The State Sort of Gives Us a Glimpse at their “Strategy”

I do not relish listening to the coronavirus briefings from the Health Department.  Something in me rebels violently at government presentation of misinformation, especially when it is done repeatedly and knowingly.  But I know few people will listen to these and then will be dependent on some misleading snippet on the nightly news, so I try to give a fuller picture of what is communicated.  But my weariness with the same garbage at every briefing leads to a tendency to sarcasm, irony and sometimes outright mockery.  This is a long post, but read to the end or skip to it, there could be a treat at the bottom of the crackerjack box.

The briefing today as usual started with a “situation” update.  We again we told about a data dump of test results from as long ago as several weeks.  Tends to screw up the data.  But, and this is a direct quote, the director said they were doing their “very best to be transparent”.  I just can’t agree with that.   We don’t get death or hospitalization data by date of occurrence.  We don’t get any real information on hospitalizations–how many admissions on a specific date, how many discharges, what is average length of stay.  We aren’t told if people were admitted for CV-19 or some other reason and just happened to have CV.  How many people became infected in the hospital.  We don’t get antibody survey data.  We don’t get contact tracing results.  Now we learn the importance of understanding positivity levels in test results and we don’t get that.  And unfortunately, I have to conclude that we tend not to get data that would present a different picture than the state is trying to message.

The Sturgis case count is up to 50 and some unrevealed, i.e. small, number of secondary cases.  And one person died, with underlying conditions.  Nationally, according to the information I have found, there have been 360 cases related to Sturgis and the one death in Minnesota.  This out of an estimated 400,000 plus attendees, often in very close contact and allegedly quite maskless.

A question was asked about a terrible study in Journal of the American Medical Association which purports to show that school closures cut cases and deaths.  This is the dreadful study I reported on a few weeks ago when it first appeared.  The authors made no effort to disentangle the most obvious of confounding effects, including that when you shut schools parents have to stay home and so their mobility and contacts are drastically reduced, and that school closures tended to occur at the same time as other lockdown actions.  Even the Journal was apparently so concerned about the poor quality of the study that it concurrently published an editorial, which I have twice dwelt on at some length, both cautioning about the interpretation of results and reminding us of the extreme harms caused by keeping children out of school.   Part of the state’s response to the question about whether the study would affect policy was to say they were being “balanced”, which of course had me alternating between belly-laughing and upchucking, and that the study would show the value of extreme actions like shutdowns or school closures.

The first and the last questions dealt with the goals of the current “strategy”, which is a woeful mis-appellation if I have ever heard one.  The first questioner noted that the original strategy was all about building health resources and we accomplished that so what are we doing now.  The honest answer, which is evident in the Incompetent Blowhard’s complete absence and invisibility in regard to CV-19 or anything (he apparently recognizes how unpopular he suddenly became) is that there is no strategy.  The answer we got was that yes we needed to do surge preparation (just so we are all clear, we had our “surge” in May, before preparations were far along and we never got close to capacity, meanwhile people missed cancer treatments and didn’t get treated for heart attacks.  And remember the warehouse for corpses).  Now we are concerned about the high level of cases and we have to reduce cases.  Why–1) here is a new twist–because some people are suffering these terrible long term consequences of the disease; and 2) because we need to be able to keep schools open, etc., a gentler version of the blatant blackmail we heard on Monday.

Again, especially when testing levels are considered, we do not have a high level of cases.  On any given day, about one in 10,000 Minnesotans is being “infected”.   And that is ignoring false positives and ignoring very low levels of positivity which mean the person is not infectious.  We don’t have information on the positivity threshholds the state is using, but if it is like NY and Mass, and I don’t know why it wouldn’t be, most of our cases aren’t “cases” that would warrant any attention or that could lead to any transmission.  So I am baffled by the effort to convince Minnesotans that we have some case crisis.  We don’t.  The few cases we have continue to be relatively mild and lead to few deaths, again almost exclusively among the elderly, in or out of nursing homes.

The nonsense about serious long-term consequences is unsupported by any rigorous evidence.  A small, very small, percent of people with serious illness are reporting some long-term complications.  It is unclear if these are truly related to CV-19 or to underlying conditions the patient had.  And this is true of any disease, it hits some people harder.  Guess what, some influenza patients have very serious long-term consequences.  To say your whole strategy is based on reducing cases so a few (and of course, the state gave us no information about how many, if any, of these patients exist in Minnesota) people don’t have some long-term complications is unfathomable and as usual, displays no recognition of the costs and harms of the measures taken to limit cases.

The last question was a follow-up in which the questioner said “it sounds like you are trying to completely eliminate cases.”  The questioner has an accurate perception.  The commissioner said, no, we know that isn’t possible, we just can’t have case growth this high (see response above and the actual data)  and we need a manageable level of transmission, without spelling out what that is.  So there you have it, our whole strategy now is to achieve manageable transmission, and we will know it when we see it.  As a side note, the commissioner referred to NY as being a stunning success in reducing case volume.  Uhhh, several tens of thousands of dead New Yorkers may beg to disagree.  (I am wondering if the commissioner is hiding for him that information on nursing home deaths that Cuomo can’t seem to find til literally two days after the election.)   New York has a low level of transmission because the virus was basically allowed to rip through the population before any serious mitigation efforts were made, and so the state has a prevalence as high as 40% to 50% in some areas, which under the most accurate and sophisticated models would suggest sufficient population immunity to slow transmission.  Whoaaa, you mean that population immunity strategy can actually work?

Finally, of course a softball mask question referring to a bogus model showing that mask use cuts cases by half.  The commissioner was restrained (because the mask mandate has zero effect in Minnesota) and said that “models are not evidence”.  I fell off my chair, which at my age is quite unpleasant and requires several minutes of crawling around in a vain attempt to regain upright status, much like the first bipedal humans.  Has she informed the Incompetent Blowhard of this revelation?  Perhaps that is why we are 7 weeks overdue from the unveiling of version 4.  She further said, and this is close to the actual quote if not it:  “if you are sick a mask doesn’t protect the people you interact with”.  Now I had  no chance of vertical attainment.  I believe the commissioner has been wearing a mask so long that she is suffering from oxygen deprivation and carbon dioxide poisoning, leading to severe off-message syndrome.  But then she ruined it by referring to multiple non-existent studies demonstrating the benefits of masks, for which I was actually grateful as it allowed me to recover my dignity and elevate myself to an appropriate human stature.