What's up with Germany, South Korea, Taiwan?

THURSDAY, MAY 21, 2020

Also, what's up with those N95 masks?
Frankly, we wonder as we wander. Today, we'll cite two questions we don't see being widely reported or discussed:

First, what explains the vastly different death rates from Covid-19 in different relevant countries? More specifically, what explains a range of cases like this?
Coronavirus deaths per million population, as of May 21:
Spain: 598
Italy: 537
United Kingdom: 531
France: 431
Canada: 163
Germany: 99
Norway: 43
South Korea: 5
Australia: 4
Taiwan: 0.3
Let's ignore the United States this once (289). Let's ignore Boris Johnson's early Trump-like clowning in jolly old England, which has been hit so hard.

What explains the difference between France, at 431, and Germany, at 99? What explains South Korea and Australia? What explains Taiwan?

These seem like fairly obvious questions. We don't see them being discussed a whole lot, except in terms of cozy sweatshirts and prefab tribal tales.

Our second question involves personal protective equipment—PPE. Let's focus on N95 masks.

In this morning's Washington Post, we find a report of a major survey of front-line health care workers. The survey was taken from April 26 through May 4. At that time, 66 percent of respondents reported that N95 masks were "in short supply at [their] workplace."

As we noted a few weeks ago, this was a major hot topic back in March and early April, after which it basically disappeared. Although the reporting has disappeared, this survey makes it sound like the shortage of PPE quite possibly hasn't.

Does a problem still exist? Consider this slightly annoying, multi-media report from a reporter in the Washington Post's Graphics department.

The report appeared online on May 17. We don't know if it will ever appear in the Post's print editions.

Does a shortage still exist? The report began with a question, and with a statistic, we ourselves advanced many times way back when. We did so early and often:
BERKOWITZ (5/17/20): On April 2, the New England Patriots’ team plane left China with mundane but suddenly precious cargo: 1.2 million N95 respirators, a critical type of mask that protects health-care workers treating patients who have infectious diseases.

Was that a big stash?

In normal, pre-covid-19 times, the answer would be yes. Most hospitals buy just a few thousand N95s per year, according to a company that negotiates purchasing contracts.

In the frenzied weeks of March and April, when the trickle of covid-19 patients suddenly grew into a deluge, the answer was a hard no. Health and Human Services Assistant Secretary Robert Kadlec had testified in February that the United States would need 3.5 billion N95s in a serious pandemic.
According to Kadlec's testimony, we were going to need 3.5 billion N95 masks! On that basis, were the Patriots' measly 1.5 million N95s just a drop in the bucket?

When we were asking similar questions, we related them to "the gong-show of very large numbers." The problem arose like this:

Every evening, in prime time, at his televised non-briefing briefings, President Trump would rattle off the number of N95s some incredible company had incredibly pledged to provide.

As with the Patriots' stash, it always sounded like a very large number of masks. Unless you considered the enormous number Kadlec had said we would need, which Trump and the press never did.
.
Two months have passed, and the Post is now dealing with the same statistic and the same basic question. Here are some newer questions which came to mind when we read this Post report:

Did Kadlec know what he was talking about? Was his estimate sound? Also, over what period of time would we need 3.5 billion N95s? The Post report didn't try to answer these questions.

Another question went largely unanswered in the Post report. Does the shortage of N95s persist?

That survey suggests that the answer is yes. By now, though, nobody seems to care about that. Our major news orgs seem to have moved on.

Does a shortage of PPE persist? Like you, we have no idea, and we don't expect to find out.

31 comments:

  1. "What explains the difference between France, at 431, and Germany, at 99?"

    Well, there's a theory that mandatory vaccinations (specifically BCG) of all newborn, practiced in most non-Western countries (including East Germany) might have something to do with it, dear Bob.

    ReplyDelete
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  2. "Did Kadlec know what he was talking about?"

    But of course he didn't. Even in normal times, pencil-pushing bureaucrats have no idea what they're talking about.

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  3. Here is the problem with Somerby's lack of research training (which he might have gotten had he not been a philosophy major). He doesn't seem to understand that qualitative and quantitative research go hand-in-hand. There are some things that numbers alone won't tell you, such as what it is like in a COVID-19 ICU in the midst of pandemic. You need those interviews with medical staff, without any numbers at all, to tell you what is happening on the ground. Those interviews help you properly interpret the statistics (and vice versa).

    It doesn't matter how many masks are being flown in team planes, if your hospital doesn't have enough to keep infections from spreading, to protect hospital staff from catching the virus, enough drugs to be able to put people on ventilators (paralytics, sedatives), enough trained staff who know how to insert breathing tubes without catching the virus. If a hospital becomes overwhelmed, deaths go up. How can a hospital become overwhelmed? First, too many sick staff (off work) or not enough emergency room/ICU trained staff in the first place. Second, too few ICU beds. Third, not enough equipment of all types, PPE, medication, ventilators. Fourth, triage in the ER (people sent home who are too sick to be home because of lack of space in the hospital). When nurses and doctors are working very long days with insufficient resources, patients die unnecessarily. This was the whole point of the stay-at-home measures -- to avoid this condition in the hospitals by flattening the curve.

    One statistic concerns percentage of deaths in nursing homes and rehab centers. What people don't realize is that people with COVID in the hospital get shipped to nursing and rehab facilities when they are well enough to be transported. It is the next stop for people too sick to be nursed at home (or who do not have family to do the nursing). They are dying there because of lack of space in the hospital and because of understaffing and virus effects in those facilities. Some reports are suggesting that the greater or more frequent the exposure to COVID, the worse the symptoms. Nursing homes are not generally a good place for people with fragile health, but it is worse with COVID, so more people die there. And no one has been looking at the circumstances for the people who have died at home. Trump doesn't want to know and it doesn't seem like a good topic for news stories, or a nice thing to interview people whose relative has just died that way. Or perhaps those people were alone and there is no one left to talk to. Trump won't count their deaths in his stats.

    Somerby perhaps wants an easy answer, such as Americans are too fat, or they all wear masks in China. Those things matter, but there may be more important differences in places such as Germany or South Korea. For one thing, a unified approach from the top down may help encourage better compliance in the population. It matters whether the President is saying different things on different days, as opposed to defining a plan and communicating it consistently at every opportunity (sweatshirt or not). It matters whether someone is encouraging the people to pull together and unit to fight the disease instead of setting everyone against each other, so that some people are going out and deliberately infecting others, and many do not feel any sense of responsibility for what happens to those they may infect. That is another failure of messaging. We have the problem here because our president is an asshole and the stubborn Republican contingent has become used to being oppositional, not pulling together. So that is what people are doing too. How do you determine this from any statistics? You have to interview those guys in the street with the signs and see what they think is going on. That means doing some qualitative research, not just administering polls (a quantitative method).

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    1. Somerby mocks those who try to talk about qualitative knowledge because they don't use statistics. That shows Somerby's ignorance. He should be listening instead of being critical, especially when he doesn't like or agree with what they are saying. With a qualitative study, the results may consist of transcribed interviews that the researcher then summarizes and interprets (pulling excerpts to substantiate the interpretation and conclusions).

      Spectrum 1 (Spectrum cables local TV station in Los Angeles) has been presenting many such interviews with people from all walks of life, including those working with homeless to prevent infection, nurses and doctors, survivors of COVID, planners and administrators at local levels, and so on. From their comments you can form a much better picture of what is happening in the Los Angeles area than you can by reading normalized death rates or numbers of masks purchased. (Why isn't Somerby calling for us to report number of masks normalized by population? It wouldn't be helpful, but it would be consistent of him.)

      Trump is only trying to demonstrate that he is doing a good job, when he rattles off his figures (whatever they are). Notice all the adjectives he uses about what a tremendous, great job he is doing. Somerby thinks that if he uses the right numbers, it will actually say something. Not in Trump's case, and not if you want answers to serious questions. This is a game that Trump is playing. Somerby should refuse to play, not join in by telling reporters they haven't found the magic numbers.

      Delete
  4. My background is business. If a business wanted to find out whether a hospital had enough N-95 masks, they would look at actual figures:
    -- How many masks are used each day?
    -- How big is the current supply?
    -- How many new masks become available each day?

    It would be not be acceptable to try to answer this question via an opinion survey.

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    1. An opinion survey is a quantitative measure, just like the other figures you mention. How many people say that they have enough masks, how many say they have too few.

      The figures you list tell you about the supply, the status quo in your business. They don't tell about the need -- whether you have enough masks.

      To figure out whether you had enough masks you might have to look at your spread of infection rates compared to those of other hospitals, whether staff are using them properly (e.g., using new ones when going in and out of different rooms, not the same mask all day). Hospitals have experts who look at infection control as their specialty, recommend training and procedures and monitor equipment use. This is the job that Trump cut in his revised nursing home regulations.

      If doctors go to put on gloves and find that the box is empty and there are none in other rooms either, isn't that an important fact that you would want to know, if you were running a hospital? Or would you not care, because profit margins dictate that only so many gloves per day can be provided? Does need dictate supply or do you just supply what your budget allows? I would want to know that so that I could avoid going to your hospital, if sick.

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  5. “According to Kadlec's testimony, we were going to need 3.5 billion N95 masks! On that basis, were the Patriots' measly 1.5 million N95s just a drop in the bucket? “

    Those masks onboard the Patriots’ plane were going to be used in Massachusetts, which presumably would end up needing somewhat less than the 3.5 billion that Kadlec claimed the entire nation would need.

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    1. Masks are a consumable. That means that you need to also specify how many masks were needed over what period of time. Somerby doesn't say, but I assume Kadlec did say over what period that 3.5 billion would be needed. We don't know if 1.5 million is for a week, a month, or longer.

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  6. From the Berkowitz story in the Post:

    “According to the CDC, the median hospital stay of a surviving covid-19 patient is 10 to 13 days. That works out to between 350 and 520 N95s per patient.

    Not all states report numbers of people hospitalized, but New York does, and on April 13, the state’s hospitals held 18,825 covid-19 patients. If caregivers used 35-40 N95s per patient, they would’ve used between 659,000 and 753,000 N95s that day. That would amount to more than half of the Patriots' planeload.

    Caring for just those patients through their entire hospital stays would’ve required between 6.6 million and 9.8 million N95s, the equivalent of half to three-quarters of the 12 million unexpired masks that were in the federal government’s emergency stockpile at the beginning of the outbreak.”

    That’s some pretty specific information that I found quite useful.

    Kadlec’s estimate was for a severe pandemic. We aren’t at the end of the cutrent outbreak, so we don’t yet know the total death toll, but the Post story gives the most specific and detailed way I have seen of calculating the actual need for N95’s. Isn’t that what good journalism is supposed to do?

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  7. Why does Dear Bob insist on relating the numbers of dead as "per 1 million of population.
    Why does Bob insist on "clowning".
    Why does he insist on not talking about infections verses deaths.
    As per infections we lead the world by a factor of 10.
    SO no matter how BOB tries to play games with numbers while criticizing Maddow and intimating that she is dishonest.
    Realize that the US has 10 times the number of infections compared to Russia which has the second highest.
    That means dear bob that he have orders of magnitude more infections then countries that have higher populations then the USA.
    It is YOU who are clowning and have an agenda.
    How you have fallen since your Gore defending days. SO SAD

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  8. “What explains South Korea and Australia?...These seem like fairly obvious questions. We don't see them being discussed a whole lot”

    Ahem.

    A small sample of it being discussed:

    “South Korea’s Health Minister on How His Country Is Beating Coronavirus Without a Lockdown”
    https://time.com/5830594/south-korea-covid19-coronavirus/

    “What’s Behind South Korea’s COVID-19 Exceptionalism?”
    https://www.theatlantic.com/ideas/archive/2020/05/whats-south-koreas-secret/611215/

    “How South Korea prevented a coronavirus disaster—and why the battle isn’t over”
    https://www.nationalgeographic.com/science/2020/05/how-south-korea-prevented-coronavirus-disaster-why-battle-is-not-over/

    “South Korea Is Beating Covid-19. Here’s How.”
    https://www.barrons.com/articles/south-korea-coronavirus-covid-19-testing-cases-deaths-51586265433

    “South Korea took rapid, intrusive measures against Covid-19 – and they worked”
    https://www.theguardian.com/commentisfree/2020/mar/20/south-korea-rapid-intrusive-measures-covid-19

    “This is how South Korea flattened its coronavirus curve”
    https://www.nbcnews.com/news/world/how-south-korea-flattened-its-coronavirus-curve-n1167376

    “How South Korea Triumphed, and the US Floundered, Over the Pandemic”
    https://www.thenation.com/article/world/coronavirus-south-korea-america/

    And from Somerby’s old standby, WaPo:

    “South Korea’s Coronavirus success story underscores how the US initially failed”
    https://www.washingtonpost.com/world/2020/03/17/south-koreas-coronavirus-success-story-underscores-how-us-initially-failed/

    “The Daily 202: South Korea, a Coronavirus success story”
    https://www.washingtonpost.com/news/powerpost/paloma/daily-202/2020/04/13/daily-202-south-korea-a-coronavirus-success-story-warns-against-easing-social-distancing-guidelines-too-soon/5e9401fc602ff10d49ae3431/

    “Two paths for Coronavirus testing”
    https://www.washingtonpost.com/world/asia_pacific/japan-targets-coronavirus-testing-while-south-korea-goes-big-the-us-faces-which-path-to-take/2020/03/28/97e81b44-6eb6-11ea-a156-0048b62cdb51_story.html

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    1. "How South Korea Triumphed"

      Indeed. Dear dembot, South Korea is a fascist regime.

      And as such, it's much better at managing national emergency, better at resource mobilization, enforcing discipline, and all the rest of it.

      That's trivial.

      Whether their model and their methods deserve glorification is a different question. But of course for you, zombies, it's Orange Man Bad uber alles.

      Delete
  9. Why did Australia have such low rates?

    Better weather, less congested living, a younger population and luck may have played a role, but the big driver looks to have been a public health response driven by expert medical advice as opposed to bravado or crackpot theories.

    https://propertyupdate.com.au/the-lucky-country-three-reasons-why-australia-may-come-through-this-period-of-global-misery-better-than-most-countries/

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    1. Yeah? And what about Japan, then, with 6 deaths per million? Highly congested, older population, no useless testing, no forced lockdowns.

      Talk about 'crackpot theories'...

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    2. They are an island. Remember, they are the ones who wouldn't let that infected cruise ship dock, until most of the crew and passengers came down with the virus.

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    3. Right. Japan is an island - and that explains everything, but in Australia "the big driver looks to have been a public health response driven by expert medical advice".

      And you know what else is an island? The UK, with 536 deaths per million.

      Delete
  10. Deadrat thinks that the press is not doing a good job reporting on the corona virus, because it cannot force Trump to answer questions he doesn't want to answer.

    Here is a story that was broken today by NPR:

    "Only it seems that those numbers may be a little less than they seem on the surface. Because on Thursday the CDC acknowledged that the number of tests being reported combines the PCR results looking for active cases, with antibody tests looking for people who have been exposed to the SARS-CoV-2 virus. By combining those two values, the CDC is including test results from tests whose accuracy is still in doubt. And it could also be badly distorting the nation’s ability to conduct additional tests."

    Here is an example of the press doing its job, something deadrat and Somerby believe the press is too incompetent to do.

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    1. Quit telling me what I think, professor. It's my job to tell you.

      Delete
  11. Here is another story, this time by CNN, demonstrating that the press is doing its job:

    "Secretary of State Mike Pompeo reportedly ordered officials at the State Department to come up with a rationale for his decision to declare an emergency last year that he used to bypass Congress in his billion-dollar arms sale to Saudi Arabia."

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  12. Here is the press, busily doing its job, during Trump's visit to the Ford Motor Company plant yesterday:

    "President Trump was photographed at a Ford factory in Michigan wearing a face mask while taking a tour of the facility on Thursday.

    The photograph, which was published by the Detroit Free Press, shows the president wearing a face mask while interacting with Ford Motor Company executive chairman Bill Ford, Jr."

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  13. This story comes from the AP (hint: the P stands for press):

    "A former elections judge in Philadelphia admitted to accepting bribes to tamper with the results of primary elections over multiple years, federal persecutors confirmed Thursday. "

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    1. The typo "persecutors" for "prosecutors" was in the story that appeared in The Hill today. Another likely Freudian slip, but deadrat doesn't believe such things exist.

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    2. Ah yes, I've seen this one.

      Of course zombie media being what they are, they won't tell you, they won't even mention that this voter fraud was perpetrated by the liberal cult.

      The Hill piece doesn't contain the word "democrat" at all. What a comedy.

      Delete
    3. The Hill is a conservative website.

      Delete
    4. Meh. The Hill is not a website. It's a standard establishment zombie publication. Their only decent investigative journo John Solomon was smeared and kicked out not long ago, for not conforming to the zombie narrative.

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    5. Quit telling me what I believe. I believe Freudian slips exist. I just don't believe you're clever enough to diagnose one from typos.

      Delete
  14. From the Los Angeles Times today, via Taegan Goddard's The Political Wire:

    “For months after the Sept. 11 terrorist attacks, the nation ached together in televised memorials, joining in a collective catharsis of uniformed salutes, bagpiped dirges and President George W. Bush declaring a national day of mourning and remembrance,” the Los Angeles Times reports.

    “The space shuttle Challenger explosion in 1986 turned classrooms into grieving sessions, with President Reagan directly addressing the national wounds. The Japanese attack on Hawaii’s Pearl Harbor in 1941 was a day that President Franklin D. Roosevelt said would live in ‘infamy,’ uniting the mainland to enter a world war.”

    “Yet as the nation nears 100,000 deaths from COVID-19 — far more than all those tragic events combined or the entire Vietnam War — there is little sense this Memorial Day weekend that Americans are grieving together or uniting in a sense of purpose.”

    One function of the press is to put things into perspective and to provide commentary on events. Here is an example of the press performing that function.

    No bungled statistics here, just the truth about Trump's leadership failure, and they didn't even have to mention his name.

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  15. Here is an interesting virus alert-system developed at Johns Hopkins, reported by Digby:

    https://preventepidemics.org/wp-content/uploads/2020/05/Annex-2_Example-of-an-alert-level-system_US_FINAL.pdf

    ReplyDelete