Blue Fragility, Part VIII: Unequal Risk

If you remember the 1980s, you might recall the early years of the AIDS epidemic. While it was clear fairly early on that the disease particularly targeted gay men and IV drug users (leading to the overnight extinction of what had been a fairly thriving “bathhouse” scene in Minneapolis), government health authorities kept hammering on the line that “anyone could catch it” and “nobody was immune”.

Which was, literally, epidemiologically the truth. Cases of children and suburban housewives coming down with AIDS got wide play in the media, to prove the point.

But eventually the world figured out AIDS was a blood-borne pathogen, spread by behaviors that transferred contaminated blood between people; sharing needles, inadvertent exposure to infected peoples’ blood, and various intimate practices that had a tendency to tear skin.

And so people learned. ER staff masked and goggled and gloved up. Condoms became mainstream. Cities gave out free needles – aggravating to law-and-order types, but it did help slash the infection rate.

Unsaid but unmistakeable? While anyone could get it, the odds moved greatly, almost completely, in one’s favor with a few minor behavioral and prophylactic practices.

So I was in North Dakota over the weekend, taking care of some family business.Here’s a county by county breakdown of the Covid situation in North Dakota as of this past of this past Thursday.

Big Left tells us, in a tone usually reserved for devotional prayers and aspirational mantras, that Red America is going to get it. Covid is going to ravage the square states, they say, like a revival preacher winding stems on the Old Testament lesson. “We’re all in this together”, after all.

So let’s take a look at North Dakota’s numbers:

The red circles with white numbers are death counts.

Of the states 74 total Covid deaths as of last Thursday, 62 of them were in Cass County – which is Fargo. Four more were in Grand Forks County.

And, significantly, the counties containing North Dakota’s four Indian reservations – which, conventional wisdom here in the Twin Cities tells us, are the most vulnerable populations in the entire state outside of nursing homes – account for a grand total of six cases, and no deaths.

It’s not lack of testing, in this reddest of states; as of last week, North Dakota has the third highest test per million rate in the country, triple that in Minnesota.

Maybe it’s time to just cut the crap and admit that Covid – and most diseases that spread via aerosol transmission – are particularly transmissible by people breathing the same air, jammed into close quarters for extended times?

Nursing homes, of course – but also bars and restaurants, mass transit, open-plan offices, and other artifacts of high-density urban life?

That’d scotch the attractiveness of any “high density” social investments (the ones that aren’t already plummeting in the wake of this month’s rioting), of course…

…which would jeopardize the gravy train for a lot of transit consultants, urban nonprofiteers, insect farmers, public union employees and other big-state hangers-on.

69 thoughts on “Blue Fragility, Part VIII: Unequal Risk

  1. You keep using the word “cases” and not “deaths.” Why is that, Emery? I have been quite clear on why I use the deaths metric. Yet you are obsessed with a meaningless number (positive test results). Everyone will be exposed to the virus sooner or later, the number of positive tests is not a useful metric.

  2. Here is what the CDC says about testing:
    About the Data
    These data are compiled from a number of sources. Not all tests are reported to CDC.
    The number of positive tests in a state is not equal to the number of cases, as one person may be tested more than once.

    The CDC says that to date the US has results from 29,339,757 tests, and of these 2,848,081 are positive. If we assume a 1% fatality rate, 28,000 of the 29,339,757 tested will die. If we assume a 0.1% fatality rate, 2,800 will die, I suppose sometime in the next two weeks.
    Hospitalisations may be a useful metric — or not. Hospitals are rewarded for caring for covid-19 patients. Patients admitted for one thing may contract the virus while in the hospital. So we need more metrics if we are going to make public policy based on the number of people in the hospital with covid-19.

  3. The Trump admin. plans to end federal funding and support for coronavirus testing sites at the end of this month,

    That will bring the numbers down.

    If we get rid of fire departments then we will no longer have fires.

  4. And why is testing more important than deaths or hospitalizations, Emery?
    You can’t answer that question, can you?

  5. In all my conversations with people about covid-19, liberal or conservative or whatever, no one mentions Trump. It is all about the governor & how things are on the mainland. Same for the letters section of my very liberal paper in this very liberal state.
    So Emery’s obsession with linking every bit of possible bad news about covid-19 (and everything else) to Trump is an interesting data point.

  6. Today’s chance of dying of covid-19 in the US? 1.84 in a million.

  7. Here are some interesting facts via the National Governors Association: over the last 2 weeks, in the 11 states that mandate wearing masks in public, new cases have fallen by 25%. Over the same period, in 16 states that do not require wearing masks in public, new cases have soared by 84%

  8. You are onto the ol’ “corellation = causation” fallacy, Emery.
    Or have you eliminated all of the other variables?
    Your ability to analyze a problem — rather than gather random factoids — is not good.

  9. “Number of tests per million is roughly the same in US and EU.”
    Is the EU using a representative sample? Is the US?
    You should know better than this, Emery.

  10. Low tech prevention (masks, distancing) seems to be making a huge difference where it has been observed and enforced. Citizens in the states with the newest spikes don’t seem to care. For them, going without a mask equals freedom from tyranny.

    The only encouraging sign is that the election is just 4 months and 9 days away.

  11. Despite being an expert on covid-19, and how it spreads, Emery cannot explain why the number of positive tests is important.
    Huh. Almost like he doesn’t know what the Hell he is talking about.

  12. Woolly— you’re a fraud — you’ve been wrong on most all of your analysis of COVID.

    Wearing the mask is an admission of Trump’s failure to contain the virus in its early stages, and his complete and utter contempt for anything except his own re-election.

    Trump’s the incumbent. And COVID has brutally exposed the fault-lines in American society, and Trump’s limited capabilities. This time it’s not about rhetoric; COVID is real, highly destructive and is impervious to slogans. Trump has badly struggled against an adversary who couldn’t care less about snowflakes, swamps or Twitter. And as time goes on, Trump is becoming more cantankerous, aggressive and irrational. The stress of battling a powerful enemy is showing.

    Biden can sit relatively quietly and carefully choose a very smart charismatic and young running mate. As Sun Tzu said “never interrupt your enemy when he is making a mistake”.

    Governor Inslee of Washington was called a snake for opening slowly. Guess who was the real snake!

  13. COVID cases in the EU and US initial outbreak about the same (US about 10 days behind)

    Then many US states opened, ignoring CDC guidelines. Inadequate social distancing. And mask wearing became politicized.

    Americans acting in bad faith on healthcare is an American cultural phenomenon.

  14. Emery Incognito on June 25, 2020 at 6:25 am said:

    Woolly— you’re a fraud — you’ve been wrong on most all of your analysis of COVID.
    This is a lie.
    No example is given of me being wrong on any point of my analysis of covid-19.
    Talking out his butt, as usual.
    And Emery still can’t explain why he believes that positive covid-19 tests are a more important metric than covid-19 deaths.

  15. Biden can sit relatively quietly and carefully choose a very smart charismatic and young running mate.
    I doubt if Biden can do more than pick his nose these days. The years have not been kind to him.
    He has no choice about his running mate. Biden’s VP pick will be female, black or mixed race, with a radical political record.

  16. Any serious epidemiologist should be horrified at the mayors and governors who have encouraged and are encouraging mass gatherings while preventing contact tracking/tracing of the participants.
    These are not serious people, they deserve contempt, not trust.

  17. Pingback: Blue Fragility: Be It Resolved | Shot in the Dark

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