Month: August 2020

The Trump Party is openly trashing mail-in voting, the system we, in the State of Washington, have run in all 39 counties for the last ten years, according to Kim Wyman, our Secretary of State (and a Republican). Trump claims rampant voter fraud with mail-in voting (at the same time as he requests an absentee ballot to vote in the State of Florida for himself). Ms. Wyman, in an NPR interview, cites a 2018 Washington State study that showed 142 people tried to vote fraudulently out of 3.2 million votes cast. So much for the endless Republican claims of fraud inherent in mail-in voting. 

In the same NPR interview Ms. Wyman notes that “Washington is in the top six to 10 states every election for turnout.”

Information on election turnout following our August 4 Primary was sometimes contradictory. Perennial candidate Leonard Christian (R) ran in the Primary against Rob Chase, the Matt Shea fellow traveler. The race was for a seat in the WA state House of Representatives in Legislative District 4 (Spokane Valley north to Mt. Spokane). In a thank you email Mr. Christian explained his 27 to 33% loss by writing: “It’s simple. Low voter turn out. Only 33% of the voters turned in their ballots.” [See P.P.S. below.]

In fact (as of last Thursday’s data update) the August 4, 2020 Washington State Primary election ballot turn-in number for Spokane countywide was 50.46%. and in Mr. Christian’s LD4 it was 50.71%, not 33%. In the comparable Washington State Primary election on August 2, 2016 (before the last Presidential general election) 34.18% of the ballots sent out in Spokane County were returned (33.66% in LD4). That was a low turnout. This year’s 50% ballot return in the August 4 Primary is even 4 percent points higher than the comparable primary in 2008. In 2008 there was lot of buzz about the upcoming Presidential contest between Barack Obama and John McCain. I’ve read that the current 50% return statistic for Spokane County is the highest recorded return in a primary election since the 1960s. 

Bottom line: There is a lot of buzz this year, too–and for good reason. In the White House sits an ignorant would-be autocrat doing everything he can to delegitimize our democratic process. Primary election ballot return is way up. Typically that foretells a high ballot return in the General Election in November. In 2008, for instance, when the Primary ballot return was 47%, the ballot return in the General Election (Obama/McCain) was a record high of 86%. It is worth noting that year that in Spokane County those two were very nearly tied (Obama 48% / McCain 49%) suggesting a higher than (recent) usual turnout of Democratic voters. Anything could happen this November–even in Spokane. (Click that link to revisit the 2008 Spokane County voting. This is solid historical data available at your fingertips.)

Keep to the high ground,
Jerry

P.S. “Turnout” is a odd term carried over from turning out from one’s home to go vote at the polls. In a state where all registered voters are mailed a ballot, isn’t “turn in” or “ballot turn in” the better term? Maybe “turnout” is like “dialing” a smartphone? 

P.P.S. The ballot return data is available at the Spokane County Elections website (the County Auditor’s, Vicky Dalton’s, office): https://www.spokanecounty.org/4578/Elections  Mr. Christian’s “33%” turnout number was likely grabbed from the first night’s “Ballot Return Statistics,” on the “Current Election” page. It is a table that is updated daily until the election results are finalized two weeks after the election. Since many ballots arrive after election day the ballot return number grows over several days. Note that ballot return statistics tend to differ from the “Voter Turnout” number presented on the “Current Election Results” page. Some small number of “returned ballots” never get “cured,” for example, a questioned signature is never verified by the voter; and the number of ballots may increase the denominator of the percent of both numbers as same day registrants’ ballots get added to the system. 

P.P.P.S. Several readers wrote to say they couldn’t find the Washington Election Results App that, in the Reference box below, I’ve recommended for download for years now. I emailed the Secretary of States Office and got the following reply: “The election results app was actually removed from all app storefronts last year. Those who still have it downloaded are able to access the app, but it is no longer supported and cannot be downloaded again. If we add the app back to each app store, we will post the new links to access it. Our election results page is optimized for mobile usage, so it can be loaded correctly with various browsers on mobile devices.” (Here’s the raw link: https://results.vote.wa.gov/results/20200804/ ) That may work but I find it really inconvenient to remember how to connect to the results with a smartphone browser from one election to the next. I encourage you to send an email to  elections@sos.wa.gov  and nicely ask if, when they can find the time and resources, they would please update the app. Voting is about community engagement. This app helps the community to engage.

Home pregnancy tests are fast and relatively inexpensive (relative to going to a doctor). A home pregnancy test is an “antigen test.” The antigen in this case is a hormone (HCG) that is excreted in a woman’s urine in the early stages of pregnancy. Urine is applied to a test strip that contains a manufactured antibody* that binds to receptors on the hormone antigen. That antigen-antibody complex triggers a color change in the test strip. It’s fast, simple, and cheap. If one is at all skeptical of the result the test can be repeated easily. Any uncertainty (or a positive result) should trigger a medical visit. [Note: a pregnancy test looks for an antigen, i.e. HCG, using a manufactured antibody. Don’t confuse that with testing for natural antibodies to Covid-19 as a way of telling if a person has been infected. These are two very distinct uses of the word antibody.]

At this time there is no such test for Covid-19, but a fast, cheap, and readily available home-based test for Covid-19 would be a major game changer: it looks like a lot of transmission of Covid-19 occurs from asymptomatic (40% of those infected never have symptoms) and pre-symptomatic (1-2 days before symptoms) people, and from folks who are a little sick, but who convince themselves they’re not sick enough to stay home. That transmission pattern is the single most intractable and troublesome characteristic of this disease. 

If, in addition to wearing masks and social distancing, a whole lot of people in the community routinely tested themselves with this (still imaginary) fast, cheap, home test–and then, if it were positive, stayed home pending the result of further testing, we would once again have some control over the spread of Covid-19. Then we could move on to the contract tracing and quarantining that has allowed many other countries to carry on in a manner much closer to normal (and to look at the U.S. in puzzled amazement).

If such a fast and cheap test were broadly available it wouldn’t even need to be highly accurate to help us out as a community. If today’s test missed a few virus particles (a negative result that was false, i.e. a “false negative”), another test later in the week would pick up the virus when it was present in higher quantities. An asymptomatic patient with a large viral load is much more likely to spread the virus than someone whose viral load is barely detectable. Similarly, a false positive result (patient has no virus but the test says they do) one morning is a nuisance, but, if false positives are not too frequent, the ones that dooccur just mean you’re quarantined until subsequent more accurate tests show the true state of affairs. 

But no such test is currently available. We have two broad kinds of tests for presence of the virus. (To be distinguished from testing patients for evidence they’ve been infected, i.e. looking for natural antibodies in patients’ blood. These are also called “serology” tests, i.e. tests of blood serum.)

There are two types of tests for presence of the virus. Antigen tests look for viral proteins (instead of viral genetic material) are generally the faster tests, but none is yet available that is home-based, nor that is it sufficiently inexpensive. “Molecular” tests, most of which detect bits and pieces of the viral genetic material, usually involving something called PCR (polymerase chain reaction), a technique that amplifies the minute quantities of the genetic material to make it more detectable. The molecular tests generally require more challenging lab technique (i.e. not practical for home use), and are more expensive. [The “molecular tests” link above is to a Johns Hopkins webpage that offers a lot more detail.]

The test Mr. Trump and his White House staff use to insulate themselves from exposure to Covid-19 (while they tell everyone else to go out and expose themselves to save the economy) is the Abbott rapid ID NOW test. It is a molecular test (for viral genetic material). It requires a small processor console that is certainly beyond the financial reach of most people. Thanks to the opaque medical pricing from which we continue to suffer in the United States, I was unable to learn what one test processed through this machine is likely to cost. For those with a device on site it delivers a result in less than 15 minutes. It has been criticized for failing to detect virus when it is present (false negatives). Nonetheless, it certainly reduces the likelihood that someone spewing virus will enter the White House. 

Most molecular tests for Covid-19 require a sample to be delivered to a qualified laboratory for processing. The test result often is not available to the patient for days or even a week. That is no help in determining whether you need to stay home on the day of the test, if there is any time left on the day of the test after you’ve jumped through the hoops necessary to be tested at all. hence, the recommendation to self-quarantine until the result is known and negative. 

Antigen tests for Covid-19 proteins (overall much faster than molecular tests, but still requiring a machine) are becoming available, but I could not find a timeline for the development of a home-based test. Somehow, one might imagine that a country that put a man on the moon could figure this out… 

None of this is cheap. Trying to learn the cost of a test is a frustrating exercise. Not only are the charges variable for currently available testing, but searching immediately brings up discussion of stock prices of the various companies making the tests. This is U.S. medical non-free market “capitalism” with all its warts. Don’t expect any help from the Trump administration.

Keep to the high ground,
Jerry

*An antibody is an organic (carbon-based) chemical, a specialized protein (made of chains of amino acids), that is produced either by a body’s immune system or chemically manufactured to bind very specifically to a “binding site” on a target protein.

P.S. I cannot think of a medical test that is perfectly sensitive (detects everyone with the disease) and perfectly specific (detects only those actually have the disease). Furthermore, among tests there is often some trade-off between sensitivity and specificity. (If math doesn’t give you hives and you want to look harder at this concept, check out https://kennis-research.shinyapps.io/Bayes-App/ It turns out that a Presbyterian minister, Thomas Bayes, worked out the math back in the 18th century.) This is the stuff that experts actually use to come up with their recommendations. Laboratory scientists and doctors spend their lives quantifying how tests work and what the results mean. It is material that very few reporters and even fewer politicians and political pundits ever understand. All of us tend to think in terms of a test being “positive” or “negative”  as the be-all and end-all, black and white result. Like so much of life, it is not that simple.

What’s a “moderate” Republican going to do? A number of prominent national Republicans, including George Will, Max Boot, and George Conway (founder of The Lincoln Project–and Kellyanne’s husband) have issued an answer: vote for Democrats, the Republican Party has lost its mind to Trumpian extremists and needs corrective action.

Here in Eastern Washington Republican “moderates” (one might hesitantly call them “traditional” Republicans) are in a bind: do they bow to the conspiracy theorists, the Ammon Bundy/Matt Shea/Heather Scott militia types, the white supremacist hosts of the extremists like James Allsup, the promoters of the theocratic “State of Liberty,” or do they defect, at least for this election, and actually vote for Democrats? 

We have the answer for Eastern Washington in the August 9th Spokesman in an article written by Rebecca White entitled, “Primary shows Rep. Matt Shea remains big influence in GOP politics in Spokane Valley.” 

We need to understand the players in this political drama–the names are confusing. The Republicans of Spokane County are the smaller group in the county. They are centered in Spokane Valley and they are the relative moderates. Their chairwoman (and spokesperson in White’s article) is Beva Miles. 

The other group, Spokane County Republicans,  have the bigger and richer tent under which a few relatively oblivious moderates cuddle with the Matt Shea extremists. Note, for example, that the Spokane County Republicans for a time had the hostess of Greenbluff white supremacy, Cecily Wright, as their chairwoman. Ozzie Knezovich (an outspoken critic of Matt Shea and his extremists) warned them, but no one listened. Cathy McMorris Rodgers, accepted Matt Shea’s endorsement in 2018, and with it, the endorsement of his supporters.

In this year’s August 4 Primary race in LD4 (Spokane Valley north to Mt. Spokane) the drama among local Republicans played out yet again in the contest between Leonard Christian (26%), Rob Chase (32%) and Lance Gurel (35%). The ballot turn-in was a measly 38.8%. Rob Chase, the Matt Shea supported extremist candidate, won out on the Republican side. So what’s a Republican moderate to do?

Beva Miles (chairwoman of the relative moderates) offers a carefully guarded answer in Rebecca White’s Spokesman article: 

Miles said she fears the results from the primary will leave many Republicans in a difficult position: vote for conservative candidates who have allied with the far right, or vote for a Democrat, who also doesn’t reflect their values. She said if far-right candidates continue to win primaries in the district as the demographics in the district shift, it could someday push the seat to a Democrat, like Gurel. [OMG, perish the thought!]

“I don’t agree with him in any way shape or form, or with the Democrat platform,” she said. “But he’s a very reasonable-sounding and lovely man. I believe that the far-right has opened the door to let the independents rule.”

Oh, horrors! she says. A Democrat! No. No. Democrats are anathema! They don’t share “our values.” Gurel can be a “lovely man” but his positions are only “reasonable-sounding.” By inference, Lori Feagan, a respected, intelligent, nurse practitioner, running against Bob McCaslin Jr., another Matt Shea acolyte, cannot possibly deserve a vote from a member of the Republican tribe because, OMG!, she’s a Democrat. Unlike George Conway, it sounds like Beva will swallow hard and vote for the Matt Shea clones because, horrible and scary as those folks are, they are not so horrible and scary as a reasonable Democrat. So the Republicans of Spokane County are instructed to vote for the theocratic militia-types who play footsie with white supremacy.

What are the Republicans selling as their “values” and outlook? Well, let’s look at that. Go to the Spokane GOP website (the big tent folks who court the support of extremists) and check out the Facebook video featuring Caleb Heimlich, the State Republican Party Chair.

Here is Mr. Heimlich’s pitch to Republican Primary voters summarized: 
1) Be fearful! Don’t let your placid Christian communities become a lawless Seattle! (Sound familiar? It’s the same campaign that Nadine Woodward pushed with the “Seattle is Dying” video.)
2) We’ve got to lower taxes. No “radical” budget! The Democrats will chase out good jobs! We’ve got to trim the fat! (Nevermind the huge budget shortfall the state now faces, nor the upside down tax system that puts the burden on those who can least afford it.)
3) Vote Republican to keep your kids safe from sex education! (Referendum 90) (After all, kids need to be kept ignorant. We can’t trust them with age-appropriate medical facts that might equip them to recognize pedophile priests and the risks of out of wedlock pregnancy.)
4) We must elect officials who will listen to their constituents, like Tim Eyman! (Well, we know how that turned out: voters didn’t like Eyman’s pitch. Republicans voted for a belligerent sheriff who says he’s running on “law and order” while he refuses to enforce the will of the people as expressed in Initiative 1639. That was the gun initiative that passed with 59% of the vote in 2018. So much for listening to the people…)
5) We must elect competent people! His example? The unemployment money lost to scammers. (We can agree about the need for competency. We should vote for an accountant [Lance Gurel] and a medical professional [Lori Feagan] in LD4.) 

“Moderate” Republicans in LD4 (and elsewhere) have a dilemma. They are so brainwashed against anyone not wearing the Republican label they feel they must swallow hard and vote for the worrisome, extremist, theocratic Matt Shea clones or their greatest fears will come to pass. The only thing I give the Republicans of Spokane County credit for is recognizing the “Threats We Face” (Ozzie Knezovich’s lecture) from the Matt Shea wing of their party. Now they need the stomach to actually cast votes that will displace that threat. 

Keep to the high ground,
Jerry

P.S. To see how “moderate” Republicans in eastern Washington are treated by the extremists, and how competent Democratic candidates are vilified check out this web article published in “The Inland Northwest Report” There is a whole electronic media ecosystem out there that keeps up the tribal drumbeat.

There is an ACTION ITEM today. Please read through and send some email thank yous. Serving on Health District boards and school boards without compensation is selfless enough. Let’s make sure the people who serve get some praise for their efforts instead of just criticism from a loud, organized minority. If we don’t get involved in this way we will have no excuse when a vocal minority takes over.

Background: Imagine the stress of having to make high-profile decisions about school re-opening during the Covid-19 pandemic. There is no perfect answer, especially in a situation where the best science-based advice has been highly politicized. Everyone wants the schools to re-open this fall for social and economic reasons and, still, no one wants to see large numbers of people sicken and some die as a result. Shawn Vestal captured the complexity in his “Pandemic creates paradox – we must open schools but we can’t open schools”  

Still there is a very noisy crowd of local folk protesting and emailing against current science-based recommendations to wear a mask and against the earlier lock-downs. Some (many?) of these folk are convinced, against all evidence, that the pandemic is either a hoax or simply “God’s will” to be endured, some are anti-vaccination and/or simply anti-science. These folks, in their hundreds, are activated through electronic media and some churches. They send emails and letters, make phone calls, and loudly demonstrate in the hope of forcing schools to reopen in person for the sake of their ideology. 

To see what the recommendations are for Spokane County I’ve appended Spokane County Health Officer Dr. Bob Lutz’ letter on school re-opening to the end of this email. Spokane County has a number of school districts. Of them, so far, the Boards of the Spokane Public School District (aka District 81 or SPSD) and Central Valley School District (CVSD) have followed Dr. Lutz’ recommendation to start the fall online only, while the Mead and East Valley School Districts have opted to open in person, bucking the science and endangering the wider community, since the coronavirus pays no attention to school, home, or geographical boundaries as it passes among us.

Here’s the ACTION ITEM assembled by Petra Hoy:

I anticipate that the SRHD (Spokane Regional Health District), School Board members and Superintendents will be hearing from the “Covid is a Hoax” and anti-mask, anti-vaxx crowd. 

I thought it would be nice if we could show our support for them making this difficult decision and following the scientific advice of Dr. Bob Lutz.

If you’d like please:

1.  Write a quick email, something as simple as “Thank you for following the advice of the SRHD and Dr. Lutz.  It’s critical that we follow science during this pandemic” 

2.  It’s okay if you live in another school district or are out of the area.  The virus doesn’t care about those arbitrary lines.

3.  You can copy and paste these email addresses:

SRHD (Spokane Regional Health District):
cweiler@srhd.org

public_comments@srhd.org

Spokane Public Schools Superintendent Dr. Adam Swinyard AdamSw@spokaneschools.org

Spokane Public School Board:
Jerrall Haynes, President JerrallHaynes@spokaneschools.org
Michael Wiser Vice President MikeWiser@spokaneschools.org
Nikki Lockwood NikkiLockwood@spokaneschools.org
Jenny Slagle JennySlagle@spokaneschools.org


Central Valley Schools Superintendent Ben Small  bsmall@cvsd.org

Central Valley School District Board:

Keith Clark,, President kclark@petvet.org
Debra Long, Vice President  debralong@icehouse.net

Cindy McMullen, cmcmullenlaw@gmail.com
Tom Dingus tdingus@cvsd.org
Mysti Reneau mystireneau@gmail.com

Thank you so much for your help!

Sincerely,
Petra (Petie) Hoy 

Keep to the high ground, 
Jerry

P.S. Bob Lutz’s Letter:

TO: Spokane County Public School Superintendents
       Spokane Private School Administrators
 
SUBJ: Education for Fall 2020 
 
Since the first case of COVID-19 was identified in Snohomish County, Washington on January 21, 2020 and the first confirmed cases in Spokane County on March 14, 2020, almost 60,000 cases have been confirmed at this time in Washington State. Governor Inslee’s Stay Home, Stay Health order on March 24, 2020 and the closure of K-12 schools March 12, led to a decline in the rate of disease across much of the state.  Eastern Washington never saw the average effective reproductive numbers (Re) fall below 1, however, and since early May, it has continued to rise, as well as across the entire state. With this has come increased rates of infections, especially in younger individuals, such that the rate is now greater than it was during March-April. The Institute of Disease Modeling (IDM) report, Schools are not islands: we must mitigate community transmission to reopen schools, stated  “community-wide mitigation efforts must improve significantly such that the effective reproductive number is below 1 at the end of August for schools to reopen in September without triggering exponential growth in COVID-19 burden.”
 
Spokane County’s COVID-19 profile is comparable to other Washington counties. Prior to Memorial Day weekend, there were 432 confirmed cases; since, 3384 cases (an increase of 783%). The incidence rate as of August 1, 2020 is 209.6/100,000/14 days.   
 
Whereas knowledge of preventing COVID-19 has increased since the beginning of the pandemic, to include evidence supporting the use of cloth face coverings, national experience implementing disease prevention efforts for COVID-19 in the K-12 setting is minimal. Internationally, in-person instruction has been most successfully implemented when incidence rates are low, i.e., ≤25/100/14 days, and decreasing. Given the current high level and upward trajectory of COVID-19 rates in Spokane County, cases and outbreaks in schools will likely occur. These could negatively impact community-wide efforts to lower rates, would impose considerable demands and instability on school operations and conceivably outpace our collective efforts to control the pandemic.  
 
Schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits. Beyond supporting the educational development of children and adolescents, schools play a critical role in addressing racial and social inequity (AAP). While returning to in-person learning is a shared-goal by SRHD, doing so may come at a significant cost likewise shared by the entire Spokane community, especially our most vulnerable. Based on our rates, the existing science regarding COVID-19, and school reopening, I strongly recommend beginning the year in remote/continuous learning for all students. Consider in-person learning for those who have special health or education needs that cannot be delivered through remote learning.  
 
Sincerely,                           
Bob Lutz, MD, MPH
Health Officer

1) Election Results: For Washington election results there is a neat little smartphone app that shows them with a daily update as counting proceeds. On an iPhone its icon is black. The upper half says “Election Results” in white letters and the lower half shows a bust of George Washington and the letter SOS, for “Secretary of State.” I expect there is a similar app for Android based phones. I recommend it.

I note the Republicans have chosen to challenge Governor Inslee with an extremist, rural, anti-mask sheriff, Loren Culp. In Legislative District 4 (Spokane Valley north to Mt. Spokane) it looks like, Rob Chase, resoundingly endorsed by Matt Shea, will run against Lance Gurel, a reputable and reasonable accountant, for the State Representative seat Mr. Shea left to tend to his extremist flock at Covenant Church. As pastor he can keep organizing for armed rebellion and wield influence over his old district. It will be an interesting couple of months. 

2) Comment on Covid-19 Death Risk: Several readers were startled by the 1 in 20 risk of death for those over age 65 infected with the Covid-19 virus. A study in Geneva, Switzerland, used antibodies as a marker for having been infected and showed a death rate of 5.6% for those over 65. . (https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(20)30584-3.pdf). (1 in 20 is simply a rough restatement of 5.6%) Data like this is constantly being refined, i.e. it is subject to change as more studies are published. Nonetheless, 1 in 20 is probably not wildly inaccurate. 

Frankly, I thought the U.S. whole population IFR (infection fatality ratio) published on the CDC website of 0.0065 (or 1 in 150) was scary enough, but the number from Geneva (the only source I had that broke the IFR down by age group) was quite sobering. 

I think we find it hard to comprehend numbers like 0.0065 or 5.6% until we re-interpret them as a risk of 1 in X number. It is easier to visualizer nineteen people standing and one in a casket than to make sense of “5.6%,” no matter your math skills. 

We strive to distance ourselves from others misfortune. It’s a natural defense mechanism. How often have I heard that “John died of a heart attack” and leapt immediately to thinking, “Oh well, John was a diabetic and drank too much—he wasn’t like me.”?

People did the same thing with the 1 in 20. They want to break it down, make it not apply: “How many of those folks were over 90, over 85, over 80, that is, any number older than my age?” I don’t have a finer breakdown by age. There isn’t enough published data from antibody prevalence studies to know. 

I was a little surprised to find that only 13% of the U.S. population is over 65. Being part of the group and knowing a lot of other people similarly getting on in years distorted my perception.

3) Trump and Testing: It is just like Mr. Trump and Betsy DeVos to exhort teachers, students, and students extended families to risk their lives by re-opening schools in a country where many cannot get the result of a Covid-19 test in less than a week, while for months Mr. Trump and his people have screened contacts with a test that delivers results in fifteen minutes. Meanwhile, he and his administration have accomplished almost nothing in making the rapid tests more available to those understandably reluctant to dive back into the virus cauldron.

Stay safe and

Keep to the high ground,
Jerry

Here is last Wednesday’s (August 5) email, Covid-19 Refined, appended for easy reference:

Early in the pandemic our understanding of Covid-19 was necessarily based on analogies to similar diseases. Influenza was the commonest comparison. For months that comparison encouraged us to believe (or at least hope) that people with Covid-19, like flu, didn’t transmit virus until they had at least some early symptoms. Folks like the Rush Limbaugh and Mr. Trump declared, based on wishful thinking, that Covid-19 was no worse than the flu and, like the flu, would just go away with warmer weather. 

Understanding of Covid-19 is gradually building as our experience broadens and information is shared. As is the way with science, no single study is gospel, but many studies, each carefully scrutinized and all considered together, are sharpening our understanding of what we face with this disease. 

Even the sober wing of the Republican Party understands Covid-19 is not the flu. The Wall Street Journal on July 21 published an article (hidden behind a paywall), “How Deadly Is Covid-19? Researchers Are Getting Closer to an Answer.” The authors assembled the results of a number of large studies and came up with some numbers to which we should all pay attention. Much of their information came from the CDC’s Pandemic Planning Scenarios webpage (which is not hidden and was updated July 10)

The current best estimates based on multiple, worldwide studies is that Covid-19 kills one person for every 150 it infects (Infection Fatality Rate [IFR] of 0.0065). The denominator of this IFR is inflated by the estimated 40% of people who are infected (judged by antibody evidence) but never are symptomatic, even though they can transmit the virus. Best estimates of seasonal flu mortality are 1 in 900, one sixth of Covid’s IFR (and would be even smaller if the flu mortality estimate included entirely asymptomatic cases–which it does not). Rush Limbaugh, Sean Hannity, Laura Ingraham, and Donald Trump were and are ignorant, opinionated fools to declare Covid-19 to be no more worrisome than the flu.

Of course, the risk of death from Covid-19 varies with age, medical condition, available medical care, and other factors. For those of us over the age of 65, the risk of death, once infected, is about one in twenty (5.6%) Is there any activity in which you would willingly take part in which the advertised risk of being killed is one in twenty? [See P.S. below] I’ve taken part in quite a number of physically risky ventures in the course of my life, but none of them carries a one in twenty risk of death,

These Infection Fatality Ratios consider mortality, not morbidity: respiratory compromise, chronic fatigue,  and multiple other long term sequelae of infection, sequelae that weaken but don’t kill. Republicans, even Trump supporters and their families, are not immune to the reality of Covid-19 infection. Herman Cain, age 74, former presidential candidate and recent mask-dissing attendee of Trump’s Tulsa rally has been hospitalized and on oxygen for nearly four weeks with Covid-19.  (The day after I composed this email Herman Cain died.)

Other truths about this virus are also coming into focus. A Spokane teenager of my acquaintance and her friend recently lost their sense of taste and smell on the same day, one week after their only plausible exposure to Covid-19. They and two others had spent time (some of it indoors) in the company of a third friend whose brother came down with symptoms and tested positive after their time together. The friend, the only link and the only plausible carrier with whom they’d had contact, never personally manifested symptoms andtested negative for the virus twice following their contact. Fortunately, my teenage acquaintance suffered only a mild case, regained her sense of taste and smell in about a week and, with careful quarantining, did not infect her family. The other young woman had a rougher course, but recovered without experiencing pneumonia. Both young women tested positive for the virus.

The take-home from this anecdote and published data is that Covid-19 can be caught from symptomatic, pre-symptomatic, and asymptomatic people infected with the disease. One best assume that everyone with whom one comes in contact may be shedding virus. Influenza is far less contagious. Viral shedding with influenza virus mostly does not occur in the absence of early symptoms of the disease. In the current world population Covid-19 is not the flu. Covid-19 is more transmissible, more deadly, and productive of greater morbidity than influenza.

Keep to the high ground,
Jerry

P.S. Unless an effective vaccine becomes widely available, the death toll from Covid-19 is probably just getting started. The following is mathematical conjecture, but, if you take the death rate of 5.6% (1 in 20) in the over age 65 cohort in the U.S. population (these over age 65 are 13% of the whole U.S. population of 330M), an IFR of 0.0065 (1 in 150) in the whole population, and assume herd immunity when 60% of the population has been infected and made antibodies, then in the U.S. alone we would see 1.44M dead overall, nearly ten times what we’ve seen so far. 1.29M of the dead would be from the over 65 yo cohort, but 212,000 of the dead  would be among working age and younger U.S. residents.

Since the greatest viral transmission occurs indoors, I predict the coming winter will be long, dark, cold, and isolated, especially for those over 65. We had better hope for a safe and effective vaccine. The earliest that could happen now appears to be early in 2021. Cross your fingers.

Early in the pandemic our understanding of Covid-19 was necessarily based on analogies to similar diseases. Influenza was the commonest comparison. For months that comparison encouraged us to believe (or at least hope) that people with Covid-19, like flu, didn’t transmit virus until they had at least some early symptoms. Folks like the Rush Limbaugh and Mr. Trump declared, based on wishful thinking, that Covid-19 was no worse than the flu and, like the flu, would just go away with warmer weather. 

Understanding of Covid-19 is gradually building as our experience broadens and information is shared. As is the way with science, no single study is gospel, but many studies, each carefully scrutinized and all considered together, are sharpening our understanding of what we face with this disease. 

Even the sober wing of the Republican Party understands Covid-19 is not the flu. The Wall Street Journal on July 21 published an article (hidden behind a paywall), “How Deadly Is Covid-19? Researchers Are Getting Closer to an Answer.” The authors assembled the results of a number of large studies and came up with some numbers to which we should all pay attention. Much of their information came from the CDC’s Pandemic Planning Scenarios webpage (which is not hidden and was updated July 10)

The current best estimates based on multiple, worldwide studies is that Covid-19 kills one person for every 150 it infects (Infection Fatality Rate [IFR] of 0.0065). The denominator of this IFR is inflated by the estimated 40% of people who are infected (judged by antibody evidence) but never are symptomatic, even though they can transmit the virus. Best estimates of seasonal flu mortality are 1 in 900, one sixth of Covid’s IFR (and would be even smaller if the flu mortality estimate included entirely asymptomatic cases–which it does not). Rush Limbaugh, Sean Hannity, Laura Ingraham, and Donald Trump were and are ignorant, opinionated fools to declare Covid-19 to be no more worrisome than the flu.

Of course, the risk of death from Covid-19 varies with age, medical condition, available medical care, and other factors. For those of us over the age of 65, the risk of death, once infected, is about one in twenty (5.6%) Is there any activity in which you would willingly take part in which the advertised risk of being killed is one in twenty? [See P.S. below] I’ve taken part in quite a number of physically risky ventures in the course of my life, but none of them carries a one in twenty risk of death,

These Infection Fatality Ratios consider mortality, not morbidity: respiratory compromise, chronic fatigue,  and multiple other long term sequelae of infection, sequelae that weaken but don’t kill. Republicans, even Trump supporters and their families, are not immune to the reality of Covid-19 infection. Herman Cain, age 74, former presidential candidate and recent mask-dissing attendee of Trump’s Tulsa rally has been hospitalized and on oxygen for nearly four weeks with Covid-19.  (The day after I composed this email Herman Cain died.)

Other truths about this virus are also coming into focus. A Spokane teenager of my acquaintance and her friend recently lost their sense of taste and smell on the same day, one week after their only plausible exposure to Covid-19. They and two others had spent time (some of it indoors) in the company of a third friend whose brother came down with symptoms and tested positive after their time together. The friend, the only link and the only plausible carrier with whom they’d had contact, never personally manifested symptoms andtested negative for the virus twice following their contact. Fortunately, my teenage acquaintance suffered only a mild case, regained her sense of taste and smell in about a week and, with careful quarantining, did not infect her family. The other young woman had a rougher course, but recovered without experiencing pneumonia. Both young women tested positive for the virus.

The take-home from this anecdote and published data is that Covid-19 can be caught from symptomatic, pre-symptomatic, and asymptomatic people infected with the disease. One best assume that everyone with whom one comes in contact may be shedding virus. Influenza is far less contagious. Viral shedding with influenza virus mostly does not occur in the absence of early symptoms of the disease. In the current world population Covid-19 is not the flu. Covid-19 is more transmissible, more deadly, and productive of greater morbidity than influenza.

Keep to the high ground,
Jerry

P.S. Unless an effective vaccine becomes widely available, the death toll from Covid-19 is probably just getting started. The following is mathematical conjecture, but, if you take the death rate of 5.6% (1 in 20) in the over age 65 cohort in the U.S. population (these over age 65 are 13% of the whole U.S. population of 330M), an IFR of 0.0065 (1 in 150) in the whole population, and assume herd immunity when 60% of the population has been infected and made antibodies, then in the U.S. alone we would see 1.44M dead overall, nearly ten times what we’ve seen so far. 1.29M of the dead would be from the over 65 yo cohort, but 212,000 of the dead  would be among working age and younger U.S. residents.

Since the greatest viral transmission occurs indoors, I predict the coming winter will be long, dark, cold, and isolated, especially for those over 65. We had better hope for a safe and effective vaccine. The earliest that could happen now appears to be early in 2021. Cross your fingers.

At least once or twice surely every one of us has been guilty of procrastination. Don’t let procrastination keep you from filling out your primary ballot (State of Washington) and mailing it in today (to be sure it is postmarked before the 8PM Tuesday deadline) or (perhaps better) driving by and dropping it in one of the Drop Boxes. Click here for a listing of Spokane County Drop Boxes. If you’ve already sent yours in check at MyVote.wa.gov to confirm that your ballot has been accepted. That website also features an electronic “Voters Guide”–there is no paper guide for the Primary.

DO NOT vote for Chris Armitage for U.S. Representative from Congressional District 5 (currently held by Cathy McMorris Rodgers). Mr. Armitage has dropped out of the race. 

I’ve published the next four paragraphs twice before, but, just in case you missed:

If you, like I, find the candidate statements in the Voters’ Guide rather bland and nonspecific, check out FUSE Washington’s progressivevotersguide.org. I find their endorsements detailed, rational, and convincing.

If you have time to dig more deeply, you can listen to interviews with candidates pertinent to Spokane County by searching candidate names at https://www.spokanepublicradio.org/search/google#stream/0.

The League of Women Voters did Zoom interviews with many area candidates; These videos are available here: https://my.lwv.org/washington/spokane-area/article/view-videos-august-2020-primary-candidate-forums

For candidates at the state level you can determine who is funding there candidacy by visiting the Washington State Public Disclosure Commission website: https://www.pdc.wa.gov/  Navigation on that site takes some learning, but there is a lot of interesting information. For example, one can quickly see that only six of the thirty-six candidates for Washington State governor have significant financial backing: https://www.pdc.wa.gov/browse/campaign-explorer.

Every candidate for whom I would consider casting a vote in this Primary is listed as “Prefers Democratic Party.” That has not always been true for me, but it is certainly true this year. 

I believe we need a very broad re-set, an electoral pummeling, for Republicans to realize what they have become and what they have decided to condone. 

The local Republican Parties set the table for right wing extremists, people they cannot renounce for fear of losing the support that keeps them in office. Many on the far right have connections to Matt Shea, the soon-to-be-former State Representative from Legislative District 4 (Spokane Valley north to Mt. Spokane). Matt Shea has morphed into a preacher of radical far right political “Christianity” at the Covenant Church in north Spokane. These are the same folks, intertwined with Shea, who present themselves as The Church at Planned Parenthood–Spokane, a Republican political interest group masquerading as a church (and carrying guns). Caleb Collier, former City of Spokane Valley city council member, frequent flier and associate of Shea at Covenant, and executive field coordinator for the extremist John Birch Society, recently made front page news in the Spokesman for his work in placing local billboards in opposition to mask wear. Anyone who gives these people the nod should be voted out of office.

Vote!

Keep to the high ground,
Jerry

P.S. Some specifics for LD4 voters: Currently on the ballot in LD4 we have the Matt Shea mini-me, McCaslin Junior, whose father, Bob McCaslin Sr., before he died wrote in a letter to the Spokane County commissioners, “I wish to state that under no circumstances would I support Matthew Shea for any public office.” Bob McCaslin Junior rode into office on his father’s good name–and followed Shea’s lead on everything he has done in the legislature. So much for listening to one’s parents. Like Matt Shea, who consistently refused to be interviewed by Spokane Public Radio and the Spokesman, McCaslin rarely consents to an interview. You can see him, however, at the League of Women Voters in a Zoom Q and A for the three candidates. Lori Feagan is my clear choice. She is clearly the best prepared.