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From coronavirus black and white to gray

Dr. Robin Schoenthaler, an oncologist at Mass. General, files her latest report from the front line: Things are getting better, even if very slowly, MGH has reduced the number of ICU beds and begun re-opening operating rooms for non-Covid-19 patients.

"Flattening the curve via strict social distancing worked, even in an area as hard-hit as Boston," she reports.

But now comes the re-opening, even without a vaccine or medical treatment for a potentially deadly disease.

The last couple of months were so incredibly hard on so many levels but one good thing was how it was so black and white: stay home, period. Now we’re going to move into a different kind of hard. We’re not going to have black and white anymore; it’s going to be gray. ...

The incubation period for Covid is 2-14 days with an average of 5, and many people wait to get tested. So it takes at least a couple of weeks after a big exposure to see an uptick in cases, and then it takes at least a few weeks more to see an increase in the death rate.

So if we open up Massachusetts on May 19, we won’t really know the impact til late June. Meanwhile everybody all over the news and social media will be hashing over every uptick and downturn but the fact is: we won’t know if we’re okay until we’re looking in the rearview mirror, and in the meantime things will be gray. And I hate gray.

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we won’t know if we’re okay until we’re looking in the rearview mirror, and in the meantime things will be gray. And I hate gray.

Unfortunately, when you measure things -- you always get uncertainty-- perhaps sometime it is ignoble -- but its always present

Well OK in some experiments involving quantum entangled photons -- so called Bell's Paradox -- with either Vertical or Horizontal Polarization of the photons -- if you measure one [to the extent that you can precisely] the other is predetermined.

Otherwise when we measure things we get some value as a result and some estimate of the magnitude and type of uncertainty -- commonly discussed in the form of a Gaussian or Bell-shaped curve. There are two types of uncertainty: systematic errors which "infect the process" and which can in principle be removed if the measurements are better characterized; random errors [noise] which is always present but with larger number of independent samples will tend to become less significant.

We see this phenomena on a dally basis when the MA COVID-19 report comes out. Consider the daily count of people who died from COVID-19 yesterday. The following is completely ignoring the pollution of the data with the cases where the person died of something else and just happened to have been infected with the COVID-19 disease on the side.

So what else can be uncertain of a death -- well the simplest case is that the death occurred but somehow was not reported until the next day. There also could be a technical glitch in the data submitted by one hospital or another which then has to be corrected at a later date. There is also the problem that between the death being noted and the deaths being tabulated that a plain old clerical error occurred somewhere in the chain. All oft these have been noted in the footnotes which accompany the statistics as reported.

Beyond all the above -- there are also people -- typically elderly and who as we used to say are "not to hail and hearty" who just pass away at home [perhaps while sleeping] and since they have never been tested for the SARS-COV-2 virus or the antibody -- their death is just given as "natural causes"

If you look at the annual reports on causes of deaths of the 58,000 or so people who will die every year in MA -- well some 14,000 or so don't fit into any of the standard categories

for 2017 [most recent data available]

Total 58,844 Deaths of Massachusetts Residents

  1. Cancer 12,937
  2. Heart Disease 12,165
  3. Unintentional Injuries 3,913
  4. Chronic Lower Respiratory Disease 2,843
  5. Stroke 2,370
  6. Alzheimer's Disease 1,844
  7. Influenza & Pneumonia 1,434
  8. Diabetes 1,323
  9. Nephritis 1,194
  10. Ill-Defined Conditions-Signs and Symptoms 912

add that up 40,935 and you still need to account for 17,909 30%

So -- the basic color of this whole COVID-19 Pandemic is many shades of Gray

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We've got all kinds of hospitals.
Covid-19 MGH
Trauma BMC
Bones Parker Hill Hospital
and many more...

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