One Person In A Leaky Boat Can Jeopardize Everyone - Same In A Pandemic

When Jim Jones' cult members drank the Kool Aid, it was a terrible tragedy.  An example of mass delusion resulting in many deaths.  But the people drinking the Kool Aid were only endangering themselves.

But when people don't self-isolate now, they endanger everyone.  Including themselves, not only through getting the virus, but through overburdening health facilities.

Then people with normal, treatable problems, may not have access to the health care they would normally get.  Car crashes, falls, fire victims, shooting victims, overdose victims, and on and on.

AND IT HAS ALREADY BEGUN

When you call the Medical Practice I go to here in Anchorage, Alaska, you get this message on the phone:

"Due to COVID-19 our visits are solely focused on the sick who need urgent care.  People scheduled for wellness visits are asked to postpone their visits."

So since I'm overall improved - three steps forward, two back - I'm not bothering them.  My coughing  is less frequent, my temperature lower (though it varies greatly and was 99˚F two nights ago, 98.4 last night), and today I don't feel as weak as I did a couple of days ago.

I also got the lab test report back.  They tested me for a lot more things that I realized and a quick glance shows that everything was negative.  The only thing I really wanted to be tested for was COVID-19, but that they didn't test for.

RESPIRATORY PATHOGEN PANEL,NAAT - Final result (03/11/2020 4:45 PM AKDT)

RESPIRATORY PATHOGEN PANEL,NAAT - Final result (03/11/2020 4:45 PM AKDT)
Component	Value	Ref Range	Performed At	Pathologist Signature
Respiratory Pathogens Panel	Negative Comment:  A negative result does not rule out the presence of viral nucleic acid below the limit of detection of this assay or the presence of PCR inhibitors and does not rule out infection with these viruses. This test is FDA approved and is intended for in vitro diagnostic use.	Negative	PAMC MICRO LAB
Adenovirus	Not Detected	Not Detected	PAMC MICRO LAB
Coronavirus 229E	Not DetectedComment: This test does NOT detect the novel Coronavirus that causes COVID-19. Follow your local Public Health Authority's guidelines for COVID-19 testing.	Not Detected	PAMC MICRO LAB
Coronavirus HKU1	Not DetectedComment: This test does NOT detect the novel Coronavirus that causes COVID-19. Follow your local Public Health Authority's guidelines for COVID-19 testing.	Not Detected	PAMC MICRO LAB
Coronavirus NL63	Not DetectedComment: This test does NOT detect the novel Coronavirus that causes COVID-19. Follow your local Public Health Authority's guidelines for COVID-19 testing.	Not Detected	PAMC MICRO LAB
Coronavirus OC43	Not DetectedComment: This test does NOT detect the novel Coronavirus that causes COVID-19. Follow your local Public Health Authority's guidelines for COVID-19 testing.	Not Detected	PAMC MICRO LAB
Human Metapneumovirus	Not Detected	Not Detected	PAMC MICRO LAB
Rhinovirus/Enterovirus	Not Detected	Not Detected	PAMC MICRO LAB
Influenza A PCR	Not Detected	Not Detected	PAMC MICRO LAB
Influenza A 2009 H1	Not Detected	Not Detected	PAMC MICRO LAB
Influenza A H1	Not Detected	Not Detected	PAMC MICRO LAB
Influenza A H3	Not Detected	Not Detected	PAMC MICRO LAB
Influenza B PCR	Not Detected	Not Detected	PAMC MICRO LAB
Parainfluenza 1	Not Detected	Not Detected	PAMC MICRO LAB
Parainfluenza 2	Not Detected	Not Detected	PAMC MICRO LAB
Parainfluenza 3	Not Detected	Not Detected	PAMC MICRO LAB
Parainfluenza 4	Not Detected	Not Detected	PAMC MICRO LAB
RSV	Not Detected	Not Detected	PAMC MICRO LAB
Bordetella Pertussis PCR	Not Detected	Not Detected	PAMC MICRO LAB
Chlamydia pneumoniae	Not Detected	Not Detected	PAMC MICRO LAB
Mycoplasma pneumoniae	Not Detected	Not Detected	PAMC MICRO LAB

Stay healthy everyone.

Peace Corps Volunteers Fired, Brought Back Home Without Insurance [Updated]

As an RPCV (Returned Peace Corps Volunteer) I feel compelled to note here that some 7300 active Peace Corps volunteers were brought back home to the US because of the Corona Virus. So far, so good.  But they were also fired and cut off from their health insurance.  Some were at the end of their two year assignments, others at various stages.

Peace Corps Volunteers don't get paid much anyway so keeping on salary for a few months wouldn't have been a big deal.

Glassdoor says the average monthly pay is $314 for Peace Corps Volunteers.  Their total pay is higher because an amount is set aside as a cash payment when they return to the United States.  There also may be other variables such as pay for housing, but that depends on each country's situation.

These are folks who have been representing the United States as teachers, sanitation engineers, forestry experts, and a wide variety of similar jobs.  They range in age from early 20s to 60s and 70s. Bringing them back and just cutting them off like that in the middle of a pandemic just seems mean spirited.

Here's more from Talking Points Memo - with a detailed report of evacuation from Peru.

[I got this update today that there's money in the emergency stimulus bill for Peace Corps evacuees.

"Late Wednesday (March 25), the U.S. Senate passed an emergency stimulus bill that includes $88 million for Peace Corps. The legislation now heads to the House of Representative for a vote expected Friday (March 27). That’s just the first step in a long-term effort to keep Peace Corps funding strong and support evacuees. That is why we are issuing a challenge to our community to send 100,000 messages to Congress. Learn more
Peace Corps volunteers come into country after learning the local language and training to improve their skills to do serious work in country.  The 'victories' of volunteers are the people they help to improve their lives or the health of their communities or the economic strength of a community.  The statistics are in the hearts of the people whose lives they touched, only occasionally being articulated."]

At the 45th Anniversary celebration of Peace Corp Thailand the Foreign Minister of Thailand told the group that his life as a poor Northeaster village kid was transformed by a Peace Corps volunteer who taught him English in school and got him into the AFS program which had him live with a US family for a year. I had a former student come to me - someone whose life I thought I'd messed up by getting him into a Bangkok school where I figured later, he'd just be a misfit - to say it had transformed his life and enabled him to live a much richer life than he ever could have had I not been there.  The director of Peace Corps in Thailand at that time (45th Anniversary) and the  US Ambassador to Thailand (both former Thai Peace Corps volunteers) each told stories of returning to their villages and finding out that they were still remembered fondly because of projects that had greatly improved the villages.

And this doesn't count all the RPCV's who return to the US speaking languages from all over the world, with a close understanding of the countries where they volunteered.  They bring this knowledge back and it transform how they do their jobs when they get back home and how they inform public debates on local as well as international issues.

Just had to make sure this was noted.

March 25 Alaska COVID-19 Update - 17 More Cases Up to 59

First, my daily summary of new cases/cumulative cases.  Wednesday we had 17 new/59 cumulative cases.  That's the highest daily jump after Tuesday's dip down to only 6 new cases.

CONFIRMED COVID-19 CASES ALASKA MARCH 2020
Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
new/total			12th  = 0/0	13th = 1/1	14th = 0/1	15th = 0/1
16th = 0/1	17th = 2/3	18th = 3/6	19th = 3/9	20th = 3/12	21st= 2/14	22nd= 8/22
23rd=14/36	24th =6/42 1 hos 1 dead	25th = 17/59 1 hos 1 dead

From the State's update page. (Note, what's up today will be replaced by the new charts.  I haven't found any other place where you can find all the older charts, except on this blog.  I'm using the tag "Alaska COVID-19 Count" for these posts.  You can click on the tag under these posts.)

I'm still trying to find a definition of 'date of onset' and how they determine that.  So the chart above DOESN'T tell us the day new cases were confirmed.  My understanding is that "date of onset" might be useful to predict new cases, but I'm not sure if that's true or how it works.  

And if anyone from the state is reading this, I'd suggest that when you have two or more of one color, instead of one big block, you separate each individual case with the same lines you use between colors.  It would be easier for people to count that way.

"Close-contact" and "Pending" have been added to the chart.  Dr. Zink explained this a little bit in last night's press conference, but the difference between non-travel and close-contact still isn't clear to me.  I'm thinking, if someone touched a surface - a door handle or an ATM keypad and then touched their face - how can you track that down?  I don't think you can, at least not for sure.

The chart above is getting longer on the screen (as the state adds individual towns and cities) and harder for me to capture in a single screen shot.  Maybe tomorrow I'll just copy the whole page, even though it has more info than I'm trying to get here.  I'll experiment.

After a steep rise on March 23 the number of new tests dropped sharply on March 24.  

Alaska Covid-19 Data by Steve on Scribd

It's another beautiful day in Anchorage I hope people can get out and enjoy it.  It seems for walkers there's plenty of space to practice healthy physical distancing.

PLUS 17 TO 59 - But Forget The Virus - Listen To Dan Bern Sing Estelle

I first heard Dan Bern sing at Loussac Library - the ticket stub in the CD case says May 25, but there's no year listed.  I'm guessing it was 1997 or 1998.  My son had let us know that we had to go to the concert.  It was one of those magical, intimate  concerts.  I was quickly pulled into the music and at the end when he sang EstelleI was in the music with him.

Figuring out the hardware to connect and play all the different genres of audio I have is on my todo list for this year.  But it looks like the virus is going to push that back a while.  So today I pulled some of the CDs from downstairs and put Dan Bern into the Bose.

I've been feeling really tired all day and my temp is back up to 99 tonight.  So I don't really feel like updating my COVID-19Alaska count tonight.  As it says in the title, we've added 17 confirmed cases and we're now at 59.

Instead, I invite you to let Dan take you somewhere else altogether. Just let it build up.

Alaska COVID-19 Case Count - State Reports First Hospitalization And First Death - Will UPDATE

CONFIRMED COVID-19 CASES ALASKA MARCH 2020
Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
new/total			12th  = 0/0	13th = 1/1	14th = 0/1	15th = 0/1
16th = 0/1	17th = 2/3	18th = 3/6	19th = 3/9	20th = 3/12	21st= 2/14	22nd= 8/22
23rd=14/36	24th =6/42 1 hos  1 death

I'm trying to find other confirmation of a death.  But here's what's on the State's newest update:

Note the last line in the chart above - 01 deaths.

I did hear on the radio about the first hospitalization, but not about a death.  Governor's COVID-19 press conference is at 6pm - here.  This link is easier - it's FB Live.  [UPDATE:  Confirmed in Press Conference now.  The person got the virus Outside of Alaska and passed away outside of Alaska.  More on this at ADN.  It said Federal Rules require Alaskans to be counted in Alaska even if they aren't there at the time.]

This is starting to show specific cities and towns, not just regions.

This is the first day where commercial tests outnumbered state tests, and it's by a lot!

I'll add more to this a little later.

Three Days Before 1964 Earthquake Anniversary - Jon Mooallem's Book This Is Chance Is Now Available

Looking for things to do while in self-isolation?  Order this book then listen to the podcast.

Genie Chance was a radio broadcaster in Anchorage when the earthquake hit, and her broadcasts got relayed from Fairbanks to the rest of the world.

"Slowly, people switched on their transistor radios and heard a familiar woman’s voice explaining what had just happened and what to do next. Genie Chance was a part-time radio reporter and working mother who would play an unlikely role in the wake of the disaster, helping to put her fractured community back together. Her tireless broadcasts over the next three days would transform her into a legendary figure in Alaska and bring her fame worldwide—but only briefly. That Easter weekend in Anchorage, Genie and a cast of endearingly eccentric characters—from a mountaineering psychologist to the local community theater group staging Our Town—were thrown into a jumbled world they could not recognize. Together, they would make a home in it again."

I 'met' Jon Mooallem first reading the intro to his book Wild Ones, which I wrote about here.

Then two years later I met him in person while on Bainbridge Island.  It turns out his daughter and my granddaughter are friends.  It took a while before I realized he was the guy who'd written Wild Ones.  And he was now writing about the 1964 Alaska Earthquake.  I wrote more about that here.

Well the new book is available as of today.  (I'm on his email list so I got a message about this today from him, and also from my daughter.)  So if you order it now you can probably get it while you're in isolation.

Meanwhile, this is the compelling audio telling of part of the book's story from two years ago, when he was working on the book.  It has lots of audio of Chance broadcasting and other audio from the time of the earthquake.  It's like an old fashioned radio show or a long This American Life story.   A great activity while you're stuck in the house.

The earthquake hit on March 27, 1964.  The 6 [5]6th anniversary will be Friday.

Here's a link where you can order the book from an Independent book store.


Here's a link to podcast interview with Jon from a couple of days ago.  I couldn't find a way to embed it here.

Alaska COVID-19 Confirmed Cases Up To 36

 It's harder to keep track of the numbers I set up based on the state numbers because they don't report things exactly like they did originally.  I'll keep posting those numbers at the bottom of these posts until I figure out a better way.  

Meanwhile I think this chart will help show the exponential growth that is beginning to occur.

CONFIRMED COVID-19 CASES ALASKA MARCH 2020
Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
new/total			12th  = 0/0	13th = 1/1	14th = 0/1	15th = 0/1
16th = 0/1	17th = 2/3	18th = 3/6	19th = 3/9	20th= 3/12	21st= 2/14	22nd=8/22
23rd=14/36

Here's what the State posted today:

The State hasn't posted how they've determined the date of onset.  But based on other studies I've seen in other countries, the number of confirmed cases lags behind onset.  My chart above shows that on March 15 there was only one confirmed case in Alaska.  But this shows lots of cases already there, so I'm guessing that this is a preview of the fast increase that's come in the last few days, and, presumably the next couple of weeks.  

This shows Anchorage numbers getting more proportional to its size.  Seven of the new Anchorage cases were confirmed on the military bases and that's why they declared an emergency Sunday night.

There was a sharp drop-off in tests.  Is that because of the weekend?  Or is it because the State has change the time they report cases?   Or?   I don't know. 

MY CHART - Yesterday the state first posted the two graphs from Saturday again on Sunday.  I had trouble working out my numbers in yesterday's post because of that.  They later fixed it and I added the new charts to yesterday's post.  I've adjusted the numbers from yesterday in the table below.  You'll see I'm having trouble in the columns on new negative state lab and new negative commercial lab tests.  The state began reporting those separately from the positive tests.  Now it doesn't say those are negative tests only (see two graphs above).  But it doesn't identify whether the positive tests were done in State or commercial labs.  As I've said in previous posts, I'm not sure why they thought it important to distinguish the two types of labs.  But with the change in how they report, I have to figure out whether and how to change the columns I'm reporting.  

Alaska Covid-19 Data by Steve on Scribd

Magpie Visits And I'm Reading The Overstory

 Richard Powers' The Overstory is a great distraction during a pandemic.  Here's just one illuminating quote:

“He reads the encyclopedia article on mental disorders.  The section on diagnosing schizophrenia contains this sentence:  Beliefs should not be considered delusional if they are in keeping with societal norms."

Alaska COVID-19 COUNT Sunday March 22 - Up By 8 To 22 [UPDATED, Up to 32 Cases Sunday Night]

What's New?

1. Updates will be made daily, not just weekdays - this weekend being the first.  This is good since the virus doesn't take the weekends off.
2. The counts up to now, apparently, were for the data from 11:59pm the day before.  I say 'apparently' because it doesn't tell us when that policy started.
3. But it's going to change to 5pm postings, it says, but it doesn't tell us what the time frame of those numbers will be.  Obviously not 11:59pm, but when?  And this will mean that comparing days after this starts to days before it starts will be from different time periods.  

All this comes from the top of the first chart posted today (Sunday, March 22, 2020)

They haven't defined 'date of onset.' Previously, I thought the dates were when the person was confirmed positive.  The top says "Laboratory Confirmed Cases." Was I wrong?  Did it change?  There's no explanation.  I thought the addition of the chart above would help us see how the number of confirmed cases grows over time.  That's what it seemed to add to the chart immediately below.  But it's easier to use the chart below to figure out where the confirmed cases are.

Here's the link that defines the economic regions.

From today's chart we learn:

• Anchorage (pop 292,000)  has six - all travel related cases. 
• Gulf Coast (pop 81,000) has three - one non-travel.
• Interior (pop 110,000) has seven - three travel, four not.
• Southeast (73,000) has six - one travel and five not.

Given that Anchorage is the biggest community by far, perhaps Mayor Berkowitz' early drastic actions (closing most everything from schools to restaurants) may have been a good call.  But it's too early to tell.

[UPDATED 9:56pm:  From Anchorage Daily News:

"Statewide, as of Sunday evening, there were 32 confirmed cases of COVID-19 in Alaska: Seven in Fairbanks; 13 in Anchorage; six in Ketchikan; two in Mat-Su, and one each in Juneau, Sterling, Soldotna and Seward."

That makes 20 new cases since the State reported yesterday.  More than doubled since Saturday.  That's the kind of exponential growth people are talking about and why people need to stay home unless it's absolutely critical.  The link on exponential growth takes you to a video that explains the concept and its application to COVID-19.]

These graphs continue to be frustrating for me.  I like that we can see tests over time.  If you look closely, these are the same two graphs that were posted yesterday.  The numbers are the same and they both end on March 20, 2010.   As I've said before:

[UPDATE Mon March 23, 2020 10:00pm:  The two graphs immediately above were replaced sometime after I did this post with the next day's graphs.  That's good, but it would also be helpful if they mentioned that they did that.  Here are the new ones.  Then I'll post the info that was posted today.

These numbers will be reflected on my chart that I'll post later tonight.]

1. Ideally these would be interactive and your cursor would show you the numbers for each day
2. The bottom one would have numbers attached to at least the last day as in the graph above
3. A third line combining the blue and red lines
4. I'm still not sure why these distinctions between State labs and commercial labs are important 
5. The lettering on the charts is going to get smaller and smaller in the next couple of weeks as they try to fit everything in.

MY UPDATED CHART

Given the changes in what the State is offering, keeping parts of my chart current is getting impossible.  There's nothing here to show a change in total tests between today's post and yesterday's.  

The only two columns that I've been able to track consistently are the first [total positive/confirmed] and the third [new positive/confirmed cases].

Alaska Covid-19 Data by Steve on Scribd

This is turning out to be one of those projects that grows way beyond the initial post.  I'm hoping I can straighten out the missing and inconsistent numbers tomorrow, if I can get through to the State Department of Health.  I know they're busy, but this seems like a fairly important set of numbers.

I'm sure the reports from other states have their own share of issues.  This all reminds me that any collective number for the US or for any state or any country is just an approximate number.  Meanwhile you can check out Worldometers pages on Corona Virus for a constantly updating count of cases, deaths, and other numbers from around the world.  As of right now (March 22, 2020, 9:11pm Alaska time) they list world wide:

• Coronavirus Cases:   338,879
• Deaths:   14,688
• Recovered:   99,011

Alaska COVID-19 Case Count Sat 3/21/20 Up To 14 Confirmed [8 More Today to 22]

As you can see in the Case Count screen shot below - the State updates these numbers "weekdays by 12:30pm." Except yesterday was a weekend day.  But I did check and they had made an update.  But they didn't tell us if they're now updating daily or not.

New:
This first chart is new and it's welcome.  People can now see, from the state, what region of Alaska they were in.  The color coding is helpful.  BUT this new chart puts up the cases based on "date of onset,"  not when the test confirmed they had COVID-19.   I don't know how they determine 'date of onset."   I'm not a data viz expert, but I find the colors scattered in different places confusing.  One has to stop and count how many from each category.  That's ok now, but won't be soon.  And this chart is going to run out of room soon.  But it's a first start at showing what's happening over time.

The format of next chart seems unchanged from yesterday.  Except there's a new note on top:  Cases Hospitalized.  And eventually, I fear, deaths.  I'd note again, that yesterday they relabeled "Community Contact" as "Non-Travel."  

What's Missing?

1. Symptoms, circumstances (travel) of those who tested positive.
2. # of medical provider tests requests turned down by state for testing.   This would show us many other people were found to be credible candidates for a test, but weren't tested.  It's clear this is an issue in Alaska and around the country.  
3. Reasons tests turned down. My guess here is lack of tests and some sort of triaging that has not been explained well.  
4. Actual numbers for the "How many people were tested each day?" chart.  Actually, if those charts were interactive so a cursor going along the lines would see the number, that would be great!  Are there data viz people who could volunteer to help the state do these charts better?  Would the state accept the help? 
5. Definitions of Terms - What exactly does "Travel Related" include?  Out of country only?  Out of state?  Certain states?  What does "Non-Travel" mean?  What about "Date of Onset?"  How do they calculate that?  
6. Explanations of changes - Why did they replace "Community Contact" with "Non-Travel"?  Why they have introduced new charts - what were they trying to clear up for people?  They previously separated cumulative confirmed from cumulative negative state tests and negative commercial tests.  Now the total tests (distinguished by whether done by State lab or commercial lab) no longer says "negative."  So I have to assume the positives are included there.  

Implications

Which data are presented and how they are presented, AND which data are not presented  reflect what an agency thinks is important, what an agency wants people to see, and what an agency doesn't want people to see.  These decisions might be based on: 

• very conscious decisions, 
• not a lot of conscious decision making, or 
• simply doing the best they can

My thoughts:

1. The State thinks it's important to
1. show the number of confirmed cases
2. show the location of confirmed cases
3. distinguish between State lab tests and commercial lab tests
4. show what parts of the state have confirmed cases
2. The State thinks it's  a) less important,  b) they don't want to call attention to,  c) they aren't keeping track of, d) they're trying to keep the info simple, or e) they don't have the time or skills to offer: 
1. number of medically recommended tests turned down
2. reasons why those tests were turned down
3. whether the positive tests were found in State or commercial labs

MY UPDATED CHART

Alaska Covid-19 Data by Steve on Scribd

NEW DATA UP TODAY  - I'll catch up on this later, but here's a quick take

Just as I was finishing this, I double checked to find that the state is now doing daily posts and there's a new one for today - Sunday, March 22. That's good, we need daily reports. But they've changed the format and way they are posting confirmed tests (the top chart with the colored boxes). Also there is the largest jump to date -  it adds 8 new cases for a total of 22 cases.