Kentucky COVID-19: It’s about the public health, not your rights. Right?

Recently, Vice President Biden when announcing his call for governors to issue mask mandates said, “It’s not about your rights, it’s about your responsibilities”. After all, it’s your responsibility to do what your told to protect the public health from greater harm. Recently, our Governor issued a recommendation that schools be delayed until September 28th. When some school systems decided to move forward, he established a series of protocols that encourage them to move toward his recommendation. But it’s not about their ability to decide for themselves, we have a public health issue.

Our current public health issue in Kentucky encompasses cases affecting 0.08% of the population and deaths totaling 0.00067% if not in a Long Term Care facility. Some experts have forecast that if we opened schools, allowed sporting events or reduced limitations on living, deaths could increase as much as 10x by the end of the year. That would take the total death rate not in Long-Term Care to 0.0067%.

It’s not about your rights when keeping the worst-case scenario of 0.72% more Kentuckians from testing positive and 0.0054% more people from dying. It’s your responsibility to limit your life choices, your livelihood, your child’s education, your mental and physical health outside of COVID-19 and your ability to make decisions about your own relative risk tolerance.  We must protect our children, our teachers, the vulnerable, the chubby people like me and our elderly. 

If you don’t mind…before I submit to my ‘responsibilities’, I have a few questions.

What am I sacrificing for? How bad is it and how bad can it be?

Because many people have PTSD from 8th grade Algebra, instead of math here is a ‘picture of the math’ that shows the current relative risk of contracting, dying and the relative risk should the deaths increase by a factor of 10. 

So, in order to keep the yellow thing (current deaths) from becoming the orange thing (10x projected growth in deaths) the blue things (that’s us) are required to disrupt their lives on a scale from somewhat to disastrously. And sorry, if you’re viewing on a mobile phone you might have to pinch and zoom to see those elements (which is kinda the point).

Also, this doesn’t factor in the truth on the Long Term Care phenomena. Accounting for over half of all fatalities in Kentucky, if we take take that into account, a 10x growth rate in deaths would only fill one third of one blue box.

Everyone has to determine what their own relative risk appetite might be, but for me, this isn’t enough for me to accept all the ‘recommendations’ or my new ‘responsibilities’ without pushing back a little.

Are we in a pandemic or a casedemic?

Here’s a recent view of KY Cases vs Deaths on a 7DMA.

Why aren’t deaths rising? Don’t know about you, but I haven’t heard from the ‘wait two weeks’ crowd in a while. If Kentuckians aren’t dying at a rate that is proportional or even increasing relative to the exploding volume of cases, then why are rising cases that bad? I don’t want anyone to get sick but If you don’t get seriously ill, then what is all the commotion? More people get it, more immunity is built and when the outbreaks occur—and they will—there will be more ‘brakes’ in place to slow the thing from being as bad as it was the first time.  

Also, how many of these ‘cases’ represent people that are…’ya know…sick? The CDC’s own data points to as many as 20.8% of positive PCR tests are from people who don’t know they have it and around 25% more that have extremely mild symptoms, like being tired, having headaches or not being able to smell the roses for a few days. “But the 20-29 year old age group (0 deaths in KY) is the fastest growing positive testing segment and they’ll spread these to older people and they’ll die.”  Again, our death rate has been stable despite all the asymptomatic youngsters spreading the disease willy nilly. 

Naysayers bring up the one anecdotal news story or the very small number of studies done with an even more selective participant group that show ‘evidence’ of long-term implications. These studies show evidence, not proof, of long-term health implications and if there are any, they are unlikely to be more prevalent than the same long-term conditions from any respiratory disease.

The most popular of these points to development of myocarditis in the heart—even among young, healthy athletes following a bout with COVID. But myocarditis is found in rare cases following many infections, including the common cold. In fact, the data on Myocarditis in young athletes looks like this:”

  • Roughly 50M kids age 13-24.

  • 16% play sports or about 8M.

  • 75 die of Myocarditis yearly.

  • That’s a 0.000938% death rate.  

There is no high probability of long-term health consequences. Could that be possible? Sure. Could you one day find out that air conditioning causes cancer? Sure. The relative risk is low, has been low and remains low despite rising cases and feels more like a casedemic than a pandemic.

Everyone has to determine what their own relative risk appetite might be, but for me, this isn’t enough for me to accept all the ‘recommendations’ or my new ‘responsibilities’ without pushing back a little.

Why is positivity rate important? 

Well, obviously, if more people are testing positive as a percentage of total tests then cases are on the rise. We sit a little under 6% today as a state. But how do you get that number, exactly? Easy. As Dr. Stack says, “it’s the total number cases divided by the total number of tests.” But there is a few reporting dilemmas that create problems with both the numerator and denominator. 

Daily testing reports vary wildly. Not uncommon to go from 4,000 tests one day to 12,000 the next and two days later have 400. The 7DMA
takes out the spikes, but the nature of how the data is reported brings questions. We have averaged a steadily increasing volume of tests for the last few weeks (up to around 50K), but an interesting thing happened on the way to Commonwealth Stadium (sorry Kroger, I just can’t). The University of Kentucky has tested over 14,000 kids with a positivity rate of 0.9% and it’s funny that those testing numbers don’t appear to be on the state’s reported testing volumes. 7DMA of testing is the same as it was July 17 and 14,000 represents a 28% or ‘big’
impact on testing volume, yet the 7DMA remains roughly similar?

Maybe the gap has to do with the reporting of the tests. The state of Kentucky requires positive tests to be reported. They do not require negative tests to be reported. And that’s a problem. While many negative tests are reported, are all of them? As Dr. Stack himself said in the hearing this week, “this complicated the positivity rate” because the denominator is in some degree of question.

Therein lies some of the devils in the data. And we’re making positivity rate the “in” thing to talk about when cases are dropping to justify executive action without asking the bigger question of:

If rising cases aren’t a harbinger of rising deaths--and they’re not--and there are at least some questions about the integrity of both case and testing data, then why is positivity rate the trendiest new statistical measure?

At this point when evaluating relative risk and potential worst case scenarios, I struggle to understand why positivity rate really matters
that much. And listen, everyone has to determine what their own relative risk appetite might be, but for me, this isn’t enough for me to accept all the ‘recommendations’ or my new ‘responsibilities’ without pushing back a little.

What is the plan to get back to normal?

What is the case, positivity or death rate threshold where our leaders release us from our ‘responsibilities’ and restore freedom of personal choice? Is it one of these things, all of these things or something else? What is the plan? Could you share it with us, the rationale behind it and the data that supports it? Or…is there a plan?

It seems we’re on a journey with a loosely defined destination and no plan to get there. Nothing will be magically different September 28th for school kids. Nothing will really be different in the Spring for college sports? When we loosen restrictions, cases will rise. When traditional flu seasons hit, cases will rise. COVID-19 ain’t going anywhere folks and I don’t know if you’re paying attention or not, but hiding doesn’t help.

Japan is one of the most mask compliant societies in the world and yet:

Hawaii has one of the most strict and longest lockdowns of any state and they are…well…and bunch of islands and yet:

Meanwhile in New York where cases exploded early before real prevention measures could get in the way:

And here are the deaths of the much-maligned genocidal Swedes that never locked down:

It’s almost like all these mitigation measures at best prolong the inevitable and the only way out of this is to get through it. “But New Zealand did it for 100 days?” New cases reported this week and growing.

You can hide for a while, but a virus is gonna virus. And Andy’s plan seems to be one of hiding rather than getting through this while protecting the most vulnerable (LTC Facilities especially). The lack of transparency around a plan is not enough for me to accept all the ‘recommendations’ or my new ‘responsibilities’ without pushing back a little.

It’s not about my rights? Yes it is. It always has been.

Since I last wrote on the relative risk of COVID in Kentucky, a small but determined army of folks have pointed out that my arguments are that of an “emotionless thug” or a “manipulative hack that is preventing us from solving the pandemic” and that stats, graphs and one tenth of a blue box are none of the above—these are human beings. And they are correct. These are people. COVID is real and people are dying. Hell, maybe I’m next.

People die all the time of lots of things—even those this emotionless thug has loved—but enforcing limitations on my life without showing the rationale, full contextual data and the plan to emerge from this is not something I can support. For those who disagree with this perspective and my points, that’s fine. But have you ever thought about why you don’t you need the same information before surrendering your way of life? And if you want me to accept my responsibilities and Andy’s recommendations, show me the plan, the rationale behind it, the data that supports it and the steps to emerge from it instead of the heavily spun, unintelligent, half-truth marketing campaigns meant to scare me into conformity.

I am citizen of the United States of America and it is always about my rights—even when there is an increased risk of dying. Even when others are scared. Even when you don’t want it to be that way. And if you’re scared of what COVID-19 is and will do—just stay home.

 

All data has been compiled from kycovid19.ky.gov, testimony from Dr. Steven Stack and the CDC. The results are calculated and analyzed over a period from March 2020 through August 13.