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, Demography

The Useable data on Covid

Figuring out the data to use is important.  On May 9, 1864, Union General John Sedgwick said “They couldn’t hit an elephant at this distance” three separate times.  After the third statement, he became the highest ranking Union officer to die in battle.  He was missing a couple relevant pieces of information – first, the Confederates had snipers with Whitworth rifles, and second, at 800 yards, the Whitworths were making 12 inch groups – far smaller than an elephant.

It’s similar with Covid – each of us is like General Sedgwick, not knowing which piece of data is relevant, or even exists.  Some data ties in blood types.  I’m not certain it is data we can use.  Death and age combine to give us the most solid data that we have – and it may be of some use.  Statista provides this information, as of January 9. 2021, for the US.

AgeNumber of Deaths
Under 134
1-421
5-1455
15-24510
25-342,196
35-445,742
45-5415,558
55-6438,830
65-7470,230
75-8490,744
85+105,673

As you look at these numbers, it’s probably worth remembering that over 50 million Americans are over 65 years old – where most of the casualties are.  Soon we’ll have the 2020 census, but until then the 2010 census data is usable – a bit low, but usable.  The tragic loss of 55 kids under 4 comes from over 20 million population in the 0 – 4 age cohort.  The 105,673 deaths of people 85 and over comes from a cohort of 5½ million.

If you want to calculate the years of life lost to covid, the social security life tables are available at: https://www.ssa.gov/oact/STATS/table4c6.html  Still, we’re dealing with big data – and, as I realized when I was being treated for colon cancer, the most important thing about your life expectancy isn’t the number for your age, it’s which side of the median you’re on. 

The data shows that Covid’s deadliness increases with the age of the person it infects.  The data isn’t adequate to show either the probability of being infected or missing the virus.  It’s easy to describe the statistics of the Spanish Flu – but most of the data was compiled and available by 1920.  This article describes how Gunnison, Colorado isolated their way out of the Spanish Flu: Isolation worked well for Gunnison. 

The folks at APM Research Lab have calculated out death rates by race – and their study is worth a look, despite the problem that race is more a social construct than genetically identifiable.  Here’s some of their data (as of January 5).

“These are the documented, nationwide actual mortality impacts from COVID-19 data (aggregated from all available U.S. states and the District of Columbia) for all race groups since the start of the pandemic.

  • 1 in 595 Indigenous Americans has died (or 168.4 deaths per 100,000)
  • 1 in 735 Black Americans has died (or 136.5 deaths per 100,000)
  • 1 in 895 Pacific Islander Americans has died (or 112.0 deaths per 100,000)
  • 1 in 1,000 Latino Americans has died (or 99.7 deaths per 100,000)
  • 1 in 1,030 White Americans has died (or 97.2 deaths per 100,000)
  • 1 in 1,670 Asian Americans has died (or 59.9 deaths per 100,000)
  • Indigenous Americans have the highest actual COVID-19 mortality rates nationwide—about 2.8 times as high as the rate for Asians, who have the lowest actual rates.

Data is data.  There’s not a lot of difference between Latino and White rates. 

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.

Community

Board Member representing 4.7% of County Proposed County-Wide Grading of Businesses on Mask Compliance

How does someone representing 4.7% of the county end up proposing something for the entire county (with 14.3% of the voting power)? To examine that, we’ll look at the County Board of Health. But, if you’re more interested in what Mr. Seifert had to say about giving businesses A/B/C/D ratings, watch the video or read about the meeting!

Is the Lincoln County Board of Health a fair representation of Lincoln County? Are some sections of the county better represented than others? Under-representation has been a common complaint, and with Board Member Jim Seifert of Troy proposing county wide grading of businesses, it’s worth looking at.

Mr. Seifert is the Board Member appointed to represent Troy. In 2010 (alas, no 2020 census data yet) the area he represents had a population of 938. That’s 4.7% of the 19,980 people living in Lincoln County.

If representation on the County Board of Health were distributed evenly, by population, we would expect Mr. Seifert to have 4.7% of the vote. However, as one of a seven member board, he has 14.3% of the vote.

Looking at the Health Board as a whole (using the information available on the county website) we see:

Area% of County PopulationMembers on Board of Health% of Vote on Board of Health
Troy4.7%1 ( Jim Seifert)14.3 %
Eureka5.2%1 (Debra Armstrong)14.3 %
Libby13.2%4 (Jan Ivers, Laura Crismore, Sara Mertes, George Jamison)57.1 %
Elsewhere76.9 %Josh Letcher (West Kootenai) 14.3 %
Locations for members were taken from the phone book when not stated on the county’s website

The Board of Health doesn’t represent the population of Lincoln County evenly. Far more of the vote is associated with “urban” areas than rural.

The Board of Health, with three members designated to represent the urban areas, is designed to unequal in representation. That’s 42.9 % of the votes on the Board of Health going to represent 23.1% of the population!

The remaining board members are one county commissioner and three appointed as county representatives. Could the board be more equal, with respect to the rural areas? Definitely.

But what about regions? Is North county represented fairly? Is it possible for the board to represent the county fairly? Could the board be designed so that it did? Next week!

Demography

Vaccination by the Pyramid

The term “population pyramid” goes back to a time when plotting populations by age really did produce a triangle, with a large base of young people and each older age cohort narrowing, until there were very few at the top.  As diseases became more controlled, and birth control entered the picture, the population pyramids changed shape,  The pyramid below is for the US in 2010.

(Data from http://www.proximityone.com/chartgraphics.htm )

Now, if we look at covid death rates by age cohort, Florida’s governor released survival rates back in September:

The numbers for the age cohorts are below – no need to extrapolate from the bars in the pyramid.  We’ll just take the complement of the survival rates, assume the vaccine is 100% effective, and calculate the potential lives saved in each cohort.

AgePopulationDeath RateLives Saved by Vaccination
70+22.8 million5.4%1,502,967
50-6985.8 million0.5%429,045
20-49127.5 million0.02%2,550
0-1983.3 million0.003%250
The Death Rate is 100% minus the survival rate for each age group. Lives Saved by Vaccination is the population of the age group multiplied by the death rate.

If everyone over the age of 70 were vaccinated (and the vaccine worked perfectly) 1,502,967 Lives would be saved. If everyone under the age of 20 were vaccinated, 250.

No editorializing here – just simple addition and multiplication with data from the census.  I know where I would put the first vaccinations if I had a limited supply.

Community, Laws, Ordinances & Regulations

Lincoln County Board of Health Informative Meeting- Part 2

The County Board of Health met Wednesday, December 16th for an informative meeting. It wasn’t just an informative meeting though- it contained a proposal (one which the board anticipates discussing at the next meeting). The proposal (by Jim Seifert of Troy), while at the end of the meeting, was sufficiently surprising that we included it in part 1 last week.

The meeting began with Jan Ivers (board chair) discussing viruses and predicting another pandemic. Then, County Commissioner Mark Peck presented on the legal foundations of the Board of Health and gave a brief “how it all works” explanation. After, Kathi Hooper (Director of the County Health Department) explained the board’s budget.

Presentation about Testing: Lyn Thompson, a laboratory scientist, spoke via zoom about testing for the virus. She spoke with great enthusiasm about her topic, three tests: Molecular Diagnostic, Antigen test and Antibody test. According to Thompson, the four important characteristics of a lab test are: accuracy, timeliness, sensitivity, specificity.

A couple big things about the molecular part of it [testing], what it does not do: It does not tell you if the patient is infectious. It does not tell you if the patient is contagious. “

Lyn Thompson

Thompson clarified that the test itself simply detects or does not detect the virus. Antigen testing looks for a protein, rather than DNA, and is less specific and less sensitive but a quicker test. Antibody tests, meanwhile, are more useful for determining if someone has had a virus than if they are currently infectious.

A lot of these tests are only supposed to be done on symptomatic patients. Specifically the antigen test is really dependent on the person has to be symptomatic with covid-like symptoms in the first five days.”

Lyn Thompson

Thompson continued to explain that delaying an antigen test could result in a negative result, even in someone who had Covid-19, if they delayed long enough. Furthermore, an asymptomatic patient with Covid-19 could still have a negative result with an antigen test.

Presentation on Collaborative Medical Care: Sara (presumably Dr. Sara Mertes of Cabinet Peaks Medical Center, new member of the health board) spoke about the procedures used to both care for patients and avoid potential exposures. When a patient tests positive, the information is given to the Health Department, which does follow-up and contact tracing with the patient.

Cabinet Peaks Medical Center is able to send patients home with a monitor, which checks for drops in oxygen levels or tachycardia (rapid heart rate). Unfortunately, these monitors require WiFi or cell service, so are of limited utility.

Presentation on Contact Tracing: Jenn McCully, Lincoln County Public Health Manager, discussed what happens when the Health Department is notified of a covid case. Contact tracing assumes that someone is contagious either two days before symptoms, or two days before the positive test (whichever is sooner). Isolation is supposed to be at least 10 days, and to include being isolated from other household members. It will also include occasional calls and check-ins from the department.

Presentation on Vaccinations: Dr. Kelli Jarrett, of the Northwest Community Health Center, gave an overview about how vaccines work. Then, she went into more detail about the Covid-19 vaccine. The vaccine is an mRNA vaccine, which makes it somewhat different from the vaccines we are used to.

The reason that mRNA technology is actually really nice, especially in this circumstance is that it can be scaled up much faster than our current vaccine technology.”

Dr. Kelli Jarrett

Dr. Jarrett provided a detailed overview of the safety data for the Pfizer vaccine, and observed that the number of adverse reactions seen in the trials is comparable to commonly used vaccines (adverse reaction can include pain, fever or muscle aches; it needn’t be severe). The efficacy rate of the vaccine seems to be quite high.

The presentations wrapped up with contact information: Anyone with questions for specific presenters should contact Kathi Hooper, the director of the County Health Department.

Finally, the meeting closed with a comment from Jim, the Board of Health member representing Troy. Seifert proposed giving businesses an A/B/C/D rating, primarily based on mask wearing (both of employees and customers). His proposal seems to entail members of the county health department inspecting and rating businesses.

The Board of Health next meets on January 13th. According to Board Chair Jan Ivers, Seifert’s proposal will probably be on the agenda.

Community, Laws, Ordinances & Regulations

Lincoln County Board of Health Informative Meeting was Held Wednesday 12/16

Did a member of the Board of Health actually propose a “grading system” for local businesses, based on compliance? Where does the County Board of Health come from? What powers does it have?

First, some background: The Lincoln County Board of Health has seven members. It is chaired by Jan Ivers of Libby. Of the seven members, three are “Lincoln County Representatives”, another three represent Libby, Eureka and Troy, and the final member is a County Commissioner (at this time, Josh Letcher).

Wednesday’s meeting was for the purpose of informing the public, rather than deciding/voting on policy. It began at 6 pm, and could be attended via zoom. A full recording of the meeting is available here– it’s about an hour and 15 minutes. I’ll give the short version here, and do my best for accurate quotes (with the right names associated, but as I’m faceblind, mistakes do sometimes slip through).

The meeting was shared by DC Orr of Libby, whom I presume can be credited with the recording.

The meeting had 7 presenters, and began with an explanation by Board Chair Jan Ivers, about viruses and pandemics. Talking about pandemics, Ivers predicted another pandemic and listed some reasons.

There will probably, as soon as we get this one under management, there will probably be another pandemic in the future. And there are a couple reasons for this: Population growth. We have a lot more people, a lot more crowding. We’ve gone from agriculture/rural into higher density populations. There’s some deforestation due to needing more agricultural land. Modern travel. I mean we can go almost anywhere to home in 24 hours which means that organisms don’t have that far, or that long to go. Increased Trade due to imported foods, exotic pets. And Change in the weather patterns that makes a difference in when these viruses go into humans. Here we don’t have this problem as much, but lack of access to public health is a big issue as far as [coughing] virus”

Jan Ivers

The first presentation was by County Commissioner (District 1) Mark Peck on the topic of Organizational Structure. Peck remarked that “There’s a lot of confusion over who has what authorities”. Peck explained:

“Essentially, Montana Code Annotated 50-2-106 covers how health boards are formed. There’s a few different kinds of health boards… We chose a number of years ago to go with the city county health board model because it allows the three cities as well as the county to have joint representation and have representation for themselves on the board.

So essentially what that means is that at minimum you have to have a county commissioner. The city of Libby has one position that they can pick at large. The city of Troy has one they can pick at large. And The city of Eureka has one they can pick at large. And then we decided within the bylaws of the board, and this was a concurrence from the commissioners and the three city councils and mayors that the commissioners would have an additional three positions. So you’ve got four positions that are selected from the county commissioners and then one from each of the cities and that’s where the seven positions come from.”

Mark Peck

With three Board Members coming out of the cities, it makes sense to consider what percentage of the county population the cities are.

CityPopulationPercentage of County
Eureka10375.2%
Libby262813.2%
Troy9384.7%
All three460323.0%
The numbers are from the 2010 Census (the 2020 data isn’t out yet) the County population was 19,980

Basically, the three incorporated communities, with 23% of the county’s population are guaranteed 43% of the board membership.

Peck continued, discussing the County Health Board and the appointed Health Officer:

Know a lot of people think well the county commissioners, we can just do away with this board. Well, actually we can’t. We have to have concurrence of the three cities to do that. Very similar to, well, the cities can’t blow it up on their own either and that’s a check and balance to make sure we’ve got consistency.

So anyway the authority of the cities and commissioners in Title 50 is strictly to appoint the Health Board. The Health Board has its own set of authorities and regulations that the cities and county don’t have, because per law that’s been delegated down to the Health Board. And those responsibilities you’ll find them in Montana Code Annotated 50-2-116 and one of the first authorities and requirements of the health board is to appoint a health officer.

The health board has appointed Dr. Black as the county health officer. The county health officer, those authorities fall under 50-2-118 so it’s a different, although they’re very similar authorities, the health officer has unique authorities that the health board does not…

Mark Peck

Peck went on to answer several questions he had been asked by his constituents. Can the health board be reorganized or disbanded?

…Yes, in theory the health board can be reorganized but it’s not a matter of just the county commissioners doing it. We would have to have all three cities as well as the county commissioners agree to disband the board….

Mark Peck

Why isn’t the sheriff enforcing the mandates?

We still are in a state and a country of laws, and the sheriff can only enforce laws that he’s been given authority through Montana Code Annotated… the Sheriff does not have authority under title 50 to go arrest somebody or to enforce the Governor’s mandate. They can assist if there’s some type of an issue. But that’s why you’re seeing law enforcement agencies not running around enforcing this…”

Mark Peck

Is the health officer completely autonomous?

No, he isn’t. The health board could replace the health officer…”

Mark Peck

After Mark Peck finished, Kathi Hooper, Directer of the County Health Department began the second presentation of the evening. The topic was finances.

The finances of the Board of Health are really pretty simple. They have a small budget that’s approved annually by the commissioners. In the previous fiscal year which is July of 2019 through June of 2020 the Board of Health expenditures $15,790. And of that total 95% was professional services, including approximately $9,400 for legal services and $6,300 for local health officer. So far this fiscal year which started July 1st the Board of Health expenditures totaled $3,198.”

Kathi Hooper

If a business spent 57% of it’s budget on legal services, well, that might suggest some problems.

Skipping ahead a bit in my summary, towards the end of the meeting Health Board Member Jim Seifert (Representative of the City of Troy) spoke for the five or so minutes of the video below. Seifert outlined a proposal that did indeed involve giving businesses grades.

I want to bring up a proposal. What I want to do is I want to do exactly what the health department already does. The health department right now regulates restaurants and food establishments. I want to regulate public spaces for the same thing for our response to covid. And what that is, is we have three things that we can do that are positive. We can do masking, social distancing and hand washing. Well, it’s hard to monitoring hand washing because you can’t be there all the time, but the masks and the social distancings[sic] we can. And what I want to do is go to public places, excluding churches and excluding schools because they’re mandating their own, and set up a A/B/C/D rating for these establishments.”

Jim Seifert

Seifert stated that he would give an A+ rating to a business that makes everyone that comes in put on a mask, a business where all the employees wear masks (but they don’t greet people at the door and inform them to put on a mask) a B, with the grade lowering for incorrectly mask wearing. C rating would be for businesses in which only some employees where masks, and D rating for those businesses that do not where them.

Jim Seifert of Troy proposes a rating system for businesses

Who would enforce Seifert’s proposal? He was quick to say not the government, and not the police. Rather, Seifert states that he expects the citizens of Lincoln County to do the enforcement. He imagines businesses being rated on social media, and in the newspaper, signs placed on their doors, and these signs helping citizens to decide where to shop.

Now, Seifert is the board member that represents the city of Troy. The 2010 population of Troy was 938, or 4.7% of the county’s population. He certainly has ideas for the whole county though!

Seifert went on to talk about vaccines, stating that the idea that vaccines would be mandated (people would be forced to get them), is a propaganda conspiracy-theory.

“We don’t do that in the United States that I know of. And what I call that, is I call that gas-lighting.”

Jim Seifert

The meeting closed with the reminder that the next Board of Health meeting is the 13th of January (the second Wednesday of the month), and the thought that Seifert’s proposal will probably be on the agenda. Written Comments or questions to the board should be addressed to Kathi Hooper. While written comments are accepted at any time, they must be received a week in advance of the meeting to be addressed at that meeting. For a comment to be addressed at the next meeting, it should be sent in no later than January 6th.

Meeting Summary to continue in next week’s Mountain Ear. If you can’t wait- feel free to watch the whole thing (and write the rest of the summary- get in touch, we’ll post it!)

Community

Trego School moves to Distance Learning

In accordance with the school’s Health and Safety Plan, the school has moved temporarily to distance learning. The School’s Health and Safety Plan is a three part plan outlining the response to each potential scenario. Part A is “Traditional Learning with Precautions” and has been in place since the school year started in September.

The screens around the desks are one of the precautions outlined in Part A of the Health and Safety Plan.

The school had recently moved to Part B, “In the event a community member in School District becomes infected”. During Part B, traditional in-person learning continued with additional precautions beyond those outlined in Part A.

As of Monday (October 19th), Trego School is in Part C: “In the event a student or staff member in School becomes infected”. Taking advantage of some very lucky timing, the school board has been able to put over two weeks between the date of potential exposure and on-site learning resuming with only a week of distance learning.

How? As parents know, last week had some time off of school. While there were not holidays there was MEA, a statewide conference hosted by the Montana Educators Association. This, combined with well timed absences, will allow for two weeks between the potential exposure and on-site learning, with a single week of distance learning.

In keeping with the Health and Safety Plan, the school bus will be delivering breakfast and lunch to students. On-site learning is scheduled to resume on Monday (October 26th). The school board, after taking input from parents, will be deciding whether to resume on-site learning in Part A or Part B of the Health and Safety Plan, but it regardless, students will be back to in-person learning on Monday.

Community, Demography

Covid’s Mask and Pascal’s Wager

According to the Internet Encyclopedia of Philosophy, “Blaise Pascal (1623-1662) offers a pragmatic reason for believing in God: even under the assumption that God’s existence is unlikely, the potential benefits of believing are so vast as to make betting on theism rational.” As a stats guy, I could write this from memory, as a scientist, I need to cite a source.

Pascal’s statistical argument is a gambler’s view of the universe – the cost of believing, of the ante, is so small compared to the infinite reward (the size of the pot).  I worked with an accountant who had a system for buying lottery tickets – his break from understanding Pascal was that both cost and reward in the statistics of lottery cards are finite – the odds really can be calculated.  Lotteries are a tax on people who don’t want to do the math.

Covid is also a game for statisticians.  It’s still at a point where we have a bunch of unknowns, but there are fewer unknowns than there were 6 months ago.  Then the Diamond Princess was a horrifying news story – now it is data, as taken from statista.com: “A total of 712 people were infected with COVID-19 on the Diamond Princess cruise ship – 567 passengers and 145 crew members. The cruise ship, which had more than 3,500 people on board, was quarantined for around two weeks. All passengers and crew members had finally disembarked the ship by March 1, 2020.”

Wikipedia shows 14 deaths among the 712 infected people on the Diamond Princess.  Somewhere right around 2%.  About the same as Texas and California, and lower than New York, New Jersey, and Massachusetts.

We’re still looking at less than perfect representative numbers – but Diamond Princess has provided some data:  roughly 20% of those exposed between January 20 and February 19 wound up infected.  In March, we had estimated R0 values from 1.5 to 3.5.  Now, we have Rt values (Average number of people who become infected by an infectious person with COVID-19 in the U.S. as of October 17, 2020).  Those numbers vary from 0.91 in Mississippi to 1.31 in New Mexico.  Montana scored 1.2. 

Generally speaking, in the absence of data, we have a tendency to assume the worst.  We have data now.  The actual infectivity is lower than the initial data – perhaps because the precautions have been effective, perhaps it is related to the fact that 80% of the people on Diamond Princess did not catch covid.  Correlation is not causation.  Causation is inferred from statistics, not proven.

This week, an article from the American Society of Hematology stated: “Blood type O may offer some protection against COVID-19 infection, according to a retrospective study. Researchers compared Danish health registry data from more than 473,000 individuals tested for COVID-19 to data from a control group of more than 2.2 million people from the general population. Among the COVID-19 positive, they found fewer people with blood type O and more people with A, B, and AB types.

Making statistics personal is a challenge – data suggests that my risk factors are increased by age (70), height (6’3”), asthma, and diabetes.  How much we don’t know – for neither my asthma nor the diabetes scores particularly high.  My risk factors are reduced by my blood type.  So let’s look at masking.

My mask is like Pascal’s wager – it seems logical that any level of masking will reduce transmission.  The question is: “How much?”  I don’t have that answer.  Does my mask protect me significantly?  When I have been in surgery, the surgeons and medical staff were masked to protect me.  Similarly, is my mask to protect others?   Business Insider offers an article comparing mask effectiveness, but cautions that “Mask studies should be taken with a grain of salt.”  My mask is like Pascal’s wager – and I hope wearing it adds a sense of security. It costs me little to wear it.