Corona Daily 462: Corona Fun Stories

News in pandemic times is not all gloom and doom. Some actually make us laugh.

Take the headline: ‘Corona beer stops production’. This is one of the bestselling Mexican beers across the world. In two recent surveys in America, 38% beer drinkers said they would not buy this beer under any circumstances. 14% said they won’t buy it in public. Corona had planned to launch a new hard Seltzer in the USA last month. The promotion campaign said: ‘introducing Corona… four flavors. Coming to your place soon.’ For some reason, Americans criticized it.

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Not having experienced a pandemic before, politicians in different countries find original ways to impose restrictions. Congo locks down people for 4 days, then they can move around freely for 2 days, then locked down for four days again. Peru and Panama’s lockdowns are gender-based. Men can leave the house on Mondays, Wednesdays, and Fridays. Women on Tuesdays, Thursdays and Saturdays. Nobody can go out on Sundays.

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New York’s Health Department has issued guidelines on how to enjoy sex in Covid-19 times. Since my Corona series has a wide readership, I refrain from giving a précis. If you are above 18, and think there is any practical utility, here is the NYC covid-sex-guidance. By way of warning, I would mention three points. (a) These guidelines are for New Yorkers, they may not apply to you. (b) The footnote says the NYC health department may change their advice as the situation evolves. (c) The safest way as prescribed by other sources is to keep a distance of at least six feet from your partner during the act.

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In April, an Indian couple named their newly born son: “Lockdown”. When the boy grows up, I can imagine mischievous reporters writing about ‘Lockdown in school’ or ‘Lockdown at State Bank of India’.

Talking about naming the baby, Boris Johnson and his fiancée Carrie Symonds had a baby boy this week. The mother and baby are doing very well; the father is also not doing badly. The upper class Brits give three names to the baby. Johnson himself is ‘Alexander Boris dePfeffel Johnson’.

Carrie wanted one of the names to be her grandfather’s. And Boris wanted one to be his grandfather’s.  Boris, in his usual nebulous way told her, ‘I want to name him after the two doctors who saved my life.’ And he left for his Zoom conference.

Two doctors? Which meant sacrificing one of the two grandfathers. And since Boris is the Prime Minister, it would be Carrie’s grandfather whose name would have to go. Carrie spent a few depressed hours before Boris returned.

‘I wish we could have named him after my grandfather.’ She said. ‘We will.’ Said Boris.

‘But you want to name him after your grandfather as well.’ ‘Yes, I do.’

‘And you want to name him after the two doctors who saved your life.’ ‘Yes, I do.’

‘How is that possible?’ she said.

‘We are naming him Wilfred (Boris’s grandfather) Lawrie (Carrie’s grandfather) Nicholas Johnson.’ Said Boris triumphantly. ‘Because the two doctors who treated me were Dr Nicholas Price and Dr Nicholas Heart.’

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Ravi

Corona Daily 463: American Couple at Sea: Part Final

If you feel this is an unending story, you are beginning to get some idea of the American couple’s feelings during the Japan quarantine.

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After the evacuated passengers reached the USA, Kent heard eleven passengers had tested positive.  The 300+ evacuees were transferred to US air force bases for another 14-day quarantine. By now the Diamond Princess warranted a special category in the daily reports of WHO and Worldometer.

In her 17 Feb interview taken by an American TV channel, Rebecca is seen depressed and frustrated. (As opposed to her optimistic, cheerful interview a week before). She blamed the US government for abandoning them. This was unacceptable, she said. As a result, she received another volley of abuse calling her selfish, one person describing the ship as a leper colony.

On 20 Feb, the Japanese health ministry announced the death of two passengers from Diamond Princess. An American channel interviewed Kent on Facetime. ‘It was so shocking to think this person had gone on a vacation and the next thing you know they’re dead. It just seemed so preventable.’ He said. That evening Rebecca and he chatted for a long time.

By now, the Diamond Princess resembled a ghost ship. Kent only saw crew members at meal times. Sometimes they forgot he was still on board. On 22 Feb. he was among the last passengers to leave the ship. The American embassy was no longer contactable. In Tokyo, Kent was on his own.

He went to Rebecca’s hospital, but was denied permission to enter. She came to the window of her room, and they talked on Facetime. In the next two weeks, Kent had to move hotels twice. This was part of the post-ship 14-day quarantine. On learning he came from the Diamond Princess, two hotels asked him to leave.

On 4 March, a month after the last date of their cruise, Kent and Rebecca finally met. They decided to celebrate their reunion by visiting Disneyland, Tokyo. Online they found Disneyland was shut to prevent the spread of the virus. Finally, they left for the airport, psychologically prepared to serve another two-week quarantine after arriving in the USA.

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Post-script: Cruise liners are a big part of the tourism industry carrying 26 million passengers annually. At any given point, 314 cruise ships worldwide carry more than 500,000 passengers and nearly 200,000 crew workers.

Diamond Princess has had 712 cases and 14 deaths so far. Over 40 ships have had confirmed positive cases. 70 passengers have died so far.

At the time of writing this, more than 100,000 crew members are trapped in ships with outbreaks, with little access to medical help, without pay and no end date for their confinement.

Nobody needs to hurry to book their next cruise vacation.

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Ravi

Corona Daily 464: American Couple at Sea: Part III

From his cabin, Kent had a magnificent view of Mount Fuji and the open seas. Now the ship had turned, and Rebecca was gone. Kent could only see an ugly port filled with ambulances and men in sci-fi type suits.

The quarantined passengers soon formed a Facebook group. Unfortunately, it was flooded with complaints and conspiracy theories. Kent used the FB messenger to chat with Rebecca. They exchanged pictures of their meals. Kent could opt for stir fry with chicken or stir fry with tofu. At the Tokyo hospital, Rebecca was given fish, rice and pickles. She was feeling all right, but was told she would be there for at least 14 days. She had stopped talking to doctors and nurses, who spoke only Japanese. Kent and Rebecca started getting nasty messages on their Facebook walls, asking them not to come back and spread the virus among innocent Americans.

On 9 February, Jan Swartz, CEO of the shipping company, promised the passengers a full refund and a free cruise in the future. Also during the quarantine booze became free.

The passengers learned more about their ship from CNN than from their captain. When Rebecca had left for the hospital, Diamond Princess had 61 cases. In a week the number had grown to 285. Kent heard some of his neighbors recording messages on their phones. Spencer Fehrenbacher, a 29-year old from Vancouver, had recorded: “If you’re seeing this video, I have tested positive for the Coronavirus and am being taken to a Japanese hospital somewhere. I’m making this video just as a way of saying ‘hi’, saying, you know, ‘I love you’ to my family and friends, and just making this in advance in case I don’t have time to…in case.”

Kent formed a WhatsApp group with twenty others he had met at the Quiz Time. The group took it upon themselves to procure fresh towels and bed-linen. Service of any sort was hard to come by.

The ship had more than 400 Americans. On 16 February, an American rescue team arrived. This was the first mission in US history where American citizens would be evacuated from a cruise ship, amid an epidemic outbreak. Each American was identified from the ship’s manifest and spoken to. Kent could not see the person, but an official American accent was promising.

‘My wife is in a Tokyo hospital. I hope you can evacuate us both.’ He said.

‘We are not allowed to take anyone from the hospital. But you…’

‘I will not leave without my wife. I would appreciate if you can send me to Tokyo. I have tested negative. I would like to be closer to my wife, and not here. I am losing my mind.’

‘Let me check,’ said the voice. ‘Mr Frazer, your quarantine counter was reset when your wife tested positive. Until 21 February, you are not allowed to leave the ship, I am sorry.’

Later, Kent saw from his cabin more than 300 Americans in masks leaving in buses for the airport. (To be continued…)

Ravi

Corona Daily 465: American Couple at Sea: Part II

The announcement that an ex-passenger from the ship had tested positive didn’t alter anything on the ship. Like a momentary pause in an action-packed film. The music, dancing, entertainment, gambling, extravagant eating and drinking continued.

Around midnight, Rebecca messaged Kent to return to their cabin. Two Japanese officials in white cotton overalls stood outside. With their faces hidden, it was difficult to decipher what they were saying. But they carried a bilingual form asking for the passengers’ travel history and symptoms, if any. Rebecca’s throat was a bit sore, but after two weeks of indulgence and sleep deficit, that was not a surprise. The officials, though, took out their kits, and took throat swabs of the couple. That night the team went around the ship and took swabs from 253 people.

February 4, the final day on the ship, started as usual. A sumptuous buffet, swimming, live music. Kent was fond of attending the Quiz night. This week after the Quiz, nobody asked them to return the pencils. Since he worked for Intel, he noticed such things.

In the evening, the ship was cruising towards Yokohama. Another night at Tokyo, and they would fly back to the USA. Kent was in the swimming pool when he heard the intercom: “This is the captain speaking. All guests are requested to immediately return to their cabins. I have received instructions from the Japanese quarantine inspectors. The ship has been quarantined. You are requested to stay in your cabins for the next 14 days. I repeat…”

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From the next morning, basic food was delivered in boxes and left outside the cabins. Guests were given masks, rubber gloves and instructions. You must stay in the cabin if you want to be safe, the instructions said. Strolls of 30 minutes per passenger were allowed, provided they kept two arms’ distance from others. People started washing their garments in the sink inside the cabin.

On the morning of 7 February, there was a knock on Kent’s door. This time the officials outside looked like astronauts. “Rebecca Frazer.” They said. “You positive. You come with us.”

Kent looked at the reports. Rebecca had tested positive. “Where are you taking her?”

“Hospital.” The men said.

“But I am feeling fine.” Said Rebecca.

“No, you positive.” Said the Japanese.

The couple started packing.

“Not you, sir. You negative. You don’t come to hospital. You here in quarantine.”

“Sorry, I am her husband.” Kent spoke slowly and clearly. “You can’t take her alone to the hospital.” Americans are aware of their rights no matter where they are located.

“No, orders from government. Mrs Frazer goes to hospital. Mr Frazer stays in cabin.”

Rebecca packed her bag and left with the Hazmat suits. Kent came out of the cabin, until he saw Rebecca disappear. He was told she would stay in the hospital for three days. (To be continued)

Ravi

Corona Daily 466: American Couple at Sea

After much careful planning, Kent Frazer, 42, and his wife Rebecca, 35, were finally off to Japan. Kent worked for Intel and Rebecca for a health insurance company. Getting a whole week off is not easy in the USA. A combination of saved comp offs, working weekends and managing bosses had allowed them a 15 day luxury cruise around Asia. The cruise brochure called the Diamond Princess ‘a precious gemstone on the seas of the world, where day or night, it’s always an adventure.’  

The flight to Tokyo to board the cruise from Yokohama was a small price to pay for the sight that awaited them. The couple boarded on 20 Jan. The brochure was not lying. This was a giant ship, the length of three football fields. It had swimming pools, a track with laps for runners, a small golf course, the Churchill lounge full of leather chairs for cigar smokers, hot tubs, nightclubs, bars, a cinema theatre; Japanese, Chinese, American and Italian restaurants, crèches that allowed young parents some private time, game centers for children, concerts, comedians, magicians, casinos and art auctions. No matter what your age or family status was, you were in awe of the choice available. It was a shame some hours needed to be wasted in sleep. Live music played all the time. Eating was a special pleasure. Food was available twenty-four hours. The grand buffet included many French sounding dishes topped by Crème Brûlée that the American couple tasted for the first time.

On 25 Jan. when the ship landed at Hong Kong, Kent noticed a few passengers embarking the ship in masks. There was some talk of a virus in China. But here, on the ship, they were safe. The mask wearers soon left their masks unworn in the festive atmosphere on the ship. You take cruise ships to be among people. The Diamond Princess had a crew of 1045 - all young, and 2666 passengers, many of them pensioners. Kent and Rebecca were at ease with both groups. On any single day, each of them shook hundreds of hands.

In three days time we will be back in Oregon, said Rebecca to Kent, sighing. The cruise had been exceptional. The ship had visited Hong Kong, Vietnam, Taiwan, and on 3 February was heading back for Yokohama. The couple was drinking to the sunset on the upper deck, when on the intercom, they heard the captain’s voice: “Please be advised. Please be advised that we have been notified by the Hong Kong public-health authorities that a Hong Kong resident who travelled with us for five days, and disembarked in Hong Kong on Jan. 25^th, has tested positive for Corona virus on Feb 1^st, six days after leaving the vessel.”

Kent and Rebecca looked at each other, and raised eyebrows. Why is the captain bothering to tell us this? (To be continued…)

Ravi

Corona Daily 467: Pentagon Orders and Japanese Hotels

One way to check if Covid-19 death numbers are under-reported is to ask how many people would have died if there was no virus. Actuarial scientists specialize in death projections, however morbid that may sound. Deaths may have seasonal variations and trends, but from year to year, the numbers are predictable.

Last month, if 6000 people were expected to die in your city, but 10,000 died, it is fair to attribute the number of excess deaths to the virus. If your government is reporting 2000 covid-19 deaths, they are probably underreporting by 50%. In its inimitable style, The Economist tracks these numbers for eleven regions on a daily basis.

Jakarta leads in the suppression of numbers. Its cemetery department records 2,800 burials a month. In March, it reported 4,400, an excess of 1,600. Jakarta’s official covid-19 toll is 84, only 5%. Turkey’s Erdogan assures the nation everything is fine, and describes how he eats a spoonful of mulberry molasses every morning to boost his immunity. Istanbul’s figures cover only 45% of the excess deaths.

Some argue that most Covid-19 victims, due to age or condition, would have died in the near future anyway. May not be true. One study in Italy calculated that among the victims men lost 14 years of life, and women 12 years (the YLL concept).

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Several other ways of cross-checking. One is to look at body bags. Pentagon has a specified standard: green nylon 94-inch by 38-inch bags. It maintains a rolling stock of 50,000 to wrap up the various people American soldiers kill across the world. Pentagon has now ordered 100,000 additional body bags for civilian use.

Mopec is the leading American company dealing with autopsy and pathology supplies. They confirm stocks of body bags are depleted. Despite adding more employees and multiple shifts, body bag manufactures in the USA are reporting backlogs of six months or longer. They are rapidly running out of fabric and zippers. Canada’s Ministry of Health has asked funeral homes to use ‘a leak-proof body bag’ marked with ‘infectious risk-handle with care’ in big letters.

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Japan is a country of the old; it sells far more adult diapers than baby diapers. Naturally, death is a big business in Japan. The Japanese funeral industry was booming even before the virus. They have drive-through funerals, and also corpse hotels (Itai Hoteru). With long queues for cremations, the dead Japanese rest in well-equipped hotel rooms, sometimes for days, before their turn comes.

Now those calculations are disrupted, because of the risk of infection. A well-known Japanese comedian Ken Shimura, 70, died of Covid-19. His brother said his body went straight to the crematorium, without the family getting a chance to say goodbye.

Funeral directors in Japan are toying with ideas such as live-streaming funerals using GoPro cameras, and cashless payments PayPay.

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Body bags, coffins, cemeteries give clues as to how lethal this virus is. In India, where Hindus are cremated, one has to look for other clues. In rural India, a farmer can be cremated in his field, and his death may not be recorded anywhere.

Ravi

Corona Daily 468: With a Pinch of Salt

Are the numbers of infected and dead that we check every morning overstated or understated?

First, let me confirm both Johns Hopkins and Worldometer are doing their job professionally. They are independent, the staff competent and hard working, the processes automated, data transparent (both mention sources, Hopkins includes raw data). They cover the world as best as they can.

We must remember, though, there is a human being at the other end. A Mafiosi killing could be mistaken for a Covid-19 death. A patient dying alone at home may not go reported. It may simply be a typo.

The number of total cases is not the total number of infected. Testing is low. Thousands currently under house arrest may be positive if tested. This figure is certainly understated.

Reporting recovery in cases is not mandatory anywhere. People recovering in hospitals routinely go home with nobody closing the case. (Closed cases= recovered + dead). This number is grossly understated, giving a ridiculously high (19%) mortality percent in closed cases.

Deaths are the figure we believe in. There is something definitive about death. Little space for doubt, you would think. But that is not so. With resource constraints, autopsies are rarely performed. Covid-19 cases are classified into three categories: Suspect, Probable and confirmed. Suspect are those dying with Covid-like symptoms but no tests. Probable are those without tests but were in contact with someone who tested positive. Confirmed are those who tested positive. The USA allowed probable cases to be included along with confirmed cases as late as April 14.

Add to that the jolts researchers receive. On 17 April, China reported 1290 Feb/March deaths from Wuhan with retrospective effect. A day earlier New York City reported a decrease of 145 deaths. On 3 April, the French ministry reported 17,827 additional cases and 532 additional deaths from nursing homes. They had forgotten about nursing homes. With few resources, the solitary researcher somehow makes the necessary adjustments.

There is always a time lag. A doctor diagnoses a case. He submits the report to the local health department. The health department must enter the data in the computer. Most of them don’t work weekends. (A seasoned statistician knows why Monday is the most fatal day). That data then travels to the state ministry and finally to the federal ministry where it is aggregated. The ministry then sends it to WHO.

The new cases or new deaths that your TV reported this morning may have happened any time during the last four weeks.

Finally, for a global effort, the researcher must know the numbering conventions. The number 9,876,543.21 (comma: UK, US) looks like 9.876.543,21 (full stop in most of Europe), 98,76,543.21 (India, two spaces), 9’876’543.21 (apostrophe: Switzerland) and 987,6543.21 (Mandarin, four spaces). India counts in lakh (100,000) and crore (10 million). An inexperienced researcher can easily kill ten times more or fewer Indians.

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In short, we need another cross-check to answer the question. I will do that tomorrow by discussing the notion of ‘excess mortality’.

Ravi

Corona Daily 469: Story of a Dashboard

With 1.2 billion hits a day, the Johns Hopkins Covid-19 dashboard is anxiously looked at in ordinary houses as well as the White House. When a pandemic begins, who commissions such a daily count? Who called the Johns Hopkins University (JHU) with this request?

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In December 2019, Frank, a first year PhD student at JHU was studying the spread of measles. He and his guide Lauren Gardner were thinking of putting the measles hotspots on the map. Gardner’s team studies population mobility and behavior (such as whether people are obeying or breaking social distancing) to assess the transmission risk. Based on that, the team builds mathematical models to predict disease hotspots.

While working on measles, Frank heard of the Pneumonia virus outbreak in Wuhan. China had started generating daily statistics. Why not translate that data into an interactive visual map, thought Frank. He began to work on the spur of the moment, and the map was created that same night.   

At the time, it was meant as a China dashboard. In the first few weeks, Frank referred to the numbers as those inside China and those outside. One day, he noticed the non-China numbers were bigger, the World map was redder.

On 22 Jan. the dashboard was made available online for other researchers. (Why would anybody outside the academic world want to look at a virus dashboard?) Frank published an academic paper on his dashboard on 19 Feb.

Then suddenly life began to change. It is a researcher’s fantasy to get 1000 online visitors for his academic product. It’s his dream to get his paper cited 2-3 times in the first few months.

Frank’s dashboard paper was cited 80 times in the first month. The Dashboard went viral logarithmically. The visitor count was in millions. The team needed to be expanded to five people. They moved to the conference room to maintain social distancing. Manual input of data became unsustainable. Automated web-scraping and aggregation were introduced to have real-time numbers. The team was working 24 hours, and their data was ahead of even the WHO, except once when a researcher overslept. While they were still in a state of shock, their daily hits reached 1.2 billion.

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Nobody commissioned the dashboard. We wrongly assume the world to be well organized. In most matters, no system exists. You and I can start creating such a dashboard, or our own analysis.

One reason why this particular dashboard happened was Frank. Chinese students studying in the USA adopt English names for the convenience of Westerners. Frank’s real name is Ensheng Dong. His family lives in China, he has several friends in Wuhan. If not for the personal bond, it’s unlikely this dashboard would be born.

Ravi

Corona Daily 470: In Numbers We Trust

At the time of writing this piece, the Johns Hopkins University Dashboard gives a global figure of 2,822,003 infected and 197,578 dead. Worldometer numbers are 2,846,575/197,859. Were these organizations appointed by the WHO or a similar world body? How are they getting their data from across the world? Should we blindly trust the numbers?

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In academic papers, you often refer to work by other authors (citation). A research scholar’s responsibility is not limited to giving the source, but also judging its credibility. The best scientific journals will not publish your paper unless it is peer-reviewed. Such scrutiny is essential for validating any paper.

This is about building a chain of trust. You can quote a fact from a reliable source, not otherwise. In private life, we have friends whose objectivity and rationality we trust. We don’t hesitate to believe them, or to pass on the information they give us. We also have friends whose word we would like to verify or simply ignore. It depends on the reputation each of them has built over their lifetime.  Conspiracy theorists are capable of seeing conspiracies everywhere.

If A trusts B, B trusts C and C trusts D, then information can pass through this chain reliably. The strength of the trust community is the strength of its least trustworthy source.

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In a pandemic situation, government sources are critical. Systems allow them to collect as well as aggregate the data. If death certificates are the proof of the pudding, hospitals or crematoriums are usually obliged to give the data to a government health body.

The trustworthiness of media is a matter of experience and choice of the researcher. The rightist Economist and the leftist Guardian stand at opposite sides of the spectrum. Their opinions and agendas may be different, but both can be equally trustworthy. They have a long history, strong editorial boards, wide global network of journalists and a reputation for objective reporting. Most writers of The Economist remain anonymous (no byline) and the charter prevents any shareholder from acquiring majority shares. Such measures build the credibility of the source.

I read, (not watch), BBC and CNN. Based on my experience, I will not hesitate to refer to BBC. But I will cross-check with several sources before quoting CNN.

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The Johns Hopkins dashboard is getting more than a billion hits a day. Before trusting the numbers issued there, or on the Worldometer site, shouldn’t you audit their process, the methodology, and the sources? By scrutinizing deeper and deeper? To be honest, few people have time to waste on this even during lockdown. In that case, you can outsource the audit to a researcher. Tomorrow, I will talk about the Johns Hopkins dashboard.

Ravi

Corona Daily 471: Give a Code Word to the Pharmacy

Many female victims of domestic violence are now unable to contact the police who are busy enforcing the lockdown. Injured women are afraid to visit hospitals for fear of catching the virus. They can’t run to their parents’ house, because parents belong to the vulnerable group.

One Palestinian woman says lockdown is hell; quarantine is hell, because it means living 24/7 with someone who can end your life. Psychological abuse has graduated to physical abuse. Frustrated males obsessed with power and control have now moved, like a cancer, to the fourth stage.

Help lines are ringing everywhere. One American husband threatened to throw his wife out of the house if she coughed. In Pennsylvania, a girlfriend of an immuno-compromised man hid his sanitizer and soap. Many Afghani women are not allowed to have phones. (If she can’t see or talk to anyone without her husband’s permission, what’s the point in having a phone?) If an Afghani woman is beaten, even in normal times, she needs two credible witnesses to prove it, and the process can last more than a year. In Mumbai, with the house help gone, irritated men are expected to contribute to domestic chores. That makes some of them violent.

Denmark has created temporary shelters. France, where DV has surged 30%, allows victims to stay in a hotel room at the government’s expense.

Calling a helpline in the presence of the violent husband is dangerous. In Spain, those women can go to a pharmacy and use the code: MASK 19. The pharmacist alerts the police.

USA has a 999 silent call service. If you call 999 and can’t talk, press 5 two times, and the police act on it. In the UK, victims are recommended to pass on notes to shop assistants, postal workers, or delivery drivers. They may be the only contact point for a woman/child who is afraid to talk.

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Several lessons I can think of:

Corona virus highlights the world’s defects and their scale.

No such thing as a developed or undeveloped country. Domestic violence shows all nations are uncivilized. Human nature is essentially mean.

People go to work to earn, and children to school for education. More importantly, workplace and school double up as shelters to hide from torture at home.

Norway, Finland, Iceland are among the best countries for women. Their density is low, and several people live on their own.

Maybe living alone is the only way to avoid domestic violence.

Ravi