Trump's Approach to Herd Immunity Would Result in 26 to 32 Million American Deaths

 

It has just been revealed that the White House is pushing a plan for the pandemic that will result in 25 to 30 million American deaths. In this post, I lay out the recently discovered facts about the Administration's plans, and the true American carnage that these plans will lead to. Finally, I will suggest actions that you, the reader, can take to stave off this monumental catastrophe.

The Plan 

In August, Scott Atlas, M.D. joined the White House staff as a special advisor to President Trump on the pandemic. Dr. Atlas is not an epidemiologist (a specialist in how diseases spread), nor is he a specialist in infectious diseases of any sort. He is a neuroradiologist, who specializes in imaging of the brain and branches of the nervous system, and the diagnosis and description of abnormalities in these areas. All of which gives him next to nothing in the way of pandemic expertise; however, as his Wikipedia entry notes, Dr. Atlas has been a medical advisor to Republican politicians, and wants to eliminate Obamacare--and that seems to be enough for the President.

The Washington Post and Yahoo News reported yesterday that Dr. Atlas has been pushing--and the Administration is supporting--an approach to the COVID-19 pandemic that involves an extremely crude implementation of a "herd immunity" strategy. To understand just how bad this approach is, let us consider just what herd immunity is.

Herd Immunity: The Good, the Bad, and the Hideously Ugly

The basic idea behind herd immunity is that, if enough people are immune to a given disease, then that disease cannot "reach" the people who are not immune. 

For example, let's take you, the reader. Let us say you have never had COVID-19 and have no immunity to it. If enough people around you do have immunity to COVID-19, then the disease simply cannot get to you. Hurrah! 

According to Noreen Iftikhar, M.D., for most diseases, "80 to 95 percent of the population must be immune to the disease to stop its spread." Okay. But wait . . . how do people become immune?

Basically, there are only two ways for people to become immune to a disease:

1. People might have been immunized (basically, vaccinated) against the disease. 
2. People might have acquired immunity because they have had the disease and developed antibodies to it. 

That's it. The immunization route would be great, but unfortunately we do not have a vaccine, and as of right now, we'll be lucky to get an effective and safe vaccine sometime in 2021.

The acquired immunity route requires that large numbers of people become infected with the disease; this is a crude approach, something like "infect them all, let God sort them out." I'm calling this bad. However, the hideously ugly part kicks in when we are dealing with a disease that is as deadly as COVID-19 is.

The True Case Fatality Rate of COVID-19

I am sure that some of my readers are of the opinion that COVID-19 "isn't that bad," and is about as lethal as the flu (0.1 percent lethality). I am sure that some other of my readers are thinking that they heard the fatality rate is "about 1 percent." All of these readers are 'way, 'way off.

When a pandemic is over and done, epidemiologists look at the number of people who died from the disease, and divide that by the number of people who ever had the disease, to derive the case fatality rate. But you should not use this method when you are in the middle of a pandemic, because you will underestimate the actual fatality rate--perhaps by a great deal. 

For a pandemic that is in progress, like the COVID-19 pandemic, the closest approximation we can get to the true case fatality rate is the Closed Cases Method. This method divides the number of deaths by the total number of closed cases (all cases that have resulted in death, recovery, or discharge from the hospital). Using the Closed Cases Method on data from the United States as of today, we see that the best approximation we have for the case fatality rate of COVID-19 is 5 percent. 

Five percent. Perhaps that is not impressive to you. But 5 percent is 50 times worse than the fatality rate of the seasonal flu, and much more than the fatality rate of the dreaded Spanish Flu of 1918 (between 2.5 percent and 3 percent).

Now let's see what happens when you apply that 5 percent fatality rate to a crude, acquired immunity approach to herd immunity in the United States.

The Mathematics of Millions of Deaths

In 2019, the population of the United States was 328.2 million. As I mentioned earlier, 80 percent to 95 percent of a population have immunity for herd immunity to kick in. That means 262.6 million to 311.8 million Americans must have immunity to achieve herd immunity.

But wait: Trump's new pandemic advisor, Dr. Atlas, wants to achieve herd immunity, not through immunization in the near future, but through infection right now. What does that look like when the disease has a fatality rate of 5 percent? Like something out of apocalyptic nightmare, that's what.

Applying the 5 percent fatality rate to the number of Americans that would have to be infected to achieve herd immunity results in a staggering number of deaths: 13.1 million to 15.6 million deaths. to be exact.

That's right: the best case scenario, applying a strategy of mass infection leading to herd immunity the hard way, we will see between 13.1 million and 15.6 million Americans die.

But wait. It gets much, much worse.

You see, that 5 percent fatality rate only applies to a situation where our hospitals are all functioning within capacity, not in an overload situation where patients must be turned away because there simply is not any room in the hospital for them. The entire American hospital system only has a capacity of under a million staffed beds. When you start talking about 260+ million people infected with COVID-19, of whom about 20 percent (52 million plus patients) require hospitalization, then you are talking the entire American hospital situation in overload situation. We're talking millions upon millions of patients receiving no hospital treatment at all. 

When that happens, we are not talking a 5 percent fatality. We are talking at least a 10 percent fatality rate--or more.

The result? Between 26 million and 32 million American deaths.

The cost in human suffering and death is beyond one human being's capacity to comprehend. I can calculate the numbers. But when I think of the meaning behind those numbers, I am horrified almost out of my wits.

What the Reader Can Do to Avert This

In the face of this potential monumental catastrophe, an American Holocaust worse than anything that the nation has ever suffered, the reader actually has some options other than despair. I strongly recommend that the reader do each of these things:

1. Contact your Senators and Representatives in Congress, right now--really, today--and tell them that you expect them to vigorously reject the Administration's plan to implement any sort of strategy involving mass infection leading to herd immunity. Tell them that to do otherwise will lose your vote, now and forever. (At the risk of mentioning the obvious, this is life and death, folks.)
2. Practice the most rigorous precautions that you ever had, and then some: masks, social distancing, washing everything in sight. Why? Because some people will follow the Administration's directions as they push their fatal approach, and you need to protect yourself from those people.
3. Prepare for conditions to get more than a bit gnarly. Store food, enough for weeks, even months. Why? Because if, despite all these warnings, the White House does force its fatal strategy on the people, it may not be safe to shop, and my guess is that no one will be delivering food for awhile.
4. Surely someone reading this will be able to pass a message to someone who knows someone who knows someone in the White House who can get this post, with the following Memo, before the President.

May peace be upon us all.

- - - - -

Memo to President Trump

Consider what the economy would look like in the scenario described in this post, one in which a "mass infection" approach to herd immunity results in 26 million to 32 million American deaths.

Consider a country with 26 million to 32 million fewer consumers. A country where the survivors struggle to survive without going outside to buy anything. A country with 26 million to 32 million fewer workers. Even the stock market will tank below Great Depression levels.

In this scenario, one need not be concerned about the election. One will need to be concerned about pitchforks and torches, and massive hordes descending upon the White House, hordes so huge that no fence, no troops, and no bunker can offer protection.

Wise men will choose carefully here.

Please join "The On The Mark Social Issues Blog" community on Facebook here. Copyright 2020 Mark Koltko-Rivera. All Rights Reserved.

Permission is hereby granted to re-post or quote this blog entry, if and only if Mark Koltko-Rivera, Ph.D., is credited as the author. 

The image of the statue of Death at the Cathedral of Trier, Germany, is the work of Jbuzbee, and appears here under the Creative Commons Attribution 3.0 Unported (https://creativecommons.org/licenses/by/3.0/deed.en) license.

Two Recommendations to Prepare for the Coming Post-Election Chaos

 

In this post, I describe a serious problem that I see on the horizon, and my suggestions for how to address it.

A recent article described a piece of an interview that the CEO of Bloomberg-funded political data firm Hawkfish gave to Axios (broadcast Monday night on HBO, 8/31/20). In the interview, that CEO predicted "mass chaos" after Election Day, because of what he calls the "Red Mirage."

It would work like this. On the night of Election Day, the more-easily counted in-person ballots may indeed show a narrow Trump victory. (Why? As I see it, a narrow in-person-voting Trump victory occurs because DT urges his followers to vote in person, not caring whether they are dead from COVID-19 by Inauguration Day). However, as that CEO noted, over the weeks following Election Day, this Red State 'victory' is seen to be a mirage, as the mail-in ballots are counted and Trump's illusory "win" erodes to a loss.

The result? "Mass chaos," the article says. I will go farther.

I think that the result could be substantial violence in many places in America.

One scenario that I consider more than plausible is that, as the mail-in ballots are counted, Trump loses his shizzle, attempts to declare the election invalid, and tries to send in troops or his own armed followers to confiscate mail-in ballots and put down the ensuing protests (which I expect would be epic).

After that? That all depends on how reasonable the U.S. military leadership and other agencies' armed officers are willing to be in dealing with a President who erupts in a Constitutional crisis. We might see a relatively brief period of civil unrest. Or, we might see a Second Civil War.

My Recommendations

For right now, focusing just on the safety of oneself and one's family, I suggest this:

1. Plan right now to stay inside your home, not going out past your mailbox, from the day after Election Day, for up to three weeks.
2. Start right now to store at least three weeks of food, supplies, and medications, to use during the three-week period following Election Day.

Why three weeks? Here is my thinking.

Week One: Trump celebrates his "win" by declaring himself the victor, and sending in armed troops and his armed followers to put down demonstrations against his premature declaration of victory.

Week Two: Trump begins to lose his fingernail-thin grip on his impulses as the mail-in ballots start to be counted, revealing that Trump's supposed victory margin is eroding. Trump orders mail-in ballots to be confiscated from all U.S. State Boards of Elections. Bigger protests ensue. Trump sends in armed troops to enforce his confiscation order, with directions to shoot to kill. Trump encourages his armed followers (militias and what he once called "Second-Amendment people") to "stand up for America" and take matters into their own hands.

Week Three: This is the minimum period of social unrest that we should prepare for. Stay away from the windows, folks. Don't count on Instacart, Amazon Prime, or other such services to be making deliveries during this period.

This leaves two questions for me to answer.

First Question: Should you protest Trump's actions during this period? I cannot answer that. Different factors--home and family circumstances, your responsibilities to others, your own and others' health statuses--need to be taken into consideration.

Second Question: Is this "mass chaos" scenario really plausible? Think about it. DT has already stated that he wants to call out military troops to deal with protesters--moments before he had police use tear gas to clear out DC protesters, just so that he could have a meaningless photo op at a church. DT has already expressed support for the illegally armed militia member who killed two people at a recent protest over police violence in Kenosha WI.

It has been said that the best predictor of future behavior in a given context is past behavior in that context. The scenario that I outlined is entirely plausible.

Get ready. If you start now (I post this early on September 1st), you have over two full months to prepare.

Peace be with you all.

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Permission is hereby granted to re-post or quote this blog entry, if and only if Mark Koltko-Rivera, Ph.D., is credited as the author. 

The "Trump Wins!" Norpoth Primary Model Election Prediction Is Built on Bubbles. Let Me Pop Them For You.

In some circles, a lot of attention is being given to the Helmut Norpoth "Primary Model," which shows Trump winning over Biden by a landslide.

Time to burst the bubbles here. The website of the Helmut Norpoth "Primary Model" states that this projection was first posted on March 2, 2020, and was not revised since.

Of course the brunt of the damage to the U.S. population and our economy from COVID-19 have occurred since that time--not to mention the revelations of Trump ignoring Russian bounties on U.S. troops, the attempted manipulation of the election through fiddling with the Post Office, and all the social unrest fomented by Trump. Anyone who thinks that these issues won't affect the election outcome is delusional. I would put no faith in this model.

Quite frankly, one needed no special knowledge of statistics to see what was wrong with this projection. It was there on the first page of their website, and the date was there for all to see, with less than five minutes of looking--for anyone who cared to look.

#thedevilisinthedetails

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That CDC Report--and Malicious Ignorance

Some people have made a very great deal of fuss regarding a recent report from the CDC stating that "94% of COVID-19 deaths had underlying medical conditions" (news report here, original CDC report here, as of August 26, 2020). These people cluck approvingly that this 'proves' (1) that COVID-19 deaths are much ado about nothing, (2) that healthy people--that is, people without these underlying conditions--have nothing to fear from COVID-19, especially because (3) relatively few people have these underlying conditions.

People who say these things are deeply ignorant people who know nothing about medical statistics or epidemiology. Worse, their gullible ignorance endangers the health of each of us, and our families.

What the Report Actually Found

The news report misreports the actual ranking of some of the underlying conditions. Looking at the actual CDC report, we see that the top 9 named diseases that are listed as "underlying medical conditions" in COVID deaths are as follows (percentages are percentages of total COVID-19 deaths in the study; percentages add up to more than 100 percent because of overlap):

#1: 42% influenza and pneumonia

#2: 34% respiratory failure

#3: 22% hypertensive diseases (i.e., high blood pressure)

#4: 16% diabetes

#5: 14% adult respiratory distress syndrome

#6: 12% cardiac arrest

#7. 12% vascular and unspecified dementia

#8: 8% chronic lower respiratory disease (formerly chronic obstructive pulmonary disorder, or COPD)

#9: 8% renal failure

#10: 6% heart failure

These diseases fall into two categories: those that are known to be caused, or made more likely, or made worse by COVID-19, and those that are widespread underlying conditions that are known to be associated with "bad outcomes" (read: death) when it comes to COVID-19.

Diseases That Are Caused, Made More Likely, or Made Worse by COVID-19

We know that COVID-19 viciously attacks the lungs, making them highly vulnerable to complications such as flu and pneumonia (#1), leading to adult respiratory distress syndrome (#5) and, often enough, ultimately to respiratory failure (#2), as patients drown in their own lung secretions.

Of those who survive, previously healthy adult athletes--including at least one real-life friend of mine--find their lung capacity diminished, possibly for the long term.

(And yes, I am saying that because COVID-19 paves the way for influenza virus and pneumonia bacteria, COVID-19 in large part makes flu and pneumonia more likely. Of course, COVID-19 does cause a type of pneumonia all by itself.)

We also know that COVID-19 viciously attacks other organs, besides the lungs.

It attacks the heart muscle, leading to cardiac arrest (#6) and heart failure (#10).

We know that COVID-19 sometimes viciously attacks the brain and seems to cause dementia, which can lead to death (#7).

We also know that COVID-19 can attack the kidneys, leading to renal failure (#9).

Widespread Preconditions That Make People Vulnerable to COVID-19

We know that high blood pressure and other hypertensive diseases (#3) predispose people to death from COVID-19. What nobody seems to mention is that roughly one-third of the American population has hypertension. So, saying that "hey, 22 percent of COVID deaths had hypertension" doesn't mean that "the vast majority of people are safe from COVID," as the ignorant people I mentioned above seem to think. Rather, it means that one-third or more of adult Americans are at special risk for dying from COVID on this basis alone.

In addition, we know that diabetes (#4) predisposes people to death from COVID-19. What nobody seems to mention is that over 10 percent of Americans have diabetes.

Finally, we know that chronic lower respiratory disease (CLRD, #8), which includes asthma, chronic bronchitis, and emphysema, predispose people to death from COVID-19. What nobody seems to mention is that about 10 percent to 12 percent of Americans have CLRD.

CONCLUSIONS

COVID-19 causes, makes more likely, or greatly exacerbates 7 of the 10 top "underlying medical conditions" found in COVID deaths. The other 3 top "underlying medical conditions" are widespread conditions that predispose people to COVID deaths, held in total by over half of Americans.

Anyone who takes the reports that "94% of COVID-19 deaths had underlying medical conditions" to mean that "the great majority of people are safe!" are gullible, ignorant, and foolish. And their ignorance endangers the health of all of us and our families.

Please join "The On The Mark Social Issues Blog" community on Facebook here. Copyright 2020 Mark Koltko-Rivera. All Rights Reserved.
Permission is hereby granted to re-post or quote this blog entry, if and only if Mark Koltko-Rivera, Ph.D., is credited as the author. 

The Rebirth of the "On The Mark" Blog

 

Consider it a sunrise: the beginning of a new day.

I have been very little active on this blog in recent years. Perhaps it was the divorce. Perhaps it was the medical condition requiring me to get two stents in my coronary arteries. 

Whatever it was does not matter now. The United States is being thrown into a dumpster fire of chaos, multiple ways:

• President Donald Trump is behaving more like a wannabe-Fascist dictator every day, trampling over Constitutional law and the Bill of Rights. Perhaps worse, his actions demonstrate that he is preparing to either ignore the 2020 election results, or declare them invalid, essentially making himself an actual Dictator Over America--perhaps for life.

• The COVID-19 pandemic in the U.S. has resulted in 6.2 million infections and 188,000 deaths--all in a period of barely 8 months (August 31, 2020 figures). It shows no signs of stopping. To the contrary, with the opening of schools and the forthcoming Labor Day holiday festivities, and with the approaching cooler weather forcing activities indoor, we are only likely to see more infections and deaths. And yet, we still have no national plan for testing or containing the pandemic. Instead, Trump touts fake cures, encourages people to believe in a promised "miracle," and runs superspreader events as part of his presidential campaign (as he did at Tulsa, OK and the White House).

• Despite the grim reality of the COVID catastrophe, we see vast amounts of misleading information, disinformation, and outright lies being posted in social media and elsewhere online, discouraging people from taking the pandemic seriously and taking appropriate protective measures, and encouraging risky behavior.

• The U.S. real economy is in tatters. Tens of millions are unemployed. Double-digit percentages of small businesses have closed for good. Many of those originally "furloughed" from their jobs at the beginning of the pandemic are now being informed that their jobs are gone for good. To make it worse, millions have lost their employer-based healthcare. To make it even worse, tens of millions of Americans are in immediate danger of eviction.

• There is widespread social unrest in the U.S., stemming from only the most recent public shootings of unarmed Black men by police, particularly in the killing of George Floyd and the shooting of Jacob Blake; the way that police let escape an illegally armed, long-rifle-carrying minor--who murdered two protesters of the Blake shooting--has not helped the situation.

I've got kids. They're all long grown up, and now they've got kids. This is not the America I want to pass on to them. What I have to change the situation are ideas expressed in logic and words. 

That's what this blog is about: addressing the threats to America, Americans, and the best version of the American way of life. 

So may it be. And may you say, "so say we all."

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Copyright 2020 Mark Koltko-Rivera. All Rights Reserved.
Permission is hereby granted to re-post or quote this blog entry, if and only if Mark Koltko-Rivera, Ph.D., is credited as the author.