Community

School Started on the First

It’s that time of the year again. Classes at Trego School started on Wednesday, September 1st. The Back to School BBQ will be held on Friday, September 10th.

School enrollment at the start of the school year is nearing 30 students. With a fourth classroom teacher hired, class size averages about 7 students per class (7.25 to be more precise).

The district was able to use part of the district’s ESSR (covid relief funds) to fund the hiring of that fourth teacher, a decision made to help keep class sizes small. While classrooms are still multi-grade, most classrooms hold only two grades.

The official count for this year’s enrollment isn’t actually in- for funding purposes, the count happens only twice a year. The first is in October. If enrollment reaches thirty, the amount of funding the school receives will increase.

Looking at the broader trend, we last discussed Trego School enrollment back in January.

Data as of January 2021

This year’s start of 29 is a bit lower than January’s 31. Not a steep decline, but the trend merits watching.

Community

You Need to Check the Experts’ Math

This offers a perspective on covid survival rates, but screws up some simple statistics:

0-1920-4950-6970+
100.000%100.000%100.000%100.000%
-99.997%-99.98%-99.5%-94.6%
0.003%0.02%0.5%5.4%
100% – Survival Rate= Infection Fatality Rate.

It’s official data.  It purports to be from CDC.  The author implies possession of a MD.

The math is screwed up.  By a factor of 100.  I learned the difference between decimals and percentages in the fifth or sixth grade – this isn’t a mistake at a graduate stats level, or even freshman stats. It appears someone releasing official data screwed up.  We need to check the math even on official data.

This site https://lincolnmtcovid.com/ has local numbers – and you can contrast them against the CDC statistics:

The local numbers show some anomalies when we compare and contrast them with CDC statistics.  The Libby area shows a cumulative 1,190 cases (in a population of 9,772  that’s 12.2%).  North County shows 467 cases (in a population of 6,470 that’s 7.2%) and Troy shows 258 cases (in a population of 3,435 that’s 7.5%). 

Lincoln County death rates can’t be contrasted with the CDC percentages – the tyranny of small numbers makes it impossible.  That said, in the 70+ age range that the CDC figures identify as a (corrected) 5.4% infection fatality rate, Lincoln County’s charts show 24 deaths in 311 cases – 7.8% – 44% more fatalities than national statistics.  The 3 deaths in the 50-69 age range, with 557 total cases work out amazingly close to the national 0.5% infection fatality rate.

There’s not enough data for me to infer causality.  It is good to have local data available – and I do wonder why the infection rate is higher in Libby.  Checking the math when you can is a good idea.

Community

Have You Two Been Vaccinated?

In the past couple of weeks, Renata and I have been asked “Have you been vaccinated?” by several different people.  Now I don’t mind saying yes – but I’m not sure that the question really is what it sounds like.  I think the question is “Can we visit your place with certainty that we won’t catch covid?”  Perhaps the question is “Have you been immunized?” 

Vaccinated and immune have two different meanings.  The history of smallpox vaccination shows the differences over a thousand-year timeline.  The first vaccinations recorded are in China, after 1000 CE.  They’d grind up the scabs from someone with smallpox, and blow the dust into your nostrils – along with something like a 2% mortality rate.  Since the death rate from smallpox was about 30%, it seemed like a decent risk.  This practice was variolation, not vaccination.

This development was state of the art until Jennings developed vaccination about 800 years later.   You remember, he took matter from the sores on a cow that had cowpox and injected it into people.  The latin word for cow – vacca – became the root of the word “vaccination.”  Since cowpox wasn’t smallpox, it took the risk of death down to about zero – but the minimal controls of the early 19th century kept the effectiveness down.  Jennings methodology didn’t guarantee the inoculation actually included cowpox.   Even as smallpox was eradicated, the vaccine was only 95% effective – but a 95% effective vaccine wiped out smallpox. 

Life is a game of percentages – the only certainty is death . . . but we don’t know when.  When my colon cancer was diagnosed in May, 2009, the prediction was June, 2012.  The prediction changed when Rick Holm convinced his colleagues to humor me and look at the 2002 chest X-rays.  Just old scars, no new metastasis.  It changed the diagnosis from stage 4 to early stage 3.  All from looking at one 7 year-old X-ray. 

CDC says my two doses of Pfizer should be 84% effective.  Israel’s health ministry rates it at 39%.   Personally, even 39% effective is worth getting the vaccine – I have made a point of getting flu shots that were no more effective.  But the answer to “Have you been vaccinated?” isn’t really a simple yes or no if the question is actually “Have you been immunized?”

I think my friends are happier visiting with the knowledge I’ve been vaccinated, and not knowing the percentage effectiveness.  Vaccinated generally translates to less chance of getting sick – but few vaccines are 100% effective.  The recent infectiousness of this last covid outbreak has demonstrated that vaccination is not synonymous with immunization. 

A Science for Everyone, Community

Other Vaccine Effectiveness

I got the Covid vaccine as soon as I could.  I think I might have been vaccinated earlier but for the manner in which the local government picked folks to vaccinate – I wasn’t sitting by the phone when the call came in, and that healthy, outdoors behavior put me a couple weeks later than I wanted.

I’m one of the people who was in line for the polio vaccine – and it wasn’t far out of the experimental stage.  A classmate who is with you in kindergarten one day, then gone, and the dread word polio makes for a willingness to step up for vaccination.  As a kid, I didn’t know that the Salk vaccine was only 65% effective against one strain, and about 90% effective against the others.  Multiplication and division were still challenges back then – but I got the vaccine.

I don’t need a perfect vaccine – the vaccine is to improve my odds.  I get flu vaccinations, and the table from CDC https://www.cdc.gov/flu/vaccines-work/past-seasons-estimates.html shows how that works.   The important part is “Adjusted Overall VE (%)

Table. Adjusted vaccine effectiveness estimates for influenza seasons from 2004-2018

CDC calculates vaccine effectiveness estimates through the U.S. VE Network

Influenza SeasonReferenceStudy Site(s)No. of PatientsAdjusted Overall VE (%)95% CI
2018-19Flannery 2020 WI, MI, PA, TX, WA3,2542921, 35
2017-18Rolfes 2019 WI, MI, PA, TX, WA8,4363831, 43
2016-17Flannery 2019 WI, MI, PA, TX, WA74104032, 46
2015-16Jackson 2017 WI, MI, PA, TX, WA68794841, 55
2014-15Zimmerman 2016 WI, MI, PA, TX, WA93111910, 27
2013-14Gaglani 2016 WI, MI, PA, TX, WA59995244, 59
2012-13McLean 2014 WI, MI, PA, TX, WA64524943, 55
2011-12Ohmit 2014 WI, MI, PA, TX, WA47714736, 56
2010-11Treanor 2011 WI, MI, NY, TN47576053, 66
2009-10Griffin 2011 WI, MI, NY, TN67575623, 75
2008-09UnpublishedWI, MI, NY, TN67134130, 50
2007-08Belongia 2011 WI19143722, 49
2006-07Belongia 2009 WI8715222, 70
2005-06Belongia 2009 WI34621-52, 59
2004-05Belongia 2009 WI76210-36, 40

The important thing is that, in 15 years of data, the best record the vaccine had was 60% effectiveness.  The worst was down to 10% effectiveness.  If I’m playing blackjack, and I can get a 10% edge, that’s good.  If I can get a 60% edge, that’s great.  I don’t expect a vaccine -particularly one that had a rushed development-  to be 100%.

Smallpox was ended with a vaccine that was about 95% effective – “Effective smallpox vaccines have a vaccinia titer of approximately 108 pock-forming units per mL, and more than 95% of individuals develop a ‘take’ with neutralizing antibodies after primary vaccination. “ It’s worth remembering that it took several centuries to develop that vaccine.

Vaccines are more a statisticians game, or a gambler’s science.  Today’s polio vaccine is about as close to 100% effective as you can get.  The vaccines aren’t magic bullets – but they are better bullets.  It may take a while – but I’m betting the Coronavirus vaccines will become increasingly effective.  The problem is that the scientists are working on better vaccines, and politicians and administrators are working on press releases.

A Science for Everyone

A Covid Risk Calculator

Johns Hopkins has a covid mortality risk calculator that is both interactive and online: https://covid19risktools.com:8443/riskcalculator 

Remember, I like statistics and correlations, and covid has provided a bit of an enigma since the data came out from the Diamond Princess outbreak last year.  This calculator takes in age, health and location and coughs up your probability of dying from covid.

My own numbers were reassuring – I answered the questions . . . age 71, height, weight, history of asthma, cancer and diabetes, and the model churned out that I was 1.1 times as likely to die of covid as the model’s norm.  Essentially I was at a normal risk.  The analysis was:

“Based on the information you have provided, the tool estimates that you have 1.1 (95% CI: 0.95 – 1.3 ) times the risk of dying from COVID-19 compared to the average risk for the US population.

Based on the estimated risk, you are categorized to be at Closer to or lower than average risk based on the following chart:

Further, based on the information available from pandemic projections in your state of residence, the tool estimates an absolute rate of mortality of 0.6 (95% CI: 0.3 – 1.3 ) per 100000 individuals in subgroups of the population with a similar risk profile to yours during the period of 05/15/2021 – 06/04/2021. This estimate is calculated based on the CDC’s Ensemble mortality forecast data.

*95% CI: Error bounds with 95% confidence.”

It’s a model – and only as good as the data that went into its development.  That said, Johns Hopkins has a pretty good reputation, and I would guess they will continue to refine the model.  Scientific method and statistical analysis do not allow perfect data for the individual.  That said, I like having a model that I can use.  Give it a try with your own data.

Demography

Life Expectancy Reported Down, with multiple reasons

I’ve seen another release about the US life expectancy dropping a year during 2020 – but this one didn’t credit Covid exclusively.  It pointed out that the US Life expectancy has been dropping for several years due to an increase in drug overdoses and suicides.  Please remember – causality is inferred, not statistically proven.

Covid, with most fatalities occurring among the the oldest, has a hard time reducing the life expectancy by a year. (Social Security has its work on life expectancy, going back to 1940, another table, for life expectancy at specific ages, is available at here)

The article reminded me of the drop in life expectancy that followed the end of the Soviet Union.  That was credited to alcohol overdoses, violent death, and suicides.  The chart shows that it happened there, so it can happen here.  The thing about the calculated life expectancy is that one 21-year-old male death takes 55.91 years from the life expectancy chart, while a 75-year-old male death takes only 11.14 years from the collective pool.

The Soviet figures suggest that a major economic or governmental change can have some immediate changes – though today’s Russians, who made it through the collapse of the Soviet Union were back on track in 2019.  CDC has released data showing excess US deaths in 2020, but they are by state and weekly.  Hopefully they will condense the data – 50 states and 52 weeks make a spreadsheet that takes a lot of effort to get through.  Summing up the data to one nation and one year will make it a lot easier to comprehend,  The data that is currently available is at this link.  It is interesting to look at – and I expect that they will have it compiled at a national level soon.

Demography

The Excess Death Data is Available from the CDC

The Center for Disease Control has compiled and released the excess death data for 2020 that gives us a better handle on Covid.  The first charts give a bit of a handle on what was happening:

There are a couple of interesting conclusions – first is that about a third of the excess deaths are not due to covid.  The second is that either the virus treats hispanic and black people different than whites, or that there are intervening variables or spurious correlations.  First, let’s look at the charts by age cohorts

They confirm that Covid was a greater threat to older folks than younger – just like the statistics have been showing us. Next, let’s look at the charts by race and hispanic ethnicity:

I’m not real sure about the relationship based on hispanic ethnicity – one of my colleagues qualifies as hispanic, but mostly Apache ancestry.  Gina is hispanic, but both parents were born in Spain.  Heck, genetically I have some Spanish or Portuguese ancestry, and my people otherwise come from Scotland and points north of there.  On the other hand, I’m waiting for the research that explains the extreme deaths in the category.

The lower left chart shows that the disease did not hit the white population so hard – which intrigues me because that is the oldest of the groups.  I’ll be waiting for more data before I make any inferences.

So click the link, read the CDC article, and start wondering – what hit us half as hard as covid at the same time?

Demography

Where Covid Fits in the Demographic Transition Model

The first stage of the demographic transition model includes high birth rates and high death rates – and infectious diseases dominate – for example, the black death was a highly infectious disease that killed millions in Europe – if memory serves, 60% of Venice died, and about a third of Italy’s population.  The 90% fatalities in Constantinople suggests that it was worse in cities.  A time of a life expectancy of around 30 years, because so many died young.  I’m not certain how effective the masks of the time were in combating the disease transmission.

The second stage includes infectious diseases – such as cholera – that could be controlled by sanitation.  Models don’t always fit as well as we would like – at the same time that public health and improved sanitation was getting a handle on cholera, smallpox vaccination was becoming a norm.   It was 1832 when Congress passed the Indian Vaccination Act, ordering the army to vaccinate the Indians.  Typhoid Mary remains in our vocabulary, a woman who showed no outward sign of infection, but spread typhoid wherever she cooked.  In her case, she was basically incarcerated because of her infection (and she kept escaping).  Stage 2 of the demographic transition is characterized by fewer pandemics, and life expectancy may rise as high as 50 years.  Our masking, quarantines and isolation are public health techniques developed in the second stage of demographic transition.  John Snow’s removal of the Broad Street pump handle was very effective at reducing the waterborne cholera transmission.

The third Stage is the stage of degenerative and man-made diseases – picture how cigarettes fit in with lung cancer and heart disease.  Just living longer increases your chances of dying from a degenerative disease.  Infant mortality drops, and life expectancy is pretty much in the mid-fifties.  The public health approach here is to change unhealthy behaviors like smoking while relying on medical research to counteract degenerative diseases.   The term “safe sex” comes from a public health program to reduce AIDS (HIV).  When it works, and it has, we move into the fourth stage of demographic transition.

Stage 4 – where we are in the US today – shows an increase in degenerative diseases, better medical care, and a life expectancy that exceeds 70 years. 

It is no wonder that Covid took everyone by surprise – in Stage 4, we’re used to having pandemics under some form of control – our top 3 causes of death are heart disease, cancer and accidents.  The Corona virus came in with an approach that complemented our stage in the demographic transition model – a pandemic that killed in a relationship to the age of the infected.  Probably the first clue was the word “comorbidity” becoming so much of the vocabulary.  This time we hit a pandemic that worked in combination with the degenerative diseases.  A disease that matches an aging population.  A disease that needed a stage 4 response.  Lacking that stage 4 response, we’ve spent the year responding as we did to diseases during the second stage of demographic transition.

Another Stage 4 pandemic will develop – after all, we have a stage 4 population as an incubator.  We may even develop new strategies for dealing with it.

Community

On trusting the experts

I have changed the trapdoor into the crawlspace under my house.  The builder was, is, a better carpenter than I.  Yet over the past 4 years, I have never been satisfied by the trapdoor he built.  He has built many houses – but I have gone into the crawlspace many times, as I worked with the water lines.  Sometime during those trips below the main floor, my expertise on that particular part of the house surpassed his – and this winter, I realized that in order to do things right, I had to strip the trapdoor out, then rebuild it so that things would work better.  The fact that his skills in carpentry exceeded mine was irrelevant.  My understanding of the requirements of this particular trapdoor exceeded his.

In my last job, I was accepted as an expert in demography.  And I can confidently state that expertise in demography requires understanding three things – births, deaths, and migration.  From those three inputs, I created models that projected future populations.  I’m looking forward to the publication of the 2020 Census, so I can see how closely my models matched reality.  Time was that demography needed a University’s library to find the data you need – now, an internet connection makes it possible to be an expert almost anywhere.

P.O. Ackley, who started the gunsmithing program at Trinidad State always denied being a gun expert – and he basically wrote the book on the topic.  I’ve encountered several experts on guns, but never one with credentials equal to Ackley.  Perhaps one of the most important aspects of expertise is knowing how much you don’t know.   

The covid pandemic has brushed alongside my expertise – disease has a definite correlation with death, and some relationship with migration.  Likewise, it brushes alongside the expertise of the medical doctor.  I’ve watched a pandemic handled by politicians and MDs (and there isn’t always a difference) with the implication that we need to follow the science and the experts.  The problem is, it’s easy to evaluate past data.  When it’s a new topic, and you’re looking at partial and fragmented data, it’s more of a challenge,

At the onset of the pandemic, Fauci wasn’t recommending masks – by June he was.  He’s changed his numbers several times on herd immunity and vaccinations.  I would prefer experts who were consistent and correct – but I have built a better trap door that works with the data I have.