) Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 22% of them have resulted in death. Compare this with the comparable number from South Korea, which is below 3%. China’s is 6%. The reason this number is so high is that total reported recoveries are so low. I’ve been assuming since March 26, when the recoveries number was first published, that it would rise, so that this percentage (which was 41% on March 26), would be far lower than it is now. But it still has to drop a long way, in order for the US to have anything less than millions of death over the course of the pandemic.

I would love to hear any comments or questions you have on this post. Drop me an email at tom@tomalrich.com