Trego's Mountain Ear

Tag: Covid-19

• 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.

  March 2, 2021
• 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. 

  February 23, 2021
• 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:

  

  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. 

  February 23, 2021
• 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.

  

  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.

  January 26, 2021
• 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.

  January 19, 2021
• 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 Population	Covid Deaths
  330,000,000	400,000
  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.

  January 19, 2021