99-Year-Old 'Piano Man' Lights Up the Internet

by Brian T. Lynch, MSW

This blog is to honor my 99-year-old father-in-law, Henry Shapiro. He has been playing piano professionally since he was 13 years old and is now performing on Facebook Live every Saturday at 5:00pm to help lift everyone's spirits during this pandemic. He is an inspiration to his many fans. You can learn more about him via his Facebook page (run by his wife)

https://www.facebook.com/photo/?fbid=112693745774618&set=a.112694182441241

Henry was featured on CBS News recently.

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99-Year-Old 'Piano Man' Lights Up Internet, Brings Joy In Face ...

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Apr 22, 2020 - MORRIS COUNTY, N.Y. (CBSNewYork) 

The following is a link to a feature About Henry that was recently published by NJ.com, a New Jersey news organization.  http://nj-ne.ws/AD4BNdh

For your enjoyment, I am posting YouTube links to just a few of his Saturday at 5pm concerts. For more, search him in YouTube using "Henry Hank Shapiro" Feel free to share these with friends and especially with parents or grandparents who would appreciate Henry's style and song selections.

28:55NOW PLAYING

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Henry Hank Shapiro June 6, 2020

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102 views3 weeks ago

Hank will be 100 in September 2020. Enjoy his Saturday pandemic gig! https://www.youtube.com/watch?v=0zzVwl-9z20

34:12NOW PLAYING

Henry “Hank” Shapiro March 28, 2020

R Lynch

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253 views3 months ago

5 pm Concert #3. Henry Shapiro, 99 1/2, live streaming during the pandemic.https://www.youtube.com/watch?v=WRbsfP9M79s

30:55NOW PLAYING

Henry Hank Shapiro June 27, 2020

R Lynch

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52 views3 days ago

Hank will be 100 in Sept! You can hear his passion for music in this Sat live Facebook gig during the pandemic. https://www.youtube.com/watch?v=tXC62YMQ9A8&t=102s

30:29NOW PLAYING

Henry Hank Shapiro 99 years old

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https://www.youtube.com/watch?v=2ph2e_6-h0o&t=643s

New COVID-19 Spikes Not Due To a Surge in Testing

by Brian T. Lynch, MSW

The media says COVID-19 testing rates are much higher than they were initially, and that this fact might help explain some of the increase in diagnosed cases. Out President says we should SLOW TESTING DOWN because we are finding new cases. He says this trying to imply to his base that testing causes cases when, of course, more cases make him look bad. Scientists have been saying for some time that by this point we should have between 5 and 10 million tests per day to safely open.

In other words, everyone should be tested monthly or every two weeks for the virus. Our 7-day average of daily COVID-19 tests as of June 27th is 541,283 tests. And if you look at the bar chart and trend line below, THERE IS NO SURGE!

What we see from the data is the gradual rise in testing numbers over time. If there was a surge at any time, it happened back in mid-May and then it faded away. So any talk about how the increased test is responsible for the current surge in confirmed infections is just not accurate. 

 

Data source: Worldometer.info. The graph is by Brian T. Lynch. It was last updated on July 6, 2020.

And our testing numbers are not good when compared with other countries. We are 26th in the world for tests per million. We are orders of magnitude away from that goal, and our situation compared to the rest of the world is obvious. The graphic below shows how we are doing compared with the EU. The biggest problem we have is politicizing of wearing surgical masks in public.

And here below is the seven-day moving average of daily testing numbers beginning on May 2, 2020.

Racism and Police Homicides in America

by Brian T. Lynch, MSW

Once again, an egregious police homicide of a Black man caught on videotape shatters the calm and erupts into national protests and outrage. This time it is George Floyd of Minnesota. His life was slowly squeezed out of him as he lay bound and helpless while a seemingly depraved and indifferent cop pinned Mr. Floyd’s neck to the pavement with his knee.

PHOTO: Minnesota State Patrol and National Guards stand in Minneapolis, Minnesota, Photo Date: 5/29/2020 - https://www.newscenter1.tv/minneapolis-overwhelmed-again-by-protests-over-floyd-death/

Once again, the eyes of the nation turn towards the seemingly intractable problem of racism that, among its many forms, would cause African Americans to be nearly twice as likely to die at the hands of law enforcement than White Americans. Racism is our greatest barrier to becoming a more perfect union and at present, the racists seem to have ascended to power.

And once again, this despicable racial killing by a cop in broad daylight has ignited a blaze that masks an underlying outrage behind the numbers. About one-thousand American civilians are being killed every year by our civilian police force. From January 1, 2015, through December 31, 2019, there have been 1,179 police homicides of Black citizens, 2,242 homicides of White citizens, 843 police homicides of Hispanic civilians, and a total of at least 4,947 civilians killed by police.

Data is from the Washington Post database. Analysis by the author. 

Civilian homicides by police always rise to public attention because they so disproportionally target African-Americans. Once the problem is framed as a systemic racial issue the proposed remedies never reach beyond the disproportionality question. The fact that our highly aggressive and militant police training is resulting in thousands of needless deaths never comes to light. Until that is addressed, the proposed solutions will never be to anyone’s satisfaction.

Data from the Washington Post database. Analysis by the Author

Civilian homicide rates by law enforcement in America are orders of magnitude higher than in Great Britain, France, or Germany. Yet, the actual number of civilian deaths could be considerably larger still. There is no mandatory federal tracking of homicides caused by police in the line of duty. Federal reporting is all voluntary and spotty at best. The countries best numbers come by combing through local newspaper accounts and gleaning what can be learned from the public account of police-involved civilian deaths. This civilian effort to track police homicides only started about five years ago. It is an imperfect system. Clearly, not all police shootings make it into the local newspapers. The information reported is rarely investigated by local reporters. They are the accounts given to the press by the local police officials. And there are undoubtedly police-related fatalities of civilians that are never reported in the local press.

No racial activist would be or should be satisfied if successful remedies to the racial problem merely end racial disparities. In practical terms that would mean about 103 fewer Black minority deaths each year while still tolerating 133 annual minority homicides. It would be equally crazy to accept 448 White civilian death by the police as long as this carnage is in proportional to the number of Blacks and Hispanics that are also killed each year.

Data is from the Washington Post database. The analysis is by the author.

The militarization of the American police force is a big part of the problem that must be addressed. If German laws and police practices were adopted here, adjusted for our larger population, the United States might expect only about 40 police homicides per year, mostly justified uses of force, as opposed to nearly 1,000.

The arguments for this position on police homicides are in numbers found in the tables I created from the data contained in five year’s worth of information collected by the Washington Post. Seeing all the names as you scroll down that database of the dead is sobering, like visiting the Vietnam Nam War Memorial. 

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https://link.springer.com/article/10.1007/s11524-020-00430-0#author-information

https://en.wikipedia.org/wiki/List_of_killings_by_law_enforcement_officers_by_country

https://www.statista.com/statistics/319246/police-fatal-shootings-england-wales/

https://en.wikipedia.org/wiki/List_of_killings_by_law_enforcement_officers_in_Germany

https://www.theguardian.com/us-news/ng-interactive/2015/jun/01/the-counted-police-killings-us-database

https://www.washingtonpost.com/graphics/2019/national/police-shootings-2019/

https://www.ajpmonline.org/article/S0749-3797(16)30384-1/fulltext

https://www.theguardian.com/us-news/2015/dec/31/the-counted-police-killings-2015-young-black-men

https://www.washingtonpost.com/graphics/investigations/police-shootings-database/

Honoring a WW II Veteran on Memorial Day - My Dad

IN MEMORIUM, MAY 25, 2020

Peter Joseph Lynch Feb. 2, 1922 - Aug. 11, 1982

Peter J. Lynch immigrated to America from Athboy, Ireland, with his mother, Ellen, in 1938 when he was 16 years old. They came to Morris Plains, New Jersey, to locate and reconnect with Peter’s father, Thomas Lynch, who had come here 10 years earlier to find work and support his family back in County Meath.

Peter discovered he had natural mechanical abilities from an early age when he was given a broken- motorbike with a blown engine. He managed to get it running again from spare parts that he walked miles to secure. His success was met with the chagrin of the local constabulary in Kildalkey who sometimes chase the lad about to keep him off the roads. When he and his mom arrived in America, Peter landed a job at an auto repair shop in Morris Plains.

Three years later America was at war. Faced with a US Army draft notice, Peter enlisted in the Army Air Corps (now the Airforce). He tried to sign up to be in the tank corps, but the recruiter was out to lunch. The Air Corps recruiter grabbed him and convinced him to become a pilot instead. Peter ended up at a flight school in Arizona where he completed his pilot training but then failed to pass his final physical before certification. He was told he was half an inch too short, so the Air Corps assigned him to be a tail gunner in a bomber crew flying the B-24 Liberator. He was disappointed, but this was probably a fateful piece of luck.

Before his deployment to England and bombing missions over North Africa, the Air Corps granted Peter his United States citizenship, an honor he lived up to for the rest of his life. During WW II it was understood that there was no greater test of loyalty than a soldier who is willing to fight and die for this country. Sadly, this is not the case today. We have many non-citizen combat veterans who are unable to take advantage of the benefits other veterans and citizens enjoy.

When the United States officially entered the war in Europe in December of 1941, direct military assistance in North Africa followed quickly, beginning on May 11, 1942. From his assigned airbase in England, Peter would crawl into the bubble at the tail end of a B-24 in the pre-dawn hours during bombing missions over North Africa. The flights were cold, dark, noisy, and bumpy. The targets were General Rommel's panzer divisions' supply lines and front lines. The immediate goal of a tail gunner was to keep up a steady stream of fire when German fighter planes were near so the German pilots would see the arch of tracer bullets and stay clear. As long as his gun didn’t jam this was usually enough to keep the enemy at bay. But the German flack that exploded around them was another matter.

When Peter’s bomber returned to base in England after their North African run, he would crawl out from his gun turret and stare in disbelief at the shafts of light where German flack pierced the skin of the aircraft. How long before a disaster? He decided that the odds were against him, so he applied to the Rolls-Royce airplane mechanics school and was accepted. After his training, he spent the rest of the war more safely on the ground repairing planes by day and visiting the pubs at night when off duty. But his contribution to the war effort didn’t end there.

Sometimes, on his off days, Peter would watch the other men in his company at work, changing the tires on the B-24s. It was an arduous process involving a team of four to six men with pry bars and sledgehammers to break the tire’s seal and force the tire over the lip of the rim. It took the men over an hour per tire. Peter and a buddy of his (sorry, but I don’t know his name) decided to come up with a better way. They tinkered around in the shop in their free time until they invented the world’s first electrically operated tire changer. It was an immediate success and greatly reduced the turn-around time for the U.S. bombers. He was written up in the local Morristown NJ newspaper for this contribution to the war effort, but credit for this invention was otherwise the property of the US government, and he was OK with that. 

Perhaps the most difficult days of Peter’s service career began on the morning of August 23, 1944. He was stationed at the Base Air Depot 2 - Warton, in Freckleton, England. The base was home to 10,000 American servicemen who worked on fixing and retrofitting US airplanes. As he walked across a field that morning an American B-24 Liberator Bomber flew very low overhead, obviously in serious trouble (It had been struck by lightning in a storm). It crashed just up ahead of him into the Sad Sack Café on Lytham Road. Across the road was the Holy Trinity Primary School where 176 children were in attendance. Part of the bomber crashed into the infant classroom and burst into flames. The crash killed the crew of three and 58 civilians including 38 children. Peter was among the first airman to arrive at this horrifying scene. He spent the next 48 hours straight digging through the school's rubble to recover the children's bodies.

After Germany surrendered, Peter remained stationed there as part of the occupation forces while awaiting the expected redeployment to Japan. That never came as Japan surrendered soon after.

Peter Lynch survived the war and returned home to Morristown, New Jersey. He took a job at Sears and Roebuck as an appliance repairman, married my mother, Nona Taylor, and raised two children on a shoestring budget in Jefferson Township, NJ. He joined the American Legion Post 245 in Jefferson, proudly serving as Commander for several years. He died at the age of 60 in 1982 and had a soldier's funeral.

Today, on this 75 Memorial Day since his discharge from the Army Air Corps and 38th Memorial Day since his passing, I wish to honor him with this brief account of the years of his youth that he gave in service to our country. Thank you for your service, Dad.

Brian T. Lynch, MSW

Staying Safe as We Open Up in this 2020 Pandemic

by Brian T. Lynch, MSW

As we flood back out into the world after Memorial Day of 2020 to remember our fallen soldiers, let’s remember the fallen in this viral war we are fighting today. If you plan to head out to the beaches, locker rooms, barbeques, churches, or synagogues, first remember to honor the lessons taught to us by 100,000 Americans who have already died. They are telling us that we cannot wash away this modern plague. We can not pray it away or wish it away. Until we control the virus through testing, isolating, and contact tracing, or through vaccinations, we are on our own. We must protect ourselves and everyone around us from the air we all breathe.

First, we need to understand that a virus is not a bacteria. Bacteria are small cellular critters that live on surfaces and feed off of the residues of film and grime that cover every surface. Bacteria are alive in most meanings of that word, and if you pick up enough of them on your hands, and touch your eyes, nose, or mouth, you can infect yourself with them.

Viruses like COVID-19 are 100 times smaller. They are mere strands of genetic material with no living activity when not in contact with host cells. They flit about in the air for a time, some of them floating around in moisture droplets released into the air that soon falls to the ground. Other virus strands end up in much smaller aerosol particles that stay suspended in the air for hours until they are sucked into your body when you take in a breath (think MASKS). If you touch a surface recently sprinkled with moisture droplets containing the virus, and then touch your eyes, nose, or mouth without first washing or sanitizing your hands, you may also infect yourself. This is a less common way to catch the virus because these viruses don't stay intact long when the moisture dries up.

When COVID-19 viruses get sucked into your lungs from the air, they land on the surface of your lung cells (or other cells). They trick the cell walls into letting them come inside. This is when they become active. They take control of the cell and force the cells into replicating them wildly until the cell ruptures, releasing an army of clones into the surrounding tissue. Some of these clones attach to surrounding cells and slip inside to begin replicating again. Others are caught up in the air currents and get rushed outside the body in a breath, or a cough, or a sneeze (think MASKS).

The amount of virus in the air (called virus load) depends on several factors, including how sick a person is who is breathing out the virus, how close to a sick person's breath-cloud you are (think SOCIAL DISTANCING), the volume of air per person in a given enclosed space, the air exchange rate in a building or enclosure and the length of time that a sick person is breathing virus into the air in a room, for example (think MASKS).

The manner of a sick person's breath matters also. A cough releases a lot more virus than a breath and a sneeze releases a huge amount of airborne virus that travels at up to 200 miles per hour across a room (think MASKS). But as we learned the hard way, even one pre-symptom person singing in a choir can release copious amounts of virus in the air and infect nearly everyone else at a rehearsal.

Finally, our exposure to COVID-19 virus in the air is dependent on two factors, the virus load in the air we are breathing (again, think MASKS) and the length of time that we are breathing contaminated air. It's a little like radiation exposure in this sense. No amount of exposure is entirely safe, but the amount of radiation and the length of time we are exposed increases our odds of getting sick.

So, as you venture out in the coming days, don’t poke your nose into anyone’s breath-cloud. Keep your social distance. Wear a mask when you are in close contact with others. Always wear a mask in stores, gyms, churches, homes, or any other enclosure where you are not alone, and wash your hands. You don’t need a mask in the open air when nobody is near you, but keep it handy. Your life could depend on it.

TESTING-ISOLATING-CONTACT TRACING: How it Works and Why it Matters

by Brian T. Lynch, MSW

The daily testing numbers for COVID-19 actually shrank from the Saturday numbers in some sort of correction on the WorldoMeter.info site. The US consistently ranks about 39th out of the 212 nations and territories reported in the statistics. The total number of tests performed to date isn't enough to cover more than 3.6% of our population. Here is why this matters, and why experts say we need a minimum of 10 times more testing PER DAY than we have now.

TESTING - ISOLATING - CONTACT TRACING

• With testing, we find out who is infected
• With isolations, we prevent them from infecting others
• With contact tracing, we figure out the people with whom they’ve been in contact
• With quarantines, we prevent these contacts from infecting others  https://medium.com/@tomaspueyo/coronavirus-how-to-do-testing-and-contact-tracing-bde85b64072e

      

       NOTE: 

Isolation is the term used when people with symptoms are kept away from the publicQuarantine is the term used when people have been exposed but are asymptomatic

In the absence of a vaccine or effective treatment/prevention for COVID-19, the best way to get our infection rates (and death rates) under control is by testing people for the virus, isolating those who have symptoms or quarantining those who test positive, and by tracing their contacts to test them for the virus. This is the way this works to the best of my layman understanding.

1. TESTING - We need to test as many people as possible, at least millions of people per day. We need those test results to be returned immediately or ask people to self-isolate until the results are returned. If they test negative they are able to engage in the reasonable social distancing and prevention measures being advocated by the CDC. (ie: wearing masks, maintaining social distances, frequent hand washing, limiting the size of social gatherings, etc. Retesting at an appropriate interval will be required. For example, healthcare workers and first responders would need frequent testing while retirees living at home and mostly staying away from public venues would require less frequent testing.

2. ISOLATING - When a person tests positive for COVID-19 and has symptoms, they should be isolated from everyone, including their family. If they test positive but don't have symptoms they should go into quarantine for a minimum of 14 days (some researchers are suggesting a longer quarantine period). The must also be interviewed to see who they may have been in close proximity to in the prior days. (I don't know how long the lookback is.)

3. CONTACT TRACING - A team of contract tracers then determines who is at risk of contracting the virus based on the interview with an infected person and visits those potentially exposed people. These people should self-quarantine until they can be tested for COVID-19. And so the whole cycle of testing, isolating, and contract tracing continues forward.

This is how we can safely begin to reopen the economy and society while reducing the rate of infections and deaths. The key first step is adequate testing with rapid results. If we set a national goal of testing every person in the US for COVID-19 over the next 3 months, that would require administering 3.7 million tests per day. This is about 10 times the current daily average.

The next step is to hire and train a huge number of the currently unemployed people in this county to become COVID-19 test administers and contact tracers. With unemployment at record highs and so many people out of work, and with the country facing a possible "Great Depression" it should be the federal government hiring an army of contact tracers to help control the pandemic while stimulating the economy, as the WPA did 85 years ago.

Here below is a list of suggested readings with a brief synopsis:

Coronavirus: why testing and contact tracing isn’t a simple solution
://theconversation.com/coronavirus-why-testing-and-contact-tracing-isnt-a-simple-solution-137214
Talks about the limitations of testing and contract tracing and the conditions when a lockdown is needed. Gives examples of how many COVID-19 tests were needed per case in countries that were able to use this technique to control the outbreak (between 52 and 64 tests per case).


Effectiveness of isolation, testing, contact tracing and physical distancing on reducing transmission of SARS-CoV-2 in different settings
https://www.medrxiv.org/content/10.1101/2020.04.23.20077024v1

Abstract: "... Consistent with previous modeling studies and country-specific COVID-19 responses to date, our analysis estimates that a high proportion of cases would need to self-isolate and a high proportion of their contacts to be successfully traced to ensure an effective reproduction number that is below one in the absence of other measures. If combined with moderate physical distancing measures, self-isolation and contact tracing would be more likely to achieve control."

Contact Tracing: Part of a Multipronged Approach to Fight the COVID-19 Pandemic

https://www.cdc.gov/coronavirus/2019-ncov/php/principles-contact-tracing.htmlxcerpt: Contact tracing is part of the process of supporting patients and warning contacts of exposure in order to stop chains of transmission. Given the magnitude of COVID-19 cases and plans to eventually relax mitigation efforts such as stay at home orders and social distancing, communities need a large number of trained contact tracers. These contact tracers need to quickly locate and talk with the patients, assist in arranging for patients to isolate themselves and work with patients to identify people with whom the patients have been in close contact so the contact tracer can locate them. The actual number of staff needed is large and varies depending on a number of factors including but not limited to:

• The daily number of cases
• The number of contacts identified
• How quickly patients are isolated, and contacts are notified and advised to stay home, self-monitor, and maintain social distance from others

HEALTH DEPARTMENTS: Interim Guidance on Developing a COVID-19 Case Investigation & Contact Tracing Plan

https://www.cdc.gov/coronavirus/2019-ncov/downloads/case-investigation-contact-tracing.pdf

Provides a comprehensive plan for local authorities to establish a TICTs (Testing, Isolating, Contact tracing) plan. Excerpt: 

Contract Tracers: Communicates with contacts to notify them of exposure, provides disease and transmission information, gathers data on demographics, living arrangements, and daily activities. Asks about signs/symptoms and underlying medical conditions. Provides referrals for testing (if appropriate). May conduct home-based specimen collection. Provides recommendations for self-quarantine and reviews daily monitoring procedures. Assesses supports necessary to maintain compliance during self-quarantine. Conversations with contacts should be guided by standard protocols. Conducts daily monitoring during self-quarantine— temperature, signs/symptoms, use of fever-reducing medications—via an electronic tool (e.g., smartphone, case management software) or other designated mechanism, until 14 days after last potential exposure, and referral to healthcare if contact becomes symptomatic.**

What Is Contact Tracing? Here's How It Could Be Used to Help Fight Coronavirus
https://time.com/5825140/what-is-contact-tracing-coronavirus/
EXCERPT:

Once someone has been confirmed to be infected with a virus, such as through a positive COVID-19 test, contact tracers try to track down others who have had recent prolonged exposure to that person when they may have been infectious. Typically, that exposure means being within 6 feet of the person for more than 10 minutes, says Dr. Breeher, though in a health care setting, such as a hospital, the bar is lowered to five minutes.

Healthcare workers then make an effort to reach out to every one of those contacts, tell them that they may have been exposed, and giving them instructions on what to do next. That may include telling them about possible symptoms or directing them to self-isolate [ie: Quarantine].

What is contact tracing?https://www.theverge.com/2020/4/10/21216550/contact-tracing-coronavirus-what-is-tracking-spread-how-it-worksExcerpt: Contact tracing is based on an obvious idea: people in close contact with someone who has COVID-19 are at risk of getting sick. The process isn’t easy. When a person gets sick, they are then interviewed by public health officials and asked who has been exposed to them. Then they take that list and fan out to ask those people either to pay close attention to how they’re feeling or to quarantine. If a person who was exposed is infected, their recent contacts will be tracked down, too. The process continues until everyone who’s been exposed is out of circulation. That stops virus transmission.

An Alternative to Total Lockdown is Urgently Needed

by Brian T. Lynch, MSW

Forget the Swedish or the German model for controlling the COVID-19 pandemic. The United States should develop its own alternative model to control the outbreak, one based on science and the particular demographic data that have emerged about this disease.

An alternative approach is urgently needed because, a) a general lockdown of the entire country and its economy cannot be sustained for long, and b) the more obstreperous elements of our population, and the billionaire elites who may be pulling their strings, are already forcing states into lifting restrictions on everyone. We are heading into what will likely be a disastrously premature reopening of the economy

America is trapped in a binary choice between letting COVID-19 run its natural course or locking down society to minimize the infections and deaths until a vaccine is available. The ultimate civilized goal in a pandemic is to achieve herd immunity through vaccinations, or by any other scientific means that results in the least possible loss of life. In the absence of any civil interventions, a novel virus simply runs rampant through the population at exponential speed, making almost everyone sick and killing millions if it is a lethal strain. In the absence of vaccinations, people who recover from the novel virus are likely to develop antibodies that will prevent reinfection for some period of time, although there are exceptions. When enough people in a population have immunity following their illness or through inoculations, the whole population develops herd immunity. This means that even those people who are susceptible to illness when exposed to the virus are rarely ever exposed to it. They are safely buffered by the many people around them who are immune.

There are two demographic characteristics of COVID-19 morbidity and mortality rates that appear significant and potentially useful in creating an alternative approach to controlling the pandemic. The first is the very differential mortality rates according to age, and the second is emerging evidence that up to 50% of individuals who contract the virus never display any symptoms of the illness. Look at the mortality differentials first.

HIGH-RISK GROUP

CDC data (see table below) shows that 97% of COVID-19 deaths are of people 45-years-old or older. This agrees with data collected in Sweden, China, and other countries.  Also, death rates are much higher in people with underlying health conditions. From these data we know that there is a high-risk group that requires optimal protection from exposure to COVID-19.  It follows that any adults caring for people in this high-risk group also need to be optimally protected from exposure to the virus. High-risk individuals by age or underlying medical conditions and their caregivers should be allowed to remain in social lockdown in those states that are starting to life restrictions.

When the data in this CDC age/mortality rate table are pictured in a bar graph, the trendline reveals an exponentially rising mortality rate with age. It turns out that 97% of all COVID-19 deaths are of people over the age of forty-five.

A confirming set of data that looks at age and hospitalization rates produces a similar pattern (see below). This graph was produced by the CDC. And it does make sense that those who are more deathly ill would be more likely to require hospitalization. Taken together it makes sense that limiting exposure to this age-related high-risk group should lower both mortality rates and hospitalization rates, thus helping to prevent our health care system from becoming overwhelmed. 

Given how many nursing home and congregate care facility residents are getting sick and dying in the United States it would be tempting to believe that poor medical care in these facilities accounts for the high mortality rates, and this might skew the demographics on age and mortality in the data. There is an unacceptably high number of residents getting infected in these facilities, and this is on the corporations that run these facilities. But the high mortality rate of the infected residents may not be due to inferior care so much as the correlation between age and mortality of the disease. The publically available global data on age and mortality shows the same exponential rise in mortality with advancing age in South Korea, Spain, China, and Italy. (see below)

NON-PERSONAL-RISK GROUP

There is data that suggests as many as 50% of the population may carry the COVID-19 virus while remaining symptom-free. These people apparently test positive for the active virus but remain free of illness. During the period of their contagion, however, they remain a vector for exposing others to COVID-19. This makes them especially dangerous to others while they, and others like them,  are not at risk of illness or death themselves. Furthermore, if the bodies of symptom-free individuals ultimately eliminate the virus, these people may also develop antibodies to prevent another contraction of the virus. If their bodies have some other way of fighting COVID-19, that should be studied investigated as it might lead to effective new therapies.

A careful analysis of the characteristics of this non-personal risk group should be conducted at once to sees if researchers can reliably identify who is likely to be asymptomatic after exposure to COVID-19. If people in this category can be reliably identified, then at the least these would people for whom initial phases of vaccinations efforts would not be as critical. That would greatly focus resources while manufacturing of the eventual vaccine is scaling up.

MODERATE-RISK GROUP

If identifying individuals who are at not at personal risk of coronavirus illness can be accomplished without any special testing (say on a demographic basis) then identifying them would be advantageous for a number of other reasons. One advantage would be to create a middle group of people who fall outside of both the high-risk category and non-personal-risk group. This middle group of people would likely mildly to moderate symptoms when exposed to COVID-19.  This group of people would know that have to maintain appropriate safety precautions to prevent getting sick when they become exposed to the virus. The greater certainty of having this knowledge would help inform their decisions and behavior when reintegrating back into a less regulated environment as states begin opening up the economy.  These are also the people who would most benefit from testing, isolation, and contact tracing to control the spread of the virus. Being a smaller subset of the population, this would help target precious testing capacity and focus it where it would do the most good. When members of this group do recover from the illness, they will presumably have developed immunity that can allow them the non-personal-risk group. 

Reopening the economy will require a transition from our current Lockdown status to a Testing, Isolating, and Contact Tracing (TICT) strategy focused initially on adults re-entering the workforce from the moderate risk and no-personal risk groups. The availability of COVID-19 testing has to be significantly increased by perhaps a factor of 10 times the current rate nationally. Until a vaccine or effective treatment is available, TICT efforts remain the best hope for controlling infection rates.  This three-tiered method of controlling the virus would permit a safer means to gradually reopen the economy and relieve the economic burdens on us all. It would allow us to direct medical and economic resources to where they are most needed and most necessary. When a vaccine is finally developed, this approach would pre-identify those who need to be inoculated first, thus not wasting precious doses on those for whom it is not in immediate need.

Pie in the sky? Maybe, but it is worth consideration.

THE SWEDISH COVID-19 RESPONSE MODEL IS WORTH CONSIDERING

by Brian T. Lynch, MSW

The American Institute for Economic Research posted an article on May 6th by Daniel B. Klein that merits attention. It is a follow-up to a piece he wrote on Masks in Sweden. It seems that the Swedes have looked closely at the demographic of COVID-19 deaths in Sweden and decided that is was a relatively low-risk option to allow everyone below age 50 to work or go about their daily lives providing they used took sensible social distancing and infection avoidance precautions while everyone 50 years of age and above is expected to self-quarantine. This advice is based on the demographics of COVID-19 deaths in Sweden. It turns out that the risks faced by people over 50, or in poor health, are far greater than the rest of the population. Could that be true here in the USA?

Before answering that question, consider that from the Swedish perspective we have a binary way of viewing the problem that doesn’t allow us to think of any possible alternatives. Here is an excerpt from the Klein article:

“In fact, a more nuanced approach not only makes more sense, but is more sustainable. That is precisely what the Swedish approach is all about… If you look at the numbers, you will see that there is negligible risk to those aged 4-50 years old. This group also happens to represent the most economically productive group in society as well as the group that spends the most money. So why shut them down?"

What are the demographics of the virus in the United States?

The CDC has posted a table of provisional COVID-19 demographics on their Website. A portion of that table is reproduced below. It shows that the age demographics for COVID-19 mortality is much the same as in Sweden. As the subsequent pie chart below the table shows, fully 97% of COVID-19 deaths occur in people over 45 years of age. Here is a portion of the CDC data:

And here is the pie chart that highlights the significant differential in COVID-19 mortality risks according to just two age groupings: 

In Sweden, all at-risk people have been asked to self-quarantine, but the at-risk definition is for those most at risk of death. Also, anyone caring for or residing with those in the high-risk category are also asked to self-quarantine to help keep the at-risk people safe.

Using the Swedish model, The US could consider a gradual lifting of stay at home orders by age for healthy adults while maintaining sensible social distancing guidelines and heightened hygiene guidelines. At the same time, more resources could be focused on the at-risk populations in congregate facilities to slow down the contagion and fatality rates. The provision would have to be made to allow younger aged adults at risk due to underlying health conditions to self-quarantine without punitive consequences by their employers. It all does seem worthy of our consideration.

One question, perhaps the first question to bring up about the Sweden model is, is it working? To answer that in part, here is the Sweden graph of daily COVID-19 deaths from the Worldometer.info Website:

The answer seems to be relatively favorable given that the peak number of deaths is under 200 in a day and the trend is at least stabilizing after the peak. There are many other questions to be asked. however.  We shall see what happens over the next few weeks.