The Eternal Bronchial Return

The search bar on this blog allows me to look back on my life and see if The History of Dave is repeating itself . . . and in regards to two topics, I certainly am on a loop: plantar fasciitis and bronchitis . . . but I am getting a little smarter each year (at least in regards to the bronchitis) because now that I know the symptoms, I'm getting to the doctor before I actually get a full blown case and getting some meds (and avoiding scenarios like this one) but I'm not that smart . . . I still went out and coached our travel game yesterday, though my assistant coach did all the talking-- it was weird, watching the game, unable to speak above a croak-- just letting the kids do their thing; we played a team that was better organized than us and could knock it around fairly well and we were missing our starting goalie, so we settled back on defense and gave them nothing, played a 4-4-2 for the counter, and ran a number of give-and goes through to breakaways and won handily, 4 - 0 . . . if I wasn't shivering so hard, it would have been delightful to watch them figure it all out on their own.

Some Good Reads, If You're On Your Deathbed

During my extended illness (which has transformed from the flu to a wicked cough, laryngitis, and finally -- as diagnosed yesterday-- some severe bronchitis) I plowed through a lot of books: Tim Cahill's ode to Yellowstone National Park (Lost in My Own Backyard . . . apparently, when we visit the park this summer, my family likely to be eaten by a bear . . . or at least bitten by a horsefly) and Duane Swierczynski's psychedelic Philadelphia time travel mystery Expiration Date (as usual, when you go back in time to solve a problem, you're probably going to create a bigger one) and David J. Hand's fairly fun book on statistics and probability, The Improbability Principle and I finally finished Alan S. Blinder's account of the financial crash, After the Music Stopped and followed up the mayhem with Michael Lewis's fast-paced non-fictional financial tech thriller Flash Boys, then I read the later chapters of Jennifer Senior's wise, well-researched, and nonjudgmental All Joy and No Fun :The Paradox of Modern Parenthood . . . I didn't need to read the early chapters because my wife and I have survived those years, but it sounds like the teen years can be quite a strain on marriage, and now I'm in the middle of Robert Stone's novel Dog Soldiers, a bleak and trippy '70's crime novel about a heroin deal gone bad . . . I'd like to thank these books for getting me through some sleepless nights and feverish days, and though I doubt I remember much of them, I'm still going to give them all a big thumbs up (and a big thumbs up to the Kindle, which is a great resource when you're too sick or hopped up on codeine syrup to drive to the library).

New Jersey Starts to Open . . . Is This a Good Thing? Too Many Numbers to Know For Sure . . .

Outdoor stuff in New Jersey is starting to open.

My wife is down at the community garden today, handing out keys and helping people to reestablish control over their wild-grown plots.

I played tennis with a buddy at the park by my house yesterday.

The dog park is open!

This is great for me. I've gone from interacting with hundreds of people a week to the usual quarantine family-time and Zoom happy hours. The lack of stimulus is making me a little crazy (although I've been passing the time with low-stakes online poker. I'm reading some books and learning some math . . . but I don't think I'm headed to the WSOP any time soon).

The dog park at least restores some random social interactions, for both me and Lola.

This morning, I got to talk to a smart guy from down the street. He's in finance and owns a HUGE house. He's a conservative but thinks Trump is a lunatic. He would have voted for Bloomberg. He thinks the free market economy is rigged against the environment but doesn't like liberal foreign policy. He's the kind of conservative that that-- if you're in a left-wing echo chamber-- you might not think exists (now, of course, he lives in Highland Park . . . which is the most liberal town in a liberal county, so that skews things).

He's a hedge-fund data scientist and he's sanguine about the numbers-- which is a nice change. He says if you look at the data, you really need three things for the pandemic to continue.

1) an elderly population

2) densely populated areas

3) cold weather

You can read all day about #3, but it seems that warmer weather will at least slow the spread of the virus (but this won't prevent it from returning in the winter). And it's getting warm and yucky in New Jersey (in fact, I've got the AC on right now . . . when my wife gets home she's going to yell at me, but it's 73 in the house and humid. That's gross).

I presented the conservative-data-guy the statistics rattling around in my mind:

For every 800 people in New Jersey, one of them has died from Covid-19.

Two percent of the state has tested positive for the virus.

We're still generating over 100 deaths and over 1500 cases a day.

He told me something I know: the vast majority of the people that died were in nursing homes. That doesn't make it right, but it could have been prevented. Old people really can't handle this thing. There does seem to be some long-lasting effects in younger people, but we're probably going to build herd immunity in New Jersey and New York (at a great cost, but the genie is out of the bottle).

He's rooting for herd immunity. It's going to be a long road. I got my antibody test this week-- I'm still waiting for results. The doctor said about 20 percent of people being tested came up positive for antibodies. I think I had it February, but my wife was negative for antibodies. And the doctor said the two things she's hearing most from people testing positive for antibodies are:

1) two weeks

2) it felt like the worst X ever . . . the variable being flu, bronchitis, cold, strep, cough, etc.

My thing in February wasn't the worst thing ever (although giving blood for the test WAS the worst thing ever . . . I was really nervous -- my blood pressure was higher than normal-- and maybe a little dehydrated because I went running. The lady had to do both arms-- she didn't get enough blood out of the first arm. I wanted to give up and leave . . . I didn't like being in a room with multiple people giving blood . . . wounds don't bother me but when blood is circulating through tubes and needles, I get light-headed).

We agreed on a few things. Other countries did a better job.

Taiwan, for instance, had 440 cases and 7 deaths. Part of this might have been the heat, but it's mainly through comprehensive testing and contact tracing.

Our President has failed us on the testing, the tracing, and the plan. This conservative totally agreed with that. Trump, like Putin and Bolsonaro and Boris Johnson, is too macho to deal with something as small and statistical as a virus.

And Americans aren't big on mandatory tracking, testing, and tracing. Our freedoms don't mesh with fighting a virus. So we aren't out of the woods yet.

The attitude of the day is guarded optimism-- for now-- but unfortunately, winter is coming.

You Can't Undo a First Impression

When I receive a new class of students, I generally try to make a good first impression; I try to come across as fun and easygoing, but remind the students that my class will be challenging and I will reward diligence; unfortunately, this doesn't always happen . . . for a fantastically awkward pair of back-to-back examples of my worst start to a class ever, read this . . . and something similar happened two weeks ago; I had bronchitis and I missed two day of school . . . including the first day of my new Creative Writing class, so, as sub work, I gave them a fairly long New Yorker article about brainstorming to read: it's a fantastic article,  and while the first few paragraphs explain some of the history behind traditional brainstorming and how much everyone loves it, the thrust of the essay is that brainstorming doesn't work at all, and in fact, is worse than working alone; there's been a battery of psychological tests, and the research indicates that people produce the best ideas when there is healthy debate and criticism, and not a system that embraces blind acceptance of any idea at all . . . but I wasn't in school and so my students-- who had never met me and didn't know that if I give you something to read, you'd better read it-- perfunctorily read a few paragraphs of the article and then wrote a bunch of unfounded BS about how much everyone loves brainstorming, and so when I returned to school on Friday, still ailing and weak, but in school because it was a delayed opening because of snow and I didn't want to waste a sick day on a truncated schedule, and I read the pile of papers that got the thesis of the article completely wrong, I got very indignant, and-- because of the wackiness of the schedule-- I didn't have lunch at the proper time, so I brought a steaming bowl of soup to class, told the kids that they did a terrible job with the article and I was really angry because they made me read a pile of unfounded BS, gave them the article again, commanded them to reread it and do the assignment again and to type it up over the weekend and then explained to them that they had made a horrible first impression on me, and then, while they silently read the article, I slurped my soup and glowered at them . . . occasionally I stopped slurping my soup and enjoyed a phlegmy cough, and then I went back to slurping, while they read in silence . . . it was a really awkward first impression, and while we've reconciled since then (aside from the one girl who dropped the class . . . she probably thought she was dealing with a lunatic) I don't think they'll ever quite forget it or get over it.

Dave vs. The Fuzzy Green Ball

Everything seems epic when you're sick, and so yesterday, during my drive to the MedExpress while running a fever (turned out to be bronchitis)-- I fought an epic battle against a worn out tennis ball; the ball kept rolling under my feet while I was driving down Route 18, and I was worried that it would become lodged under the gas or brake pedal, and so I repeatedly bent down and grabbed the ball from under my feet-- temporarily obscuring my view of the road-- and then tossed the ball to the back of the van . . . and moments later it would come rolling back up again, like it had a mind of its own, and so-- finally-- and, as I said earlier, I was running a fever and my mind was cloudy, I thought to put it in one of the many cupholders my Toyota van possesses, and this was a perfect fit-- the ball will stay lodged in there until my kids decide to remove it, so they can play catch in the car (and it is possible that this fairly obvious idea didn't dawn on me for so long because my old car, a Jeep Cherokee, had no cupholders and so I had to use the sneaker which resided in the passenger seat . . . there were rarely passengers brave enough to ride in the "deathbox," and I'm too sick to do any research-- so I'll leave this work to Sentence of Dave fanatics-- but I wonder how many automobile accidents are caused by unrestricted rolling tennis balls . . . I'm guessing this is at least as dangerous as trying to clip your dog's nails as a stoplight.

High School + COVID + Math = Hot-Zone Mess

Here's some basic math so you can get a grip on the back-to-school situation in New Jersey. For the past week, 426 cases of COVID-19 have been blossoming in The Garden State each day. On average. And depending on what source you check, the numbers can be higher than this. 

These positive tests are accumulating while bars and restaurants and gyms and schools are closed. 

The population of New Jersey is 8.82 million, but for the sake of making the math easy, we'll round the population up to nine million.

In comparison, Germany has a population of 83 million. Nearly ten times the population of New Jersey. Germany is also generating around 400-500 cases a day. Though Germany is 10x our size, they are "very concerned" with this number of cases per day. So while New Jersey may have this under control in comparison to Florida and Arizona, we do NOT have this actually under control.

Let's look at the math, see what will happen statistically if we send everyone back to school (if you don't want to look at the math, the Superintendent of South Brunswick High School has written a very compelling, non-mathematical argument of why it is too soon to open).

For the sake of easy arithmetic, we'll say that Jersey is germinating 3000 new positive tests each week. Obviously, there are far more than 3000 people in New Jersey that have COVID at any given time. Some people are asymptomatic and some have less severe symptoms. Some didn't get tested.

There may be ten times as many people with the virus as the testing indicates, but I can't even get into those numbers . . . they would be nuts.

COVID is transmissible before you have a fever, while you have a fever-- which can last from a couple of days to a couple of weeks-- and then it's still transmissible after the fever has broken. It is recommended that you quarantine for ten days once the fever naturally breaks. So a week's worth of COVID cases is probably contagious for around two weeks after that. The point is this: the five hundred or so cases that test positive each day in New Jersey don't just disappear a day later. They pile up.

Understand that all these numbers underestimate the actual prevalence of the virus. 

In a three week period, at the very least, 9000 people in New Jersey are going to test positive for COVID-19. Many more will actually be contagious. But we'll work with 9000 because that's approximately .1 percent of our population. 

One in every thousand New Jerseyans. 

Doesn't sound like much . . . until you put people in school.

Of course, far more than one in a thousand residents will be contagious in any three week period, but we'll use that very low number to illustrate my point.

New Jersey has lots of huge high schools. 

34 of them have over 2000 students. 

I teach in one of these schools: East Brunswick High School. We have over two thousand students (and that's just grades 10-12). We have over 200 adult employees. All crammed into an old, cobbled together building with crowded hallways, poor ventilation, and no central air-conditioning. 

If you had a school of exactly one student, using our simple mathematical model, there's a one in a thousand chance that your student has COVID (in any three week period).

But if you have 2000+ students in a high school, there is almost no chance that all people inside are NOT going to have the virus. One easy way to estimate this is to multiply 999/1000 times itself two thousand times. Then subtract that percentage from one hundred percent. You get 87%. That's the chance on any given day that some student is going to have COVID in a 2000 person high school. This isn't taking into account the teachers and janitors and guidance counselors and coaches and trainers and all the parents and child study teams and other humans that come into the building or work in the building. It's not taking into account the asymptomatic and mild cases. It's not taking into account sports, the possibility of playing teams from other towns. So any large school is probably going to have two or three or five or ten people with COVID in the building. Probably more.

Some schools might get lucky for a short period of time, but it won't last. It's statistically impossible. The virus will be present. It has to be. One in a thousand is a low estimate, but these high schools contain many thousands of people. Indoors, for long periods of time. So the virus will spread. That's what the virus does, even when schools are NOT open. Even in the summer.

So what happens when we open?

There's nothing like a school to harbor germs and spread sickness. In fact, schools are the germiest place on earth. Teaching is the germiest job.

Here's some research on this:

When Gerba and other University of Arizona researchers studied the desks, computers, and phones from various professions, teachers wrecked the curve.

Teachers had six times more germs in their workspace than accountants, the second-place finisher, with slightly cleaner desks but five-and-a-half times more germs on their phones, nearly twice as many germs on their computer mice and nearly 27 times more germs on their computer keyboards than the other professions studied.

The reason for all the germs is, of course, the reason why the teachers are there in the first place.

"Kids' desktops are really bad, too," Gerba said. "Probably the dirtiest object in a classroom is a kid's desktop."

During a typical school year, I get sick a couple of times. A cold or two, perhaps bronchitis, a stomach bug, occasionally strep, and the one year I didn't get the flu shot, I got H1N1. I used to think this was normal for adults, but now I realize it's not. 

Since the lockdown, I have not been sick at all. Not even a sniffle. The last time I was sick was February. I had an awful cough for two weeks and a fever. It may have been COVID, though I tested negative for antibodies (that test isn't supposed to be accurate). The teacher across the hall from me had COVID . . . so who knows? The point is, when you are in a huge school, there's stuff going around all the time. It's a petri dish. 

I used to think this was a perk of the job. My immune system is so strong! It's dealt with everything! 

Now I think it's a bargaining chip. We are going to be on the front line of this pandemic and we've been on the front line of general sickness and we should be compensated for it, with money and health benefits. I never really considered this until now. Many of us work in hot, crowded, poorly ventilated buildings, and-- unlike the meatpackers that have been sacrificed during this pandemic-- we have a union. 

It's going to be quite a clash.

I understand that it's hard to wrap your head around this because it's so statistical. We all really want things to go back to normal, the economy to open, schools to open, etc. It sucks. 

But 1 in every 550 people has died in New Jersey. That's significant. Many of these people were old and/or sick, but not all of them. We've had over 182,000 cases and nearly 16,000 deaths. So nearly nine percent of the people that tested positive died. That's an insanely high rate of death. Yes, many of them were in nursing homes, but lately, according to recent hospitalization data in the New York Times:

Adults aged 18 to 49 now account for more hospitalized cases than people aged 50 to 64 or those 65 and older.

Again, this is all happening with schools closed, bars closed, restaurants closed, gyms closed.

If you haven't felt the pernicious power of this virus, you are lucky. You are probably also fairly well off economically, you probably have the ability to work from home, you probably don't live in a multi-generational house or apartment, you might not have a lot of underlying health conditions, and you probably don't work in an essential service, as a grocery store employer or meatpacker or a nurse. 

You might not know people in those situations. 

So to understand the situation, you need to study the numbers.

You also need to understand that schools are the social-class blender of many towns. Kids from mansions and kids from apartments mingle. Kids who spent the summer in quarantine hang out with kids who worked all summer. Kids with their own bedroom in their own large suburban house come to learn with kids who live in crowded multi-generation households. And kids from different towns go to battle against each other on the pitch or court or field . . . the COVID permutations of high school sporting events are incalculable.

While kids probably won't die from COVID, they will pass it around. Especially high school kids. And then other people will die. COVID is not as dangerous as Ebola, so it's hard to put it in perspective. Death rates lag behind infection rates, so once again, you've got to look at the data.

The final arbiter is that many more people are dying than "normal." This is with schools closed. People who think this is an overreaction need to understand these numbers. The death toll is the final statistic. The bodies are piling up. And we're probably undercounting. 

Here are some numbers about "excess deaths" from the white paper I linked to.  Not only are there many many more deaths than usual this year-- and these deaths are directly attributable to COVID-- but there are also extra deaths above and beyond the COVID deaths. 

Results: There were approximately 781,000 total deaths in the United States from March 1 to May 30, 2020, representing 122,300 more deaths than would typically be expected at that time of year. There were 95,235 reported deaths officially attributed to COVID-19 from March 1 to May 30, 2020. The number of excess all-cause deaths was 28% higher than the official tally of COVID-19–reported deaths during that period.

Conclusions and Relevance: Excess deaths provide an estimate of the full COVID-19 burden and indicate that official tallies likely undercount deaths due to the virus. 

There's going to be a vaccine soon, and then things will go back to some sort of new (and hopefully more vigilant) normal. But this has exposed some serious problems in our infrastructure and preparedness. Most of our public schools are hot, crowded, poorly-ventilated places where large numbers of humans congregate without much thought to hygiene and the spread of sickness. 

Elementary schools may have a shot to open because you can keep the numbers very small. The Daily did a good podcast on how other countries (with the virus under control) have had some success in elementary schools. 

We may be able to send small pods of kids back to high school. Perhaps special education students and others that need school the most, but trying to parade several thousand bodies through a typical high school-- even on a rotating schedule, even with masks-- is going to perpetuate and accelerate the spread of COVID. No question about that.

I know people don't want to hear this. I'm not happy with my math. It's inconvenient and awful. But that's the story, right now. If we want schools to open, we're going to have to get the case count way, way down.

Israel tried to reopen schools on a large scale and this probably fueled a new outbreak. 

Sweden has kept schools open, and they have the highest death rate (12%) of any European country and several teachers have died of COVID.

I don't envy the administrators and politicians that have to make these decisions, but if you look at the simplest of math, while underestimating the amount of COVID in the population, there is still only one conclusion:

The fall is going to be a hot-zone mess.

Irony Embodied

One month ago, I took a day off to take my kids snowboarding -- and I believed I had earned this day off, as I hadn't taken a sick day all year, and so this was my reward for being so healthy . . . and after I drove home from the snowboarding trip, I felt so vigorous and energetic that I went to my Wednesday night basketball game, thinking to myself: though I'm forty-four, I feel invincible . . . I can snowboard all day, and still play basketball at night, I'm made of iron, I'm unbreakable . . . and then five days later I came down with the flu, which led to severe bronchitis, and now, though I'm a bit better, I'm still mired in mucous and have a lingering cough, and though I know in my brain that there's no connection between my boastful thoughts and the virus that brought me down, my heart thinks differently.