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. 

A Science for Everyone, Demography

Death Rates by Country

One of the more useful publications to compare nations is the CIA World Factbook.  While we tend to think of the CIA as secret agents, a lot of them are data geeks crunching numbers.  The data they develop about each country is impressive, and like the US Census, the CIA sets the standard for the most accessible and reliable information.  When I started using it, I needed a land-grant college library.  Now, I click World Factbook.

National death rates in 2018 ranged from 19.3 per 1000 in South Sudan down to 1.6 per 1000 in Quatar.   The reasons vary – a higher median age (Japan is 48.36) combined with healthy living and good health care can still have relatively low death rates (Japan was 9.9 in 2018).  The explanation is Demographic Transition theory – in the old days we had high birth rates and high infant/youth mortality.  The second stage occurred with health care improvements – birth rates remained high, but death rates dropped.  Stage 3 showed lower birth rates and death rates continuing to drop, but more slowly.  The fourth stage maintains the lower birth rates, but in an aging population the diseases change – in the US, the big killers are heart disease and cancer.

Lesotho, in Southern Africa, has the second highest death rate – high infant mortality (44.6 deaths per 1000 births), the world’s second highest HIV rate.  A dozen years ago, I first encountered https://www.worldlifeexpectancy.com/ and the website gets increasingly useful.  It isn’t that the covid is so insignificant in Lesotho, it’s that Diarrhea is so much more prevalent.  Click the link – and check out the demographic factors for your own country.  In the US, it shows life expectancy changes since 1960:

US life expectancy from World Life Expectancy

The personal computer has taken demography from being a science that need a major university’s library facilities in my undergraduate days into being a science with the data available to a Fortine resident who has insomnia at 3:00 am. 

Community

Stimulus payments, not junk mail!

Covid19 stimulus payments have begun to trickle into North Lincoln County again, and as the current PSE/Postmaster of Fortine, I feel it’s quite important to spread this information around. You see, some of these stimulus payments aren’t as official-looking as they could be.

The above piece of suspicious-looking mail is actually a stimulus payment from the federal government, not junk mail. Covid stimulus payments were first issued as prepaid debit cards this past May. There wasn’t much coverage of the different payment method, and as a result, is it any wonder that folks all over the country accidentally threw them away?

A couple of stimulus payments later, the same thing is happening again. Folks all across the nation have begun to accidentally throw their EIP (“Economic Impact Payment”) cards away. .

If you received your previous stimulus payments as direct deposits, you should have received this one as a direct deposit as well. However, receiving an actual stimulus check last time does not guarantee that you’ll get a check this time.

An example of what our EIC Card envelope looked like.
(I’ve obscured the address, but it was right beneath the barcode.)

The above envelope contains a prepaid debit card, though how much money that card contains may vary depending on whether or not it is a joint card for you and your spouse, etc. You’ll want to activate your card promptly and check its value on the official EIP Card website. Nowhere on the EIP Cards, or in their enclosed letters is their value stated! Your EIP card can be used similarly to a normal debit card, but it’s worth noting that there are extra fees associated with using it.0

Fees associated with the EIP Card:
I’m not terribly fond of these cards – there’s a number of ways your balance gets whittled down.
Doesn’t it feel like death by a thousand cuts? The fees are as follows:

ATM withdrawals – Domestic——$2.00 fee,
This applies to all out-of-network ATMS, but is waived for your 1st withdrawal.
There are no-fee ATMs, though few and far between.
Our only one in the North Lincoln County area is at Stein’s Market in Eureka.
Your next closest options are Libby and Whitefish.
ATM balance inquiry—————-$0.25 fee
This fee applies at all ATMs – both in-network and out-of-network.
Instead of wasting those 25 cents, check your balance online for free.
You can also check your balance by calling Customer Service: 1.800.240.8100.
Bank/cashier withdrawal————$5.00 fee
Like the out-of-network ATM withdrawals, this fee is waived for your first cash withdrawal, but will apply to all others.

What if your card was thrown away, lost, or stolen?
Call the EIP Customer Service helpline at 1.800.240.8100.
If you manage to get through to them, (and then jump through the relevant hoops to deactivate the damaged or missing one), they’ll send you a replacement card at no extra charge.

If you can’t get through to the IRS via their phone number (their line has been rather busy lately), consider downloading IRS Form 3911, filling it out, and submitting it via the IRS website.

Here’s the IRS page on how to request a trace of your EIP (card or check). It also contains information on how to properly submit form 3911.

Community

Board of Health Recommended New Member, Appointed Officers

Since the board met via zoom, attendance was relatively straight forward. It did, however, require an installation (brief) of zoom.

The meeting began with the nomination of officers. Current Board Chair Jan Ivers mentioned a desire not to return as chair, but expressed doubts that anyone else would wish to take the position.

She and Josh Letcher (County Commissioner, representing District 3) were both nominated for board chair and the floor was opened for comment, which went as follows:

The first public comment came from DC Orr, of Libby. He began by remarking on the necessity of use of parliamentary procedure by the board chair, and suggesting it was an area in which Jan Ivers had been lacking as chair.

Jonathon Allen spoke next, suggested that officers should be chosen later, once a new member is appointed, since George (Jamison) stepped down.

Deb (presumably Debra Armstrong, board member representing Eureka) spoke next, in favor of Josh as board chair. She expressed some concerns about rules of order not being followed, not sticking with the agenda, etc.

Laura (presumably Laura Crismore representing Libby) inquired if it was necessary to follow the bylaws. In response to her question the bylaws were cited and the board seemed to conclude following them was necessary.

Josh Letcher remarked that he appreciated being nominated and that he understood the frustration with the way meetings had been going. He also praised Jan Ivers for improving in her role as board chair. He concluded by commenting on the difficulties the current meeting schedule would cause him, given his need to travel if he were elected Board Chair.

Then Jan Ivers spoke, remarking that “Four years ago, no one wanted this position, so I took it”.

Jim Seifert (representing Troy) referenced a comment Josh Letcher had made previously about acting as a liaison between the board and the county commissioners, asking Josh to clarify his role on the board.

Josh Letcher replied that he did not remember the comment, but did remember an email, pointing out that the county doesn’t actually have a representative on the board from north county.

The Board, upon voting to appoint a board chair appeared to do so unanimously. Yes, Josh Letcher and the board member that nominated him both voted in favor of appointing the other candidate. Sara (Sarah Mertes, county representative out of the Libby area) was appointed as vice chair (3 votes to 2, with one abstaining. The other candidate was Debra Armstrong of Eureka). After the definition of secretary was read aloud from the bylaws, Jim Seifert accepted the nomination and was appointed secretary (no other nominations).

Board Recommendation: The board interviewed 6 candidates, rating them using a rubric (not provided the public). Interviews were in alphabetical order

  • Scott Bernard.
    • Scott Bernard lives in Eureka. He is a Eureka town councilmen with training in Hazmat and emergency response. He has experience in the American Red Cross as well as time as a Volunteer Fire Fighter, in addition to the training he received during his time with the army.
    • When asked about his reasons for wanting to be on the board, he advocated diverse backgrounds and experience in board members.
    • When asked his opinions about the pandemic response, he stated he had mixed feelings.
  • Anne German
    • Ann German is of the Libby Area. She was very blunt that she should not be appointed in order to represent North County, and would defer to someone from North Lincoln County (were that what the board was seeking- this was not confirmed to be the case), though she is interested in serving if another opening occurs.
  • Robin Gray,
    • Robin Gray is a native Montanan, born in Hamilton. She has 43 years in education, a degree in Elementary Ed, and a Masters in Education (and administration?). She referenced some of her time as a superintendent. She stated that she has prior board experience (listing several boards) and remarked that she brings a “team atmosphere”
    • On the pandemic response, she said she would have liked more communication or more ongoing communication on the pandemic, so that the board could promote factual information.
  • Latimer Hoke
    • Latimer was the youngest of the candidates. He has a bachelors of science and secondary Ed, a masters of science in education. He has been an EMT for 11 years, and a member of the ski patrol for 10. He has spent the last 8 years as a teacher in Eureka. He remarked that his board experience more limited than the other members, since he’d had less time to accumulate it. He has been on the ambulance board in Eureka.
    • Asked his opinion on the pandemic response, he remarked that he has observed a lot of passing the buck and not leading by example.
  • Patty Kincheloe
    • Patty Kincheloe chose Montana rather than being born here. Her degree is in education. She has a Masters in Educational Leadership and was a principal for a few years. She’s spent 30 years in the public school and 5 years in an alternative school. She currently substitutes at Chrysalis. Patty Kincheloe has spent 18 years with the ambulance, and worked with children with fetal alcohol.
    • On the pandemic response, she stated that she believes that we should wear masks when we’re in a spot people feel uncomfortable
  • Jeff Peterson
    • Jeff Peterson has a PhD in Health Communication. This would be his first community board, he’s been on several academic boards
    • On the Pandemic: He stated that it certainly could have been handled better, coordination from top down could have been better. Peterson remarked that there had been a lot of community passion around this issue which could have been better harnessed.
    • Jeff Peterson believes that his job and specialty on the board would be to “help people find appropriate information and the sources we can all agree on and translate that”

The board discussed the candidates briefly. It came down to Patty Kincheloe vs Jeff Peterson, with what sounded like 4 votes in favor of Jeff Peterson. The recommendation will go to the Commissioners, who have final say.

At 7:40 (it began at 6), the meeting finally moved the the next agenda item and the board went on to hear from Jeff Peterson (yes, the same Jeff Peterson) who’s working on contract with the Health Department. Peterson clarified that he would not serve on the board until his contract was over.

But, you don’t have to take my word for it. Go watch the whole thing! Fair warning, though, it’s about 3 hours. Or- read about the rest of the meeting.

Community, Demography

Easy Math but Fake News

Yesterday, I read that US Life Expectancy had dropped by a full year due to Covid.  I didn’t really think about it – I had taught about the drop in life expectancy accompanying the Spanish Flu, and had invented hypothetical plagues for student exercises in demography class.  But when I had the full-year drop in life expectancy cited to me a second time, I realized that large numbers keep us from checking the math, even when the data is readily available.  Here’s the basic math for checking the assertion, worked as we would have in the slide rule era.

The US population is just a little under 330 million.  At present there are approximately 400,000 Covid deaths.  Using the Social Security life expectancy tables was a good decision – the data is readily available to check your work . . . but we don’t need complex math to check the claim that US life expectancy will drop 1 year due to covid.  It’s probably worth mentioning that life expectancy is a statistical thing, accurate for a large group but not particularly accurate for an individual.  I’ve known people who lived past 100 and others who died at 14.  At age 12, they had similar chances to live to old age.

To reduce US life expectancy by one year, Covid would have to take away 330 million years of life (remember, there are 330 million people. If each loses one year…)

This is possible, but to make the math easy, lets state the problem in millions to get away from the tyranny of large numbers. .  We’re left with 330 for population, and 0.40 for deaths.  To reduce US life expectancy by one year, we have to have 330 (million years of life) lost by 0.40 (million people).

US PopulationCovid Deaths
330,000,000400,000
330 million.4 million

Checking the math is nothing more than setting up a word problem: How many years of life are lost for each covid victim? Can there be 330 (million) total years of life lost with 0.40 (million) deaths due to covid?

Well, 330 years of life lost divided by .40 is: 825 years lost per covid death. That implies the average Covid death deprives its hypothetical victim of 825 years of life.  Since average life expectancy is now about 80 years, it looks like several orders of magnitude were lost in someone’s calculations.  The old slide rule techniques still have value in checking one’s work.

The same day, another stats guy ran numbers showing that the average Covid death was 13 years early.  That seems to have a bit more face validity – we can go to the charts that show death rates by age, develop percentages, and check his data against the tables – but I’m still making the math easy:

400,000 Covid deaths X 13 years = 5,200,000 lost years of life, or 5.2 million
5.2 million (lost years) divided by 330 million (population) = 0.0158 years of life expectancy per individual. 
0.0158 X 365 (days in a year) = 6 day drop in life expectancy.

The availability of data makes it possible for demography to be a science for everyone, and not confined to university campuses.

Community

Board of Health Meeting: Reports, Vaccines, and more

In a meeting that lasted the better part of three hours, the board of health appointed officers, selected a candidate to recommend to the commissioners for replacing a board member, heard reports and answered questions.

After an hour and forty minutes (when the audience had, admittedly, started to thin substantially), reports began.

Team 56: It’s not entirely clear why Team 56 reports to the health board, or what their precise relationship to the board is. However, it was reported to the board that Team 56 delivered masks to high schools, “spread kindness, not covid” posters, as well as delivered thank you notes and balloon bouquets to the ER staff.

Covid Response Report: Jeff Peterson (yes, this is the same Jeff Peterson that the board recommended the commissioners appoint to the board) reported on the work he’s doing for the county (on contract). It sounds as though most of Peterson’s time has been spent filming videos for the website. The current focus is on frequently asked questions and “translating the science”.

Medical Provider Summary: Provided by board member Dr. Sara Mertes. Many of the first responders have received their first vaccine and the second will be administered soon. The vaccine used was the Moderna vaccine, and they hope to be administering vaccines to the community in the next several weeks.

Covid 19- Vaccinations– The county health department is working with clinics and hospital to put together a central list so that when vaccines arrive, people will be on the list for vaccines. They are prioritizing age and underlying conditions. The public can call the health department to get on the list, and the county will ask only for age and name (though information about a qualifying health condition could be provided). While there is a CDC program people can opt into for tracking symptoms/side-effects, it’s totally optional.

They were very blunt on the current states of vaccines in Lincoln County. They county has no idea how many vaccines we will receive, where they will arrive, or when. We can, however, expect that it will be the Moderna vaccine.

ChemPACK plan– No changes, but the plan is reviewed annually. This is part of the emergency medical counter measure plan. The chempack is a CDC owned cache containing nerve agent antidotes. Board approved the plan.

Liaison (George Jamison, county representative, leaving the board in order to devote more time as a volunteer with the asbestos program ): The PEN regulation– property valuation notification process- was formally adopted last March. One of the provisions was deferment on when it would become effective. This evening’s action item was to make it effective, as of February 1st. This regulation will impact the folks down in the Libby Asbestos Superfund Site.

Health Officer: Dr. Black spoke. He stated that while vaccines are not that far away, it’ll take time to get enough people vaccinated in the community. Dr. Black imagined looking at people’s faces with out masks in 6 or 7 months, but says we won’t be there until we get 80% of people vaccinated. He thinks that a high participation in vaccination will be necessary in order to get back to normal.

At 8:40, Jim Seifert discussed the rating system he’d proposed at the last meeting. He had decided not to put it on the agenda. One reason is that the health department is already overwhelmed and he didn’t want to add to their burden. He says he still believes that if one hospitalization or one death would be prevented, a rating system would be worthwhile. However, implementation would take several months and the vaccine is coming out.

Proposed update to operating procedures– tabled (It’s getting late. The room is cold)

Public Comment:

DC Orr: DC Orr critiqued Dr. Black’s response to someone’s question on vaccine safety (Dr. Black responded to a question by telling the person asking to read the vaccine studies). DC Orr suggests that Dr. Black could present on the topic. He also noted that the board is not familiar with its bylaws and did not follow the rules of order. He suggests they read a handbook on board membership. He then asked why Team 56, not being a governmental unit, was on the Agenda. Quoting Jim Seifert at the previous meeting, he described Seifert’s words as “demonizing” the community and called for him to apologize.

Trista Gillmore: Trista Gillmore, as Lincoln County Public Health Nurse would like to answer people’s questions about mRNA vaccines and provided her email (she may need a few days to answer questions): tgilmore@lincolncounty.org

Diane Watson: Diane Watson noted that the website for the county health department states that it says the public has 7 days to submit questions if they want them discussed at the meeting. She asked when the agenda and minutes would be posted?

The board clarified that the agenda must be posted 48 hours (2 days) in advance of the meeting but will be posted at least the Friday before the meeting). Draft minutes are always posted with the agenda.

While there seemed to be some confusion on how to answer the question (the problem of having to ask questions 7 days in advance of the meeting with the agenda not yet posted). Finally, Jan Ivers (board chair) explained that it is what the board is looking at with revising operating procedure number 2.

With that, the meeting was adjourned. The meeting times have been changed to 6 pm on Tuesdays, the second Tuesday of the month. The next meeting will be February 9th.