Category Archives: Web Article Review

Google’s pedestrian foot traffic data

The Philadelphia Inquirer has an article showing foot traffic at various locations around the city during the coronavirus shut down compared to average. As might be expected, foot traffic is down pretty much everywhere except grocery stores, where it is up slightly. This matches my personal observations. It doesn’t match the media accounts of crazy lines at grocery stores and big box stores in the suburbs. Maybe this is because in a dense walkable city, we have many small stores instead of a few large stores, and people tend to spread out their shopping over the entire day and week and to buy just a bag or two at a time that they can carry home. There are odd, sporadic shortages, but I have not observed any extreme shortages of basic goods.

The data supposedly come from Google. I tried to find out more about how, where and when Google is collecting this data, and came up short after 15 minutes or so of looking.

Now, I admit that clearly dense cities with a lot of social interaction have their down side right now. The big dense cities are also where the most international arrivals happen, and this factor along with density might be why they are the worst places to be right now. Hopefully they also have the largest medical facilities with the most experienced medical staff, but whatever we have is clearly not going to be enough to help everyone who needs help in the next month or so.

more epidemic simulations

Okay, the current pandemic is not a game and not fun, people are suffering and I certainly don’t want to make light of it. But maybe we can at least learn something about systems, such as positive and negative feedback loops, S-shaped curves, and time delays. Netlogo has a few agent-based virus simulations to play with. The MIT system dynamics people put together a whole lesson on simulation of an epidemic as a teaching tool. (This is part of their “road maps” series, which you can find here. Just be warned that many of the hyperlinks don’t work, but if you cut and paste the names of the documents into a search engine, you can usually find them.)

And of course, there is the old flash game Pandemic 2, which is kind of fun in ordinary times but seems a little crass to play now, or at least to admit that you’re playing it. (Your goal is to kill everybody in the world, for example by making them vomit blood from their eyes…) On the other hand, Flash seems like it is on the way out so if you want to try this game it may be best to try it soon. And those of you stuck at home without multiple small children to entertain (not a category that includes me!) might have the time right now.

coronavirus simulations

The Washington Post has some interesting simulations that explain why quarantine is not all that effective a strategy, and why aggressive social distancing can be so effective. Basically, by isolating healthy people from each other you can drastically slow down the rate of spread and reduce the number of cases hitting the health care system at any one time to something manageable. These are agent-based simulations with accompanying time series graphs, and I find them pretty intuitive and informative.

the goal of social distancing

Vox has an informative article with some visuals on the goal of social distancing in an epidemic. If you can reduce the total number of infections that is a bonus, but the primary goal is to reduce the peak number of infections happening at any one time. You can do this by delaying cases and spreading them out of time, so that the capacity of the health care system is better able to deal with them. This looks very similar to a stormwater or flood control engineer – often, our goal is also to reduce and delay the peak. Reducing the volume is a bonus if you can manage it. The lesson is not that epidemics are like hydrology, it’s that there are certain fundamental system structures that lead to fundamental behaviors, and they are shared between systems. A couple more that come to mind along the lines of this basic model are congestion pricing to spread traffic out over time, and batteries to store solar and wind energy and trickle them back over time.

another indicator that the U.S. is falling behind

The Atlantic has an article on just how badly the United States has dropped the ball on testing people for the novel coronavirus compared to other developed countries. We can add this to list along with overall life expectancy, child and maternal mortality, mass incarceration, depression, suicide, drug overdoses, blackouts, traffic delays, educational outcomes, drinking water quality, poverty, and the list goes on. We were great once, in the sense that we were the world’s leader on most or all of these categories. Over the last decade or two, we have not just lost that leadership position, we have fallen to the bottom of the pack and continue to lose ground. True patriots don’t just say their country is great again and hope that makes it true in the face of contrary evidence, they face the facts and do something about it.

the Flynn effect and the reverse Flynn effect

When IQ tests are taken by each generation, they are always normalized so that the average is a score of 100. However, when people are asked to take tests from older generations, they tend to do better than the older generations did. This is the Flynn effect. It was very consistent throughout the second half of the 20th century and into the 21st, but a number of studies in Scandinavia indicate that it may have reversed more recently. Immigration is one controversial explanation that has been suggested, whether due to genetic or cultural reasons. But the study I link to here tested the effect within families against the effect across unrelated people, and found that it is just as strong within families. This suggests environmental factors such as education and nutrition as the culprits, although the article does still put “migration” in this category. I suppose if you had a society with a high quality of nutrition and education, and you then have an influx of new people with more bad habits (let’s say, a high rate of smoking), that could have an effect.

private equity and surprise medical billing

This article from Center for Economic and Policy Research (I admit I don’t know much about this organization) claims that private equity firms have bought up medical practices and intentionally insert out-of-network doctors into teams treating you at your in-network hospital. Members of Congress have introduced legislation to curb this, but the financial lobby has been too powerful to beat.

Private equity-owned physician staffing firms grow by buying up many small specialty practices and “rolling them up” into umbrella organizations that serve health care systems across the United States. KKR-owned Envision Healthcare with 69,300 employees, and Blackstone-owned TeamHealth with 20,000 employees, dominate the market for outsourced doctors’ practices. A team of Yale University health economists examined what happened when private equity-owned companies EmCare (part of Envision Healthcare) and TeamHealth took over hospital emergency departments.5 They found that when EmCare took over the management of emergency departments, it nearly doubled its charges for caring for patients compared to the charges billed by previous physician groups. The researchers also found that TeamHealth took a somewhat different tack. It used the threat of sending high out-of-network surprise bills for ER doctors’ services to an insurance company’s covered patients in order to gain high fees from insurance companies as in-network doctors.6 This avoids the situation where a patient gets stuck with a large, surprise medical bill, but it raises premium costs for everyone. In both cases, healthcare costs increase when outsourced emergency rooms and other physician services are owned by private equity firms.

My take: Campaign finance reform and Medicare for All, baby!

what happens in Vegas doesn’t stay in Vegas

Axios has some interesting stats comparing the demographics of Nevada today to the projected future of the U.S. as a whole.

  • The U.S. is on track to become minority white by 2045. Nevada is one of just 4 states that are already there.
  • Hispanic people are expected to make up 25% of the American population by 2045. They’re 29% of Nevada’s population today.
  • Immigration will likely be the backbone of the U.S.’ future population growth, and will likely hit record levels by 2045. Today, immigrants’ share of the Nevada population is the 5th largest of any state.
  • The vast majority of Nevadans live in urban areas, just as 89% of Americans are projected to by 2050, according to UN data.
  • At 10% of the population, Nevada’s black voting bloc is also significant. The U.S. will be 13% black in 2045.

coronavirus 2020!

I try not to write a lot about fast-moving current events because anything I write will be instantly outdated (I’m writing this on the morning of March 1, 2020). But here are a few thoughts I have and things I am reading on the subject.

First, I plan to pay attention and do whatever the health authorities suggest I do. “Health authorities” means the CDC, my state health department, and my county health department. These sources aren’t infallible. Already, it appears the CDC could have used a test from the World Health Organization to monitor for the virus here, but they thought they knew better, dropped the ball completely, and there has been no monitoring. That means it could already be spreading undetected and the chance to contain it to just a few people could be lost. There is also concern about budget cuts to pandemic preparedness and public health in general by the Trump administration, and interference by political appointees and industry lobbyists. Despite all this, “the authorities” have the most expertise and are the most reliable source of information available. I have added these three sources (the CDC, my state and county health departments) to my Twitter feed. (I almost never use Twitter, but I do find it useful in a fast-moving situation like a snowstorm or oil refinery or power plant disaster – the first of which, there have been zero this winter and the second and third of which, there have been two, quite recently and quite close to my house.)

I have a decent backlog of food in my house and am trying to add a little extra. If “the authorities” tell me to keep my children home from school or myself home from work, I plan to do it. If they don’t I don’t plan to. I just hope the people who keep the water, power, gas, and communication systems running continue to go to work. An extended quarantine could be different from a fire, flood, or hurricane in this way, but of course it would be much longer. The CDC has not given any guidance on cabin fever, which can be an extraordinarily debilitating illness among children and their caregivers in confined spaces.

I wondered what powers the federal, state, and local authorities actually have and what the break down is between them. This Bloomberg article talks about that a little.

That’s in part because the president clearly has the power to declare a national health emergency and start ordering quarantines. This power comes from Congress, and is conferred on the president by the Robert T. Stafford Disaster Relief and Emergency Assistance Act. As the name suggests, this is the same law that lets the president declare disaster relief emergencies. President Donald Trump invoked this power in late January, when he declared a public health emergency and ordered the quarantine of Americans returning from areas of China where Covid-19 had already spread. Quarantines can also be authorized by the surgeon general, who is specifically given that power by federal law.

Bloomberg

The article says that local jurisdictions pretty much have to do what their state authorities tell them to do. The CDC can’t actually commandeer state officials, but that states can choose to place their officials under CDC direction, and they most likely would. So effectively, there really is a chain of command from top to bottom.

By definition, a quarantine limits the freedom of movement of people who are completely innocent of any wrongdoing to serve the overall good of avoiding more infections. Supreme Court doctrine directs that essentially all our individual liberties can be suspended if the government has a compelling interest to do so and if its measures are narrowly tailored to achieving that end. Slowing a pandemic is a textbook example of a compelling state interest; and quarantine is presumably the narrowest available method to do so in the middle of an outbreak.

Local police would seem to have the authority to enforce a quarantine, but how strictly they might do that and whether citizens would be able to challenge that on legal grounds has not been fully tested. I note that during “mandatory” hurricane evacuations, local police departments generally don’t drag people out of their homes against their will. Of course, in that situation they are just putting themselves and their families at risk, not others. If someone was walking down a busy street wearing a suicide vest, of course the police would shoot that person because they are a danger to others.