The testimony(https://www.hsgac.senate.gov/covid-19-how-new-information-should-drive-policy) from Dr. Inglesby has been haunting me – he is against herd immunity largely because of the numbers he alluded to:

“Some have proposed allowing the disease to spread until the point where the country has

achieved “herd immunity”. Epidemiologic estimates are that it will require on the order of 70%

of the population to be infected to achieve herd immunity. 70% of the US population is about

people 233 million people. Most studies that have been done calculate the infected fatality

rate to be in the .5 to 1% range. For example, this Lancet analysis concluded that there was an

infected fatality rate of .66% in China. If .5% of 233 million people were to die from this illness

in the US, that would be 1,165,000 deaths.”

The Lancet study he refers to – https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext#tbl1

I don’t think ANYONE in the herd immunity would suggest the elder not be quarantined – to use 0.66% is EXTREMELY misleading.

Less than 60 age is 0.145! IF we go even lower less than 50 it is 0.10% – now we have 6X difference than Dr. Inglesby testified number – 233K

To reduce the number more – also ask to quarantine comorbidities we know are fatal with Covid-19 (Hypertension, Diabetes, BMI>30) – https://jamanetwork.com/journals/jama/fullarticle/2765184?guestAccessKey=906e474e-0b94-4e0e-8eaa-606ddf0224f5&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=042220

In fact if you HAD ONLY 1 comorbidity this would be reasonable to be able to go out – only if you had more than 1 you should quarantine.

So we can reduce the 233K to potentially less than 23K deaths! This will be below auto fatalities a year (33.6K). Clearly implementation will not be perfect and not everyone will listen – but at the same time there will be extra cautious people in fear. This could be a manageable number – the initial goal of all this quarantine was not 0 deaths or 0 spread – but to not overwhelm the healthcare system putting doctors in a position to choose who dies. A herd immunity with smart measures can do this without the ENTIRE population who has not done anything to merit quarantine result in being quarantined.

Visiting and taking care of the elderly and those with multiple comorbidity can still be done. Strict guidelines will need to be in placed to do this – but it is all technically feasible once you know who needs to be quarantined – in fact it can be done more effective than it is now. There are still many elderly and multiple comorbidity having to go groceries and other things. Once we know not everyone quarantines we can have a new industry/service to take care of this group with strict appropriate guidelines.

This study highlights Vitamin D again but also looks into the issue of sunnier regions doing worse. They identified the northern states fortified foods with Vitamin D. And as I have noted before just because its more sunny doesn’t mean people go outside. – http://imj.ie/vitamin-d-and-inflammation-potential-implications-for-severity-of-covid-19/

Rhode Island is over 9% per capita tested now.

They have detail information available – https://ri-department-of-health-covid-19-data-rihealth.hub.arcgis.com/

Even though cases are more towards the <50– they are not being hospitalized or showing up in the death figures.

52% less than 50 =6154

20% <50

54 hospitalized

Only 4% fatalities less than 50

Fatality rate = 19/6154=0.3% Unfortunately no comorbidity data to calculate a smaller fatality rate.

60% of death at longterm care facility.

US numbers below 2K again. Brazil growing

NY still leading the way for the US but at much smaller number (193)

Opened states nothing to note yet…

Brazil and Mexico with large growing deaths with hardly any testing is quite concerning. Russia testing and low deaths are amazing. Perhaps BCG?

Brazil and Mexico showing up as the leaders in the 7 day MA daily difference. Japan is showing another up tick but not at there previous peak. Interesting to note going to zero after 100+ days would seem to be an unachievable goal.