Thursday, April 30, 2020

Vietnam on my mind


Today, April 30, is the 45th 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?

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