Gregory Travis Profile picture
Healthcare patient experience expert. Technology writer. Pilot and airplane owner. Cybersecurity Guy. Airborne Animal Rescue. Widower and SuperDad.
1 Jun
Many, such as @youyanggu, make the inaccurate conclusion that statutory restrictions, such as NPI mandates (i.e. masks, distancing, etc. orders) are equivalent to effective restrictions (i.e. voluntary use of masks independent of government order)

They are not
In the US in particular, state-level mandates are entirely toothless and unenforced.

To believe that people not inclined to wear a mask will wear one because of a toothless order is ridiculous.

Likewise that those inclined to wear one will stop once the state order is lifted
A good example is the wide gulf between statutory tax rates and effective tax rates.

Anyone who believes that, say, General Electric paid 35% of its income in taxes in 2017 (the statutory rate), for example.

Its actual rate was -4.5%
Read 4 tweets
28 May
Who are the "Mask Gap Bunch?"

They are those states which adopted NPIs, such as mask wearing, at the local level

Local NPI adoption is driven by political sensibilities of the given county/city/town. Liberal/affluent/educated counties/towns/cities adopted local NPIs at ...
far higher rates than others -- a fact reflected in everything from surveys to vaccination uptake data

And death rates

States with significant divides between liberal/conservative demographics show this dramatically
in that death rates of liberal counties tend to be much smaller than the death rates of conservative counties, particularly after the enactment of local mask ordinances -- such as happened in Florida:
Read 6 tweets
26 May
"It's because Republicans counties are older!" -- California version

The argument has been made that the reason I see higher PFRs in Republican counties than in Democratic counties is because they tend to be older

That's kind of true (sometimes). But the effect on PFRs is not Image
"It's because Republican counties are older!" -- Montana version (see above) Image
"It's because Republican counties are older!" -- South Dakota version Image
Read 4 tweets
25 May
1/Here's the story, of a lovely party, that was bringing up a thousand lovely lies.

All of them were preposterous, like their mother. The dumbest ones in years
2/Here's the story, of a party named Donkey,
Who was busy juggling all his virtue signals
They were a statistician, an epidemiologist, a pollster and a journalist
They were all blue-ticks
3/Till one day when the lies met the donkey
And they knew it was much more than a hunch
This group must somehow form a consensus
That's how they all became the There's No Mask Gap Bunch
Read 4 tweets
25 May
This is flawed on so many levels. A quick summary:

1. Looking at state-level aggregations, not county-level aggregations, makes the inherent assumption that states are ideologically, culturally and economically internally homologous
2. Oxford stringency restrictions are qualitative assessments of legal mandates. They do not capture effective compliance (i.e. mandates are ineffective if unenforced)
3. Unemployment levels are a function of state response. It is an error to assume that there should be a relationship between Oxford stringency assessments and unemployment levels for all kinds of reasons
Read 5 tweets
4 May
Case study: Michigan

Michigan currently has the highest deaths per day (per capita) of any US state.

It is an instructive case in both the effectiveness of lockdowns as well as the non-seasonality of COVID
Michigan, like many states in spring of 2020, had an explosive first wave. Lockdowns were put in place but not soon enough to prevent the first wave from generating the highest deaths per day of all three weeks

But notice how the sharp uptick in deaths is followed very quickly
by a sharp downtick.

This is a shape similar to what Belgium experienced -- a very "pointy" (steep and high) initial wave of deaths

This is a common pattern that we see when:
a. There is a comprehensive attribution of COVID deaths -- for instance Belgium confirmed COVID cases
Read 12 tweets
4 May
1/Why there is no such thing as a "healthy" immune system -- Tesla Autopilot version

I have a Tesla. Best car I've ever owned, by far.

Only flaw is that Elon Musk is a complete asshole.

Part of his assholery is selling a fantasy that a car can drive itself
2/It can't. And if you give the the chance to drive itself, it's going to kill you

The autopilot in my car is made up of hardware -- the stuff that drives the brakes, the steering wheel, the accelerator, the battery

And the "eyes" -- the cameras that look around for threats
3/All of that is pretty straight forward. We've known how to make motors, servos, electronics -- even ccd cameras for a long time

The problem is that all of that is brought together and controlled by...

Read 16 tweets
4 May
There are those of us who have worked with "the data" for some time, but who are not data scientists

And there are those who know all about data, statistical analysis, etc. but who have little "boots on the ground" experience

There is a natural antagonism between the camps
Which is counter productive

The boots on the ground folks, of which I include myself, need to get over their natural fear of being talked down to by the scientists

And the scientists need to acknowledge that those of us who have been slogging through the shit for decades...
probably gained some insight along the way

Demographic data and health data is UNBELIEVABLY dirty, balkanized and full of characteristics that make it very difficult to coalesce -- example: longitudinal data recorded across different time frames
Read 9 tweets
3 May
1/Some quick stats (consider these tailings off work I've done today)

Fattest county/city in the United States:
Owsley County, KY (men), Issaquena County, MS (women)

San Francisco County, CA (men) (except when I am visiting my mother), Falls Church (women)
2/Least physically active county/city in the United States:
Owsley County, KY (men), Issaquena County, MS (women)

Teton County, WY (men), Routt County, CO (women)
3/Shortest life expectancy:
McDowell County, WV (men), Perry County, KY (female)

Fairfax County, VA (men), Marin County, CA (female)
Read 6 tweets
3 May
Can anyone name a single pollyannish prediction about a country or region by @MLevitt_NP2013 that didn't turn into bodies stacked three deep in mass graves?

Because I am very worried about India
Seriously, help me out

Israel? Predict: 10, Actual: 6,366
USA? P: 170K, A: 600K
Brazil? P 98K, A: 408K
Italy? P: 20K, A: 121K
Peru? P: 14K, A: 62K
Russia? P: 13K, A: 109K
Bangladesh? P: 5K, A: 12K
Indonesia? P: 3K, A: 46K
Argentinia? P: 2K, A: 64K
Ukraine? P: 2K, A: 47K
Nigeria? P 840, A: 2063
Armenia? P: 666, A: 4K
Sudan? P: 615, A: 2350
Los Angeles? P: 3506, A: 24K
El Paso? P: 190, A: 2658
India? P: 33K, A: 220K
World: P: 700K, A: 3.2 Million
Read 4 tweets
3 May
1/COVID and Obesity

For a primer on BMI and the ranges used here, see:

Objective: I wanted to find a way to easily understand the relationship between body mass index (BMI) and COVID severity
2/Executive summary:

The underweight represent 1.5% of the US population and 2.4% of those admitted to hospital

Normal: 26.10% of US pop & 19.70% of those admitted

Overweight: 30.00% and 27.80% admitted

Obese: 33.20% and 36.20%

Severely obese: 9.2% and 14% Image
3/In other words:

Those with a normal or overweight BMI are admitted to hospital at a lower rate than their population prevalence (75% and 92% respectively)

The underweight, the obese and the severely obese are admitted in excess of their population prevalence (160%/109%/152%)
Read 7 tweets
2 May
1/BMI/Obesity primer

In advance of talking some more about this in a bit, I thought it would be helpful to know what we mean in a clinical sense when we say things like "Obese, Overweight, Underweight and Normal"
2/These clinical categories are calculated from a very simple formula:

Your Gender -> How much you weigh -> How tall you are

The result is something called the "Body Mass Index," or BMI
3/BMI is divided into ranges:

A BMI of 0-18.5 is considered underweight
18.6-24.9 is normal
25-29.9 is overweight
30+ is obese
Read 7 tweets
2 May
Obesity and COVID outcomes

42.4% of US adults are considered to be obese as a baseline

50.8% of those in hospital (ER or inpatient) with COVID are obese

Here is how they did

Off the top of my head:

1. It looks like if you have a normal BMI and you end up in the hospital with COVID, you're toast (i.e. you are going to die)

2. If you are obese, you're going to get ventilated.
Put another way: Most people who are hospitalized for COVID are obese because most people are obese

And if you are skinny and nonetheless manage to screw up and end up hospitalized with COVID, you're going to fucking die, slim
Read 7 tweets
2 May
1/Recently engaged an individual whose position was that COVID outcomes (disease severity) was largely a matter of lifestyle choice

And that because he made responsible choices in terms of exercise & diet, he was in excellent metabolic health and unlikely to fall ill from COVID
2/Now there are several things wrong with this, including the fiction/fetishization of the "healthy" immune system

But I want to focus on one thing in particular: The entitlement of agency
3/By that I mean the assumption among social elites that because they have choices, everyone else must also have choices

Who are "social elites?"

White people
Read 11 tweets
2 May
Nobel Prize laureate @MLevitt_NP2013 is using Twitter to promote this COVID denier website and its claim that COVID has killed only half as many people as normally die of flu every year

He is also a prominent member of the Great Barrington Declaration team

#COVID19 @lpachter
This is not the first time that Levitt has intentionally amplified COVID disinformation. Nor even the worst

Six months ago he was working to spread Russian disinformation in what I can only assume was an attempt to destabilize the United States
Read 4 tweets
1 May
This festering piece of crap deserves a technical Oscar for the sheer amount of bullshit packed into five minutes (half a minute at the end is reserved for appeals to donate to his Patreon account)…
1. He starts by telling us that influenza always has a winter seasonal pattern (true). And that, because COVID is just influenza on steroids, it has the same pattern

Which he demonstrates by overlaying a graph of COVID cases on flu cases. Which don't match AT ALL
2. He next explains the drop in cases in summer of 2020 (in Ireland) to "Seasonal De-Triggering" (FFS).

Not lockdown even though in dozens of other places (USA, etc) there was no substantial drop in cases in summer of 2020.

So it's seasonal, but only in Ireland
Read 10 tweets
1 May
I would like to nominate:

“These IFR calculations mean there is no excuse for Tesla’s workers not to work”

“Why it’s essential to not raise minimum wage for essential workers in a pandemic”

“Shut down the grid: temperature, season and why Texas is a COVID success story”
“Why everything I say is wrong: revisiting my ‘Why most published research findings are wrong’ paper”

“Why it’s reasonable to expect children to infect their parents with influenza caught at school. And why thinking they’ll infect them with COVID is crazy talk”
Read 5 tweets
1 May
1. NPIs are not limited to hand washing and wearing a mask. They also include telecommuting, seating capacity restrictions, school closing, etc. all of which directly affect the indoor transmission of the virus
2. NPIs do not eliminate transmission, they modulate it down. Intrinsically less transmissible diseases, such as influenza, can expect to be more heavily modulated by NPIs than COVID thus it is not surprising that NPIs eliminate a greater amoung of influenza infection than COVID
Read 10 tweets
30 Apr
1/I look at COVID data every single day and usually spend a couple hours at it

What I've been seeing recently is that vaccination is kicking in in a huge way

And this is a great thing for the World...

@cjsnowdon @s8mb @dr_barrett @DrDomPimenta @AtomsksSanakan @thereal_truther
2/There is one group for whom this is a terrible thing

The COVID deniers/Anti-Vaxxers/Flat-Earthers

For them, effective vaccination is an existential threat

3/Their entire narrative is built around the virtue of inaction. That mitigation simply leads to more, not less, harm

The fundamental theory behind the concept of lockdowns (by which I mean NPIs, such as social distancing, masks, etc.) is the Germ Theory
Read 8 tweets
28 Nov 20
Saturday morning COVID update. First focus: South Dakota

South Dakota continues its reign as the deadliest place on the planet. Its death rate is 2.5 per 100,000 per day.

To put that in perspective, if the USA had that rate it would translate to 8,000 deaths a day. ImageImageImage
Second focus: USA. Deaths are running 1,500 a day though that is probably slightly depressed due to Thanksgiving holiday in US. ImageImageImage
Third focus: Europe. Europe and USA constitute 50% of worldwide deaths currently. However, Europe's "lockdown" efforts are paying off as infections show sharp decline.

However fall COVID resurgence in Europe is worse than peaks of last spring. ImageImageImageImage
Read 4 tweets
16 Nov 20
Monday morning report. N.B. Many locations have either limited (USA) or no (Sweden) reporting of infection and death statistics over the weekends.

This means that Monday's numbers usually produce a false picture of the situation with infections and deaths underrepresented.
1/US States ranked by COVID death rate (avg of last three days). The Dakotas continue to be the deadliest place in the United States. My home state, Indiana, has dropped from sixth place to tenth in today's rankings.
2/World locations ranked by death rates (avg over past three days). Czech Republic is leading (up from North Dakota) with North Dakota currently second deadliest place on Earth.
Read 4 tweets