Thursday, April 30, 2020

Norman, Correlate

Tam remarks on the Right-wing moonbattery of late.
We second the motion, with the affirmation that there's a whole lotta that going on now.

We have always seen and heard the moonbats on both sides of the political aisle, and made frequent sport of the most egregious examples on these very pages. We note for taxonomy and field recognition purposes that while both parties tend to relegate the most obnoxious mouth-breathers to anonymous internet postings, The Evil Party tends to elect them to jobs like Congress, governor, and mayor with a tedious predictability; while on the Stupid Party side, they are generally relegated to running talk shows and making YouTube videos.

When you hear people on the right making the same arguments as the left-wing moonbats, it isn't common sense that re-located off the bullseye and over to somewhere deep in left field.

Update your field guides accordingly.

Celebrating Diversity

Commander Zero reminded us yesterday that this is Rooftop Korean Anniversary time.

His linked story, however, is large amounts of ahistoric twaddle.

Whoever wrote that tripe has no idea what went down, and clearly wasn’t alive nor living in L.A. at the time. I was.

During the interim between the Rodney King incident, and the Rodney King Verdict, a female Korean liquor store clerk in South Central was getting walloped for stopping a teenage black girl from shoplifting, so as the black girl (the 1991 exemplar of Trayvon Martin Syndrome: "Play Stupid games: Win Stupid Prizes") left the store with (or without) a stolen orange juice bottle, the store owner capped her with her gat – in the back. Deader than canned tuna, right there.
And then got a pass from the L.A. County court (probation, fine, community service. No prison time). C'est la guerre.

Koreans had taken over many of the markets in South Central L.A. over decades, after the previous owners (generally Jewish) had been burned out of the ‘hood in the Watts Riots of ’65. The lack of any supermarkets in that aftermath, for those long decades, made South Central (exactly as today) a “food desert”, where absent a long drive to less diverse regions of the city, only corner liquor stores had the handy necessities of life, like milk, eggs, bread, etc., and being the Diversity, the locals, either lacking the wherewithal and desire to run their own markets, or more likely, knowing that they’d be robbed and shoplifted blind by their own co-Diversity beans, resented the outsiders. Plus ça change...

The shooting above didn’t add anything to their fund of ill will.

So come the Rodney King Free Shoes and Televisions Festival, old scores got settled. Not least of which with Korean shopkeepers in the ‘hood.

In one memorable bit of local color, the Koreans, many former military veterans of South Korea’s National Service rules, took to the roofs of their stores.

LAPD, all aflutter, bypassed rioting Diversity beans of all colors in their haste to disarm the Koreans doing what LAPD would not do. (And no, LAPD wasn’t “stretched too thin”, they were deployed to the central bus yards, and there waited and watched the riots for three days, because Chief Knucklehead Wannabe Gates and Mayor Egging The Riots On Bradley weren’t on speaking terms. The rank and file was largely furious, but management’s plan was to do absolutely nothing, mainly to punish the citizenry at large for daring to indict police officers for beating the hell out of anyone they felt deserved it. Anybody above the rank of Sgt. in LAPD from then on was and is now, a complete gutless douchebadge.)

So when confronted by LAPD on the point, the Koreans handed over their rifles, and LAPD did what they did best in the riots: they beat feet and hid again.

Whereupon the Koreans, being no dummies, waited until the black-and-whites drove off leaving skidmarks, went to their trunks, pulled out their second set of arms, returned to their rooftops, and prevented many a mob from doing to their stores what happened to thousands of others.

On seeing one approaching group seeking cheap goods, the rooftop Koreans present scattered a number of rounds into the pavement ahead of the melee, and the crowd quickly decided to go loot and burn on another street, while still several hundred yards short of their objective.

That’s how it works in a riot: people tend not to go all in just for the fun of looting and arson, if it’s going to become a life-and-death proposition.

There were no complaints, and no arrests, AFAIK, of any rooftop Koreans for the duration. IDK whether they ever got the original set of confiscated rifles back, but knowing the LAPD and D.A., it’s doubtful.

And the whole kerfluffle could have been nipped in the bud, when videographer George Halliday showed up at the Foothill Division station with his homeshot video of the original incident the next day, suggesting that the LAPD might want to pass it along to their Internal Affairs folks for further investigation. Whereupon the desk sergeant in L.A.'s Finest "suggested" to Halliday that he ought to get the hell out of the station rapidly, before he got himself arrested, so he took it over to KTLA-TV  instead. The rest is history.

The moral of the story:

Tuesday, April 28, 2020

How Not To Do This

Morons in action. This is the cover pic for my upcoming book, Pandemic
Prevention For Dummies. It's like looking for a gas leak with a lit road
flare, or looking for a tiger with a bloody dripping side of beef. 

As businesses  grope for ways to re-open without doing it using Gilligan Logic, they're searching for ways to limit the exposure of their employees and customers to Kung Flu.

The brighter lights out there are actually putting some thought into what they do, and don't do. In that light, recently, another blogger PM'ed me about using temperature checks.

It's a poor choice, other than being the only non-invasive non-test-dependent indicator.
That last is the only thing in its favor.

1) The TSA uses it. That alone should tell you all you need to know, but we'll continue.

2) When checking temperatures, rectal is most accurate, axillary (armpit) is least, and oral is problematic (for instance, if you're sipping iced tea or hot coffee - which I used to get a doctor's note during college, and almost bought myself an ICU sepsis admission, because I overdid it). At any rate, you're trying to determine body core temperature, with reasonably close accuracy.

3) My hospital is using thermal sensors like A/C and heating techs use. Worst method of all, because it's measuring skin temp, not core temp. (That goes for forehead strips too, btw.) And we're a hospital, FFS. It's pure kabuki theater. And can be defeated simply by pressing an ice pack against your forehead for a minute before entering, even if you had a fever of 104° F. (And no, don't pull that dumbass trick either. If you have a fever, stay your @$$ at home.)

4) Ear temps run the risk of poor circulation, ear infections, and cerumen impaction, so false readings, both ways.
5) Killer app problem: asymptomatic carriers with NO fever. That was the problem with the last strain/outbreak of Ebola, BTW: 50% of those infected showed no fever spike.
Kung Flu may be as high as 90%. Any percentage at all means using temperature as a screening method pretty much guarantees you're letting foxes into the chicken coop, every day, and rolling the dice on outcomes. Just like the actual Typhoid Mary, asymptomatic carriers have been driving the bus on the Kung Flu outbreak in every country, since Day One to right this minute. That's what makes this disease such a royal flaming pain in the @$$. So using temperature as a screening tool is World-Class Stupid, in the same league as trying to catch flies with a hula hoop, and no net. Or issuing your minefield clearing parties sledge hammers and pogo sticks. Only not quite as smart as that.

Like the TSA and Customs and Immigration has been doing with air travel during this pandemic, for a virus that may not show symptoms for 11-21 days, if ever, not to put too fine a point on it.

TL;DR: Temp checks: Better than nothing, but not by much.
BTW: The book-standard average range is 97.6°F to 99.6°F = normal.
I.e. 98.6°F, ±1°F either way, for oral.
-1°F for axillary range.
+1°F for rectal range.
(not that you're going to ever do rectal temps at work or anything, just for completeness).

If your business is planning to do temperature checks, and you can get away with it, beat them cheerfully about the head and shoulders with a large 2x4. What they're telling you, as an employee, is that they're using you for live bait in the mosquito trap, and your bosses are too stupid to work for.

So, knowing that, why would the TSA use temperature to screen out arriving passengers for Kung Flu?

"Because we're from the government, and we're here to help..."


Sunday, April 26, 2020

Sunday Music: I Couldn't Say No

Another proof of why music in the '80s was so effortlessly good is this underrated gem from Robert Ellis Orrall, in a duet with Carlene Carter (who could've outshone Stevie Nicks with half a minute's effort). This 1983 track is the sole single that snuck onto the charts for about 15 minutes of fame and Top 40 status, from his album Special Pain. He later switched from rock to country, writing a number of hits for other artists, including launching/inflicting (depending on your point of view) Taylor Swift onto America, producing her 2006 debut album and a 2008 EP follow-up.

Saturday, April 25, 2020

About Those Studies

Peer review on those Kung Flu studies is in...


You may recall we've had a bit to say, and none of it good, about the surveys that allege that Kung Flu is vastly more widespread than was supposed.
We pointed out no small number of major flaws in all those studies.
Lest you think I'm alone in this, let me share a few links and pull quotes, courtesy of MD Ed Grouch:
"(The Guardian/UK) Both studies [at Stanford and USC/LA County] used an antibody test made by Premier Biotech company that has not been approved by the FDA and comes with an acknowledgment that it can record false positives. 
Hundreds of antibody tests have emerged on the world market in recent weeks, including some that promise a result from a finger prick in just hours, an executive from the diagnostics and pharmaceutical company Roche told Reuters on Tuesday. None of them currently have FDA approval and some of them are “a disaster”, the Roche CEO, Severin Schwan, said. 
Then there are concerns about the Stanford study’s sample and statistical analysis. The biggest criticism was that it estimated cases for the whole county’s population based on detecting only 50 positives out of 3,300 people sampled. And since the tests had a false positive rate in one assessment of two out of 371, critics argued all the Covid-19 cases detected by the tests in Santa Clara could conceivably have been false positives.

“I think the authors of the above-linked paper owe us all an apology,” wrote Andrew Gelman, director of the applied statistics center at Columbia University, who has written numerous books on teaching statistical methods. “We wasted time and effort discussing this paper whose main selling point was some numbers that were essentially the product of a statistical error.”  
The prominent Washington state genetics researcher Trevor Bedford said on Twitter he was glad to see antibody studies emerging but was “skeptical” of the high results. The author and biotech investor Peter Kolchinsky tweeted that the “flaws with this study could trick you into thinking that getting shot in the head has a low chance of killing you”.  
The study was also criticized for recruiting its volunteers on Facebook, a method some critics charged could have induced some to participate in the study because they had had symptoms but were unable to get tested. Researchers say they attempted to screen for this by collecting information from participants on any recent symptoms, such as coughing or fever. 
Both the Stanford University team and the researchers at USC declined to respond to a request for comment.
We're just getting started.
From a peer review of the Stanford study posted on Medium
  1. First, the false positive rate may be high enough to generate many of the reported 50 positives out of 3330 samples. Or put another way, we don’t have high confidence in a very low false positive rate, as the 95% confidence interval for the false positive rate is roughly [0%, >1.2%] and the reported positive rate is ~1.5%.
From Columbia University's Statistical Modeling page, quotes from an e-mail sent to Andrew Gelman, Director of Columbia's Applied Statistics Center, and posted on their site:
It’s perfectly plausible that the shocking prevalence rates published in the study are mostly, or even entirely, due to false positives. 
Recruitment was done via facebook ads with basic demographic targeting. Since we’re looking for a feature that affects something like 2% of the population (or much, much less), we really have to worry about self selection. They may have discussed this in the portions of the paper I didn’t read, but I can’t imagine how researchers would defeat the desire to get a test if you had reason to believe that you, or someone near you, had the virus (and wouldn’t some people hide those reasons to avoid being disqualified from getting the test?).
So all 50 positives could be statistical error, and they had people self-selecting with an ulterior motive, either of which, by itself, could have represented the entire positive sample size. That's about as crapola as you can get.

But wait! There's more, this time about the tests being used in those studies:
(NBC News) But some COVID-19 antibody tests, including those being used by public health departments in Denver and Los Angeles and provided to urgent care centers in Maryland and North Carolina, were supplied by Chinese manufacturers that are not approved by China's Center for Medical Device Evaluation, a unit of the National Medical Product Administration, or NMPA, the country's equivalent of the U.S. Food and Drug Administration, NBC News has found.
Two U.S. companies — Premier Biotech of Minneapolis and Aytu Bioscience of Colorado — have been distributing the tests from unapproved Chinese manufacturers, according to health officials, FDA filings and a spokesman for one of the Chinese manufacturers. Many of the unapproved tests appear to have been shipped to the U.S. after the FDA relaxed its guidelines for tests in mid-March and before the Chinese government banned their export just over two weeks later. 
If COVID-19 antibody tests are unreliable, they can produce false results, either negative or positive, health officials said.

Sketchy tests, with accuracy so dubious it even worries the Chinese, with false results both positively and negatively, being used to do surveys on which public health decisions might be made. What could possibly go wrong?

I repeat, all the US surveys to date have HUUUUUGE problems with sample size, selection bias, accuracy of the tests, and are unpeer-reviewed hokum and horsie pooh that should be laughed out of any serious consideration.

You're being bullshitted by people who should know better, doing shoddy work, using subpar tests, and passing it off as research.

Friday, April 24, 2020

On Pandemics, Lockdowns, and Consequences

This Was A Test. You Just Failed, Hard.

So You Want Out Of Lockdown?

First, a few points:

Ending lockdowns isn't going to jumpstart the economy, nor end massive unemployment.

1) Airline and cruise travel, tourism, pro sports, amusement parks, hotels, etc. - oh, and the entire oil industry - are all going to be in the sh*tter for the rest of this year, and well beyond.

2) I seem to recall this wee $11.5T stock market massive flaming nosedive ending in a smoking hole, that may have just a tad to do with how the economy performs going forward, even if your Fairy Godmother whisked this pandemic away with a flick of her wand, right now.

3) I'm not impressed by the whinging and hyperventilating about the horrors of a seven-week shutdown. There are no bloat-bellied orange-haired children with flies in their eyes walking the streets of anyone's city, town, suburb, or dirt road, neither in Big City, nor Hootenholler. So quit with the panic attacks.

4) Let's also recall the situation in the Great Depression, where it was far worse, and everyone ate their babies, committed suicide, and the whole country starved to death because...oh, wait, never mind, none of that happened because of the Great Depression. So let's tone down the "OMG! Economic Catastrophe" what-ifs for a minute.

The economy is currently shit. The lockdown being lifted isn't going to turn that into ice cream, and certainly not overnight. But stupidly lifting it unilaterally has a damned good chance of showing you what 49 more NYFCs look like, where you live.

So let's not do that, shall we?

We've flattened the curve. In some places, flatter than whale turds at the bottom of the Marianas Trench. Everyplace else, much flatter than NYFC.

They are now the poster child for how not to deal with this pandemic.

How about doing and trying everything other than stay-at-home/shelter-in-place?

1) Latest word from WH briefings and the CDC (caveat emptor) is that summer sunlight and temperatures kill this thing on surfaces and in air in less time than a commercial. So a priority ought to be lifting the jackassical lockdowns on outdoor recreation areas and beaches. The bathrooms there, and any indoor air-conditioned venues, not so much.

2) Ordinary isopropyl alcohol apparently kills this bitch deader than canned tuna in half a minute too. So how's about we all agree to decon the f**k out of everything not moving, especially in public, over and over again, with every anti-viral cleansing agent known to man?

3) There will always be the 10% Gilligans in any population (Stout cudgel. Cranium. Assembly required.) , but people should be required to wear and use properly appropriate PPE, like masks and gloves, and given the opportunity to take responsibility for their own protection, and get out and about. I've taken care of 1-2 dozen Kung Flu patients already, at close range, using nothing more complicated than that. It works, and if I can do it, you darned sure can, if you have access to enough of the PPE to do it. Let's require its use in public, universally, and crank that stuff out by the metric f**kton.

4) We're going to have to test, and universally. First to find out who doesn't have it, and who does. So we need gajillions of rapid tests, that are accurate, and specific to SARS-CoV-2, not just any coronavirus including ones that cause a cold. We should start by testing the populations of lesser inhabited states first, and turning them loose, both because they'll be easier to clear faster, and if mistakes are made, they endanger fewer people. Besides, it's time North Dakota and Wyoming were at the head of the line for something. IL, FL, NY, TX, and CA should be dead last. Suck it up, buttercups. By the time we get to them, we should have a lot more tests, equipment, etc., so we'll be better prepared to open them as well, and fast enough to get it done.

5) And BTW, start by testing the actual essential workers, to clear them. Transportation/drivers, freight handlers, farmers, grocery clerks, water/gas/power engineers and workers, garbage collectors, cops, firefighters, EMS, and medical personnel. Then, everybody else, household by household.

6) Actual no-shit quarantines of infected/contagious people, with full lockdown "stay your @$$ at home" quarantine rules, posted signs, public health monitoring, and draconian enforcement for any violations, until they're cleared. Instead of locking up the healthy people.

None of that requires waiting on treatments nor vaccines made of vaporware. It isn't stupid, and it's all doable starting tomorrow. And none of it, done right, is liable to contribute a single new infection or death. It simply takes hospital and public health common sense from a century ago, and demands that we use it now.

Let's do this by hemming this bitch virus in, instead of stupidly doing unilateral lifting of lockdowns, which will just spread it around, and guarantee that we spread this to everyone,  create 49 or 100 more NYFCs, and kill people off by the bushel for the rest of the year.

That, I can get behind unreservedly, and other than the contagious infected, requires just about Jack and Squat Big Brother nannyism, or any more jackassical overreach by local petty tyrants and our would-be clipboard commando overlords. It also requires not one single bit of dubious surveys, magical models, calculating unknowable percentages of exposed, sick, hospitalized, dead, nor any other wild thing.

That doesn't mean they, and sheltering in place, never served any useful purpose, but their utility is largely over (unless TPTB/Idiots In Charge cock this up by the numbers, and get us back to Square One).We know what we need to know about things, and pushing decimal points back and forth solves nothing.

It will require hordes of testing materials, and PPE and decon supplies in small and large mountains. Okay, so let's get on that.

Wash your damned hands, wear your mask, and gloves - and change them! -  decon the hell out of everything not moving, and lock up the infected people, and we can get through this without killing off worst case estimates.

Or, slow-roll an idiotic unilateral lockdown lift, and spend the whole year killing great gobs more people slowly, with a dull rusty saw.

You pays your nickel, and you takes your chances.

We're #1! We're #1!

Seven whole weeks since stay-at-home started here, and we've already got the equivalent of a year's worth of deaths from flu, in a bad year, and two and a half times the death toll of an average flu year.
"We're sorry, but your order for 1 Nothingburger cannot be processed at this time, and all orders for Hoaxes are currently completely sold out, on backorder, the waiting list is full, and we don't know when we'll be getting them again. Your order is important to us. All operators are currently busy. Please stand by for the next available representative to take your order..."


h/t Captain's Journal

California Tyranny: Spanked, hard.: background checks for ammo purchases sh*tcanned.

Federal District Court Judge Roger Benitez didn't just throw out this unconstitutional travesty, he kicked it out so hard the state's attorney's ass didn't hit ground until it cleared the curb outside the courthouse:

"The experiment has been tried. The casualties have been counted.

California’s new ammunition background check law misfires and the Second Amendment rights of California citizens have been gravely injured.
In this action, Plaintiffs seek a preliminary injunction enjoining California’s onerous and convoluted new laws requiring ammunition purchase background checks and implementing ammunition anti-importation laws. For the reasons that follow, the motion for preliminary injunction is granted.
The purported state interest to be achieved by these new laws is keeping ammunition out of the hands of prohibited Californians. These new laws are constitutionally defective for several reasons.  
First, criminals, tyrants, and terrorists don’t do background checks. The background check experiment defies common sense while unduly and severely burdening the Second Amendment rights of every responsible, gun-owning citizen desiring to lawfully buy ammunition. 
Second, the implementing regulations systematically prohibit or deter an untold number of law-abiding California citizen-residents from undergoing the required background checks.  
Third, in the seven months since implementation, the standard background check rejected citizen-residents who are not prohibited persons approximately 16.4 % of the time.  
Fourth, the ammunition anti-importation laws directly violate the federal dormant Commerce Clause."
Somebody get a multitrauma dressing for counsel for the State of CA; his ass seems to be bleeding, and about 10 pound lighter.

RTWT (pdf).  And I mean RTWT. You haven't seen anything this good come down from a judicial ruling since Judge Silberman issued the DC Circuit opinion in Heller v. D.C.

FYI: Federal District Judge Benitez was an American originally born as a citizen of Bautista's Cuba, in Havana in 1950, and likely brought here as a child by his parents to escape Castro's communism. Huzzah.

He was appointed to the federal bench in 2004, by Dubbya.
(Keep telling yourselves "elections don't matter", and let us know how that works out for ya.)

Also, nota bene, no Gun Woodstocks were necessary to overthrow the overreach of the tyrants sitting in the state capitol of Excremento, Califrutopia.

Being an injunction, the law is thus moot and dead unless and until the state obtains a favorable ruling from a higher court. IOW, it's dead until re-animated.

Bonus{edit}: Once it's finalized, it becomes federal precedent. Stare decisis, bitchez.

CA shelves not already cleaned out, suddenly cleared of ammunition in 3, 2,...


Never have so many used a word so much with less idea of what it actually means.
Even Vizzini stands in humble awe. The serial failures are currently scream-worthy.

So what does it really mean?

Here's that bastion of low-cost truthiness, Wikipedia:
Co-Morbidity: the presence of one or more additional conditions co-occurring with a primary condition; in the countable sense of the term, a comorbidity is each additional condition.
Here's Google Dictionary:
Co-Morbidity: the simultaneous presence of two chronic diseases or conditions in a patient.
Nota bene: the operative word for both definitions is presence. I put it to you: Were you ever present when someone died? Were you therefore responsible for their death? Was anybody/everybody else who was present similarly culpable?

If you can answer this here, thus endeth the lesson. If not, plow on.

So, what are some likely co-morbidities, in common experience?
For examples, let's look at the Grand Slam of Death:
1) Obesity
2) Hypertension
3) Diabetes
4) Chronic Renal Failure

Let's explain. Since this will help you, because all of the above are frequently observed co-morbidities of a poor outcome when combined with SARS-CoV-2, AKA Kung Flu.

Obesity. You're a fat ass. Like more than 20% over your ideal maximum healthy body weight. This has consequences, over time. (Think years to decades). Like

Hypertension. A resting blood pressure anything greater than 140/90. because carrying all that extra flab forces your heart to have to push blood through miles of extra fat, to service the whole body, it has to push harder. Combined with atherosclerosis, the aging and hardening of your arteries, which you can't help because you're old enough to have eaten enough double cheeseburgers, and your body's metabolism, having passed the Rubicon of middle age, has now gone from Magnum P.I. to Higgins.

Diabetes. In this case, Type II, i.e. the old adult version, as opposed to Type I, which is people whose Islets of Langerhans, in their pancreas, aren't making any or enough insulin anymore, which usually begins in childhood. In Type II, your body makes insulin, it even makes enough for a normal-sized person, but when you get fat, the cells tell the insulin, which brings the sugar into the cells, in essence, "F**k you, we don't take that card any more." So the sugar stays in free circulation, making it harder for you to get fine blood circulation to your feet (so you get infections, and even gangrene, from simple wounds that don't heal, because lousy circulation) to your eyes (so you get progressively blind), and to your kidneys, which then progressively fail. If you want to be legless, blind, and tied to a dialysis machine three days a week, for three or four hours a day, until you die - early - just ignore your obesity, hypertension, and diabetes. As a bonus, the diabetes demands your kidneys process more and pee more, right when they can't, and also the extra osmotic pressure drives up your blood pressure, which is already too high, and when you use meds to absorb the extra sugar you should be cutting back on, it makes you fatter. Special bonus: the nerves in your heart muscle, the ones that let you sense pain, die. So frequently, your first clue about a heart attack is keeling over dead. This is what's known in medical terms as a "vicious circle". And the kidney disease becomes

Chronic Renal Failure. Chronic, meaning long-term, permanent, and progressive until total.
So now, all the crap your kidneys (which, with your liver, are the body's main filters, exactly like oil filters on an engine) used to filter out and excrete, only gets pulled out at dialysis, along with the extra fluid you can no longer pee. If all of this sounds like a hellish existence, it's because it is. No points for guessing what sort of hip pocket lecture I give to new-onset hypertensives and non-compliant diabetics, who still have all their body parts, while it's yet early enough not to be the walking hulk I describe at the end of the process. Scaring the hell out of people like that is the best way I know to save their lives, while it's yet early enough to make a difference. Kind of like the "No Swimming" signs upstream from Niagara Falls.

Pay attention now, this is where we blow your minds, and correct your misimpressions of the meaning of co-morbidities in Kung Flu, or anything else.

NONE of these conditions kills anyone.

Let me fine tune that for you.


Do they contribute, indirectly, sometimes even directly?
O Hell yes they do. That's why we treat them, and want you to get them under control, to put off paying the Reaper the bill we all owe, for as long as possible.
But trying to pin things on them is the same misguided sensibility that would stop obesity by banning forks and 40 oz. sodas, and putting 10-day waiting periods on Oreos and Twinkies.

What kills people?
(Pay attention here: this is human physiology, in two words:)
Cardio-respiratory failure.
Due to any number of pathologies.
Like any form of shock. Obstructive, hypovolemic, distributive, or neurogenic.

Will Obesity kill you? No. But cardio-respiratory failure, secondary to being fat as a house, and your heart failing to be able to do its job as a direct result, will kill you deader than canned tuna. Years early, as a rule.

Will Hypertension kill you? No. But it will give you a huge and ongoing increased risk for heart attack, or a stroke, which will induce cardiogenic shock, or neurogenic shock, or cerebral edema, or a brain aneurysm that pops and fills your skull with blood, which, having no place to go, squeezes your brains out the little hole at the base of the skull, which tends to shut off your pulse, blood pressure, and respiratory drive.
Which is cardio-respiratory failure.

Will diabetes kill you? No. But it'll give you a diabetic coma, unleash diabetic ketoacidosis, as your body tries to eat itself, gets dehydrated, you go into circulatory shock, and die.
From cardio-respiratory failure.

Will chronic renal failure kill you? No. Unless you skip dialysis for a couple of visits. And one of the by-products not being filtered out is potassium, which normally ranges from levels of 3.5-5 mmol/L (or 3.6-5.2 mmol/L depending on whose lab/reference you're using). But you skipped visiting your artificial kidneys a couple of trips, so your potassium level is north of 6 or 7, maybe 8, perhaps even all the way to 9 mmol/L.
( 9 mmol/L is much like Stage V of Cancer: it is equal to the ECU: the Eternal Care Unit, at Forest Lawn mortuary and cemeteries, hereabouts).

{Trade secret: Lethal injection, when carried out, consists of three drugs:
1) A sleep-inducing agent, like Valium, Versed, etc., to knock you out, so you miss watching/experiencing the final act.
2) Succinylcholine, a synthetic derivative of curare (yes, exactly like from natives' blow-darts) which paralyzes your muscles, including those used for breathing, for long enough to kill you. We do the sleep agent first, because being conscious, and unable to breathe, is suffocating while wide awake, and rather terroristically panic-inducing. We're usually talking mass murderers here, but I'm still not willing to add torture to the execution, as a general rule, amusing as it might be. Slippery slopes and all.
3) Potassium. Because every muscle in you body needs an electrolyte balance, and sodium, potassium, etc. go back and forth to make your muscles work. But get the potassium too high, and you shut off the muscles. So what? Well, you may recall your heart is a muscle, and rather important, since it beats about 37M times/yr until you die. So when your potassium gets to about 9, everything stops moving. Including your ticker. In seconds after a suitable KCl bolus, BTW.
So we turn off your consciousness, your breathing, and your heart, like flicking off light switches.
Which causes: cardio-respiratory failure.

And you - or Mack The Knife - have now paid the state the debt owed for capital crimes.
O frabjous day! Callooh! Callay! But again, we digress.}

So in you come, after skipping your dialysis serially, with your potassium headed for the final elevator stop before the afterlife, and then your heart stops, and we can't get it going to get you back, most times.
Cardio-respiratory failure.

So what?
Having these things with Kung Flu, doesn't mean you died from them instead of from Kung Flu.
Could they have made it easier to get Kung Flu?
Hell yes, from what I've seen published.
Could they make it a bit easier for Kung Flu to kill you?
Hell yes, because your heart is already strained from obesity, hypertension, and your kidneys weakened or failed from diabetes, and thus you have poorer reserves of cardiac or respiratory stamina, or electrolyte imbalances, or sepsis, or twelve other things Kung Flu does to you.

So what kills you, virtually every stinking time:
Cardio-respiratory failure! Because of Kung Flu!

NOT because of obesity, hypertension, diabetes, or renal failure.
Those just made you a juicier target, and a slower moving prey.

Fat antelopes die of cardio-respiratory failure too, because the lion bit down on their wind pipe, and severed their jugular, and clawed their hindquarters open and bloody.
She/he caught them because they were fat, but what killed them was the lion, not their fat ass.

When you get mugged and killed in a robbery, because of a Rolex and a diamond pinkie ring, you die of cardio-respiratory failure from getting shot in the heart. Wealth didn't kill you, the mugger did. Wealth just made you a juicier target.

When you get raped, it's the rapist who rapes you.
You got raped because rapists are evil douchebags, not because of your short skirt and high heels.

Those of you mistakenly or deliberately trying to pretend (co-morbidity = proximate cause of death) are not only wrong, and functionally dumb, you're using the excuse that the victim's skirt was too short, their heels were too high, and they had it coming.

Which is definitionally incorrect, morally reprehensible, and also not very bright.
Please, stop doing that.

People don't drop dead from just old age. Nor just obesity. Nor just hypertension. Nor just diabetes. Nor just chronic renal failure. To a certainty, those things hasten their deaths and shorten their days. But they don't abruptly drop at 2000/week in one city alone because of those things.

They're dying of Kung Flu, which is inducing cardio-respiratory failure, from lungs full of goo, from coagulopathy, from God Only Knows (and pathology is going to start telling us, to a certainty), because they had Kung Flu.

NOT because they had co-morbidities.
To say the latter was causative puts the cart before the horse, and only shows you lack the basic understanding of how this works.
Kung Flu is the lion, the robber, the rapist.

So for crying out loud, stop waving your hands as if you have an "AHA!" moment when it turns out that large numbers of the dead had one or more of those conditions.
This is America: nearly half the country is obese (haven't you been to a Wal-Mart, or even just the "people of Wal-Mart" site?), and a third probably have hypertension, diabetes, or both. You may as well claim they died because they had arms and legs.

Now, if you can find an example of someone driving a snowmobile off a cliff, eaten by wolverines, struck by lightning, or fell in a wood chipper, and whose death was then lumped into the daily Kung Flu death stats, by all means, call that silly b.s. out, loud and clear. But somebody dying in the ICU, with bilateral multifocal pneumonia, a tube down their throat, in NYFC or Bugtussle, amidst a pandemic, is overwhelmingly likely to be a Kung Flu death, until proven otherwise.

Extra credit: Go look up post hoc, ergo propter hoc , and his little brother that starts with cum. They are examples of how not to deduce truth and discover reason.

Thursday, April 23, 2020

Let The White Whale Quest End, Please

Pursuit of the impossible past the point of insanity never
 turns out well for Captain Ahab.

Angus: try reading the story, not just the headlines.
New York Gov. Andrew Cuomo revealed Thursday that preliminary results from a coronavirus antibody study show the statewide infection rate is 13.9 percent, which would mean around 2.7 million residents could have carried the disease.
The 3,000 samples were collected from 40 sites in 19 counties, according to Cuomo, and suggested the infection rate is as high as 21.2 percent in places like New York City.
The governor says the testing was conducted at sites set up outside places like grocery and box stores.
“These are people who were out and about shopping,” Cuomo said. “They were not people who were in their home, they are not people who are isolated, they are not people who are quarantined -- who you could argue probably had a lower rate of infection because they wouldn’t come out of the house.” 
Nearly 70 percent of the overall testing was done in the regions of Westchester, New York City and Long Island. 
In Long Island, the positive rate was 16.7 percent, while the positive rate in Westchester/Rockland Counties and the rest of the state was 11.7 and 3.6 percent, respectively.
That's direct from the text.
How does that stack up with actual science and statistics?
Pretty poorly.

Sample size: adequate.
Specificity of testing for Kung Flu: uncertain, at best.
Controlled for age, sex, race, etc.: unknown, but dubious likelihood.
Selection: anything but random.
Skewed heavily towards NYFC, the world capitol of Kung Flu.

If we wanted to know the infection rate among people regularly breaking quarantine around Kung Flu City World Pandemic HQ, it tells us a lot.
NYFC rate of infection: 21.2%
Long Island rate: 16.7%
Westchester/Rockland County rate: 11.7%
Rate of infection in the rest of NYFS: 3.6%

So, granting the premise of this dubious study, with 16,000 dead there alone already, unlocking everything in NYFC could yield a final death toll of as much as 80,000, if they manage to infect every single person in New York Effing City.


Meanwhile, the rate of infection in the rest of the state, under, once again, the rosiest non-vetted, unpeer-reviewed piece of totally questionable codswallop is not 21.2%, nor even the weighted 13.9% in the headline Angus grabbed, but only 3.6%.

Jesus, Mary, and Joseph, man, they printed that right in front of you, in English, FFS. What more could you possibly want??

Meaning the rest of the state still stands to infect the other 96.4% of the population with no antibodies whatsoever, and increase their final death toll by as much as 25 times what it is right now.

I cannot imagine why all the residents of both the Big Horse Apple, and the Empire State, are not clamoring loudly to be allowed the freedom to roam without let or hindrance, with the prospect of only another 64,000 dead in NYFC (where X=16000; 5X-16000=_____.), and another 108,000 or so dead in the non-NYFC part of the state as their reward, if they can just max out the spread. (That's the 4500 NYFS non-NYFC Kung Flu deaths currently, times 24 multiplier, represented by the 96% of NYFS that isn't infected, according to this latest polished turd of a survey, Angus. Wouldn't want you to have to do your own math to see where I come up with my numbers, would we? IOW, if X=4500, 25X - 4500 =______.) I mean, seriously, who'd pass up the chance to kill more people in one state from this than the entire U.S. lost in combat in every war since WWII, to date, combined, perhaps as early as Labor Day?!?
Other than anybody with two brain cells, I mean.
But cheer up. If they contain the spread to only 50% of the state, it'll "only" kill 96,000, instead of 192,000! Maybe even more, if the people locked in and not coming out to "grocery and big box stores" come out of hiding too! What's not to like?

And now guess who's butthurt, exactly as I noted, and got spanked by another blogger, and engendered his own special commemorative post. Angus, seriously: when I say you're butthurt, and then you get flagged for being butthurt, and then you post on your blog about how butthurt you are, how do you think it looks to everyone else on the internet?

You've devolved from occasional information to mere entertainment. And your butt is so scorching it could pop popcorn.

Your ongoing attempts to paint me as the bad guy in your silly Ahab-like quest just ran headfirst into a neutral third party, got you correctly called out by same, and you got burned.
And you did it all by yourself. Toddle back to your HQ, stop slandering innocent third parties and trying to throw shade at someone who's been blogging longer than I have, and probably longer than you too, and stop making up such tall tales that archived blogs from dead people even demonstrate your mendacity. You've forgotten that any number of live people who also visited there regularly can undo your fairytales as well.

IANAD, but I would suggest you need a case of this, stat:

It should go without needing to be said, but I don't want this pandemic to be any worse than it really is. I will, most happily, cheer any legitimate work that shows it's less severe, or liable to dry up and blow away, provided the authors of any such news haven't been huffing hopeium by the metric fuckton, to the detriment of actual science and statistical accuracy. And I sure as Hell don't want it to be a biblical apocalypse, just to be able to rub your nose in "I told you so". If you can't grok that, you're certifiable. I, however, most certainly am not.

I told you at Borepatch's blog that I still read yours. So if it'll help, let me suggest that if you want to get my attention, it isn't necessary for you to set yourself on fire like this. It's gotta be painful. I can get a post without your kamikaze antics. Trust me on that.

You want to blog Coronafest? Knock yourself out. It's a free blogosphere.
Just maybe consider the option to leave me out of your rants. It isn't turning out like you'd hoped, and you aren't getting any luckier with each dice roll. I'm not the white whale you're hunting. If it makes you feel better to think I'm the retard in this internet argument, go right ahead. It's on me. You will anyways, so what the hell, right? Get over it. Let it go, man. Live your life, and stop worrying about me.

Ontology, Epistemology, and Life In A Dumpster Fire

Ontology is the study of What Is.
Epistemology is the study of How We Know What We Know.
Despite the fact that this has been pursued since at least the ancient Greeks, for some definite amount of people on the internet, this is news.

This is generally why any discussion on the internet quickly devolves to a pick-up game of four blind men describing an elephant.

I've shared before on this site James Burke's excellent synopsis of when medicine transmogrified from superstition and stupidity into science, from his 1986 book, The Day The Universe Changed.  

Briefly, for those unfamiliar, before about 1800, little was known and even less was understood, medically speaking. Any doctor that figured something out kept it a deep, dark trade secret, lest his colleagues learn them, and his livelihood be lost. This is a recipe for exactly the pre-literate practices that survived well into the 19th century. It's why George Washington was bled to death with what was probably a simple case of influenza.

But in post-Revolutionary France, courtesy of Napoleon, there were two drastic changes which took place, and one new idea, that revolutionized the art and science of healing. First, medicine, in the form of hospitals, became available to the common people, by design intent of TPTB. Second, Napoleon's constant campaigns and conquests provided the medical practitioners of the time with a near endless stream of subjects of all types.

But what drove things into civilizational hyperspeed was when these two things were combined with the nascent practice of medical statistical analysis, both formally and informally. The hospitals in Paris of the day, for example, were all specialized. One hospital only worked with broken bones. Another only did skin diseases. Another would treat gunshot wounds. And so on.

So when a patient came into the hospital that dealt with amputated limbs, for example, they could see what worked, and what didn't. Of 60 men with amputated legs, 20 might be treated with a poultice of horse manure and dog droppings on the stump. (No, really). 20 more might have the wound sealed with hot tar. And the last 20 might have the bloody stump washed daily, and clean bandages applied. Unsurprisingly, one of these methods surpassed the others. But unlike earlier eras, records were kept, statistics were compiled, and the results published for the medical community. Voila! medicine was no longer superstition, but now a scientific endeavor. In medieval and renaissance times, working class barber surgeons gradually surpassed degreed physicians for primacy (a trend which has continued to this day), because their hands-on practical experience in cutting people open and sewing them up worked better than the philosophical theories of balancing humors. But this trend really took off when it was combined with numbers, statistical analysis, then Germ Theory, and then anesthesia.

I bring this up because someone carped that what I bring to the discussion on the current Kung Flu pandemic is not the work of a statistician. My response to that (at least the part that's printable and mentionable in polite company) is "Au contraire!" and "Sweet Jesus!!"

I do statistical analysis my entire working day, for my entire career.
What works best, how each patient is doing, trend over time, temperature, pulse rate, respiration rate, blood pressure, systolic, diastolic, and mean, pulse oxygenation, over and over, lather, rinse and repeat. I work, on an average day, with more figures than anyone who isn't doing nuclear physics, astronomy, or high finance, with a pencil and paper. I gather statistical data all day long until my eyes hurt. The average nurse does more data collection and data analysis in one week than university student in statistics class does in a month.

When I'm running sedation for someone with a dislocated limb, the doctor or physician assistant is worried about getting it back in place, as that's what they're trained to do. But I'm the one doing the anesthesia. Monitoring the patient's vital signs and mentation, before, during and after, and checking the temperature, pulse, and sensation of the restored limb. Doctor's and P.A.s care about that, but they don't collect the data. I do.

So suffice it to say I know a wee bit about data collection and analysis.

Doing data collection and analysis is the entire heart of medical research.
How many patients have which symptoms, which side affects, how severe, how frequently. How much is enough, how much is too much, what to do if you give too much, how much is safe in a day. Body weight, dosages in milligrams or micrograms per kilogram, per hour, per day, overall. What's a therapeutic dose, versus a sub-therapeutic dose, versus a lethal dose.

Anybody that thinks I (or anyone else in similar circumstances) don't know statistics, frankly, has his head absolutely up his ass.

Actual hardcore number-crunching statisticians, however, are concerned with the applicability of numbers to problems. They can and have, for example, work out the formulas for how many people you need to extrapolate a valid result.

Which, by the way, is why most of what's being passed around on the internet as "data" goes by the statistical name "invalid" (which is an industry term translating to "total bullshit").
This includes the Stanford survey (because they didn't control for age, and almost certainly oversampled young tech-savvy yuppies with a youthful invincibility complex, and ignored or grossly undersampled seniors locked in their homes lest they die of the Kung Flu). The L.A. County test was less than half the size needed for statistical validity. Neither test has been shown to be specific for Kung Flu antibodies, rather than any other coronavirus, including strains that produce the common cold. Which is why neither one is peer-reviewed, because they'd be laughingstocks. But people who don't know any better are waving them around like magic talismans of "proof".

Which gets me back to the main point.

The position I've taken isn't right because I say it is. It's simply where the current evidence available to me points. So it doesn't matter, strictly speaking, that I'm a nurse. I could be a pipefitter or a chauffeur; if I'm right I'm right, and if I'm wrong, I'm wrong.

People that don't get that are ascientific asshats, because they don't get how science works, and cannot grok that science isn't about scientific consensus, nor does it give a flying fuck about what degrees you possess. Einstein was a patent clerk when he wrote his Theory of Relativity. It isn't any less true because of that, nor did it become more true when he lectured at Princeton or Caltech, nor because the other physicists believed him. Every scientist was once sure the earth was the center of the universe. That was "scientific consensus". Galileo was the guy who stood up and said "You're all full of stercore. Eppur si muove." (because educated Italian men spoke Latin, as well as Italian, back then). He was right, they were all wrong. Period.

Barry Marshall was a humble ordinary doctor in West Australia (think North Dakota, except farther from civilization) who thought all the hacking people open for ulcers was wrong and stupid, and theorized that a bacteria was behind the problem. The entire medical establishment told him he was crazy. So he swallowed the bacterium he thought was responsible, got ulcers as a result, took antibiotics, and cured them. Now he has a Nobel Prize in Medicine, the Lasker prize, and is a Fellow of the Royal Society, while a million lesser doctors with far more on their C.V. and pedigree possess none of those honors, not leastly all the ones who assured him most learnedly and earnestly that he was completely wrong.

That's how science works.

And if you disagree with what I've said, that's meaningless.
Unless you have evidence that proves your point.
The reason comments are gone here, probably forever, is partly the jackwagons who think with their diaper, but just as much because of people who think they can just throw darts at the board, and that their responsibility stops with "You're wrong! I disagree!"
Like I'm doing a magic trick or something.

"Albuquerque! Snorkel! See, I can do it too."

As if I came to my conclusions with a oiuja board, instead of using the same mouse and keyboard you have, but also using my head for more than a hat rack.

For the Fucktard Army's benefit: that's not how it works.

Your work isn't ended when you scrape your diaper and fling it at the wall, and shout, like Madame DeFarge, "J'accuse!"
That's when your work starts.

Just as in any other court not presided over by kangaroos, if you have no evidence, you don't get to prosecute your case, and the gallery laughs you out the door. And to date, that was damned near every whiny jabberjaw popinjay lately who popped in here full of piss and vinegar.

You've got contrary evidence? Trot it out, and let's cut it open and see how, and if, it works.
If it doesn't pan out, no harm, no foul. And nothing personal, either way. We both look at what is, and adjust what we think in light of what we find. That's how a rational argument works.

But if you don't have anything like that, in fact couldn't be bothered to even address the concept that you have to have evidence for what you're shilling for, or to undo my argument that you're shilling against, and you can't be bothered to read up on the last 42 ideas that have already been examined and discarded, because you're a Baby Duck, and you get exactly the scorn and contempt you deserve. If that hurts your butt, maybe pull your head out of it. Better yet, stop doing that.

Which brings me to my theory of why this has been so hard on some people, and the vitriol it's engendered.

I deal with uncertainty every day. What's going on? Is it this? Is it that? What if that happens? Or the other thing? Or ALL the other things?

Not knowing the whole story is every patient, every day. There are hunches, and correlations, and diagnoses, and sometimes even certainty. But rarely a slam dunk, for me, for the doctors, for the patient, except when a Stevie Wonder diagnosis* is involved.

Most of you don't live or work like that. Some of you, almost never. Life is as comfortable as an old shoe.

So now, bring a virus that no one knows anything about. (At least, not anyone who's telling, without risking a Chinese firing squad, or 40 years in U.S federal SuperMax). Then it starts killing people. We're only just figuring out now, months later, how that may be happening. Then panic over it crashes the stock market, to the tune of $11.5T, overnight. Then you're laid off. Locked down. Your job may be gone forever. You might lose your house, your livelihood, your ability to do for yourself without charity handouts. You might become a refugee in your own country, like the Joads in The Grapes Of Wrath , which for most of you is pre-history from your parents or grandparents, in the misty past, like moon landings, trench warfare, and T. rex.

And after being stunned into inaction for a month or so, you're now just starting to go through grief stages.
All at once, in random order, cycling every hour, or day, back and forth, through all of them. Like people do.
Which is why people still won't accept what they see with their lying eyes.
We're headed for 50,000 people dead by the weekend, kids. Stop clutching at straws. Those people are really dead, and they're not coming back, and this could just be the beginning.

And then the Uncertainty magnifies it all: You don't know how long this will last, because no one does. You don't know how bad it's going to get, because no one does.
No One Does?!? HOLY SHIT!!!

And you'll clutch at anything, like a man drowning, including any slight glimmer, no matter how recockulous, that has the merest twinkling shot at making things Go Back To The Way It Was Before.

And any possibility that's not going to happen really scares the living shit right out your britches, and turns your brain full goose bozo. So you lash out, trying to fight what you can, instead of dealing with how it is, and what you don't know, and what nobody knows.

You're feeling helpless, hopeless, alone, and afraid of the dark.
And it's all dark, everywhere you look.

If you were expecting this is the part where I give you a big rhetorical hug, this is where I completely disappoint you.

In fact, let me offer you some amplification.

Because even if you had Ruby Slippers, clicked your heels together three times, and repeated "There's no place like home.", things are NEVER going back to How They Used To Be. That's been true your whole life, but it's been a more subtle kind of thing.

Now, it's going to be subtle like this:

Suck it up, buttercup. It's a big shit sandwich, and we're all gonna hafta take a bite.
Pining for better days is a sucker play. You had your heydays, and they're over.
This may suck for weeks, months, maybe even years.

Everybody's got a plan until they get hit in the mouth.
We all got tagged, but good.
Navy BUDS candidates get beaten into a zombie-like state, and the ones who don't crack, don't crumble, and don't quit, get a shot at being SEALs. Because their brains have learned that pain is in your head, you don't control anything but you, and you don't have to like it, you just have to do it. So just FIDO: Fuck It, Drive On. The ones who learn that lesson are turned into world-beaters, but their secret is no secret. It's just that they believe it enough to get through it.

The sooner all y'all start dealing with your shit, the sooner you can begin to process what you should be doing, instead of convincing yourself this is all not happening.

It's happening, it's real, it may go on (and on, and on) or it may fizzle out, but you don't know, and no one you trust does either. So deal with what you can, take stock of what you've got, and start thinking about how you're going to deal with whatever comes next.
You're cold, wet, and sandy, and you don't know when this will ever end. Except you can't puss out and ring out on this version of Hell Week. Bummer. None of us can.

A good first start would be to recognize you're in freefall, and stop flailing like a spaz, even mentally. Stop trying to fight the current.
Get your shit together, handle it, and deal with it.

I didn't put you in it, and I'm not going to get you out.
YOU are.

The sooner you start tracking with that reality, the better off you're going to be, and the less this problem is going to affect you.
Even if the pandemic is over next week, or next month, you won't be gliding on Easy Street when it's done and gone. Things are going to be different, in ways you haven't even thought about.

Beat your head, or your gums, about that topic, in the inner monologue inside your head.
Start by reminding yourselves that you're going to get through this.
Stop wasting time and energy on shit you can't control.
(And hey, back the fuck offa me, too.)
Regroup, and expect chaos and disorder to keep counter-attacking, until you get your head dug in to being in charge of you, at most. And sometimes, not even that.

And be okay with the chaos.
Just not blown around by it.
If the current situation has you at the end of your rope, tie a knot and hang on.
IF you can pull that off.
If you can keep your head when all about you   
    Are losing theirs and blaming it on you,   
If you can trust yourself when all men doubt you,
    But make allowance for their doubting too;   
If you can wait and not be tired by waiting,
    Or being lied about, don’t deal in lies,
Or being hated, don’t give way to hating,
    And yet don’t look too good, nor talk too wise:

If you can dream—and not make dreams your master;   
    If you can think—and not make thoughts your aim;   
If you can meet with Triumph and Disaster
    And treat those two impostors just the same;   
If you can bear to hear the truth you’ve spoken
    Twisted by knaves to make a trap for fools,
Or watch the things you gave your life to, broken,
    And stoop and build ’em up with worn-out tools:

If you can make one heap of all your winnings
    And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings
    And never breathe a word about your loss;
If you can force your heart and nerve and sinew
    To serve your turn long after they are gone,   
And so hold on when there is nothing in you
    Except the Will which says to them: ‘Hold on!’

If you can talk with crowds and keep your virtue,   
    Or walk with Kings—nor lose the common touch,
If neither foes nor loving friends can hurt you,
    If all men count with you, but none too much;
If you can fill the unforgiving minute
    With sixty seconds’ worth of distance run,   
Yours is the Earth and everything that’s in it,   
    And—which is more—you’ll be a Man, my son!

*{i.e.: Any vein I can see from across the room is a Stevie Wonder vein, because even Stevie could get an IV in it; a broken arm in a Z formation is a Stevie Wonder fracture, because even Dr. Stevie Wonder could diagnose that.}