Fully Open Up Society Now? Really?

Mish

Several readers sent me links regarding claims by two California doctors that deaths rates and risks are overstated.

Dr. Dan Erickson and Dr. Artin Massihi say Open Up Society Now.

That article is making the rounds. It sounds nice. Many will be convinced.

I asked Chris Martenson a simple not leading question: "What is your response to this article?"

To rule out any leading bias, that question, plus a link was the entire extent of my email to Chris. Here is his reply.

"Check my Twitter feed. Statistician Carl took these doctors on. Sadly, they are talking pure junk."

Note: Carl T. Bergstrom is a professor of biology at the University of Wisconsin.

Twitter Feed Response by Carl T. Bergstrom

  1. Unfortunately the misleading claims of those two doctors in Bakersfield keep making the rounds, so I want to very briefly address the problem with what they are saying.  I won't get into their possible motives, past political activity, etc. 
  2. What they did was simple: they looked at the fraction of patients who tested positive for #COVID19 at the clinics they own. They found 340 out of 5213 tests were positive, about 6.6%. Then they assume the same fraction of the whole population are infected.
  3. From there, they scale up to the state level and claim 12% incidence statewide. The news story says it is using the same calculation, but it can't be—how did they get from 6.6% to 12%? Perhaps they estimating infected *ever* versus infected *currently*. It's not clear.
  4. Using that 12% infected figure, and a known 1400 deaths in California, they assume 1400 out of 4.7 million have died. That gives them an infection fatality rate of 0.03%. That is, they think that if 10,000 are infected, 3 will die on average.
  5. The problem with this approach is that during a pandemic, the people who come into an urgent care clinic are not a random sample of the population.  A large fraction of them are coming in precisely because they suspect that they have the disease.  This generates sampling bias.
  6. Estimating that fraction infected from patients at an urgent care facility is a bit like estimating the average height of Americans from the players on an NBA court. It's not a random sample, and it gives a highly biased estimate.
  7. Moreover the estimate does not pass even a basic plausibility check. In New York City, 12,067 people are known to have died from the virus, out of a population of 8.4 million.  This is a rate of 0.14% of all people. Not just infected people. All people.
  8. That gives us a lower bound on the death rate in New York. Not an estimate, a lower bound. The death rate for infected people is obviously higher than 0.14%, because not everyone in New York has been infected.
  9. And yet that 0.14% lower bound is nearly *five times as high* as the 0.03% that the Bakerfield duo are claiming. They've used absurd methodology to arrive at an implausible number. If the pandemic were not so severely politicized, this would be a non-issue from the start.

On Sampling Bias

A Bit of Perspective


I asked Martenson his opinion for a few of reasons.

  • Most know Chris Martenson as an economic writer but he also has a PhD in pathology.
  • I know him personally as a straight shooter.
  • Had that study changed his mind, I would have listened. 

Unfortunately, people cling to what they want to hear. 

Worse yet, these charlatan doctors sound like they know what they are talking about, enough so to be offering dangerous advice that many will follow.

OK, When?

We do need to open up the economy. We cannot stay locked down forever.

I will have more to say on when and how later today. 

Mish

Comments (195)
No. 1-44
palmer808
palmer808

Really, in this day and age?!
Humans on the moon?!
And yet....
We lack the ability to produce a forced air haz-mat suit for every child, woman, man, walking the earth?!
I'm calling holy giant B.S.!
we're all walking around in haz-mat suits like it's the new normal...
KISS
REMEMBER?!

palmer808
palmer808

KEEP IT STUPID SIMPLE

For the youngins who dare read this tripe...

palmer808
palmer808

😜

Tengen
Tengen

I agree with Martenson, but the nice thing about this is that we will have actual feedback after reopening. We'll see if more people get sick and how other countries fare around the world.

This may not sound like much, but after 12 years of suspended animation where the Fed papered over everything, real world feedback is refreshing!

UKMark
UKMark

I fear these two jokers will end up in the same way as Andrew Wakefield, the widely discredited doctor who stirred up a frenzy over the MMR vaccine with his BS "research" about autism. I'm sure a lot of people want to believe the conclusions, but when it becomes clear that their message is utter bollocks and ends up costing lives then the backlash will likely be violent.

Meanwhile what is becoming clear that different countries are reporting death numbers in very different ways. Belgium (a small, densely packed country in Europe) is at pains to report in a timely manner any death which is even suspected of being COVID related as a COVID stat (source: Bloomberg). The UK's stats are still playing catch-up, with official numbers only representing hospital deaths, and numbers from home/care-homes only now beginning to become clear (and not yet represented in the totals). Other countries are clearly massively under-reporting numbers as COVID stats are well below "excess death" stats from general mortalities (source FT). In yet more countries (e.g. Germany) there are as yet no general mortality figures to cross check against, and in yet others (e.g. China) the numbers are clearly hogwash, being perhaps only 1/20th - 1/100th of reality. Frankly, any reasonably densely populated country with a temperate climate that is not yet seeing deaths in the 500+ per 1M area is either doing an amazing job (a minority), is lying (a few) or still struggling to get its stats in order (many). I doubt that when the dust settles we will see a mortality rate much under 1.5% (for typical demographics with a realistic proportion of older and BAME cohorts).

The bottom line is that it's probably going to take many weeks yet before numbers become really clear, and in that information vacuum I doubt we've seen the last of the dubious claims from "scientists" wanting their 10 minutes of fame.

Scooot
Scooot

Thanks for this Mish.

Lance Manly
Lance Manly

Seems like South Korea, New Zealand, and Australia have pretty good at setting themselves up to return to a least a new normal. Looks like it took a serious approach to testing and contact tracing throughout the society is key. Unfortunately "serious approach by the administration" would appear to be an oxymoron.

Blurtman
Blurtman

If you run the NYC antibody test results by NYC age demographics, you get extraordinarily high fatality rates for the elderly population with comorbidities, around 8% for over 75 age group, 3.4% for 65-74, and it keeps dropping. But for the 18-44 population, the fatality rate is less that 0.1%. And if you look at the fatality rates in all age groups without comorbidities, the fatality rates are very low. So clearly older folks with comorbidities should be protected, but the economy should not be shut down, nor the freedom of everyone restricted.

njbr
njbr

Two things to remember

Doctors can be motivated by money and politics

Doctors can be dumb-asses, too

Herkie
Herkie

These doctors also are running walk in urgent care clinics, specifically these are designed for people that mostly do not have any alternative care. They are not used by the vast majority of insured patients that have continuity of care.

More specifically they are not gerontologists and as we know the older you are the more likely you will die from Covid once infected.

This really is just another variation on "go ahead and open the economy because it is only useless old people dying anyway." As a useless old person I take some umbridge with the attitude that people are disposable as long as they are old. I intend to live every last minute of life I can and if there are some out there that do not value that life then I suggest they use a razor on their own wrists right now, after all there is nothing special about them that makes their own lives more valuable than mine.

Anda
Anda

The Spanish government just put forward its re-opening schedule, there are fun videos on how to walk a child out also :/ .... anyway, they said eight weeks yesterday till the "new normal" is reached, like before...but just not quite like before... indefinitely...today they are saying no time frame...businesses say the new plan is untenable... there is some kind of undeclared synchronisation going on at EU level also... and figures for Spain are so chaotic and manipulable, and trust in authority so low, that it comes across as a power play...though infections seem to be increasing from minor previous restriction lifting... anyway the schedule is described here, Mathew Bennett has a critical look at Spanish figures in other posts. Posts 19. to 35. in the below thread describe the schedule

wootendw
wootendw

Covid is only more dangerous than the flu because it is new and no one had any immunity to it until recently. If the flu had just popped up out of nowhere today, it would have been just as deadly and probably as contagious. If the country is re-opened now, the most 'hurt' people will be those who advocated shutting it down.

The US foreign policy establishment is using covid as part of it's "tilt to China" - a new Cold War to keep military sales going. The Hong Kong demonstrators, many paid by the National Endowment for Democracy - a front for the IC - were also part of that.

Anda
Anda

Also of interest are the narratives on contact tracing coming out, for example

“In a decentralized system you have the simple problem that you would broadcast the anonymous IDs of infected people to everybody — so some countries’ health legislation will absolutely forbid that. Even though you have a cryptographic method, you’re broadcasting the IDs to all over the place — that’s the only way your local phone can find out have I been in contact or no,” Boos went on."

So anonymous IDs are not anonymous really (who would have thought) plus it is tabbed on health legislation, not national policy, but

tells a different story of how countries define their claims on public data.

Which all looks like classic mission creep to me.

BaronAsh
BaronAsh

Those doctors made a lot of sense to me. And they explained how they started off testing those with symptoms, then people who knew people with symptoms, then employers asked them to test employees so it would be safe for them to be in the workplace, then they started testing anyone who asked. So they began with those presenting symptoms and ended up doing a somewhat equivalent of a random trial. Their main point - and it is valid - is that the thing has spread far more than most 'experts' have been saying. Which also means that far more are asymptomatic which is another way of saying that it isn't dangerous at all for the vast majority of people.

Those with co-morbidity factors (i.e. people who are very unhealthy) should self-isolate, be careful etc. Everyone else should wake up out of this collective - clearly manipulated - delusion, stop quoting 'scientists' and 'experts' as if they know what they are talking about, and try to rescue what's left of the country before it's too late and descends into the Orwellian nightmare leftists with conviction have been salivating over for more than a century now. If they get their way, millions will suffer and die, and some of them could be you.

Wake up!

pvguy
pvguy

So we have doctors who do not understand statistics, and statisticians who do not understand medicine. There is an additional wrinkle that The statisticians are only concerned with Covid-19 deaths, and the doctors are concerned with death from all sources. Delaying treatments for non-virus conditions is going to start killing people too. Somewhere there is a trade off.

And here in Grant County WA, we have had 3 virus deaths out of 90,000 people, or 0.003%. I don't know why the virus hates New Yorkers, unless is it purely population density, or low level air pollution, but then LA would be hammered, and they are not. Still more questions than answers.

Isaiah217
Isaiah217

“Unfortunately, people cling to what they want to hear”.
That applies to everyone, including you Mish.
“The simple believes everything, but the prudent gives thoughts to his ways”

Tony Bennett
Tony Bennett

"Dr. Daniel W. Erickson of Bakersfield, California, is a former emergency-room physician who co-owns, with his partner Dr. Artin Massih, Accelerated Urgent Care in Bakersfield."

...

Financial

I have a relationship with an urgent care facility. Guess what? They are not busy. At all. People are scared to come and risk catching virus. And not just urgent care.

CHARLOTTESVILLE, Va. (WVIR) - On Tuesday, April 28, the University of Virginia Health System announced it has had a deficit of $85 million per month since the onset of COVID-19 shutdowns. One of the biggest reasons for the loss of money is the lack of elective surgeries and clinic visits.
UVA Health spokesperson Eric Swensen says surgeries are down 70% and clinic visits are down 90%. To cut back on those losses, the health system will furlough non-patient staff.

...

Physicians will have their pay cut by 20% through July, and retirement contributions will be suspended through the end of July.

tokidoki
tokidoki

Does it matter? Market up. That's all that matters.

Flic1
Flic1

These guys were easy to figure even though they had a couple good points. Their Urgent Care practice is probably very slow right now but it seems their biggest concern is that their favorite cafe is shut down....

NewUlm
NewUlm

The thing most people can't get is the R0 of 3 to 5 means cases will peak 3-5x faster and so will the CFR. But, it also means that it will be over faster too - unlike the flue which lasts 6 months, C19 peak will be over in 60-80 days. You can NOT look at peaks to make projects, it has to annualized.

I think the overall rate will come in around .2 to .4... so 2-4x than a normal flu year but well below cancer and heart disease which kill 1.2 million annually (including over 200K under 50 years old).

And I looked at the '57 and '68 flu pandemics in the US... after adjusting for population 57 = 204K and 68 = 198K deaths... which is what we could see with C19.
Guess what they did not shut in health people and cause a great depression. Also, adjusting the Spanish flu for the population would be 2.17 Million deaths in the US today - we won't get close to that.

Is this bad - YES, Are mitigation efforts working - Only to slow cases, it will not "burn out" and this strategy may make it worse in the long run - even limited antibodies in more of the population would be better in the fall.

Also, why aren't we talking about who is actually at risk? If you don't have co-morbidity this is LESS deadly than the flu, if you do it likely 5-10x worse. Data from NY and across the world shows co-morbidities in 90% plus of cases.

numike
numike

Japan’s northern island of Hokkaido offers a grim lesson in the next phase of the battle against COVID-19. It acted quickly and contained an early outbreak of the coronavirus with a 3-week lockdown. But, when the governor lifted restrictions, a second wave of infections hit even harder. [Twenty-six days later, the island was forced back into lockdown.] https://time.com/5826918/hokkaido-coronavirus-lockdown/

tokidoki
tokidoki

People should watch the video. My eyes glazed over when they mentioned that they had attended "hundreds of autopsies".

Sure.

Realist
Realist

Good article Mish.

As always, the posted comments show exactly what you predict: people will believe anyone who supports their point of view, no matter how un-scientific or clearly wrong.

Just like those who don’t recognize the reality of global warming.

The anti-science crowd remains a strong minority.

Expat
Expat

There are many out there who believe these assholes because they want to and because they are profoundly ignorant and stupid. There are many who believe these mass murderers because their bullshit aligns with the absurd and dangerous claims made by Captain Bonespurs. Others simply agree because they are right-wing and this sounds very right-wing (despite these two docs being Coastal Elites and possibly gay since they are "partners" in a clinic).

Let's take all these believers and put them together in one community (I suggest we send them to Idaho...because who cares about Idaho, right?). Take away all forms of government support because they are probably not commies and would want to live like real Americans! Then make sure they all get infected. And let them die and so benefit the gene pool.

Sarcasm? Hmm, who knows anymore?

BaselineT
BaselineT

Chris Martinsen may be a virologist, however he has a stake in this argument also. Last time I checked, he makes his living off of panic. The more people panic, the more they pay for his services. He may be a bit more reasoned about his panic but that’s exactly what he is selling. I stopped reading him after he warned that the world was ending with Fukashima.

Louis Winthorpe III
Louis Winthorpe III

Dr. Daniel Erickson, DO ... graduated from Western Univ Of Health Sciences/College Of Osteopathic Medicine Of The Pacific, Western University Of Health Sciences in 2004 and specializes in emergency medicine.

In case anyone is wondering, USNews rates this school:

#94-122 in Best Medical Schools: Research
#94-122 in Best Medical Schools: Primary Care

And, if I had to guess, also #94-122 in statistics.

El_Ted0
El_Ted0

Questioning Dr. Dan Erickson and Dr. Artin Massihi's numbers is completely valid, but accepting unquestioning NY's death claims and considering the economic incentives for attributing all these deaths to Covid is ridiculous.

bradw2k
bradw2k

Bergstrom is at University of Washington, not Wisconsin.

Zardoz
Zardoz

Speaking of Covid denying whackjobs, here's something you might or might not end up seeing on the news. Guy walks into a medical clinic for his appointment but won't put on a mask. They won't let him in without it, he gets aggro, and starts punching the security guard. Doctor jumps in to help, knocks the doctor down (ended up with a nasty back injury). Eventually the nurses jump in, and they all sit on said whackjob until the cops come get him.

The sheer raging sense of entitlement and lack of care for other people of this guy is mirrored in a lot of the posts here. Y'all ask yourselves: What would Jesus do?

Jdog1
Jdog1

The ability to think critically is a rare commodity in our country today.

The "powers that be" want this thing to be over ASAP, because this thing is not only costing them gillions of dollars a day, it is destroying everything they have worked decades to build.
The entire debt based economy, globalism, and trust in the institutions are all being threatened by this shut down.
For the leaders of every country world wide to commit financial suicide and shut down their own economies because of this thing tells you they know how serious this thing really is.

sh310
sh310

looking at it from this Californian perspective: CA 2018 flu deaths: 7k, Covid deaths: 1.8k as of today. Hospitals in LA area are empty. Try to justify the hospitals postponing of a friends cancer surgery for the wave of Covid patients that may or may not come

Dave Long
Dave Long

Social media is an amazing and rapid condemnation machine but what these doctors did is really being mischaracterized here. They did not extrapolate data from their own clinic, they used the data available from various sources. For example, they compared Sweden (with minimal shutdown) to Norway (with major shutdown) using data from those countries. To suggest that their analysis is flawed because they failed to use randomized data is a disingenuous comment, since it should be clear to anyone who is reading current events that such data does not exist, i.e. no one is testing random samples of their populations. So everyone is doing what these doctors did - using the next best available substitute.
When the first models suggesting millions of possible deaths came out, draconian measures seemed like the way to go. It's been clear now for a while that the danger is far lower than that, that the extreme measures are having very little effect, and that they are very poorly and unequally applied. I'm 69 and I run a small store, so I'm high risk and I intend to continue to be cautious for an undetermined period of time. But I can quarantine myself. The whole of society doesn't need to quarantine itself to protect me.

bradw2k
bradw2k

Q: What do you call a person who graduated last in his class at a low-rated medical school?

A: "Doctor"

How the F someone gets through med school yet doesn't understand the basics of statistical inference is beyond me.

Anyway, I want to find out how many people believe in Santa Claus, so I'm going to take a poll at a five-year-old's birthday party, then extrapolate to the entire planet.

ToInfinityandBeyond
ToInfinityandBeyond

If the below quote is correct then I suspect these 2 fine doctors are just trying to drum up business for their urgent care facility.
"Dr. Daniel W. Erickson of Bakersfield, California, is a former emergency-room physician who co-owns, with his partner Dr. Artin Massih, Accelerated Urgent Care in Bakersfield.

frozeninthenorth
frozeninthenorth

Another way of looking at the impact of Covid 19 is to look at historical death rates in city/state/nation and see how these numbers compare with this year. Statis will tell you everything you need to know because in a large population death is the one truth (Since you need death certificates!

I think its a much simpler way at looking at the impact of Covid 19 on a large population sample. It has the simple elegance of being simple and statistically robust

Brochacho
Brochacho

I didn't read any mention of the antibody testing. It is showing that 15% of NY was already infected. That gives us a death rate around a half a percentage ie 0.5% or less. That is a significantly lower mortality rate. It is more deadly than flu, but as the Swedes have shown us, hide the vulnerable and open up the rest. They are approaching a herd immunity and will avoid the second wave.

Waafootball
Waafootball

Mish, It is more than just these 2 doctors. There are antibody studies from Stanford, USC, NY Health Dept, University of Miami, just to name a few. We will see more in the coming weeks. Also, how do you explain Sweden? This has been over-hyped from the beginning. This will turn out to be one of the biggest global mistakes in the last 200 years.

larryarie
larryarie

One man's calculation based on a global mortality rate of .45%, a global infection rate of 40%, and 80% of deaths occurring to people over 65. - People under 65 face a mortality risk of 37 per 100,000 which is six times their death rate from flu. Over 65, 587 per 100,000 which is seven times their death rate from flu. These risks should be communicated so that people can make informed decisions for themselves.

MishMeMuch
MishMeMuch

Freedom is Life.

Tyranny is Death.

Totally verifiable FACTS.

Now tell me how the lockdown and economic heist will not kill many many many more people than CV19.

Another tool working against freedom and for tyranny.

Prove you are not Mish.

Science like journalism is about constantly questioning. At least you are honest and pray at the altar of "experts" who we shall never question.

So many 4our letter words are so deserving to label such evil...

MishMeMuch
MishMeMuch

Jesus would have healed those in the clinic.

What kind of a nutjob would be so stupid to ask such a question?

aprnext
aprnext

You 'sorta' liked this vid??? I watched due to your, uh, rather restrained (?) response and simply fell on the floor. Anyway you can recommend to Mish, and the rest of the USA, really, to watch this thing?


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