More Miscellaneous News and Studies

By April 30, 2020 Commentary

I am trying to catch up.  First up, a very nice article giving a lot of technical details on the coronavirus and how it mutates and spreads, from the NY Times.  (NYT Article)   This is a very good background article on the nature of the virus and how it replicates and mutates and what the implication of the mutations may be.  It discusses various kinds of mutations.  The mutation pattern tells us where the virus in different parts of the US may have come from.  The virus appears to mutate slowly and so far no real new “strains” have emerged which have different infectious capabilities.

Milliman is probably the leading health care actuarial firm in the country.  They have released an analysis of the impact of coronavirus disease and the (over) reaction to the epidemic on health care spending.  (Milliman Analysis)  The firm finds that while there are costs relating to coronavirus treatment, the drop in elective care, or even needed care for that matter, is far exceeding those costs.  If the current pattern continues, the firm believes total spending will drop by between $75 billion and $575 billion in 2020.  Medicare and commercial payers will likely see the most reduction, while Medicaid sees an increase.  There could be a rebound of pent-up demand in 2021.

This article discusses how we get to population immunity, published in the respected medical journal Lancet.  (Lancet Article)   The authors give a fair amount of basic information about the development of immunity to coronavirus infection and note some of the uncertainties around durability of response.  They do not seem aware of the recent study indicating that even asymptomatic individuals developed strong antibody responses.  They also apparently wrote before the recent release of information from South Korea indicating that in apparently reinfected individuals, the tests were just picking up virus fragments.  The article paints a gloomier picture than is probably warranted by current research.  But there seems to be a section of the research community that wants everyone on lockdown forever.

There is reason to believe that children may get infected at lower rates than adults.  They are exposed but don’t get infected.  An article about Switzerland quotes the head of the country’s infectious disease unit as saying that children under the age of ten don’t get infected and don’t pass the disease on.  No specific study was cited for this conclusion, with which others disagree.   (Swiss Article)   A recent article in the Wall Street Journal mentioned the same possibility, but again not citing any specific research.  (WSJ Article)  The article cites a review of 67 studies finding that children are much less likely to be symptomatic and may not get infected at the same rates as adults.  This seems consistent with the relative rates of infection among children in proportion to the share of the population.  School age children in particular certainly had lots of opportunity to be infected.  In any event, the disease is so rarely serious in children that there really has been no basis for closing schools.

Many people have wondered what is happening to overall death rates since the epidemic began.  Some have speculated we are missing a lot of coronavirus deaths.  Others think that too many deaths are being attributed to coronavirus that are actually due to other causes.  Because people have been scared sh*tless, there may be excess deaths from suicides, drug and alcohol abuse, and most unfortunately, because of fear and the government orders shutting down some health care facilities, people are skipping or can’t get needed health care and some are dying.  (Lest you think this is a myth, someone in my office building today said their father-in-law had been scheduled for a heart procedure, couldn’t have it done, and a couple of days ago died from a heart attack.  Numerous physicians have written articles warning of this.)  So there is an article in an Oregon paper talking about this phenomenon.   (Oregon Article)   There is a spike in total death rates in Oregon, but it probably isn’t all attributable to coronavirus.  In fact, less than half the excess deaths could have been explained by coronavirus.  All of the above average deaths appeared to occur at home, which would be consistent with people fearful of seeking medical care.  That share of deaths occurring at home was inconsistent with past Oregon trends.  Nobody seems to know for sure what is happening, but it is hard not to suspect that people are dying from not getting health care.

And here is an article which tells us what most readers already know–lockdown critics may have a point. Bloomberg News brings us this brilliant observation.  (BB Article)   The article cites what will now be familiar points to most readers, including that the current strategies are simply not sustainable, they aren’t balanced, they are probably causing their own health harms, the disease doesn’t strike similarly in all geographies, it is only dangerous to the old and those with pre-existing conditions.  Yep, tell us something we don’t know.

And finally, for now at least, a weather blog suggests that meteorologists may be able to help epidemic modelers.  Can you say the blind leading the blind.    (Blog Post)   The author claims that meteorologists could help because they are more experienced at dealing with complex situations.  He then just makes a few obvious points about the difficulty in ascertaining the current situation due to lack of testing, etc. which makes modeling difficult.  He describes the varying epidemiologic modeling approaches and then notes that none have been very accurate.  And then he tells us nothing that might improve the modeling.

And on that useless note, we will end for now.

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