Vietnam on my mind

Today, April 30, is the 45^th anniversary of what we in the US know as the “fall of Saigon”, and what is known in Vietnam as Reunification Day (this is their great national holiday every year, like our Independence Day. Vietnam’s Independence Day is September 2, the day that Ho Chi Minh declared Vietnam – and really just the northern part - independent of France in 1945. Since that turned out to be just the beginning of an eight-year war with the French, followed by a 15-year war with the Americans and the South Vietnamese, it was hardly a climactic moment). On this day in 1975, the North Vietnamese army and their National Liberation Front (Viet Cong) allies in South Vietnam took control of Saigon, the capital of South Vietnam, overthrowing the government the US supported during what we call the Vietnam War – and what the Vietnamese today call the American War. The first thing the North Vietnamese did when they took over Saigon was to change its name to Ho Chi Minh City - which it of course remains today.

I remember that day quite well, and I remember feeling very sad for the huge number of American and Vietnamese lives lost (58,200 American and a million or so Vietnamese), because the US ignored history and facts and chose to back one side – which had very little popular support, even in the south - in a civil war in 1954. We did this despite the fact that an international treaty had been signed in Geneva that mandated a nationwide election in all of Vietnam, so the people could decide what the next government would be. The election would have been won overwhelmingly by Ho Chi Minh and his Communist Party of Vietnam, since Ho Chi Minh was – and continues to be – looked on in the same way we look on George Washington in the US. But George was lucky enough not to be embalmed. “Uncle Ho” wanted to have his ashes scattered across Vietnam, but now he – or more correctly a life-sized image that appears to be mostly wax – rests unhappily in a mausoleum in Hanoi, where people wait for hours to get a glimpse of him).

But the effects of this initial error were greatly compounded by the fact that Lyndon Johnson, after he became president when John Kennedy was assassinated, decided not to start to withdraw from Vietnam, as Kennedy seemed to be contemplating before he was killed. Instead, he decided to double and triple down and bring in a huge number of new troops – so that we had over half a million servicemen and women in Vietnam at the war’s height in 1967. He did this despite admitting to senators and others (and a couple of these admissions are on tape) that he knew there was no way the US could win the war. He knew he would get pilloried politically for “losing” Vietnam to the Communists, just as Truman and others ended up being pilloried for “losing” China to the Communists (as if China were ours to lose or win). Rather than take that heat, he was willing to sacrifice a lot of people, although he agonized over that and eventually didn’t run for a second term (and died a couple years after leaving the White House).

Vietnam was also mentioned in the news (and in my blog yesterday) because on April 28, US Covid-19 deaths passed the number of military deaths in the Vietnam War. Of course, it’s a complete coincidence that this happened two days before Vietnam’s Reunification Day, but it did cause some news organizations – in particular the Washington Post today and the New York Times yesterday – to look at how Vietnam has done in the pandemic. And the results are amazing: In spite of the fact that Vietnam borders China and had identified a few coronavirus infections in early January, it has fewer than 300 total infections now, and has recorded no deaths.

Most impressively, there hasn’t been a single new Covid-19 case identified in Vietnam in two weeks, since they’ve been on a total lockdown for more than a month (and were on more targeted lockdowns before that). Now that they’ve passed that milestone, the government is now starting to ease up on the restrictions, and will let restaurants open next week. Contrast this with the US, where we’re over 60,000 deaths now, with the number currently rising by more than 2,000 every day. And far from having new cases under control, we have no idea how many cases we have, except that it’s almost certainly 25-50 times the reported number of one million.

How did Vietnam, a poor country whose per capita GDP is less than 1/20 of the US figure and whose medical facilities, while good, can only serve a small fraction of the population, get in this position? The biggest reason was testing. In early January, the government could see what was happening next door in China, and ordered development of their own test. This test is freely available, but the most amazing fact is that Vietnam has conducted only 200,000 tests vs. about six million in the US - yet their ratio of tests per confirmed case far exceeds that of any other country in the world. In fact, Vietnam’s ratio is 966 tests per confirmed case. Number 2 in the world is Taiwan, with 145 test per case. The US ratio is 5.9, and of course because the number of cases is so much smaller than actual cases, that ratio would be .1 or .2 if the true number were known.

Full disclosure: I have a very personal interest in what’s going on in Vietnam. My wife is Vietnamese and she is there now, helping take care of her parents who have various medical problems unrelated to the coronavirus. She was scheduled to return last week, but neither of us wanted her to leave the relative safety of Vietnam to come back here and have to cower in my apartment, as I’m now doing. She now is scheduled to come back in late June, but even that might have to be pushed back, if things aren’t a lot more under control in the US than they are now. In February and again in March, she thought she might have some symptoms of Covid-19. Even though in neither case did she have anything more than a cold, she had no problem getting tested. She could have had a test every week if she’d wanted to.

The numbers

After a couple days of declines, my projected deaths numbers have moved back up, because the daily number of deaths has recovered from a dip of a few days. So what is my real forecast? The answer, as I discussed a few days ago, is that I’m not doing forecasts, just mindless projections based on yesterday’s 3-day growth rate in recorded Covid-19 deaths (which BTW is a gross underestimate of total deaths due to the pandemic, as reported by the CDC yesterday). If I were to do real forecasts of deaths, I’d need a reliable number of current cases. As it is, the reported cases are probably about 1/50 of the total number. The only thing reported cases measure is the availability of tests. If we had twice as many tests available today, we’d have twice as many new cases reported. Ten times as many tests – ten times as many new cases. Etc. Therefore, I see no choice but to simply trend out deaths, since that’s a somewhat reliable number.

So the real number of deaths for any given week or month below will without a doubt be far off the actual number – I can assure you of that. What I can’t tell you for sure is whether the actual number will be higher or lower, although given the push to rapidly reopen the economy now and the fact that the national stay-at-home guidelines expire today, I have to believe the numbers below are on the low side. Also, remember that these projections end in June, but it’s 100% certain the epidemic will continue well beyond June, and now it looks more likely that it will never end until a vaccine is developed and made available to the whole country (as well as the whole world, since this is a worldwide pandemic, not just a US one). Plus keep in mind that we may never have a vaccine, as has happened with AIDS, since we still don’t have a vaccine for that, about 40 years since the HIV virus appeared.

These numbers are updated every day, based on reported US Covid-19 deaths the day before (taken from the Worldometers.info site, where I’ve been getting my numbers all along). No other variables go into these numbers – they are all projections based on yesterday’s 3-day rate of increase in total Covid-19 deaths, which was 11%.

Week ending	Deaths reported during week/month	Avg. deaths per day during week/month	Pct. Change from previous week/month
March 7	18	3
March 14	38	5	111%
March 21	244	35	542%
March 28	1,928	275	690%
Month of March	4,058	131
April 4	6,225	889	223%
April 11	12,126	1,732	95%
April 18	18,434	2,633	52%
April 25	15,251	2,179	-17%
Month of April	59,156	1,972	1457%
May 2	14,366	2,052	-6%
May 9	18,497	2,642	29%
May 16	25,458	3,637	38%
May 23	32,507	4,644	28%
May 30	39,104	5,586	20%
Month of May	128,970	4,160	218%
June 6	53,821	7,689	38%
June 13	68,723	9,818	28%
June 20	82,671	11,810	20%
June 27	113,784	16,255	38%
Month of June	367,811	12,260	285%
Total March - June	559,994

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 61,670

Increase in deaths since previous day: 2,404 (vs. 2,463 yesterday)

Percent increase in deaths since previous day: 4% (vs. 4% yesterday)

Yesterday’s 3-day rate of increase in total deaths: 11% (This number is used to project deaths in the table above. It was 9% yesterday)

II. Total reported cases

Total US reported cases: 1,089,740

Increase in reported cases since previous day: 28,972

Percent increase in reported cases since yesterday: 3%

Percent increase in reported cases since 3 days previous: 8%

III. Reported case mortality rate so far in the pandemic in the US:

Total Recoveries in US as of yesterday: 147,411

Total Deaths as of yesterday: 61,670

Deaths so far as percentage of closed cases (=deaths + recoveries): 29% (vs. 29% yesterday) Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 29% of them have resulted in death. Compare this with the comparable number from South Korea, which is 3%. Do you think that might have something to do with the fact that they had fewer than 250 deaths, while we had over 55,000 deaths as of April 27?

There’s no shortage of magical thinking nowadays

Holman Jenkins, Jr., editor and columnist for the Wall Street Journal, clearly thinks of himself as a realist in the midst of a sea of journalists who don’t necessarily mean harm, but are causing more harm than good by calling for continuing lockdowns to fight the coronavirus pandemic. In a column this morning, he very cogently makes the argument:

1. Given that there’s no cure or vaccine for Covid-19 on the horizon in the near term, we’re going to have a certain number of deaths – there’s very little we can do at this point to change that fact.
2. The rationale for lockdowns is that they “flatten the curve” to keep hospital systems from being overwhelmed, as we wait for a cure or a vaccine to get us out of this mess. Yet even New York City’s hospital system didn’t get overwhelmed by the recent crisis, which is definitely past its peak.
3. Therefore, given that nothing we can do now is going to significantly lower deaths over the course of the pandemic, we might as well open up the economy (beyond the small amounts of opening up being done today, in the states that locked down in the first place), so that we can have at least some economic activity while we wait for a cure, a vaccine, or the arrival of Godot to fix our problem.
4. (this is implied in his column, but not stated) Since we can’t count on a cure, vaccine or Godot to bail us out anytime in the near – or even in the far – future, making the decision to reopen now means we’ve decided to wait for herd immunity (which is supposed to kick in when 50-70% of the population is infected) to end our misery (and a number of our lives, along with the misery). And since there’s still no evidence that even the presence of antibodies ensures someone won’t be infected a second time with Covid-19, herd immunity itself can’t be counted on. So we’ll just have to accept the fact that close to the entire US population will be infected in the next year or two. This means we need to be prepared for six million deaths.

I disagree with all four of the above statements, since they all underestimate the problem we’re in. But I want to focus now on the third statement, which assumes that, when the economy is opened up, at least a significant portion of the previous level of activity will quickly return – in other words, “If you build it (specifically, reopen it), they will come.” Both in the movie Field of Dreams and in the current crisis, this will only happen if we have a great deal of magic working for us. We’ll need a series of miracles, and I challenge Mr. Jenkins to identify which of the following miracles will occur, and how they will occur.

1. Nobody is going to walk into a store or restaurant unless they’re reasonably sure that nobody else with Covid-19 isn’t there now, or won’t walk in while they’re being served. Yet, given that so many people are asymptomatic and the number of infected people is somewhere between 25 and 50 times the reported infections – and that won’t change until nearly ubiquitous testing is available – when will they ever have that assurance? It will be a miracle if they have it before our poor country has the virus under control, and that goal seems to have been pushed aside in the frenzy to open up the economy.
2. Almost the same consideration applies to workers: If someone isn’t sure that the people they’re interacting with on the job are virus-free, why would they go back to work? I’ll note that, in the discussions about the meat packers yesterday, one union official said the workers would want all workers and visitors tested every day before they come into the plant. I would think that workers in every workplace, large and small, would also want that – as I mentioned in my post yesterday, the one office I know of that has this practice in place now is the Oval Office. Yet it will obviously take a miracle to be able to do this in all workplaces in the US, at any time in the near future.
3. Absent testing everybody every day, there’s another condition that needs to be in place for workers to feel safe returning to a workplace: paid sick leave. If this isn’t in place, how can any worker be sure the guy working next to him doesn’t feel well, but came in because he can’t afford to miss any pay? And by the way, this also applies to shoppers – would you go into a store or restaurant if you thought the person who serves you might only be working because they can’t afford to stay home?
4. One assumption behind the call to reopen now is that any workplace will be made safe enough that the owner or managers could call workers back with a clear conscience. Yet in how many workplaces is that the case today? We used to have a government agency called OSHA (started by a Republican president, Richard Nixon – along with the EPA, earned income credit, and other useful measures. He would be considered a frothing-at-the-mouth leftist today), which is supposed to promulgate and enforce standards for workplace safety. However the small rump that remains of OSHA after lots of budget cuts now explicitly disavows even writing standards, let alone enforcing them. Will workers decide they aren’t at all concerned about their safety once they’ve made the decision to return to work – and therefore OSHA won’t be missed? It will take a miracle, to be sure.
5. Here’s a problem that affects a huge portion of the workforce: Schools are closed just about everywhere, and for some reason parents haven’t been jumping for joy at the idea that their children might be brought back to school while the pandemic rages outside, despite the helpful suggestions my Messrs. Trump and Pence that this will happen soon. Since probably at least half of all workers have children at home that need to be watched over, how are they going to feel safe to come back to work until the fall, when the schools might finally be open again? I haven’t even heard any proposals for that. Mr. Jenkins, do you have one?
6. Along with all of the above miracles, we still need the miracle we’ve been waiting for all along: the government needs to get the novel coronavirus under control. This requires ubiquitous testing capacity, a robust contract tracing program, an end of growth in new cases, and isolation of all quarantined people by themselves, not with their families (the first three criteria were prerequisites stated in the White House’s opening up guidelines put out a couple weeks ago, yet none of the states that are now opening up – with the possible exception of Montana – meet them).
7. There’s another prerequisite that I realized was needed for reopening, when I recently wrote about a different column by Mr. Jenkins: Any owner or manager of a workplace or retail location, who wants to get people to patronize their store or work in their office or factory in the near future, needs to work with his or her workers on the front line, for at least one day a week. And any commentator like Mr. Jenkins, who airily dismisses concerns about safety as something that’s easily manageable, should volunteer to work on one of those front lines - again for at least a day a week, but an entire month would be more appropriate.

I originally framed the above point as a possible legal mandate, but now I realize the shoppers and workers can easily enforce this themselves, as long as workplaces and retail establishments voluntarily disclose when and where managers and owners have volunteered – and if they don’t post anything, the assumption will be that they haven’t, and said shoppers and workers need to proceed at their own risk. Don’t you just love a free market?

The numbers

These numbers are updated every day, based on reported US Covid-19 deaths the day before (taken from the Worldometers.info site, where I’ve been getting my numbers all along). No other variables go into these numbers – they are all projections based on yesterday’s 3-day rate of increase in total Covid-19 deaths, which was 9%.

Yesterday, we passed the Vietnam War in total deaths. In a couple weeks, we’ll pass total military deaths since WWII, and keep going up from there.

Week ending	Deaths reported during week/month	Avg. deaths per day during week/month	Pct. Change from previous week/month
March 7	18	3
March 14	38	5	111%
March 21	244	35	542%
March 28	1,928	275	690%
Month of March	4,058	131
April 4	6,225	889	223%
April 11	12,126	1,732	95%
April 18	18,434	2,633	52%
April 25	15,251	2,179	-17%
Month of April	57,979	1,933	1428%
May 2	11,835	1,691	-22%
May 9	14,720	2,103	24%
May 16	19,763	2,823	34%
May 23	21,936	3,134	11%
May 30	27,283	3,898	24%
Month of May	94,259	3,041	163%
June 6	36,631	5,233	34%
June 13	40,659	5,808	11%
June 20	50,570	7,224	24%
June 27	67,897	9,700	34%
Month of June	221,108	7,370	235%
Total March - June	377,404

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 59,266

Increase in deaths since previous day: 2,463 (vs. 1,388 yesterday)

Percent increase in deaths since previous day: 4% (vs. 3% yesterday)

Yesterday’s 3-day rate of increase in total deaths: 9% (This number is used to project deaths in the table above. It was 9% yesterday)

II. Total reported cases

Total US reported cases: 1,035,765

Increase in reported cases since previous day: 25,258

Percent increase in reported cases since yesterday: 2%

Percent increase in reported cases since 3 days previous: 8%

III. Reported case mortality rate so far in the pandemic in the US:

Total Recoveries in US as of yesterday: 142,238

Total Deaths as of yesterday: 59,266

Deaths so far as percentage of closed cases (=deaths + recoveries): 29% (vs. 29% yesterday) Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 29% of them have resulted in death. Compare this with the comparable number from South Korea, which is 3%. Do you think that might have something to do with the fact that they had fewer than 250 deaths, while we had over 55,000 deaths as of April 27?