Water Cooler Observations, April 8, 2020

Hiemstra_FHFA_02052009By Stephen W. Hiemstra

Midwesterners have a reputation for being friendly people. As a kid, I spent a lot of time on my grandparent’s farm where the reason for the positive attitudes was very simple. Out on the farm, you did not see a lot of people and, when you did, you were happy to see them.

Walking around the neighborhood these past several weeks, I have seen more smiling faces than all last year. As I enter my fifth week sheltering in place, I too am happy to see my neighbors.

Secondary Trauma

The relentless discussion of corona virus on television is triggering a form of secondary trauma that manifests itself as unexplained anxiety. Secondary trauma normally refers to the trauma induced in caregivers during horrible disasters, like plane crashes and earthquakes. Seeing large numbers of suffering people can overwhelm the caregivers, triggering anxiety and depression.

If you suffer from secondary trauma, limit your television time watching news reports and try getting outside. Sunshine and exercise are natural anti-depressants that you can use to keep a healthy balance.

Bright Spots

Optimism today centered around decreasing hospital admissions in NYC (probably due to social distancing) and the discovery of an antibody treatment (link) that may soon be available to first responders.

Antibody treatment is really good news, but it is not a vaccine. How quickly it can be rolled out, remains to be seen.

Social distancing works to reduce hospital admissions by spreading out the caseload over time. This allows hospitals to treat the critically ill patients without exceeding capacity limitations on staff and equipment, like ventilators. This way lives are saved that might otherwise have been lost.

Corona Statistics

For me, reviewing statistics on the corona virus is an anxiety-inducing event. The mortality rate in the U.S. rose today to 3.0 percent with the cases and deaths both rising about ten percent daily.

Corona Virus Cases, Deaths, and Mortality Rates by Region, April 7, 2020
Countries Cases Deaths Mortality Rates
Count Change 1/ Count Change 1/
Western Europe 611,964 4.4% 51,223 6.5% 8.4%
Eastern Europe 26,329 6.7% 674 14.0% 2.6%
Africa 9,758 6.7% 473 8.7% 4.8%
Middle East 110,502 6.7% 4,611 5.2% 4.2%
Asia 119,236 2.2% 3,891 0.6% 3.3%
Australia and New Zealand 6,787 2.0% 43 16.2% 0.6%
Pacific 11,290 7.8% 472 6.5% 4.2%
Atlantic 87 11.5% 9 28.6% 10.3%
North America 385,404 9.0% 11,334 13.9% 2.9%
Central America 5,469 8.8% 212 18.4% 3.9%
Caribbean 2,669 5.1% 116 7.4% 4.3%
Latin America 27,493 7.2% 1,008 12.5% 3.7%
World 1,316,988 5.8% 74,066 7.4% 5.6%
1/ Percentage change from prior day reported
Source: European Centre for Disease Prevention and Control

Corona virus hot spots around the world are much worse than the U.S. Europe remains the worst hit area of the world with Italy and France reporting mortality rates above 12 percent, likely because of a large elderly population. The Europe situation is particularly worrisome because European have socialized medicine not available in the U.S.

In the U.S. we have many undocumented workers and others not covered by health insurance. Think of all the people laid off in recent weeks. If these people are slow to ask for medical treatment when they need it, then they may infect others and  the U.S. mortality rates will rise to compete with European rates.

Corona Virus Hot Spots by Country, April 7, 2020
Countries Region Cases Deaths Mortality rates
Italy 1 132,547 16,525 12.5%
France 1 74,390 8,911 12.0%
United_Kingdom 1 51,608 5,373 10.4%
Netherlands 1 18,803 1,867 9.9%
Spain 1 135,032 13,055 9.7%
Indonesia 7 2,491 209 8.4%
Belgium 1 20,814 1,632 7.8%
Sweden 1 7,206 477 6.6%
Iran 4 60,500 3,739 6.2%
Mexico 10 2,439 125 5.1%
Note: Counties with at least 2,000 cases.
Source: European Centre for Disease Prevention and Control

Pre-Existing Conditions

What counts as a pre-existing condition to raise mortality rates for corona virus patients?

Your probability of death about doubles for age groups over sixty, being male, and having certain medical conditions. Heart disease, chronic respiratory ailments, diabetes, hyper-tension, and cancer are all factors more than doubling your risk. Deaths in minority communities are especially high because of these pre-existing conditions.

These statistics come from China where treatment options may be more limited. For details, see (link).

Economy

After 9-11, economists at the Comptroller of the Currency, which regulates national banks, were busy doing regional and industrial studies to determine the distribution of losses in the economy and how they would affect banks.

The process of determining these economic effects was to examine the industries that would have obvious problems, like hospitality, airlines, and travel business, and look to the Census data to see where these industries were concentrated. Banks serving those areas were then assumed to have been disproportionally affected.

This week I wondered about how laid off workers would pay their mortgages in the coming months. What happens to their lenders?

Also, corona virus deaths may reach levels not previously seen–what happens to the insurance companies standing behind hospitals and individuals that pass away that have insufficient reserves? Companies like hospitals, pharmacies, and grocery stories are likely to have corona related deaths where infection obviously took place on the job.

Response of Churches

Just about every church now offers some form of online worship on Sundays. Many have added midweek Zoom get togethers, Facebook parties, and video devotions. Many are quite good. Check your favorite church website for details.

Turning to God in Distress: A Gethsemane Moment

When you are in pain or afraid, where do you turn?

When Jesus was facing death in the Garden of Gethsemane, he turned to God instead of his pain and fear.

Then Jesus went with them to a place called Gethsemane, and he said to his disciples, “Sit here, while I go over there and pray.” And taking with him Peter and the two sons of Zebedee, he began to be sorrowful and troubled. Then he said to them, “My soul is very sorrowful, even to death; remain here, and watch with me.” And going a little farther he fell on his face and prayed, saying, “My Father, if it be possible, let this cup pass from me; nevertheless, not as I will, but as you will.” (Matt 26:36-39 ESV)

We face a Gethsemane Moment today worldwide. Where will you turn?

Spiritual Disciplines

Turn to God in your pain.

Consider reading Psalm 8 as a prayer, if you can not find the words to pray. I did this myself for about ten years.

Consider practicing continuous prayer–talking to God while you go about your day. I find prayer comes more easily when I am jogging or swimming laps. One of my own prayers is. Prayer for Shelter.

Consider daily journaling. I start my days in the morning with a daily examine–looking for God’s work in your life over the previous day.

Consider daily bible reading or study. I try to read a Psalm daily after I journal. Once I finish reading them all, I start over.

Consider joining a small group. It is a great comfort seeing people and talking with them about what you are going through. If you don’t have a group, check your favorite church website or call the church.

Whatever you do, turn to God.

Water Cooler Observations, April 8, 2020

Also see:

Water Cooler Observations, April 1, 2020

Water Cooler Observations, March 25, 2020

Corona Virus Versus the Flu

Black Plague

CDC Flu Statistics

Managing Change 

Believer’s Prayer

Other ways to engage online:

Author site: http://www.StephenWHiemstra.net

Publisher site: http://www.T2Pneuma.com.

Newsletter: https://bit.ly/Meet_2020

 

 

 

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Water Cooler Observations, April 1, 2020

Hiemstra_FHFA_02052009By Stephen W. Hiemstra

During the spring  of 1973 I returned home from college to a new neighborhood in McLean, Virginia where the homes had garages rather than carports. Every day our new neighbors went to and returned from work without leaving their air conditioned houses. An electrical storm the following summer knocked out the power and, with it, the air conditioning. One after the other neighbor came outside to sit on their porch and escape the heat. That was when we finally got to meet them.

Walking in the neighborhood evenings with my wife, Maryam, the past couple weeks, I have seen more kids and adults outside than at any point since my childhood.

Year of the TV Preacher

Over the past two Sundays just about every church that I am associated with (6-8) has started holding services and meditations online. Some have even added midweek online sessions to match Sunday services. TV preacher Joel Olsteen recently reported having broken online attendance recordsabout five million viewers (link).

Local churches have typically not had a sophisticated online presence and the move online has been challenging. At one church that I know, giving is down about fifty percent in recent weeks.

How are local churches to compete in this new online-only environment?

Two observations come to mind.

First, recognize that local churches are unlikely to compete with Joel Olsteen for media sophistication. Don’t play a game that you are not likely to win.

Second, media sophistication is not what most people want today. People are hurting, lonely, and in need of reassurancethey desperately want to see familiar faces. This is where the local church can shine.

My advice to pastors is to check out what other churches are doing and find a format online that fits your style and audience. Personally, I think that the pastors offering online services from their living room couch with the spouse at their side provide the best fit for the current environment—the visual says from my family to yours. This reassures that pastor and parishioner are in this together.

Stat Wars

The daily news is grim. As a former chaplain, my heart goes out to all those patients and hospital staff contending daily with the grim reaper without family support. As field hospitals are built and American companies have diverted their facilities into producing medical supplies, we are writing the book on pandemic response.

Meanwhile, I feel like a contestant in a macabre game show as I spend my days reverse engineering the statistics that Dr. Fauci reports on the daily news. He has earned my respect repeatedly as he focuses on keeping the media and the administration focused on a reasoned response to the crisis. Science has become a contact sport. Perhaps, it always was.

Corona Virus Cases, Deaths, and Mortality Rates by Region, March 31, 2020
Countries Region Cases Deaths Mortality Rates
Count Change Count Change
Western Europe 391,444 7.6% 26,292 11.3% 6.7%
Eastern Europe 13,585 7.0% 196 16.0% 1.4%
Africa 5,043 10.7% 160 15.1% 3.2%
Middle East 62,919 11.2% 3,032 5.9% 4.8%
Asia 104,090 1.1% 3,603 0.6% 3.5%
Australia and New Zealand 5,204 12.0% 20 17.6% 0.4%
Pacific 6,608 15.6% 280 10.7% 4.2%
Atlantic 51 8.5% 1 0.0% 2.0%
North America 172,248 15.3% 3,265 26.8% 1.9%
Central America 2,712 8.3% 66 29.4% 2.4%
Caribbean 1,375 7.2% 52 8.3% 3.8%
Latin America 12,519 9.6% 305 18.2% 2.4%
World 777,798 8.7% 37,272 11.0% 4.8%
Source: European Centre for Disease Prevention and Control

A key estimate by Dr. Fauci this week was that this pandemic would cost two hundred thousand American lives. Two hundred thousand is two percent of ten million corona virus cases.

Two percent has been the estimated mortality rate for the United States reported since this pandemic began and probably comes from the 1918 experience with the Spanish flu. Today’s rate for the U.S. is 1.9 percent, while the world average is now 4.8 percent (see the table). Italy has a mortality rate today that is 11.4 percent.

Ten million is an estimate of the eventual total case load of corona virus cases for the U.S. Meanwhile, the U.S. population is around three hundred million, suggesting a much larger number of cases.

If I had to guess, Dr. Fauci’s estimate is the result of a government oversight committee negotiation, focused on managing the optics. While this sounds political, managing fear is on every leader’s mind because fear compounds the underlying problem. Whether you consider the mortality rate or the caseload assumed in this calculation, the estimate is the most optimistic figure that could be reported with a straight face.

The two million death figure, which entered the briefing styled as a worst case scenario, arises from considering the population, not caseloads, and reflects a more reasonable set of assumptions. It may still be optimistic. Two percent of three hundred million is about six million, not two and, if the U.S. eventually sees worldwide mortality rates (4.8 percent today), then you have to more than double that figure.

Endgame

The statistics on mortality depend critically on how one expects this pandemic to end.

Social distancing works to reduce mortality rates by keeping the number of critically ill patients under the carrying capacity of the hospital system, thereby minimizing deaths.

For example, if the Washington metro area has thousand beds with ventilators and support staff, and the caseload remains under a thousand, then deaths are minimized (1.9 percent). As the caseload increases over a thousand, the mortality rate rises (4.8 to 11.4 percent). The mortality rate cannot remain at zero because even well-staffed and supplied hospitals will lose patients with pre-existing conditions.

This pandemic ends when one of two things happens. Either we develop an effective vaccine or so many people get the virus that it can no longer spread (herd immunity). Best estimates that a vaccine is 12-18 months away so the most likely case is that the virus burns itself out like a forest fire that stops spreading because it runs out of forest. This is why Dr. Fauci’s estimate is optimisticten million cases is not the forest.

Caveats

Three caveats are worth mentioning.

First, researchers have been working to develop a therapy involving a direct transfer of antibodies from patients already infected to those in dire straits. This is a novel approach, but it is untested. Other existing therapies are also being tested that relieve the stress that patients experience, improving their chances of survival.

Second, researchers will soon have a quick-turnaround test for corona virus antibodies. While this may not yield a new therapy, it may allow those who have recovered to return safely to work—a critical need in standing up our troubled economy. For many people, getting back to work not only means that they can pay their bills, it improves their access to medical services.

Third, existing conditions kill by offering a one-two punch combined with the corona virus. Continuing to work out and keep a positive attitude improve your chances of survival because a positive attitude strengthens your immune system.

Flu Versus Corona Virus

The story about the flu is helpful in understanding our current dilemma with the corona virus. Influenza is a human pathogen, which implies that the human race has a long history of developing immunity to flu. Johns Hopkins University research recently reported  annual deaths ranging from 12,000 to 61,000 deaths in the U.S. per year. These statistics are well-known, which is why I get a flu shot every year.

While the annual death toll from the flu currently seems high relative to this epidemic, the above statistics are annual numbers while the current death toll from corona virus covers only a couple of weeks. Annualizing (take a weekly death figure and multiply by 52) the current number of deaths from corona virus (3,170 today) yields a number from 80-100 thousand, still a low number compared to estimates above that may suggest an alternative way to understand the Fauci estimate.

****************************************************************************

Keep in mind that annualizing losses is wildly sensitive to your technique for coming up with a weekly rate from a number increasing exponentially over time. Averages (a linear estimator) are not representative of nonlinear processes (like exponentially growing numbers), which to the non-mathematically inclined means that this is a very weak method for forecasting mortality rates.

****************************************************************************

Corona virus is not a human pathogen, but a virus that has jumped species from bats to pangolins to humans (link). This is why the virus is so lethal and why we do not have a natural immunity. Apparently, the Black Plague was a pathogen with a similar genesis.

Gethsemane Moment

When you are in pain or afraid, where do you turn?

When Jesus was facing death in the Garden of Gethsemane, he turned to God instead of his pain and fear.

 Then Jesus went with them to a place called Gethsemane, and he said to his disciples, “Sit here, while I go over there and pray.” And taking with him Peter and the two sons of Zebedee, he began to be sorrowful and troubled. Then he said to them, “My soul is very sorrowful, even to death; remain here, and watch with me.” And going a little farther he fell on his face and prayed, saying, “My Father, if it be possible, let this cup pass from me; nevertheless, not as I will, but as you will.” (Matt 26:36-39 ESV)

We face a Gethsemane Moment today worldwide. Where will you turn?

Water Cooler Observations, April 1, 2020

Also see:

Water Cooler Observations, March 25, 2020

Corona Virus Versus the Flu

Black Plague

CDC Flu Statistics

Managing Change 

Believer’s Prayer

Other ways to engage online:

Author site: http://www.StephenWHiemstra.net

Publisher site: http://www.T2Pneuma.com.

Newsletter: https://bit.ly/Meet_2020

 

 

 

 

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Water Cooler Observations, March 25, 2020

Hiemstra_FHFA_02052009By Stephen W. Hiemstra

Those of you who know me know that in my first career, I was a financial engineer and economist with various federal agencies, as the photo to the right shows.

Starting Wednesday, March 25, 2020, I am going to lean into my background as a recovering economist to offer observations on our distracting world here on T2Pneuma.net. Let me know your questions if this piques your interest.

Corona Virus

During the past week, I was asked by a pastor friend to report on international corona virus statistics. The European Centre for Disease Prevention and Control,An agency of the European Union, reports daily case and deaths statistics for 166 nations around the world.

These statistics show that mortality rates different significantly by country and region. These differences reflected differing levels of testing, differences in the local spread of the virus, and differing intervention capabilities.

Corona Virus Cases, Deaths, and Mortality Rates by Region, March 24, 2020
Countries Region Cases Deaths Mortality Rates
Count Change Count Change
Western Europe 186,347 13.9% 10,108 16.5% 5.4%
Eastern Europe 5,374 14.9% 40 25.0% 0.7%
Africa 1,689 31.0% 52 23.8% 3.1%
Middle East 28,696 8.6% 1,881 7.9% 6.6%
Asia 96,397 0.8% 3,443 0.7% 3.6%
Australia and New Zealand 1,965 8.5% 7 0.0% 0.4%
Pacific 3,143 41.7% 134 14.5% 4.3%
Atlantic 13 0.0% 0 #DIV/0! 0.0%
North America 48,105 31.3% 614 25.6% 1.3%
Central America 927 13.9% 13 62.5% 1.4%
Caribbean 405 16.4% 5 0.0% 1.2%
Latin America 4,980 18.6% 68 28.3% 1.4%
World 378,041 11.7% 16,365 12.1% 4.3%
Source: European Centre for Disease Prevention and Control

Mortality rate hot spots include Italy (9.5 %), Indonesia (8.5 %), Iran (7.9 %),  Spain (6.6 %), UK (5.0 %), Netherlands (4.5 %), France (4.3 %), and China (4 %). This list changes daily. By contrast, the U.S. rate is 1.3 percent. Other countries with high rates do not report enough cases to have confidence in the figures.

This crisis will not end until the daily changes in the number of cases begins to decline and mortality rates begin to fall. Currently, worldwide the number of cases increased over yesterday by 11.7 percent and the average mortality rates for reported cases  was 4.3 percent.

Testing Implications

While most testing today is on patients with obvious symptoms, I look forward to a wider field of testing. South Korean data that I saw earlier in the week showed a significant number of young people testing positive who perhaps were asymptomatic.

Several aspects of this asymptomatic phenomena are important. While most commentators have focused on the potential for these people to spread the virus, we need to know who has effectively been inoculated. Before anyone talked about the corona virus in January, my wife was horribly sick with similar symptoms–she never previously took any sick leave. Afterwards, I had a head cold have self-quarantined the past two weeks. If either or both of us are now immune from getting corona virus, then we both need to be out helping others.

The punchline in this discussion is the question: when and how do we stand down safely as a nation from the quarantines? Politicians have begun to talk about this issue. Those who have recovered from the virus presumably have immunity and can safely return to work after some point, but we need to know from physicians when it is safe to do so.

Financial Implications

As a former financial regulator, I worry about the financial system with so many people out of work. Bank regulators normally are required by law and regulation to write off non-performing loans from capital after 90 days. By June, many institutions will be hitting that trigger. While regulators can waive these requirements temporarily, the longer this crisis lingers the more pressing the concern will be.

Insolvent banks are unlikely to make new loans and foreclosures will hit young workers and minorities harder than other groups whose employment is more secure. For those already strapped with student debt, the bind will grow even faster. This outcome could change election outcomes and permanently change people’s attitudes about credit and investing. My grandfather nearly lost the farm in the Great Depression of the 1930s and the experience forever changed his attitude about banking.

Regulators worry about insolvent banks because they have the perverse incentive to take risky bets. If you are going to fail anyway, why not bet the farm, so to speak? Changing accounting rules does not completely negate this effect because then bankers are investing someone else’s money, not their own.

Gethsemane Moment

When you are in pain or afraid, where do you turn? When Jesus was facing death in the Garden of Gethsemane, he turned to God instead of his pain and fear.

 Then Jesus went with them to a place called Gethsemane, and he said to his disciples, “Sit here, while I go over there and pray.” And taking with him Peter and the two sons of Zebedee, he began to be sorrowful and troubled. Then he said to them, “My soul is very sorrowful, even to death; remain here, and watch with me.” And going a little farther he fell on his face and prayed, saying, “My Father, if it be possible, let this cup pass from me; nevertheless, not as I will, but as you will.” (Matt. 26:36-39 ESV)

We face a Gethsemane Moment today worldwide. Where will you turn?

Water Cooler Observations, March 25, 2020

Also see:

Believer’s Prayer

Other ways to engage online:

Author site: http://www.StephenWHiemstra.net

Publisher site: http://www.T2Pneuma.com.

Newsletter: https://bit.ly/Meet_2020

 

 

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