The toll of COVID-19 has been terrible: 660,000 dead by my count, based on excess deaths, graph below, or 620,000 according to the CDC based on hospital records. Death rates appear to have returned to pre-pandemic levels, more or less*, but folks are still getting very sick and going to the hospital, mostly for “the delta variant.”
Weekly US death rates since October 2015.
As the following chart shows, severe symptoms of COVID are now almost entirely in the old, and unvaccinated. The risk to the young and middle aged is low, but even there, vaccination helps. According to the CDC, 72.2% of the adult US population is vaccinated with at least one shot. The vaccination, doesn’t prevent you from getting the delta variant nor from spreading it; it just protects from the most serious consequences of the disease. It seems a previous infection has the same effect, though less so.
Vaccination helps prevent hospitalization – at all ages (Israeli data)
If you’re over 60 and unvaccinated, I recommend getting vaccinated with at least one shot; the inconvenience and side-effects are few, and the benefit is large. The second shot seemswothshile too, and for all I know a third will too. Sooner or later there is a diminishing return. The benefit of masks seems is smaller, as I judge things. I notice that the disease is spreading at about the same rate in masked and unmasked states, and that the death numbers are as high, or higher in heavily masked, blue states as in red. New York and NJ are the top COVID death states, with Michigan not far behind. Masks seem to help, just not very much.
If you wish to check my analysis, go here to get the raw data: https://gis.cdc.gov/grasp/fluview/mortality.html. Then, to calculate the COVID effect, I subtracted the weekly death rates in 2020 and 2021 from the corresponding week rates in 2019, correcting the deaths by 1%/year for population growth and aging. *I find that there are about 500 excess deaths per week, and I assume those are among the unvaccinated. If you are vaccinated, I’d worry about something else besides COVID-delta: heart attack, cancer, suicide, or Afghanistan.
Some years ago I wrote a largely negative review of Brown’s gas, but the COVID crisis in India makes me want to reconsider. Browns gas can provide a simple source of oxygen for those who are in need. First, an explanation, Browns gas is a two-to-one mix of hydrogen and oxygen; it’s what you get when you do electrolysis of water without any internal separator. Any source of DC electricity will do, e.g. the alternator of a car or a trickle charger of the sort folks buy for their car batteries, and almost any electrode will do too (I’d suggest stainless steel). You can generate pressure just by restricting flow from the electrolysis vessel, and it can be a reasonable source of small-scale oxygen or hydrogen. The reaction is:
H2O –> H2 + 1/2 O2.
The problem with Brown’s gas is that it is explosive, more explosive than hydrogen itself, so you have to handle it with care; avoid sparks until you separate the H2 from the O2. Even the unseparated mix has found some uses, e.g. as a welding gas, or for putting in cars to avoid misfires, increase milage, and decrease pollution. I think that methanol reforming is a better source of automotive hydrogen: hydrogen is a lot safer than this hydrogen-oxygen mix.
Browns gas to oxygen for those who need it.
The mix is a lot less dangerous if you separate the oxygen from the hydrogen with a membrane, as I show in the figure. at right. If you do this it’s a reasonable wy to make oxygen for patients who need oxygen. The electrolysis cell can be a sealed bottle with water and the electrodes; add a flow restriction as shown to create the hydrogen pressure that drives the separation. The power can be an automotive trickle charger. You can get this sort of membranes from REB Research, here and many other suppliers. REB provide consulting services if you like.
In a pinch, you don’t even need the membrane, by the way. You can rely on your lungs to make the separation. A warning, though, the mix is dangerous. Avoid all sparks. Also, don’t put salt into the water. You can can put in some baking soda or lye to speed the electrolysis, but If you put salt in, you’ll find you don’t make oxygen, but will instead make chlorine. And chlorine is deadly. If you’re not sure, smell the gas. If it smells acrid, don’t use it. This is the chlorine-forming reaction.
2NaCl + 2 H2O –> H2 + Cl2 + 2NaOH
Ideally you should vent the hydrogen stream out the window, but for short term, emergency use, the hydrogen can be vented into your home. Don’t do this if anyone smokes (not that anyone should smoke about someone on oxygen). This is a semi-patentable design, but I’m giving it away; not everything that can be patented should be.
The Boy Scouts of America filed for bankruptcy some months ago, and I’d began this article as a project to discover what went wrong. They have gotten mountains of bad press amidst land sales and lost membership, and there is a class action law suit over sexual abuse. Everything about this suggested that scouting had lost its way, and I thought I explore what. My sense after some searching is that scouting is doing fine, serving its members despite its troubles and growing in part because of them.
Baden-Powell in Africa his Stetson The Boy Scout retained much form Baden-Powell, including the hat.
The basic idea of scouting was to provide an environment where boys would d become men, learning to be prepared, and be helpful, decent, active human beings. Some details have changed, but the goal remains, and I’d say they are reasonably successful. But that’s getting ahead. I’m better off starting my story by describing two army scouts, one British one American, who met fighting the Boer wars in the late 1890s. The American was an Indian-raised cowboy, a US army scout named Fredrick Burnham. He joined the British in South Africa as a scout against the natives and Dutch (The Boers). He was good at it, gaining valuable information, leading raids, and blowing things up. Such activities made him a hero of boys of a previous generation, but leaves current sensitivities a bit on edge.
The other scout was his boss, lieutenant general Robert Baden-Powell, an excellent scout himself, but also and organizer, artist, writer, speaker, and spy. He’d run intelligence in India, and now ran it in Africa, spying on the Boers and leading others like Burnham to do the same. Burnham taught Baden-Powell survival techniques he’d learned from the Indians, including “woodcraft”. Baden-Powell brought organization and a positive, faith-based attitude towards difficult situations; “Be prepared”
Frederick Russell Burnham with his signature Stetson campaign hat. The hat and curchif would become part of the Scout uniform, and the woodcraft methods of tracking and survival would become central to Boy scouting, both in the US and in England.
Baden-Power also wrote a book on military scouting illustrated with his own drawings, it became a hit with young, male readers in turn of the century England. Retiring from the military, Baden-Powell noted the enthusiasm among boys and put together a military-style scout-camp for boys on Brownsea Island, UK. From there, scouting grew: in numbers, in properties, and in scope. Baden-Powell devised the oath: “On my honor, I will do my best; To do my duty to God and my country and to obey the Scout Law; To help other people at all times; To keep myself physically strong, mentally awake and morally straight.” It was the embodiment of a positive, active, masculine life — but it appealed to women too. A few years later “Girl Guides” were founded in England; Boy Scouts and “Girl Scouts” were founded in the US as independent, parallel organizations. So what went wrong?
It is clear that some of the military aspects of scouting are out of tune with current, non militarism, but that’s not something quite new. Perhaps, I thought, the current problems came because of gender dysphoria – -that active masculinity is somewhat out of fashion, as is the white-supremacy at the heart of the Boer war. Then I thought that, perhaps the problem was when the organization accepted women, and thus it wasn’t for boys, uniquely, or that it had dropped the physical requirements, or the belief in God. What was left. Perhaps the problem was poor financial management, or that sex-laws had become a minefield with #metoo and transgender. These are all problems, but not exactly new, and I no longer see them as problems with Scouts as such.
Boys still want to be active and relevant, and seem to still take to woodcraft even if they realize that woodcraft isn’t likely to be that useful. It is enough that woodcraft is sometimes useful, and that it’s fun and provides a training for other things. Though boy-girl interactions are fraught, I no longer see it as a problem. Scouting provides an avenue to maturity, and If the particulars of maturity have changed, the general attraction has not. That numbers are down is not a problem either. Some religious groups have left, particularly the Mormons, and some scouts have moved on to other activities: soccer, tennis, band, etc. Even with these other avenues, there are still some 4 million Scouts in the US including Scouts BSA and Girl Scouts. After 100 years, that’s not a failing organization.
A lot of the bad press comes, I think, from the fact that things changed fast in the US, far faster than in British version of scouting. In Britain, gay leaders were accepted in the 1980s; the US didn’t accept them till 2015. British scouting accepted girls in the 1970s, the Boy Scouts didn’t admit them till 2018, and didn’t accept transgender members till 2019. It was all so sudden. US scouting changed their name then and dropped the belief in God, also the need for wood lore and swimming. The rapid changes left older leaders dazed, but were probably for the best, and over-due. The law suits and bankruptcy also seems to have caused more trouble to the leaders than for the scouts; scout troops were always fairly autonomous.
As for the military aspect, some of it remains, and I get no sense that it’s resented. it seems to help distinguish the Boy Scouts (Scouting BSA) from the Girl Scouts; Girl Scouts focuses on economics and social activism, while Scouting BSA has been able to use the military preparedness to position itself as the more rugged alternative, and the more masculine, even if it accepts girls.
Some in management would like to go further away from Badden-Powell’s Boer-war outlook, to be more like the Girl Scouts. In Market Week, the Scouts’ director of communications claims to have …”positioned BSA to be the primary internet organization that serves diversity and deprived communities.” That sounds like a me-too to Girl Scouting, and the Girl Scouts have filed suit to prevent it.
In terms of predators and law suits, while one could claim that scouting should have done better, I think the troops themselves did well, though the upper management fell short, and tried to protect their own. Still, it is something of a defense to say you tried your best in an uncertain situation. There are no claims that leaders encouraged pederasts. The only claim is that they did not do enough to prevent them. While not everyone did their best, many did. Pederasts are drawn to kids organizations, and there is always be a tension between inclusiveness and protection. I’m reminded of the Be Prepared song (Tom Lehrer). it seems appropriate to the new scouting.
Rents in New York and San Francisco are far less expensive than before the pandemic. It’s been a boon for the suburbs, the south and the midwest, one that’s likely to continue unless Biden steps in. Before the pandemic, rent in San Francisco for a one bedroom apartment averaged over $3700 per month. New York rent was similar. People paid it because these cities offered robust business and entertainment, the best restaurants and bars, the best salons and clubs, the best music, museums, universities, and theater. New York was Wall Street, Madison Avenue and Broadway; San Francisco was Silicon valley and Hollywood. These cities were the place to be, and then the pandemic hit.
Post COVID-19, the benefits of big city life are gone, and replaced by negatives. The great restaurants are mostly gone; the museums, theaters, and salons, shut along with Hollywood. Wall Street and Madison Ave have gone on-line, as have the universities. If you can work and study from anywhere, why do it from an expensive hotbed of Corona.
People of means left the big cities with the first lockdowns. Wall Street moved on line, with offices in New Jersey, and many followed, along with college students, and hotel and restaurant workers. New York’s unemployment rate increased from 4-5% to over 9.5% today, among the highest rates in the nation, 9.5%. It would be higher if not for the departures. Crime spiked; the murder rate doubled. To keep people from leaving, landlords have lowered rents and many will now forgive a month or two of rent to keep apartments full with some rent coming in and an illusion of exclusivity. This is good for tenants, but tough on landlords.
Detroit rent history, 2014 to January 2021. Rents fell a lot on election day, maybe because of Biden, or because we think the pandemic is over.
As things stand, the suburbs and smaller cities are the beneficiaries of the exodus. Among the cities benefiting the most are cities in the south and mid-west: states that are more open and are relatively low cost: Phoenix, Oakland, Cleveland, St. Petersburg, and even Detroit. Detroit’s rents were already moving up as auto manufacturing returned from Mexico, see chart. Between early 2017 and October 2020, they went from $500/month to $1250/month for a 1 bedroom apartment, according to Zumper. Detroit rents fell after election day, but are still up 20% on the year. The influx of wealthier working folk to Detroit is welcome to some, unwelcome to tenants who find their rents are raised. I think it’s is a sign of a healthy economy that people follow life-quality, and that rents follow people. Our landlords are happy, but there are a lot of Detroit renters who are not
Joe Biden has promised to step in to make things right for everyone. He promised to have the government pay people’s rent so they don’t get evicted. I presume that means paying about double to people in NY and SF as to those in Detroit. He claims he will shutter smokestack industries too, and create the good jobs of the future in computers and high tech. It’s a nice claim. I suspect it’s a bailout of big city landlords, but what would I know. I suspect that the US would be better off if Joe just sat back and let New York rents fall, while allowing Detroit to gentrify. Detroiters need not worry about rents getting too pricy here. We’ve1500 shootings per year, that 15 times more than NYC, per capita. Unless that ratio changes, Detroit will continue to be the lower rent city.
COVID-19 has a decided racial preference for Western blood, killing Americans and Europeans at more than ten times the rate of people in Japan, China, Hong Kong, Taiwan, Korea, or Vietnam. The chart below shows the COVID-19 death rate per million population in several significant countries countries. The US and Belgium is seen to be more than 100 times worse than China or Hong Kong, etc., based on data from http://www.worldometers.info. IN the figure, the death-rate rank of each country is shown on the left, next to the country name.
For clarity, I didn’t include all the countries of Europe, but note that European countries are the majority of the top ten in terms of deaths per million. Belgium is number one with over 1,400. That is somewhat over 0.14% of the population has died of COVID-19 so far.
Peru has the highest COVID-19 death rate in South America at over 1000 per million, 0.1%. The US rate is similar, 0.082%. These are shockingly high numbers despite our best efforts to stop the disease by mandating masks, closing schools, and generally closing our economies. Meanwhile, in China and Japan, the economies are open and the total death rate is only about 1/100 that of Europe or the Americas. Any health numbers from China are suspect, but here I tend to believe it. Their rates are very similar to those in Hong Kong and Taiwan. At 3 per million, China’s death rate is 1/400 th the rate of the US, and Taiwan’s is lower.
This is not for lack of good healthcare systems in Europe, or lack of preparation. As of December 1-10, Germany, a country of 80 million, is seeing a COVID death rate of 388 per day. Japan, a country of 120 million, sees about 20. These are modern countries with good record keeping; Germany is locked down and Japan is open.
The question is why, and the answer seems to be genetics. A British study of the genetics of people who got the disease particularly severely found a few genes responsible, among these, TYK2. “It is part of the system that makes your immune cells more angry, and more inflammatory,” explained Dr Kenneth Baillie, a consultant in medicine at the Royal Infirmary in Edinburgh, who led the Genomicc project. He’s theory is that versions of this gene can allow the virus to put your immune response “into overdrive, putting patients at risk of damaging lung inflammation.” If his explanation is right, a class of anti-inflammatory drugs could work. (I’d already mentioned data suggesting that a baby aspirin or two seems helpful).
As reported in Nature this week, another gene that causes problems is IFNAR2. IFNAR2 is linked to release of interferon, which helps to kick-start the immune system as soon as an infection is detected.
It could be accidental that Asians are just lucky interns of not having the gene variations that make this disease deadly. Alternately, it could be that the disease is was engineered (in China?) and released either as a bio-attack, or by accident. Or it could be a combination. Whatever the cause of the disease, that east Asians should be spared this way is really weird.
Suggesting that this is not biowarfare is the observation that, in San Francisco, the Asian, per case fatality rate is as high as for white people or higher. One problem with this argument is that there is a difference between death rate per confirmed case and death rate per million population. It is possible that, for one reason or another Chinese people in San Francisco do not seek to be tested until they are at death’s door. Such things were seen in Iran and North Korea, for example. It pushed up the per-case death rate to 100%. Another possibility is that the high death rates in the west reflect disease mutation, or perhaps eastern exposure to a non-deadly variant of COVID that never made it west. If this is the case, it would be just as odd as any other explanation of a100x difference in death rates. Maybe I’m being paranoid here, but as the saying goes, even paranoids have enemies.
Most people know that aspirin can reduce blood clots and thus the risk heart attack, as shown famously in the 1989 “Physicians’ Health Study” where 22,000 male physicians were randomly assigned to either a regular aspirin (325 mg) every other day or an identical looking placebo. The results are shown in the table below, where “Myocardial Infarction” or “MI” is doctor-speak for heart attack.
Treatment
Myocardial Infarctions
No Infarction
Total
fraction with MI
Aspirin
139
10,898
11,037
139/11,037 = 0.0126
Placebo
239
10,795
11,034
239/11,034 = 0.0217
Over the 5 years of the study, the physicians had 378 MI events, but mostly in the group that didn’t take aspirin: 1.28% of the doctors who took aspirin had a heart attack as opposed to 2.17% for those with the placebo. The ratio 1.28/2.17 = 0.58 is called the risk ratio. Apparently, aspirin in this dose reduces your MI risk to 58% of what it was otherwise — at least in white males of a certain age.
A blood clot showing red cells held together by fibrin fibers. Clots can cause heart attack, stroke, and breathing problems. photo: Steve Gschmeissner.
Further study showed aspirin benefits with women and other ethnicities, and benefits beyond hear attack, in any disease that induces disseminated intravascular coagulopathy. That’s doctor speak for excessive blood clots. Aspirin produced a reduction in stroke and in some cancers (Leukemia among them) and now it now seems likely that aspirin reduces the deadliness of COVID-19. Data from Wuhan showed that excessive blood clots were present in 71% of deaths vs. 0.4% of survivors. In the US, some 30% of those with serious COVID symptoms and death show excessive blood clots, particularly in the lungs. Aspirin and Vitamin D seem to help.
.The down-side of aspirin use is a reduction in wound healing and some intestinal bleeding. The intestinal bleeding is known as aspirin burn. Because of these side-effects it is common to give a lower dose today, just one baby aspirin per day, 81 mg. While this does does some good, It is not clear that it is ideal for all people. This recent study in the Lanset (2018) shows a strong relationship between body weight and aspirin response. Based on 117,279 patients, male and female, the Lanset study found that the low dose, baby aspirin provides MI benefits only in thin people, those who weigh less than about 60 kg (130 lb). If you weigh more than that, you need a higher dose, perhaps two baby aspirin per day, or a single adult aspirin every other day, the dose of the original doctors study.
In this study of COVID patients, published in July, those who had been taking aspirin fared far better than those who did not A followup study will examine the benefits of one baby aspirin (81 mg) with and without Vitamin D, read about it here. I should note that other pain medications do not have this blood-thinning effect, and would not be expected to have the same benefit.
While it seems likely that 2 baby aspirins might be better in fat people, or one full aspirin every other day, taking a lot more than this is deadly. During the Spanish flu some patients were given as much as 80 adult aspirins per day. It likely killed them. As Paracelsus noted, the difference between a cure and a poison is the dose.
A few days ago, I asked for and received the PCV-13 pneumonia vaccine, and a few days earlier, the flu shot. These vaccines are free if you are over 65, but you have to ask for them. PCV-13 is the milder of the pneumonia vaccines, providing moderate resistance to 12 common pneumonia strains, plus a strain of diphtheria. There is a stronger shot, with more side-effects. The main reason I got these vaccines was to cut my risk from COVID-19.
Some 230,00 people have died from COVID-19. Almost all none of them were under 20, and hardly any died from the virus itself. As with the common flu, they died from side infections and pneumonia. Though the vaccine I took is not 100% effective against event these 13 pneumonias, it is fairly effective, especially in the absence of co-morbidities, and has few side effects beyond stiffness in my arm. I felt it was a worthwhile protection, and further reading suggests it was more worthwhile than I’d thought at first.
It is far from clear there will be a working vaccine for SARS-CoV-2, the virus that causes COV-19. We’ve been trying for 40 years to make a vaccine against AIDS, without success. We have also failed to create a working vaccine for SARS, MERS, or the common cold. Why should SARS-CoV-2 be different? We do have a flu vaccine, and I took it, but it isn’t very effective, viruses mutate. Despite claims that we would have a vaccine for COVID-19 by early next year, I came to imagine it would not be a particularly good vaccine, and it might have side effects. On the other hand, there is a fair amount of evidence that the pneumonia vaccine works and does a lot more good than one might expected against COVID-19.
A colleague of mine from Michigan State, Robert Root Bernstein, analyzed the effectiveness of several vaccines in the fight against COVID-19 by comparing the impact of COVID-19 on two dozen countries as a function of all the major inoculations. He found a strong correlation only with pneumonia vaccine: “Nations such as Spain, Italy, Belgium, Brazil, Peru and Chile that have the highest COVID-19 rates per million have the poorest pneumococcal vaccination rates among both infants and adults. Nations with the lowest rates of COVID-19 – Japan, Korea, Denmark, Australia and New Zealand – have the highest rates of pneumococcal vaccination among both infants and adults.” Root-Bernstein also looked at the effectiveness of adult inoculation and child inoculation. Both were effective, at about the same rate. This suggests that the the plots below are not statistical flukes. Here is a link to the scientific article, and here is a link to the more popular version.
An analysis of countries in terms of COVID rates and deaths versus pneumonia vaccination rates in children and adults. The US has a high child vaccination rate, but a low adult vaccination rate. Japan, Korea, etc. are much better. Italy, Belgium, Spain, Brazil, and Peru are worse. Similar correlations were found with child and adult inoculation, suggesting that these correlations are not flukes of statistics.
I decided to check up on Root-Bernstein’s finding by checking the state-by state differences in pneumonia vaccination rates — information available here — and found that the two US states that were hardest hit by COVID, NY and NJ, have among the lowest rates of inoculation. Of course there are other reasons at play. These states are uncommonly densely populated, and the governments of both made the unfortunate choice of sending infected patients to live in old age homes. At least half of the deaths were in these homes.
Pneumonia vaccination may also explain why the virus barely affected those under 20. Pneumonia vaccines was available only in 2000 or so. Many states then began to vaccinate about then and required it to attend school. The time of immunization could explain why those younger than 20 in the US do so well compared to older individuals, and compared to some other countries where inoculation was later. I note that China has near universal inoculation for pneumonia, and was very mildly hit.
I also took the flu shot, and had taken the MMR (measles) vaccine last year. The side effects, though bad, are less bad than the benefits, I thought, but there was another reason, and that’s mimicry. It is not uncommon that exposure to one virus or vaccine will excite the immune system to similar viruses, so-called B cells and T-cell immunity. A recent study from the Mayo Clinic, read it here, shows that other inoculations help you fight COVID-19. By simple logic, I had expected that the flu vaccine would help me this way. The following study (from Root-Bernstein again) shows little COVID benefit from flu vaccine, but evidence that MMR helps (R-squared of 0.118). Let men suggest it’s worth a shot, as it were. Similar to this, I saw just today, published September 24, 2020 in the journal, Vaccines, that the disease most molecularly similar to SARS-CoV-2 is pneumonia. If so, mimicry provides yet another reason for pneumonia vaccination, and yet another explanation for the high correlations shown above.
As a final comparison, I note that Sweden has a very high pneumonia inoculation rate, but seems to have a low mask use rate. Despite this, Sweden has done somewhat better than the US against COVID-19. Chile has a low inoculation rates, and though they strongly enforced masks and social distance, it was harder hit than we were. The correlation isn’t 100%, and masks clearly do some good, but it seems inoculation may be more effective than masks.
There are two main routes for catching flu. One is via your hands and your eyes and nose. Your hands pick up germs from the surfaces you touch, and when you touch your eyes or nose passages, the germs infect you. This was thought to be the main route for infection, and I still think it is. I’d been pushing iodine hand sanitizer for some time, the stuff used in hospitals, saying that that the alcohol hand sanitizer doesn’t work well, that it evaporates.
The other route, the one touted by the press these days is via direct cough droplets, breathing them in or getting them in your eyes. Masks and face shields are the preferred protection from this route, and the claim is that masks will stop 63% of the spread. The 63% number has an interesting history, it comes from this test with infected hamsters. Hamsters are 63% less likely to infect other hamsters when they wear a mask. Of course, the comparison has some weaknesses: hamsters don’t put their fingers in their noses, nor do they rub their eyes with their hands, and hamsters can be forced to keep the mask barrier all the time — read the study to see how.
A more realistic study, or more relevant to people, in my opinion showed a far lower effect for masks, about 20%. During the HiNi flu pandemic of 2009 a group of 1437 college students at a single university were divided into three randomized groups, see the original report here. Students at a few chosen residence halls were instructed to wash their hands regularly, use sanitizer, and wear masks. Students at other halls were either told to wear masks only, or told to go on as they pleased. This was the largest group, the control. They included students of the the largest residence hall on campus. The main results appear as the graph below, Figure 1 of the report. It shows a difference of 6% or 20%, depending on how you look at things, with the mask plus hand-health group, MPHH, doing the best.
After 6 weeks of monitoring, approximately 36% of the control group had gotten the flu or some collection of flu symptoms. The remaining 64% of the residents remained symptom free. This is he darkest line above.
Of the FM Only group, the medium line above, those instructed to wear face masks only. 30% of this group showed flu symptoms, with 70% remaining symptom free. Clearly masks do help with humans, but far less than what you’d expect from the news reports.
Sweden kept the primary schools open and allows people to wear masks and social distance at they see fit. The death toll to August 1 is identical to Michigan, or slightly bette Sweden’s top virologist recommends that the US follow suit. Open up and trust people.
The group that did best was FMHH, the group who both wore facemarks and used hand health, regular hand washing plus hand sanitizer. This group reported an average of 3.5 hours per day of mask use above the control group average. This is about as good or better than I see in Michigan. Adding the hand health provided an additional 1% improvement, or a 3% improvement, depending on how you look at these things. The press claims hand health is wasted effort, but I’m not so sure. I argue that the effect was significant, and that the hand sanitizer was bad. I argue that iodine hand wash would have done better at far less social cost.
I also note that doing nothing was not that much worse than mask use. This matches with the observation of COVID-19 in Sweden. With no enforced social distancing, Sweden did about the same as Michigan — slightly better, despite Michigan closing the schools and restaurants, and imposing some of the toughest requirements for social distancing and mask use.
Other things that affect how likely you are to get flu symptoms. I find these rustles more interesting than the main face-mask result.
There were other observations from the university study that i found isignificant. There are racial differences and social differences. The authors didn’t highlight these, but they are at least as large as the effect of mask use. Asians got the flu only 70% as often as others, while black students got it 8% more often. This matches what has been seen in the US with COVID-19. Also interesting, those with a recent flu shot got flu more often; those with physical activity 13% more often. Smokers got the flu less than non-smokers and women got it 22% more often than men. The last two are the reverse with COVID-19. I could speculate on the reasons, but clearly there is a lot going on.
Why did Asians do better than others? Perhaps Asians have had prior exposure to some similar virus, and are thus slightly immune, or perhaps they used the masks more, being more socially acceptable. Why were smokers protected? It’s likely that smoke kills germs; was that the cause. These are speculations, and as for the rest I don’t know.
I am not that bothered that the students probably didn’t wear their masks 100% of the time. Better would be better, but even with mask use 100% of the time, there are other known routes that are almost impossible to remove: clothing, food, touching your face. I still think there is a big advantage to iodine hand wash, and I suspect we would be better off opening up a bit too.
Sweden has scientists; Michigan has scientists. Sweden’s scientists said to trust people to social distance and let the COVID-19 disease run its course. It was a highly controversial take, but Sweden didn’t close the schools, didn’t enforce masks, and let people social distance as they would. Michigan’s scientists said to wear masks and close everything, and the governor enforced just that. She closed the schools, the restaurants, the golf courses, and even the parks for a while. In Michigan you can not attend a baseball game, and you can be fined for not wearing a mask in public. The net result: Michigan and Sweden had almost the same death totals and rates, as the graphs below show. As of July 28, 2020: Sweden had 5,702 dead of COVID-19, Michigan had 6,402. That’s 13 more dead for a population that’s 20% smaller.
Sweden’s deaths pre day. There are 5,702 COVID dead since the start, out of a population of 10.63 million. There are 79,494 confirmed COVID cases, but likely a lot more infected.
Sweden and Michigan are equally industrial, with populations in a few dense cities and a rural back-country. Both banned large-scale use of hydroxy-chloroquine. Given the large difference in social distance laws, you’d expect a vastly different death rate, with Michigan’s, presumably lower, but there is hardly any difference at all, and it’s worthwhile to consider what we might learn from this.
Michigan’s deaths pre day. There are 6,426 COVID dead since the start, out of a population of 9.99 million. There are 88,025 confirmed COVID cases, but likely a lot more infected.
What I learn from this is not that social distance is unimportant, and not that hand washing and masks don’t work, but rather it seems to me that people are more likely to social distance if they themselves are in control of the rules. This is something I also notice comparing freezer economies to communist or controlled ones: people work harder when they have more of a say in what they do. Some call this self -exploitation, but it seems to be a universal lesson.
Both Sweden and the US began the epidemic with some moderate testing of a drug called hydroxychloroquine (HCQ)and both mostly stopped in April when the drug became a political football. President Trump recommended it based on studies in France and China, but the response was many publications showing the didn’t work and was even deadly. Virtually ever western country cut back use of the drug. Brazil’s scientists objected — see here where they claim that those studies were crooked. It seems that countries that continued to use the drug had fewer COVID deaths, see graph, but it’s hard to say. The Brazilians claim that the anti HCQ studies were politically motivated, but doctors in both Sweden and the US largely stopped prescribing the drug. This seems to have been a mistake.
US hospitals stopped using HCQ in early April almost as soon as Trump recommended it. Sweden did the same.
In July, Henry Ford hospitals published this large-scale study showing a strong benefit: for HCQ: out of 2,541 patients in six hospitals, the death rate for those treated with HCQ was 13%. For those not treated with HCQ, the death rate was more than double: 26.4%. It’s not clear that this is cause and effect. It’s suggestive, but there is room for unconscious bias in who got the drug. Similarly, last week, a Yale researcher this week used epidemiological evidence to say HCQ works. This might be proof, or not. Since epidemiology is not double-blind, there is more than common room for confounding variables. By and large the newspaper experts are unconvinced by epidemiology and say there is no real evidence of HCQ benefit. In Michigan and Sweden the politicians strongly recommend continuing their approaches, by and large avoiding HCQ. In Brazil, India and much of the mideast, HCQ is popular. The countries that use HCQ claim it works. The countries that don’t claim it does not. The countries with strict lock-down say that science shows this is what’s working. The countries without, claim they are right to go without. All claim SCIENCE to support their behaviors, and likely that’s faulty logic.
Hydroxychloroquine and COVID-19 fatality rates in different countries as of early June 2020. This isn’t enough to prove HCQ effectiveness, but it’s promising, and suggests that increased use is warranted, at least among those without heart problems.
Given my choice, I’d like to see more use of HCQ. I’m not sure it works, but I’m ,sure there’s enough evidence to put it into the top tier of testing. I’d also prefer the Sweden method, of nor enforced lockdown, or a very moderate lockdown, but I live I’m Michigan where the governor claims she knows science, and I’m willing to live within the governor’s lockdown.There is good, scientific evidence that, if you don’t you get fined or go to jail.
When I was eight or nine year old, I went to the 1963-64 World’s Fair in New York. Among the attractions, in “the kitchen of the future”, I saw the first version of an amazing fry-pan that was coated with plastic. You could cook an egg on that plastic without any oil, and the egg didn’t stick. The plastic was called teflon, a DuPont innovation, whose molecule is shown below.
The molecular structure of Teflon. There is an interior carbon backbone that is completely enclosed with tightly bound fluorine atoms. The net result is a compound that does not bind readily to anything else.
Years later, I came to understand that Teflon’s high-temperature stability and non-stick properties derive from the carbon-fluorine bonds. These bonds are much stronger than the carbon-hydrogen bonds found in food, and most solid, organic things. Because of the strength of the carbon-fluorine bond, Teflon is resistant to oxidation, and to chemical interaction with other molecules, e.g. in food. It does not even interact with water, making it hydrophobic and non-wetting on metals. The carbon-carbon bonds in the middle remained high temperature stable, in part because they were completely shielded by the fluorine atoms.
This is a PFAS. The left side is just like teflon, and very hydrophobic. The right side is hydrophilic and highly bonding to pans, and many other things like water or cotton.
But as remarkable as teflon’s non-stick properties are, perhaps the most amazing thing was that it somehow sticks to the pan. For the first generation pans I saw, it didn’t stick very well. Still, the DuPont engineers had found a way to stick non-stick Teflon to a metal for long enough to cook many meals. If they had not found this trick, teflon would not have the majority of its value, but how did they do it? It turns out they used a thin coating of a di-functional compound called PFAS, a a polyfluoro sulphonyl (or polyfluoroalkyl) substance. The molecular structure of a common PFAS, is shown above.
Each molecule of PFAS has one end that’s teflon-like and another end that’s different. The non-Teflon end, in this case a sulfonyl group, is chosen to be both high temperature stable and sticky to metal oxides. The sulphonyl group above is highly polar, and acidic. Acidic will bind to bases, like metal oxides. The surface of the metal pan is prepared by applying a thin layer of oxide or amidine, making it a polar base. The PFAS is then applied, then Teflon. The Teflon-end of the PFAS is bound to teflon by the hydrophobicity of everything else rejecting it.
There are many other uses for PFAS. For example, PFAS is applied to clothing to make it wrinkle free and stain resistant. It can also be used as a super soap, making uncommonly stable foams and bubbles. It is also used in fire-fighting and plane de-icing. Finally, PFAS is the main component of Nafion, the most common membrane for PEM fuel cells. (I can think of yet other applications..) There is just one small problem with PFAS, though. Like teflon, this molecule is uncommonly stable. It doesn’t readily decompose in nature. That would be a small problem if we were sure that PFAS was safe. As it happens it seems safe, but we’re not totally sure.
The safety of PFAS was studied extensively before PFAS-teflon pans was put on the market, but the methodology has been questioned. Large doses of PFAS were fed to test animals, and their health observed. Since the test animals showed no real signs of ill-health though some showed a slight liver enlargement, PFAS was accepted as safe for humans at a lower exposure dose. PFAS was approved for use on pans and allowed to be dumped under conditions where humans would be exposed to 1/1000 of that used on the animals. The assumption was that there would be little or no health hazard at these low exposure levels.
But low risk is not no risk, and today one can sue for even the hint of an effect though use of a class action suit. That is, lawyers sue on behalf of all the people who might have been damaged. My city was sued successfully this way for complicity in sewage over-flows. Of course, since the citizens being paid by the suit are the same ones who have to pay for the damage, only the lawyers benefit. Still, the law is the law, and at least for some judges, putting anyone at risk is enough evidence of willful disregard to hand down a stinging judgement against the evil doer. Judges have begun awarding large claims for PFAS too. While no individual can get the claim more than a tiny amount of money, the lawyers can do very well.
There is no new evidence that PFAS is dangerous, but none is needed if you can get yourself the right judge. In this regard, an industry of judicial tourism has sprung up, where class-action lawyers travel to districts where the judges are favorable. For Teflon suits, the bust hunting grounds are in New York, New Hampshire, and California, and the worst are blood-red states like Wyoming and Utah. Just as different judges promote different precedents, different states allow vastly different PFAS concentrations in the water. A common standard, one used by Michigan, is 70 ppt, 1 billion times stricter than the amounts tested on animals. This is roughly 500 times stricter than the acceptable concentratios for lead, a known poison. The standard in New York is 7 times stricter than Michigan, 10 ppt. The standard in North Carolina is 140,000 ppt, in in several states there is no legal limit to PFAS dumping. There is no scientific logic to all of this, and skeptical view is that the states that rule more strictly for PFAS than lead do so make money for lawyers. Lead is everyone in the natural environment, so you can’t sue as easily for lead. PFAS is a man-made intruder, though, and a strict standard helps lawyers sue. You can find a summary of state by state regulations here.
Any guideline stricter than about 1000 ppt, presents a challenge to the water commissioner who must measure it and enforce the law. There are tricks, though. You can use the surfactant quality of PFAS to concentrate it by a factor of 100 or more. To do this, you take a sample of river water and create bubbles. Any bubbles that form will be highly concentrated in PFAS. Once PFAS can be identified this way, and the concentrators estimated, the polluters can be held liable. Whether we benefit from the strict rulings is another story. If I were making the law for Michigan, I’d probably choose a limit about 1 ppb, but I’m not making the law. The law, as written, may be an idiot, as Bumble said, but the Law is the Law.
In terms of Michigan fishing, while some rivers have PFAS concentrators above the MI-legal limit, they are generally not far over the line. I would trust the fish in the Huron River, even west of Wixom road but I’d suggest you avoid any foam you find floating there. The PFAS content of foam will be much higher than that of the water in general.
Robert E. Buxbaum, June 30, 2020, edited July 8, 2020. There are seven compounds known as PFAS’s: perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexanesulfonic acid (PFHxS), perfluoroheptanoic acid (PFHpA), and perfluorobutanesulfonic acid (PFBS).
