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Those of us in California, Illinois, and New York are on lockdown. Is it just coincidence  that at this time, that those states which are the most affected by this Wuhan virus are blue states? Now before you go off thinking that I am some sort of anti-blue-ite, my answer is “not likely a coincidence at this point as places with a higher population, or more accurately a denser population are higher risk areas . . . Los Angeles, San Francisco, New York, Chicago, Seattle, etc. However, we do not know what the actual incidence is in these places. In certain places we know how many cases there are, and how many have died, but we can only estimate what the actual incidence is. How many have this virus, but have little if any symptoms? We don’t know. Statisticians can give an estimate, but how good is the estimate? We don’t know.

I think that a random estimate should be done, perhaps a couple of times per week, to more accurately access the progress, or lack thereof, of this deliberate strangulation of our economy. For instance, I would suggest a random sampling of the people in, let’s say, in Los Angeles County. If 100, or perhaps 1000 random people were tested, we would then have an estimate of the actual incidence of infection in Los Angeles County, and then we would then be able to compare this incidence to the incidence last week or next week to see if any progress has been made. If the incidence is not decreasing or even increasing, then perhaps the logic of these lockdowns should re-considered. Likewise if the incidence were decreasing, then perhaps the pain from these lockdowns is worth it. 
In the future, at some point, a decision will have to be made to lighten up or not lighten up on lockdowns. When that time comes, how will we know if a relaxation is a good idea? To me the answer is obvious . . . test 1000 random people and see if the decreasing incidence is maintaining or not.
There is no segue here . . . just a few more random thoughts:

-In the Midwest, there are lines outside the doors of stores that are selling guns!

-When this is over, there will be a lot of thinner dogs (having been walked multiple times a day), and a lot of heavier people (having been trapped inside, snacking incessantly)!

-Companies will learn that a lot of people can work very efficiently from home. Some may ask, “Why have large office buildings with all of the overhead that goes along with these large offices?

-A lot of parents will discover that home-schooling is very efficient, and the kids actually like it, and some learn more.

-College students and their parents will ask, “Why are we paying these outlandish tuition costs when a significant number of classes can be done on-line, and then be repeated again and again for years with no additional input from the professors?”

-Does anyone else find it ironic that those who are going to suffer the least health-wise from this virus (the young) are going to suffer the most economically from this remedy (shutdown), and vice-versa, those who will potentially suffer the most from this virus (the oldest among us) will suffer the least economically (I haven’t heard any rumors about the stopping of Social Security checks).

-Is it also somewhat ironic that this so called, “vindictive” President appears to giving the most help to those states whose Democrats have called him such!

If you were to advise your children/grandchildren what to take in graduate school, what would you advise them? The obvious hackneyed response is “Make sure that you go into something that you like doing.” No one would disagree with that. Practically speaking, one obviously shouldn’t get an MBA, if he/she really doesn’t like numbers. Likewise, practically speaking, for the most part, one should not go into medicine or dentistry, if he/she doesn’t  like interacting with people, as for the most part, that is what they will be doing all day.

However, these days the college loans and the paying back of these loans is a big deal. One may enjoy the arts, but it is wise to rack up huge debt with a Master’s in the arts . . . and as a result not be able to afford a house? I guess one could get a Master’s in Social Work, for instance, and hope that “President Warren” will forgive all education debts . . . not very realistic or practical!

As far as graduate degrees are concerned, which are best in terms of indebtedness compared to median earned income after three years? The average income at three years is a measure, albeit not perfect, which in essence helps determine how rapidly one’s education loans can possibly be paid off.

Consider the following graduate degrees, and rank them according to the median debt incurred vs. median income three years down the road:

-Law

-Medicine

-Dentistry

-Pharmacy

-MBA

-Master’s (science, engineering)

-Master’s (arts)

-PhD

Remember getting a degree in a lot of the higher paying occupations will also cost much more meaning more debt.

The following (median debt – median income at three years) is from Earnest.com :

For a Master’s (arts)($57k -$64k),Medicine ($200k-$204k), and Law ($122k -$121k). With these the salary at three years is about the same as the debt incurred.

For a Master’s (science, engineering) ($61k-$87k), a PhD ($65k-$91k), and an MBA ($$64-$115) the median income at three years is much better than the average debt incurred.

The worst bang for the buck . . . Pharmacy ($$132k-$122k) and Dentistry ($220k-$155k). Dentistry incurs the largest imbalance, and it’s not close.

So practically speaking, brush and floss regularly, starting now, as in years to come,  it will be significantly more and more expensive to go to the dentist.

Today somebody asked me my opinion of the Wuhan flu. I will start out by saying that I think that it is similar to what influenza was like before we had flu shots. Prior to flu shots everybody was at risk for the flu, and many who were older and more infirm, died as a result of the flu. How is that different from the Wuhan flu of today? I do not think that it is much different. 
There are three basic differences:

-This flu is much more contagious than in prior years. On average a single person with this Wuhan flu will infect more than two others.

-The incubation period is much longer, and so a lot of the person to person spread occurs before the one with the virus is even aware that he/she has it. This long incubation period just adds to the spread.

-The world is a much smaller place than it was years ago. Travel is much easier, and because individuals can go from China to the U.S. to Europe in just a day or so.

But in the end the Wuhan flu is still the flu. A bad flu . . . Yes, but the flu, nonetheless. Will people die from it? Yes, and like basically all illnesses, the older you are,  the less likely that you are going to do well. At my age my mortality rate is statically about 7% if I catch it . . . but this means that I have a 93% chance of recovering.
I have had the regular flu in the past. I did not like it. I felt like crap for weeks. If I catch this one, I will not be a happy camper. Don’t get me wrong, I am doing all of the usual things to prevent me from catching it      .  . . hand washing, purell, etc., however we are still watching our grandkids and going shopping for groceries. Our life style will take a minor hit, but que sera,sera.

Right now my biggest concern is the an economic one. I am not sure at this point in time if the economic damage that is going to be done will be worth it. Many people will lose their jobs, and a lot of these jobs will not come back in the near future. IRAs and 401K are being destroyed. In 2009, the Swine Flu, H1N1, started off like gangbusters. Lots of people died, including children. The economy took a hit, but the country survived without the draconian measures that are being taken today. I sometimes wonder if the difference is that 2020 is an election year, and 2009 was not.

In the end, go with the flow, say your prayers, and stay safe., and as someone I know said, “Use gloves to get your mail!”

In my last blog I talked about the importance of the denominator when talking about the incidence of and the mortality of the Wuhan flu.  
(Incidence of Wuhan flu = # of people infected/ total number of people). The dilemma: Is the denominator the total number of people or the total number of people tested ?The true incidence should the number of cases in the total population, not the total number of people tested. If the denominator is only the number of people tested then the “incidence” will be estimated to be falsely high. If we use the total population, then the true incidence is actually very very low. Look at the following numbers:       
U.S.A.: 3813 cases/331,022,651 population = 0.0011 % incidence. Washington State: 769 cases/ 7,800,000 population = 0.0098% incidence. California: 458 cases/ 37,253,956 population = 0.0012% incidence. New York: 740 cases/ 19,440,469 population = 0.0038% incidence
One of the critical points in today’s Wall Street Journal article by Neeraj Sood  addresses the question of the true incidence of this Wuhan flu. First off let’s be clear, Mr. Sood is a professor at U.S.C’s Schaeffer Center for Health Policy and Economics, not some schmo like me!  He suggests random testing to estimate the actual incidence of the Wuhan flu in certain populations. 

The other issue in this article: “Is the Wuhan flu actually much different from the typical influenza that we see in the U.S. virtually every year in the fall and winter?” Certainly this Wuhan flu seems to spread faster (RO > 2), and it is especially deadly for the elderly, especially those with other medical issues, and especially-plus for those in the close confines of nursing homes. But is it such a scourge that basically all of the Western world (basically all of Europe and North America) should come to a standstill? Is this Wuhan flu threat worth the economic disaster that is coming . . . a major economic disaster!
I guess the answer is: “Yes it certainly is to the elderly!”

But what about to the rest of us?  
(BTW: I am in one of the higher risk groups,  but I have to finish this now because I am going to the gym.)

In the Wall Street Journal on 3/14/20 there was an article comparing the Wuhan flu (coronavirus) in South Korea vs. Italy. The main drift of the article was comparing the populace of an Eastern culture with that of a Western culture. To paraphrase, the influence of Confucianism in Eastern cultures emphasizes respect for authority, and the good of the nation above individualism. In contrast in Western cultures there is widespread skepticism  toward authority. Take for example, the public pressure that forced the relaxing of a 6 p.m. curfew on bars in Milan. Oops!

The other significant thing that I noticed in this article was “ the influence of the denominator,” which turns out to be a very significant influence of any statistics. For those of you who are somewhat math handicapped, I will try to explain. It is actually a very simple concept. Basically, if the denominator increases while the numerator stays the same, the resultant percent decreases. 

Italy and South Korea have comparable populations. although Italy has about 15% more people. . . . Italy = 60 million, South Korea = 52 million. In Italy, initially, testing for the virus was restricted to those with symptoms (about 3,000 tests per day) whereas South Korea was performing more than 15,000 tests per day. The incidence of the Wuhan flu was the following:

Italy = 17,660 cases/ 97,488 tested for incidence of about 18%. So.Korea = 7,979 cases/240,668 tested for incidence of about 3%. So what is the true incidence of infection? . . . it depends on the denominator. Likewise, for the mortality:
Italy = 1,286deaths/17,660 cases for a mortality of about 7%. So. Korea = 67deaths/7,979 cases for a morality of 0.8 %. So what is the true mortality? Here it is a bit more complicated, as it depends on who is included in the denominator. If the denominator includes all of those tested, many of whom were minimally symptomatic or even asymptomatic, (South Korea) then the number of cases in the denominator will be skewed, and the mortality will be much less. Likewise, if the denominator is made up mostly of older, sicker people, (Italy) the denominator will also be skewed, but in the opposite direction. The same will apply here in the U.S. . . . what is the denominator? If, as is the situation in Washington State, the denominator is predominately made up of those in nursing homes and their close contacts, then the mortality will be much higher than the overall mortality once drive-through testing becomes widely available and the denominator is drastically increased.

So how dangerous is this Wuhan flu? It depends on the denominator!

From now on I am going to refer the the present outbreak as the “Wuhan flu.” Why? Well basically it is a variety of influenza similar to what we get every year. Obviously, there are some significant differences. The most significant is its ability to spread rapidly, because of two things. First,the RO, (which tells us how many are likely to be infected from a single individual) is above 2.0. In other words it is likely to be easily spread from person to person. Adding to its “spreadability” is the fact that it has a significantly longer incubation period than the typical virus, upwards of two weeks, and so people can spread this infection for a long time before they realize that they are sick.
How does the Wuhan flu measure up with yearly and other more serious past flu epidemics? 
Seasonal influenza is bad enough. It is estimated that kills between 3,600 – 49,000 people in the U.S In a year, and between 250,000 and 500,000 globally.
We know that the present outbreak is not as deadly as the SARS epidemic of 2003, which killed about 10% of the 8,098 confirmed cases of the respiratory illness In 2012. And the Wuhan flu is far less deadly than the 2012 MERS, which killed about 34% of approximately only 2,500 confirmed cases.

In 2009-2010 it was the Swine flu (H1N1), which infected 61 million Americans and killed about 12,000, which included 282 children. To me this is a quandary. Why are children and young adults either less susceptible to the present Wuhan flu, or perhaps, better said, less likely to have a severe form of Wuhan flu? For instance, in China the mortality for those <40 years old was 0.2%, and similarly in South Korea, where in those younger 60 years the mortality was quite low. In other words this Wuhan flu appears to be significantly less severe for those < 60, and even progressively less severe, the younger one is. Why?

Follow me with this logical presumption . . . a large percent of common colds are due to garden variety corona viruses (obviously different strains). Could it be that because young children are “sick, just about all the time with snotty runny noses,” they have a lot of antibodies and thus a relative immunity to the Wuhan strain of the corona virus? If this postulate is true, then I would expect that pre-school and kindergarten teachers would be less likely to get this variety of flu. 

We’ll see.

I would guess that most of you are familiar with Jim Acosta. Yes that schmuck who is the chief White House correspondent for CNN. I have to admit something embarrassing. Today I found myself agreeing with that CNN loudmouth! Now before anyone jumps to a foolish conclusion . . . no, I was not watching CNN, as my TV still, for some reason, cannot get CNN.

Actually I was watching Mike Pence and his daily update on the coronavirus on Fox News. At the end, as usual, there was some time for questions. Many of the questions were thinly disguised attempts to trap the Vice President. One question had to do with whether President Trump should order the closure of all schools. This was one of those “you can only be wrong” questions . . . If you say “no, do not close the schools,” and a large high school has a student with the virus, you will get fried in the press. On the other hand, if you answer, “yes, close all the schools,” and there is not one case in a student, then you will get fried because you have disrupted the lives of millions of families by making the kids stay home. The answer given was at this time to let every state decide for itself, as it would be ludicrous to close all the schools in a state that has only a few, or even zero cases.

Next it was Jim Acosta who in essence asked why the President is still going around shaking hands, when that is one of recognized ways of spreading this disease. The answer was actually a mumbled ridiculous hodge-podge of an answer that avoided the question.  Here, drum roll please . . . I agree with what Acosta was insinuating. President Trump should not be shaking hands with anybody for basically two reasons. First, to set an example for the rest of the country, he should not be shaking hands in public. And in addition, for his own safety he should not be shaking hands with anybody in public or in private. I certainly would not put it past some liberal nut-job to try to purposely try to shake hands with the President, solely to give him the coronavirus!

The last question had to do with the President and his “Make America Great “ rallies., “Shouldn’t he cancel these rallies?” No real answer was given to that question either, but rather another Tennessee two-step answer that really was not an answer. Again a question with no real answer, but actually the only good answer should be “yes, he should cancel them for the time being.” Again here my reasoning is two-fold: first, lead by example Mr. President! And second, why risk infecting the avid Trump fans at these rallies, when some liberal nut-job could be there specifically to infect Pro-Trumpers?

You heard it here first!

Two of the Democratic strongholds are in for big trouble financially in the near future. First let’s consider  Cook County, IL(Chicago). The American College of Cardiology (ACC) just this morning at 9:36 EST, cancelled its annual convention scheduled for Chicago at the end of this March. In the past, this convention has had upwards of about 15,000 attendees. With drug company reps, and spouses of physicians and nurses, this number typically rises considerably. Now in one fell-swoop, the rug was just pulled  out from under The Windy City. The sales tax rate in Cook County (Chicago) is one of the highest in the country, and so the millions of dollars that was going to go into the city’s coffers . . . Poof! Gone! Hotels, restaurants, and their suppliers . . . suddenly nada, and big big loss of tax revenue for the city. Likewise, taxis, ubers, airport shuttles, etc., also nada, and so it goes. Less and less tax revenue for a city already deep in the hole.

The other big Democratic stronghold that will find itself in big trouble because of COVID-19 is California. As I am sure most everybody is aware California has one of the highest income tax rates in the country. When a recession hits, and make no mistake there will be a recession because of COVID-19, states with highest income tax rates will be hit the hardest. Hollywood will take a significant hit, as who is going to want to go to a movie theater and sit with a lot of strangers? A big hit to Hollywood revenue means a big hit to California. Less income to Hollywood means less tax revenue to California. California has three NBA teams and if these games are cancelled or played before empty stadiums, another big hit to the Golden State. Likewise with the five  Major League Baseball teams. Apple has been making most of its iPhone components in China, and less iPhones means less Apple revenue, and so less tax revenue for the Sacramento politicians to spend. Here I have mentioned only the big players in California, but coming recession-associated job layoffs will take another big toll on Californians taxable incomes.

Californians, gird you’re loins.

You heard it here first!

The last I heard this Coronavirus (COVID-29) is in 99 of 195 countries, and has infected over 105,000 people. Keep in mind that these numbers are increasing almost every hour, and certainly every day. Some are comparing COVID-19 to the 1918 flu pandemic, which, according to the CDC, had a mortality rate of > 2.5% compared to a mortality of <0.1% with other influenza pandemics. The WHO has recently revised the mortality rate of COVID-19 to 3.4%.

Okay, wash your hands and keep them away from your face. Now, just about everybody has heard these simple precautions, but yesterday I still found workers at various businesses extending their hand to shake my hand. This is discouraging news, as this is a relatively simple way to spread this infection from person to person. The estimated R0 of COVID-19 is 2-3. (This means the the average infected person will spread this infection to 2-3 others.) According to The Lancet, this suggests that 50-60% of the population could well eventually be infected, because the population is naive to this new virus.

This is all bad news!

How should individuals, and how should the country approach COVID-19? Obviously the U.S.A. cannot impose mandatory quarantines on individuals, like was done in China. Individuals could certainly quarantine themselves . . . but for how long? What is practical?

 Should individuals voluntarily restrict themselves from situations where there will be large crowds? Some would say, obviously yes, but what if you had tickets to March Madness? These tickets are not cheap, and you may have been waiting a long time for them. Going to a Final Four game may be on your Bucket List. What to do? What is practical? 

In the same vein, the games that lead up to the Final Four will also expect 10-20,000 or so at multiple games on multiple different days at multiple different sites, all high population centers. Would anyone dare recommend that the NCAA cancel this tournament? Perhaps these games should be played in empty arenas, devoid of fans. What is practical?

In Italy, there have already been soccer games played in empty stadiums. Of course, there is an ongoing outbreak in Italy, so this restricting of the fans seems logical. However, in San Jose, the profession hockey team (N.H.L.) reportedly refused a request to play its game in an empty arena, as was suggested. There are multiple professional basketball, professional hockey, and professional soccer games being played every day. Just about all in high population centers. Should these be cancelled or be played in empty arenas or stadiums? What is practical? 
Should the fact that every restriction and cancellation will have an economic consequence be of any importance? Cancelled airline flights, cancelled conventions, cancelled sporting events, and cancelled festivals all have economic consequences. For example the upcoming South by Southwest (SXSW) festival in Austin typically attracts about 100,000 people. Should it be cancelled? What would be the economic consequences for the city of Austin? What is practical?

I do not pretend to have the answers to these practical questions, but keep in mind that “you ain’t seen nothin’ yet”!

When one thinks of Chuck Schumer, does the limbo come to mind?  It does to me!  I am hearing a lot mumbling, some “WTF-ing!” But bear with me.
When his obit is eventually written, what will be its predominant theme? What will he be remembered for? What adjectives will be used to describe his “illustrious” career?Will he be remembered as a lawyer? After all he did go to law school. However, despite the fact that he graduated from Harvard Law School in 1974, he has never practiced law. So no, he will not be remembered as a lawyer.

Will he be remembered as being obstreperous? (Yes, I had to look up this word this word also!) To rephrase the question . . . will he be remembered as noisy, clamorous and boisterous? . . .Yes, probably!
Will he be know as a foreign policy guru? Unlikely, as never conducted any foreign policy. He has never sat across a negotiating table, other than one with other politicians.
Will he be known as a garrulous partisan who exaggerates and blows things out of proportion? Ummm, yes, he does fit this description. For instance, last year he referred to the handling of illegal immigrants and their children as “the worst thing I can have ever seen in America.” Perhaps Chuckie has never heard of the Japanese internment during WWII, or worse yet slavery, with hundreds of thousands of human beings being denied liberty, forced to work long hours, live in miserable conditions – and being beaten or worse. Schumer should be reminded of the thousands of families that were separated in the slave markets and the women raped without legal recourse. When I think of Chuckie, I immediately picture him standing next to Nancy Pelosi,  giving the world his impression of a docile lapdog.
All that notwithstanding, his actions lately have firmly implanted “limbo” in my mind whenever Chuckie’s name is mentioned. (Although I do not know him personally, I doubt that he will be remembered as a dancer! I can’t even imagine him trying to squeeze under the limbo pole.) 
So why “limbo?”  Chuckie’s threatening of Supreme Court Justices earlier this week is beyond the pale, and will forever remind me of the chorus of “Limbo Rock” by Chubby Checker . . . “How low can you go?”
3/6/20