Can we escape this folly?

What is happening on the USS Theodore Roosevelt provides an important data point. Take it along with findings from two NYC hospitals that tested 100% of women admitted to Labor and Delivery wards and found 88% who tested positive for Coronavirus had no symptoms of the disease. 

Coronavirus clue? Most cases aboard U.S. aircraft carrier are symptom-free

https://news.yahoo.com/coronavirus-clue-most-cases-aboard-152447944.html

Most pregnant women with Coronavirus had no symptoms, study finds.

https://www.today.com/health/most-pregnant-women-coronavirus-had-no-symptoms-study-finds-t178958

This illustrates the absolute folly of relaxing current efforts to contain COVID-19 spread. If done too soon, without the ability to identify infected asymptomatic patients, the disease will rebound and kill tens of thousands more Americans. 

This should not be about left or right. It  should not be about Democrat or Republican. It is about the health and welfare of our country, our neighbors, our families, our loved ones.

Needed: Competence, Humility, Honesty

If announcing an arbitrary date to withdraw from a theater of war -- a date divorced from realities on the ground -- is a bad idea, how much worse an idea is announcing an arbitrary date to "reopen the economy?" In this case the date will be divorced from the reality that many infection rates in parts of the country have yet to peak, and that respiratory disease epidemics have a nasty tendency to rebound, even when we do things right. 

Because we have not been able to test a statistically significant  asymptomatic population, we don't know what the disease burden in the population. This is an epidemiological problem and knowing "n" is an important piece of the puzzle. Without it you don't know infection rates or case fatality rates and you can't do contact tracing and management. Without that knowledge you will guarantee an already likely rebound within weeks of "reopening."

This isn't about politics. It isn't about left or right, Democrat or Republican, or whether you approve of Trump or not.  It's about competence and the humility to listen to experts over your friends and political allies.

To Mask, or not to... Just Mask!

CDC changed its position on wearing face masks and now urges people wear them in addition to practicing social distancing and rigorous hand washing. They also urge people to use DIY masks or other alternatives so as not to impact the stock of N95 masks available for health care workers. 

The reason for wearing masks in public is not to protect you, but to protect others from you, should you be infected but without symptoms (or with symptoms and not paying attention). It's having other people wearing masks that protects you from them.

Data Matters, Statistics Matter, Testing Matters

There's been a lot of talk about China's government and the Communist Party heirarchy covering up COVID-19 case numbers. I don't doubt there have been coverups but I think it's more complicated than the Central Committee orders a cover-up and, presto, it happens. 

Based on some years spent as an analyst looking at China, I believe that cover-ups, such as alleged or presumed with COVID-19 numbers, happen from the bottom up rather than top down. The evidence of this happening in Hubei province is compelling. 

A local official will get reports of a disease spreading and supress the information because it makes him look bad or puts his boss in a bad light. Perhaps the official's cousin owns the local bird market and will take a financial hit if the market is closed. Once the cover-up begins, it seeps upward because it's in no one's interest to expose it (and that they can't control corrupt underlings). When the cover-up is exposed to the national leadership, the usual result is more foot-dragging. In the case of COVID-19, it appears Beijing saw the impending disaster and decided red faces were preferable to what they knew was coming anyway and they started taking public measures to control the catastrophe. 

The official data coming from China is suspect. Recent press reports about seriously underreported deaths in Wuhan are highly credible, for example.

The point is that when cover-ups begin in such a disorganized and self-interested fashion, they are much harder to untangle and correct; not just for western health officials, journalist and intelligence agencies, but for the national leadership in Beijing. For the west, we are left with flaky numbers and models to go by. Beijing is left with blunt force measures to contain a monster of unknown size. 

Data matters, reliable statistics matter, testing matters.