Human Behavior

COVID-19, the State of the Vaccine, Fan Attendance, MLB’s Timeline, Baseball Budgets – bleachernation.com

Although the remains the case that the story of the pandemic and COVID-19 has import and consequences that stretch so much further than the sports world its hard to imagine too many of us havent yet been impacted personally in some way thats our lens. Sports, and the pandemics impact on sports.

Well circle to the sports in a moment. First, the state of things.

This week, Pfizer was the first vaccine manufacturer to reveal positive results (90% efficacy) from Phase 3 of its trials, and while we are waiting on the full data and peer reviews, people are very optimistic. It was never a lock that a vaccine would be successfully developed, much less at this pace, so these kinds of positive signs are heartening, to put it mildly.

Thats especially true given the state of the state of the pandemic, where deaths are again on the rise, hospitalizations are hitting a new peak, and new cases are exploding:

Unfortunately those spikes arent just going to stop on a dime, and I dont know to what extent human behavior is changing right now to create a top in the coming weeks. The election, important as it was, really distracted from the public messaging about trying to remain vigilant about the virus. Unfortunately, as more people cluster in the colder weather and with the holidays ahead, it could be a rough few months.

Still, the vaccine news is worth celebrating, in large part because if this version works, its a really good sign for the others in development:

Although the estimate of the efficacy of the vaccine could change as the study is completed, it is close to a best-case scenario. That also bodes well for other vaccines in the late stages of testing, including those developed by Moderna, AstraZeneca, and Johnson & Johnson.

If that headline really number really holds up, that is huge. That is much better than I was expecting and it will make a huge difference, said Ashish Jha, the dean of the School of Public Health at Brown University. He cautioned, however, that it is always difficult to evaluate science via press release and that researchers will need to see the full results. He noted that side effects are something to watch, because even if there are no serious long-term complications, people feeling sick for a day or two could lead some to be hesitant to take a vaccine.

As for the vaccine process, Pfizer is expected to apply for an emergency use authorization later this month, which would mean that front-line workers and the highest-risk individuals could start receiving doses before the end of the year. If other vaccine manufacturers follow soon thereafter, things *could* be looking good for the first half of next year.

To that end, Dr. Anthony Fauci who has been optimistic about the vaccine process, but who is guided by science and isnt prone to creating wild expectations says that his guess is the vaccine(s) could be widely available to low-risk individuals by late April 2021. In other words, while that doesnt mean the vaccine is IN EVERYONE by late April, it does mean, by his best guess, youd be able to schedule an appointment and go get it then, regardless of your risk level or front-line status or whatever.

So, in theory, if enough people got the vaccine, the pandemic could be broadly under control by May/June of next year. That presumes, of course, that the full data and medical science support that these are safe and effective vaccines. If that proves to be the case, however, then you better believe Im going to be an evangelist for everyone, everywhere going to get the vaccine not just to protect themselves, but because thats how you stamp out the virus from circulation. Cut off as many hosts as possible as quickly as possible. Theres a long time between now and April, so I hope the time is used wisely to (1) ensure that any vaccines are indeed safe and effective, and (2) convincing people on the fence that its worth getting the vaccine.

So, then, the sports angles.

The biggest that comes to mind, given the timeline here and what we know about MLBs fears in 2021, is that April happens to be when the 2021 MLB season is supposed to really get up and going. Lets imagine for a moment that, over the next month or two, it becomes all the more clear that effective vaccines are coming, and they can be widely deployed in April. If that happens, might MLB not try to have Opening Day pushed back a bit in the hopes that they can have significant attendance from day 1, rather than day 31? Or do that just eat that first month+ because they have more confidence that things will turn around eventually?

I tend to think the owners will want as much revenue as possible and as little expense, so if they are projecting that April will be a lost month for attendance, they may simply ask the players to push Opening Day to May 1, and have the season be only 140 games. Not that the players have to just say yes, of course.

Even having this conversation, however, is really notable for baseball, sinceexpectations about the vaccine and attendance are what will drive budget projections for MLB teams. That is to say, as confidence in a vaccine and attendance increases (by the week? by the day?), you might see some MLB teams adjusting their 2021 budgets on the fly. The teams that have the most confidence or the most appetite for risk could try to move quickly while there is a perception that the market is still depressed. If theyre right, they could wind up with a haul of players on the relative cheap, AND a resumption of near-normal revenues after April. Big risk, yes, but significant upside potential.

Heres hoping the Cubs have a medical scientist on staff to help them with their projections on the vaccine and human behavior, eh?

Since the NBA elected not to push its next season back any further than December, they will be kicking off long before there is a serious chance of vaccine availability, and will not be in a bubble. So, that means questions about how to accommodate fans at the height of the pandemic.

Heres the reported plan for now:

The big question I have in that is about the availability of rapid tests. Its long been the case that if they were available widely enough, so much of normal life could return, but we havent seen them exploding in availability and usage. No, they arent quite as accurate as the full test, but if theyre 85-90% accurate, then that might be good enough for purposes like a socially-distanced basketball game. The rub would be whether youd see pushback from fans, in advance, not even wanting to bother making the drive (and buying tickets, paying for parking) if they might show up and test positive. Note that the NBA, unlike most MLB and NFL stadiums, has it a little tougher since they are entirely indoors. The level of transmission concern is a little higher.

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COVID-19, the State of the Vaccine, Fan Attendance, MLB's Timeline, Baseball Budgets - bleachernation.com

Human Behavior

Why Were the Pollsters Wrong Again in 2020? – The Globe Post

We all know that the pollsters got it wrong when they forecast a Hillary Clinton victory over Donald Trump in the 2016 presidential election. In fact, their error was not trivial, and hence, post-2016, many in the polling industry appear to have done a lot of soul-searching and studying to ensure that a mistake of this magnitude is not repeated.

Now let us fast forward to 2020.

Once again, a variety of pollsters predicted a decisive victory for Joe Biden over President Trump. As The Times of London appositely pointed out, many of the pollsters who predicted that there would be a blue wave ended up with red faces.

To give one specific example, the vaunted Economists regularly updated poll suggested one day before the election on November 3 that Biden would win 350 electoral votes with greater than 90 percent probability and that the Democrats would get 52 seats in the Senate with higher than 75 percent probability. The presidential race has now been called broadly in favor of Biden but it is clear that the best that he will do is to get 306 electoral votes. So, why do pollsters keep getting it wrong?

One reason has to do with determining the degree to which a sample of contacted voters is representative of the larger group about which the pollster is seeking information.

For instance, does a randomly sampled list of 1,000 African-American women in Colorado that a pollster contacts truly represent all eligible African-American voters in Colorado? On a related note, is the number 1,000 sufficiently large, or should the sample size be increased?

The key point to comprehend is that these are sampling issues. As such, even if a pollster does not get the sample right in a given instance, there is an established body of work in sampling theory that can be drawn upon, at least in principle, to fix the underlying problem or problems.

A problem that is much harder to fix is well-known to economists and this concerns human behavior. Simply put, the issue is this: will an individual, when contacted by a pollster, truthfully reveal whether he or she plans to vote for Biden or Trump?

Because Donald Trump is a broadly unpopular candidate, many individuals do not have an incentive to answer truthfully and thereby reveal to the pollster that they plan to support an unpopular candidate and potentially be judged to be a racist or worse.

This kind of non-truthful response can certainly arise if a poll is conducted in-person and it can also happen over the phone.

Writing in Politico, Zack Stanton recently referred to this as the shy Trump voter phenomenon. Because of the presence of this phenomenon, it is certainly not axiomatic that even a carefully designed poll will lead to the truthful revelation of preferences.

When working with problems involving the design of, for instance, an auction to sell 5G airwave licenses, where the truthful revelation of preferences is important, economists insist that whatever mechanism is designed be incentive compatible.

This means that the incentives the mechanism designer (the Federal Communications Commission in the case of 5G airwave license sales) sets up must be such that the relevant players (mobile phone carriers) want to participate and that they also want to reveal their preferences (about how much they value the airwave licenses) truthfully.

So, with regard to polling, sampling refinements alone, although important, will not yield accurate results.

Until pollsters figure out how to make their polls incentive compatible, it is unlikely that they will systematically produce results deemed to be reliable by the general public. It sure looks like pollsters have something to learn from the practitioners of the so called dismal science.

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Why Were the Pollsters Wrong Again in 2020? - The Globe Post

Human Behavior

Election 2020 aftermath taught us a few things | Opinion – Foothills Focus

E

ven before the race for president was official, you could learn some early lessons from Election 2020.

Like: Our need for immediate gratification conflicts deeply with our need for election accuracy.

Every election cycle is a journey that takes four years. The cycle culminates in millions of pieces of paper marked with dozens of selections.

It should not be mystifying that it takes a few days to total those pieces of paper with zero errors.

The ranks of the impatient will scream absurdities like, If Chick-fil-A was counting this, it would have been done in an hour. This isnt whipping up a sandwich and waffle fries, people.

This is thousands of jurisdictions counting millions of ballots in thousands of races under extreme pressure.

If we want the count to be correcta premise many Americans seem to want only when the count goes their waythen we should give elections officials around the country a break.

If a once-every-four-years presidential election takes, say, four days to tabulate, youd think we might control ourselves for that brief interval.

We also learned stupid people will do stupid things and elections bring out the dummies.

On Wednesday night after Election Day, hundreds of angry pro-Trump folks gathered to protest outside the Maricopa County vote tabulation center downtownand even tried to force their way inside.

Naturally, an angry crowd of anti-Trump folks showed up for a tense standoff policed by sheriffs deputies in SWAT gear. Congressman Paul Gosar, R-Stupid, showed up to add to the clown show.

The mobs big concern? That we count every vote! Which is exactly what elections workers were doing inside the building at the time.

What next, an angry mob outside McDonalds demanding they make burgers and fries?

Speaking of pointless, its time for the media to stop calling races. On Election Eve, the Associated Press and Fox News called Arizona for Joe Biden while the other networks and CNN did not. This led to widespread confusion and finger pointing.

This is great for the media, who love a dumpster fire, but not great for voters or democracy, which the media claims to serve.

Calling a race serves no official function and has no legal bearing; it simply exists to serve journalists need for suspense and to give reporters a chance to feel super important on election night.

Every race call is a predictiona sophisticated prediction, surebut still only as good as the underlying math about voter turnout, geography, political preference and human behavior.

Football broadcasters could call the Super Bowl early, too, and likely be almost perfect. But the games still get played to the final whistle and election workers still tabulate every ballot. If no one gets to call it quits, whats the point of calling the race?

We also learned pollsters also are a generally useless bunch. To be fair, the pollsters in Arizona were nowhere near as wrong on the presidential race as pollsters in other states and those making national predictions.

Most Arizona pollsters gave Joe Biden a lead in the range of three or four points on their final polls.

As we know in hindsight, that was wrongbut it was within most polls margin of error. Clearly, theres something pollsters dont understand about todays voter turnout and the behavior of Trump voters in particular.

As someone who has paid pollsters for campaigns Ive run, I think they can help provide insight into trends and the impact of certain messages. But do I believe them like I do my bank balance or a thermometer? Hell no. And neither should you.

Stay tuned, folks. Who knows, we might even have a president to discuss.

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Election 2020 aftermath taught us a few things | Opinion - Foothills Focus

Human Behavior

Coronavirus Vaccine Hopes Tempered by Caveats – The RoundTable is Evanston’s newspaper – Evanston RoundTable

News that a coronavirusvaccine might be available to our most vulnerable residents by the end ofDecember came amid a nationwide surge in cases, driven by rising numbers in theMidwest.

The drug company Pfizerannounced a vaccine candidate that is more than 90% effective in preventing COVID-19,according to an early analysis of results from a phase III trial. Pfizer C.E.O.Albert Bourla appeared on major broadcast networks on Nov. 9.

Ninety-percent is a gamechanger. Now you are hoping to have a tool in your war against this pandemicthat could be significantly effective. How long this protection will last issomething we dont know right now, but its part of the objective of the study.We will follow up with the 44,000 people that are part of this study for twoyears. And during this follow-up, we will be looking at the durability of theimmune responses, Mr. Bourla said during an appearance on CNN.

The New York Times reportedon Nov. 9, If results hold up, that level of protection would put it on parwith highly effective childhood vaccines for diseases such as measles.

The promising results forthe Pfizer vaccine, now in late-stage clinical trials, were tempered by healthexperts who expressed cautious optimism. To date, no one, including Mr. Bourla hasseen the actual data, other than an independent data safety monitoring boardthat unblinded the data and informed Mr. Bourla of the results.

Science writer ClaireMaldarelli reported that Pfizers Phase III clinical trial enrolled 44,000people in July 2020, with about half of the cohort receiving the vaccine (intwo doses, given over the course of a month) and the rest getting a placeboToevaluate the vaccines effectiveness, the researchers had to wait for enoughpeople in the trial (in both the vaccine group and the placebo group) to catchCOVID-19. The first analysis is based on 94 participants who contracted thenovel viral illness.

But its worth noting thatPfizer hasnt been following participants for very long, so it remains to beseen how many people in the trail will contract the coronavirus in the long run,wrote Ms. Maldarelli in a Nov. 9 article titled Pfizer claims its COVID-19vaccine is 90 percent effective. Heres what that actually means, published onPopular Science Magazine.

Pfizer senior vice presidentKathrin Jansen told The New York Times that a 90% effectiveness rate means thatat most, nine people in the vaccine group of the trial have gotten COVID-19 sofar.

The vaccine trial is ongoingand results have not been peer reviewed. Pfizer has not reported any seriousside effects associated with the vaccine. The company says it will requestemergency use authorization from the FDA, possibly as early as the end ofNovember.

In addition to concernsabout durability, or long term effectiveness of the vaccine, scientists havevoiced concerns about distribution of a drug that needs to be stored at anextremely cold temperature of - 94 F and requires a second dose three weeksafter the first.

I believe, with theimpressive nature of the data, if that should go through smoothly, by the timewe get into December, well be able to have doses available for people who arejudged to be at the highest priority, said Dr. Anthony Fauci said in a reportto CNN on Nov. 10.

Health care workers andfirst responders could start receiving the vaccine by the end of January, andwidespread vaccination could begin in a number of months, possibly as early asApril, 2021.

Pfizer developed the vaccinein partnership with the German drug company, BioNTech, which uses a moleculethat has never before been license for ruse in a vaccine. It relies on geneticmaterial call messenger RNA (mRNA), which occurs naturally in the human body.

It works like aninstruction manual for our cells. It essentially is introduced to a cell andinstructs it how to act, reported Willem Marx, NBC News and GlobalCorrespondent.

The technology allows forinjection of mRNA into muscle cells, making it an instruction manual for thecells, telling them to create a specific protein, which is found on the surfaceof the coronavirus. It encourages the cells to create spike protein, which inturn provoke an immune response in our bodies. Antibodies are created that canattack the virus if it shows up in the human body.

The New York Times hasreported that eleven vaccines are in late-stage trials, including four in theUnited States. The drug company Moderna uses similar technology.

Johnson and JohnsonsCOVID-19 vaccine has also entered Phase III in clinical trials. The Johnson& Johnson vaccine is called a viral-vector vaccine, which is the onlysingle-dose vaccine to enter late-stage studies, according to the MarketWatchwebsite.

More than 1.25 millionpeople throughout the world have died from COID-19, and there are more than50.5 million confirmed cases, according to data published by Johns Hopkins University.The novel coronavirus continues to surge throughout the U.S., with particularlyhigh numbers in the Midwestern states.

Experts have attributed thealarming surge in cases to human behavior, primarily pandemic fatigue and anunwillingness take precautions that have been proven to slow the spread of thecoronavirus. Research has shown that people throughout the world can fight thebattle against the novel coronavirus by following the three Ws: Wear a mask;Wash Hands; Watch distance.

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Coronavirus Vaccine Hopes Tempered by Caveats - The RoundTable is Evanston's newspaper - Evanston RoundTable

Human Behavior

Kamala Harris and the evolution of the birds: worldwide lessons – Salon

The United States has elected a woman and a woman of color to boot to the second highest office in the most powerful country in the world.

What's the big deal? You wonder, in having Kamala Harris as Vice President-Elect? After all, other democracies have long put women into the top political post in their country.

A big deal

We women know it is a big deal because for some reason men have always, the world over, predominated in such positions of power. And in earlier times, other women both in the U.S. and abroad have failed to attain that power.

Why is that so? Is there any biological, neurological and sociological reason that would explain that unequal development?

Let's take a truly intelligent look at this phenomenon by looking into it through the eyes of stay with me birds!

Our guide in this journey is an ornithology professor at Yale. In his 2017book,"The Evolution of Beauty, How Darwin's Forgotten Theory of Mate Choice Shapes the Animal World" part of my summer reading he tells us that "being able to figure out what's going on when it's not obvious is perhaps the most fundamental advantage of intelligence." (p.69)

Richard O. Prum, whose full title is William Robertson Coe Professor of Ornithology at Yale University and the head curator of Vertebrate Zoology at the Yale Peabody Museum of Natural History, employs this "fundamental advantage of intelligence" to cast light on the behavior of birds and of human beings.

Where the males are prettier than the female

You see, among the birds, the male is usually brighter in color and prettier than the female. Of course, that fact usually assumed some kind of male superiority.

As it turns out, that's just another failure of thought. Having to rely on being colorfulness means you are essentially the beggar, not the one in the power position.

A feminist book, written by a feminist man

When I started reading this book, little did I know that the election of Kamala Harris, a woman of color, to the second-highest office in the United States was just months away. (It was long before Joe Biden announced his VP candidate).

And even more poignantly, I did not know that this is in some ways a feminist book, clearly written by a feminist man.

It is probably significant that Professor Prum grew up with a twin sister and dedicated his book to his wife, also an ornithologist.

There are big ideas in this book, presented against a complicated scientific background. Its reader, however, is in the hands of someone who knows the science so thoroughly that he can explain it clearly.

For now, it's best to start with a concrete example from the world of the birds which, lest you forget, are ex-dinosaurs.

The beautiful yardman

The Great Argus, which lives in the Far East, is "one of the most aesthetically extreme animals on the planet." (p. 54) Though living a largely bachelor existence, the male goes full throttle during courtship. The male Argus elaborately preps his court:

Assiduously picking up all the leaves, roots, and sticks in the space he's chosenhe carries them to the periphery of his court. Like a modern yardman, he employs his huge wing feathers as a leaf blower by beating them rhythmically, sending all the remaining debris flying from his court until it is completely clearOnce his court is ready for the business of mating, all he needs is a female visitor. (p. 56)

The female arrives

A female arrives in response to his carefully orchestrated calls and the male begins his amazing courtship ritual:

he rushes around her in wide circles with his wings hunched up at an angle that exposes their upper surfaces. Then, without warning, when he is just a foot or two away from the female, the male transforms himself instantly into an entirely different shape, revealing unimaginably intricate color patterns on his four-foot-long wing feathersthe male bows down to the femaleIn this extraordinary posture, the male tucks his head under one of his wings and peeks out at the female from behind the gap in his feathersto gauge her reaction to his display. (pp.58-59)

The even more amazing fact concerns the reaction of the female Argus. To this elegant, beautiful and precise display, the female's response is "completely underwhelming, or even undetectable." (p. 85)

Take it from the birds: The female as the decider

Yes, unlike the humans watching this wonder, the female fulfills her role as the decider, the discerning, responsible and privileged holder of selection aesthetic and sexual selection.

In fact, the male's display is so colorful and elaborate precisely because most males are not selected in this courtship process.

The experienced, well-educated connoisseur

The female is "more like an experienced, well-educated connoisseur evaluating one of the many extraordinary works available to her scrutiny."

Further, she is "rigid with highly focused attention as she casts her discerning eye over the displaying maleit's her cool-headed mating decisions over the course of millions of years that have provided the co-evolutionary engine that has culminated in the male Argus's display" (pp.63-64).

Proving Darwin right once again

What is at play here is proof of a theory of mate choice that Darwin himself actually put forth but which he couldn't really champion in his times and which other scientists since then have not wanted to embrace.

Proof has come through the work of Prum and his like.

As Darwin had intimated and scientists like Prum have now proved, aesthetic selection is critical to the progress of evolution and the choice lies with the female.

Goethe and Darwin

Prum goes on to show more about male behavior and female response in other species of birds, never over-simplifying but helping us see in nature what Johann Wolfgang von Goethe called "das ewig Weibliche," or the "eternal feminine" that leads us onwards:

Darwin observed that in many of the most highly ornamented species the evolutionary force of sexual selection acted predominantly through female mate choiceit is female sexual autonomy that is responsible for the evolution of natural beauty. (p.27)

One must not fail to point out another part of Prum's account, namely, "the dynamic evolutionary history of penis morphology" (p. 244) and how female mate choice has contributed to the evolution of the human penis.

It is interesting to note that the anatomical part so important to males' identity and actions has evolved through choices made by the female of the species. If that story doesn't cause you to read this book, nothing will.

The dark side of bird sex

The story of bird sex is not an entirely pretty picture. Some avian species, particularly ducks, commit rape, even gang rape, such that females and evolution have had to work together to discourage such behavior and to stand on the side of female choice:

"sexual violence is a selfish male evolutionary strategy that is at odds with the evolutionary interests of its female victims and possibly with the evolutionary interests of the entire species." (p.159)Indeed.

The story of Lysistrata

Prum recounts Aristophanes's story "Lysistrata" in this context. This play of 411 BCE has it that women in the enemy states of Athens and Sparta withheld sex in order to restore peace to Greece. Prum muses:

"So, in answer to the question 'Under what conditions will males give up their weapons?' "Lysistrata" teaches us that the most efficient way to fight back against male violence is to hit men where they are most vulnerable below the belt." (p.292)

How to lower male aggression?

Prum concludes that desirable social behaviors like lower male aggression, cooperative social temperament and social intelligence are the result of females making their choice of mates through aesthetic sexual selection. (p. 292)

Given that, one is led to conclude in general that the more female choice that "cool-headed approach" the more acceptable behavior among males.

Women's task: Keeping cool

Any woman who has attempted to occupy any place of influence knows that this process can be a rocky road. Keeping a cool head does not guarantee that there won't be hot heads among one's male counterparts.

Hillary Clinton, for instance, ultimately kept a cool head and graciously conceded the election of 2016 to that ultimate hothead Donald Trump, who now refuses to concede the election of 2020, even to another man!

The defenders of patriarchy have it wrong

Timely for our current human conundrums, Prum explains that all those people who defend patriarchy "mischaracterize feminism as an ideology of power." That misses the point entirely: "feminism is not an ideology of power or control over others; rather, it is an ideology of freedom of choice." (p. 555)

In recent times we have witnessed, even in the supposedly advanced democracies, the age-old treatment of women as an underclass, as a threat, as a criminal, as a "monster."

Women and global crisis management

Women throughout the world bear the larger brunt of an international crisis like the pandemic.And whether they are "important" people or ordinary people, they endure inappropriate treatment.

U.S. vilifiers of women

In the United States, we have seen Hilary Clinton, Nancy Pelosi, Elizabeth Warren and many others, all unquestionably intelligent and competent, unjustly belittled and vilified.

We witnessed sickening schadenfreude by powerful men about the death of one of the country's great women and great jurists, Justice Ruth Bader Ginsburg. It goes on and on.

Kamala Harris and a smile as evolutionary choice

Even so, like the sovereign female Argus and like the black women in the novels of William Faulkner, they endure. U.S. Vice President Mike Pence tried to verbally run over Kamala Harris in their debate, and President Trump called her a "monster" afterwards, but she won the debate.

And she won in part with a method that was culturally derived, one may even say a product of evolution. As Michele L. Norris wrote in The Washington Post, "she smiled as she held her ground and of course they called it a smirkBut it was more than that. Harris gave Pence 'The Look.'"

Strong black women

Speaking of strong black women:

Black women have elevated the 'Mama don't take no mess' expression to a form of high art a narrowing of the eye, a lift of the eyebrow, a tilt of the head. Sometimes there is a sideways arch of the neck, a molasses-slow movement of the jaw that says, without speaking, 'You've got exactly 10 seconds to pick up your feet and run for the hills.'

Women's sovereignty matters

The teachings of this fascinating book on the evolution of birds have parallels in human behavior. The sovereign female Argus dispassionately makes her evaluation of the most suitable mate for the sake of her children's future, just as a sovereign American female politician skillfully employs a smile and "the Look" for the good of the United States.

This is what most women want: Fairness for their children and others' children, as for themselves. They want to be loving but also sovereign. They want to make their choices. They will insist on that.

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Kamala Harris and the evolution of the birds: worldwide lessons - Salon

Human Behavior

Election Pollsters Got It Wrong Again. – wgbh.org

Fool me once, shame on you. Fool me twice, shame on me.

And theres plenty of shame to go around in this post-election postmortem especially for those who thought the polls predicted either a red mirage or a blue wave of victory.

Easy to get fooled when several polls said Texas was a dead heat, and even a possible flip to blue for former Vice President Joe Biden. Others claimed hed possibly win traditionally red Iowa, and many cited stats showing President Donald Trump was significantly behind in Florida. All of those were wrong, and some like the Florida surveys were way off. On election night, Trump had an early wide lead in his adopted home state.

Ive always been suspicious of political polls. That distrust was underscored after the 2016 presidential race, when the vote essentially turned predictions upside down. Now the pollsters will tell you that the final tally from four years ago did, in fact, prove them right; Secretary Hillary Clinton won the popular vote, as they said, topping Trump by 3 million ballots.

But I would argue if you are like the average news consumer, you heard the constant polling drumbeat of her potential for victory as confirmation of victory.

To be fair, there was frequent commentary about Clintons need to win the crucial Electoral College map. But expert pollsters told a twin tale, urging caution while at the same time pointing to past scenarios that seemed to indicate a win information that the ubiquitous pundits amplified ad nauseum.

I believe in data, but its clear that the science of gathering an accurate sense of Americans voting patterns is outdated, or at the very least critically flawed. Maybe the sample sizes are too small or too city-centered, or perhaps its still hard to surface voters through cell phone outreach. Bottom line: the survey sampling is not broad or deep enough.

In 2016, I bought the idea of large, hidden groups of so-called shy Trump voters who didnt want to publicly state their support for the brash candidate. But in 2020, there was no shortage of eager and enthusiastic supporters of the president who were loud and proud about voting for him again. Why werent more of their huge ranks reflected in the surveys? Im convinced it all comes down to human behavior, which psychologists and behaviorists will tell you is often unpredictable. Theres simply no amount of number crunching, algorithm juggling, and the best technology money can buy that can produce absolute results.

Like the human behavior I questioned David Plouffe about during the 2016 campaign. Plouffe was campaign manager for Sen. Barack Obamas successful 2008 campaign, and later a senior advisor to the president. He was an executive at Uber when I interviewed him. It was August, and then candidate Donald Trump was barnstorming the country as the Republican nominee. Enthusiastic voters were driving hours to his rallies, standing outside when the inside venues filled up. The polls all said Secretary Hillary Clinton had a strong lead.

'But what about those rally attendees?' I asked him. 'Couldnt they indicate a huge voter turnout for Trump?'

'Nope,' he said. 'They dont vote.'

I pushed back. 'Who drives hours to attend a candidates rally, if they dont intend to vote?'

He explained it was more complicated than that, and Id see.

Well, I did see. And the results then and now prove what the veteran politicos always say: The only poll that counts is the one on Election Day.

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Election Pollsters Got It Wrong Again. - wgbh.org

Human Behavior

Oddsmakers are pretty sure Joe Rogan won’t be the next host of Jeopardy! – Yahoo Lifestyle

There are few things on this planet that human beings wont place a bet on, given a volatile situation, a degree of uncertainty, and sufficient cash to burn. Game Of Thrones, national elections, the Puppy Bowl: All are beholden to the oddsmakers art, as these wizards of prediction try to figure out exactly how much money you should get if you bet that, say, Jon Stewart was going to give up his life of movie making and cattle rescuing to go host Jeopardy!, and then this improbable turn of events did, in fact, come to pass. (33-1, as it happens.)

Which is all to say: Washington Post entertainment writer Steven Zeitchik got our brains pumping with all the vigor of a Daily Double adrenaline rush today when he posted a list of sportsbook odds (provenance not entirely clear) on who the new Jeopardy! host will be, with names ranging from the obvious (long-time champion Ken Jennings, at 1-1), to That actually sounds delightful, like LaVar Burton (20-1), to Dear god, why would you even put the thought out into the world (Piers Morgan, at 40-1). The most outside shot that someone actually bothered to venture a number for was Joe Rogan, whose chances of a double reign as Fear Factor/Joepardy! host lands at a slim 66-1.

Other actual frontrunners for the position include sportscaster Alex Faust (18-1) and CNN legal analyst Lauren Coates (same), both of whom received a personal vote of confidence from the late Alex Trebek in recent years. Theres also the usual glut of current game show hosts like Drew Carey (33-1), Pat Sajak (16-1), Tom Bergeron (18-1), and our favorite, Steve Harvey (40-1)and also apparently George Stephanopoulos (7-2), whos reportedly been lobbying for the role.

All of which is, in its own weird way, a sort of tribute to Trebek, a man who made a very difficult job look easy, and who carried himself in a way that was funny but rarely mocking, dignified without ever seeming stiff. Finding someone to fill his shoes is a daunting, nigh-impossible taskto the point that not even the people whose job it is to predict human behavior for money might be up to spitting out a decent answer at the moment.

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Oddsmakers are pretty sure Joe Rogan won't be the next host of Jeopardy! - Yahoo Lifestyle

Human Behavior

SNF Brain Insight Lecture on ‘Making the Right Moves in a Pandemic’ – The National Herald

NEW YORK The Stavros Niarchos Foundation (SNF) Brain Insight Lecture series, hosted by Columbia University's Mortimer B. Zuckerman Mind Brain Behavior Institute, continued with Making the Right Moves in a Pandemic on November 10. The virtual event, via Zoom featured the speakers Dara Kass, MD, Associate Professor of Emergency Medicine at the Columbia University Irving Medical Center, and Andrs Bendesky, MD, PhD, Assistant Professor of Ecology, Evolution and Environmental Biology at Columbia University's Zuckerman Institute. The discussion was moderated by Natalie Steinemann, PhD, Columbia's Zuckerman Institute.

Rui Costa, director and chief executive officer of Columbia's Zuckerman Institute and a professor of neuroscience and neurology at Columbia's Vagelos College of Physicians and Surgeons, gave the welcoming remarks to open the virtual event, thanking SNF in particular for its continuing support of this important lecture series.

According to the event's description, the COVID-19 pandemic continues to affect our lives at multiple levels: our health, our daily lives and our communities. Dealing with the pandemic requires us to make effective decisions, communicate rapidly and harness all our resources.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has challenged the world with unprecedented public health and economic crises. We need effective strategies to slow the spread of the virus.

We must be able to rapidly and affordably diagnose the virus because a major reason for the extreme societal and economic disruptions is the lack of appropriate testing technology to easily identify infectious people, especially those who do not have symptoms. We also need effective decision making and communication at both the clinical and community level to mitigate SARS-CoV-2 transmission in schools, at work and in the community at large.

The National Herald

The Stavros Niarchos Foundation Brain Insight Lecture, titled Making the Right Moves in a Pandemic, hosted by Columbia University's Mortimer B. Zuckerman Mind Brain Behavior Institute, featured Dr. Dara Kass and Dr. Andres Bendesky with moderator Natalie Steinemann.

In the virtual SNF Brain Insight Lecture Series event, the discussion featured two experts from Columbia University who are involved in the response to the COVID-19 pandemic in very different ways. Dr. Dara Kass reflected on decision making, both clinical and community, from the perspective of an emergency medicine doctor who, herself, was infected with the virus. She also discussed how to communicate rapidly evolving information in an effective manner. Dr. Andrs Bendesky discussed his lab's work to develop a simple, affordable test that can be performed at home.

The informative presentation was followed by a Q&A session which offered even more insights into the pandemic and the significant advances that have been made so quickly in the study of the SARS-CoV-2 virus. Both speakers were hopeful for the future, and as Dr. Kass noted concerning the response to the pandemic by New York in particular, We had our nationally renowned health centers, clear and consistent messaging from our leadership, and we had a citizenry that felt united around a collective identity, so to me that reaction was very helpful. It made me realize that New Yorkers can do anything and I'd never been more proud to be a New Yorker and I've been one my entire life.

This talk was part of the Stavros Niarchos Foundation Brain Insight Lecture series, offered free to the public to enhance understanding of the biology of the mind and the complexity of human behavior. The lectures are hosted by Columbia's Zuckerman Institute and supported by the Stavros Niarchos Foundation.

The lecture was also streamed live online and is available on YouTube: https://youtu.be/zF_219Mv1_0.

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SNF Brain Insight Lecture on 'Making the Right Moves in a Pandemic' - The National Herald

Human Behavior

A Covid-19 surge of depression and anxiety is being treated by robots – CNBC

Hundreds of millions of people around the world were suffering from common mental health issues including anxiety and depression before Covid-19, and the scale of the health-care crisis has escalated as a result of the pandemic. But demand for mental health services is far outstripping the available supply of trained professionals. Machines are rising to the challenge as a first point of contact for struggling individuals, but just how far can the robot brain go in treating the mind of the human individual?

The research is still in the early days, but as artificial intelligence technology including natural language processing experiences a period of rapid advances, experts confront the delicate issue of how to properly use technology for mental health treatment. One factor is becoming undeniable, though: many people prefer to reveal their mental health struggle to a non-human confidante: a robot.

A recent survey from Workplace Intelligence and Oracle found that across more than 12,000 workers around the globe only 18% prefer humans over robots to support their mental health. Sixty-eight percent prefer to talk to a robot over their manager about stress and anxiety at work, and 80% indicated they were open to having a robot as a therapist or counselor.

As mental health issues around the world increase and resources are limited, experts are devising technological approaches to patient treatment, though some experts say an AI-based approach can never offer one critical human skill: empathy.

bestdesigns | iStock | Getty Images

"Unbiased information is what people want," said Dan Schawbel, founder and managing partner of Workplace Intelligence.

There are a few primary reasons people are turning to technology for this sensitive conversation: accessibility of getting help 24-7, and getting that help without having to admit to a struggle.

"There really is a stigma behind mental health globally. Talking about stress, or anxiety and depression with managers, employees will hold back. People don't seek help from humans because they don't want to be judged," Schawbel said.

Technology does have the potential to provide mental health support at scale, as well as unbiased information, non-judgmental responses, and a blindness to rank in the workplace context a machine doesn't discern if the employee seeking help is a CEO or lower down the company hierarchy.

"We're not going to have a billion therapists in the world so we need technology," Schawbel said. "But there is no AI replacement for one of the greatest values that therapists provide: human empathy. Robots can't do that yet."

The use of chatbots in mental health is backed, at least in a general sense, by research already decades-old: people were more likely to be honest using telephone voice-response systems than when talking to a live human.

"Chatbot are OK for basic things," said Bruce Rollman, director of the Center for Behavioral Health and Smart Technology at the University of Pittsburgh School of Medicine, who has researched online treatments for mood and anxiety disorders. "But when we start getting into mental health, it's a game of chess and we're not always playing with Deep Blue," he said, referencing the IBM AI that beat world champions.

"I'd be skeptical if was just computer algorithm, but it might be fine before you talk to a therapist, and AI that does a questionnaire," Rollman said.

Employers expect a wave of mental health challenges for the labor force in the prolonged remote work period, and they realize a chatbot might be preferable for reasons that go beyond the basic stigmatization of mental health, but because employees worry about risking promotions or raises, and job safety. Managers are not always adept at providing the right answers, either.

"Humans are not adequately trained on mental health issues. When people tell you they are stressed or depressed, we often give the wrong answers, and technology is a great way to scale some sequence of questions and best practices," said Emily He, senior vice president of the human capital management in Oracle's cloud business group.

Technology can help guide an employee through a mental health journey in a manner similar to it already does for the onboarding process as a new hire. Conversational AIs, or chatbots, can interface on a daily basis and track answers to questions, in some cases monitoring voice tone as well, and identify and predict someone who needs more advanced treatment.

"The end goal is to enable humans to do what they are best at, which is managing relationships, but there are some baseline questions and great ways to leverage technology," He said.

Record levels of venture capital money are flowing into the sector. According to digital healthcare-focused venture fund Rock Health's proprietary database, $9.4 billion was invested in overall digital health this year, and $4 billion of that was in Q3 alone.Investment in U.S.-based, AI-powered digital health start-ups it has tracked since 2011 are above $10 billion, with investment in mental/behavioral health AI reaching over $230 million across close to 20 deals. And the numbers are getting bigger: in 2020, there was $72 million invested across two sizable mental health AI transactions.The sums recently invested into mental health start-ups, including those not focused specifically on AI, are far higher.

"As an investor in a handful of mental and behavioral health start-ups, we know first hand that our portfolio companies have experienced strong and rising demand throughout the pandemic," said Rock Health CEO Bill Evans. "Like never before, automation and thoughtful use of technologies like AI is absolutely critical to delivering a human touch to those of us in greatest need."

"Eighty percent of the U.S. population owns a phone, and phones can tell you if there's been a change in your behavior," Pitt's Rollman said. He added that while it may sound creepy, predictive analytics are the future across many aspects of our lives, from Spotify knowing what music we prefer to listen to, to maybe mental health. The big gap right now in mental health is an AI that can make the right suggestion at the right time, especially if it is a high-risk person, a person with substance abuse or suicidal tendencies.

Woebot offers therapy options for people suffering from anxiety, depression, and mental health issues, in a stigma-free environment. "A robot can see me on my worst day and it's just a robot, it's not judging me," says founder Alison Darcy.

David Paul Morris | Bloomberg | Getty Images

Among the AI pioneers pushing the boundaries of what the technology can do is Alison Darcy, founder and president of Woebot Health, a start-up that has engineered a conversational agent (chatbot) to provide digital mental health counseling. Darcy, a research psychologist and former software engineer, worked earlier in her career with Coursera co-founder Andrew Ng at his Stanford University Health Innovation Lab in Computer Science (Ng is the chairman of Woebot).

Darcy said the technology has come a long way in a short number of years and it can help to push people past the primary reason they don't reach out for help: the stigma and fear of being judged.

"Therapists have to spend so much time building rapport. A robot can see me on my worst day and it's just a robot, it's not judging me. They have no judgment," Darcy said. "It's just software."

Woebot refers to itself as a robot in communication with users, and the company chose to not create a human avatar for the interface, though these design decisions also point to the challenge. "There is no human connection, no deep relationship, and that is the limit of the technology," Darcy said.

The limitations, combined with the recent increased investment, worry some mental health experts.

"There is a gold rush in the space and we believe in it, but also believe in science," said Catherine Serio, a clinical psychologist and associate vice president of digital behavior solutions at the University of Pittsburgh Medical Center. "There is lots of money to be made out there."

The University of Pittsburgh Medical Center recently launched a behavioral health app called RxWell which aims for a middle ground between reliance on technology and the need to offer increased access to individuals enabling them to take the first step in seeking help for depression and anxiety.

Serio, who has treated patients with depression and anxiety for years, acknowledged the issue with stigma and scaling in behavioral health, but believes a hybrid model is the only responsible route. "We believe the AI needs to mature more. A chatbot is basically a series of business rules to respond to people and we have not seen a completely coded response that is going to work for people with depression and anxiety," she said.

Building a relationship, a therapeutic bond, has been cited as the reason digital therapy cannot be effective. But Woebot has shown in a trial of young adults the ability to reduce mental health symptoms and deliver cognitive behavioral therapy. "That is not to say it's replacing therapy. It's really not, but it is allowing for full potency of therapy to be unlocked," Darcy said. "Our data shows it can be a useful first step. It is incredibly easy and destigmatizing."

Woebot can also detect crisis language and in those cases it is programmed to tell the user they require a human therapist. Or in other words, the robot's programming is designed to identify its own limitations. "The robot would rather ask you about your mood than detect it. The best person to tell us how you are doing is you," Darcy said.

She said research shows users are also turning to the robot further along in recovery as follow up care. "We see people talking to robots over a long period, maybe for three months when it is a difficult time, and then checking in again nine months later when in another difficult patch. And that is a longer-term perspective than what we normally think about," the Woebot founder said. "Humans respond well to the needs of a patient in the moment. A chatbot can do it too. It is responsive to where a person is at."

The Covid-19 pandemic has resulted in a boom in technology-based health care, and in psychiatry departments, a rare financial feat: an area of care that usually loses money for health institutions becoming a source of profits, according to Soo Jeong Youn, a research psychologist at Harvard Medical School and the Massachusetts General Hospital. She says technology should be used more to combat stigma in mental health, and to provide greater access to care across more cultures and populations, but she added that the research is still preliminary.

"We're not there yet. We're not close to what we see in Sci-Fi movies and responses catered to each person, but the AI has gotten really good," she said.

For example, if a person says they are feeling anxious, the AI can provide resources tailored to anxiety. "Even just searching on 'I'm anxious. What do I do?' There is something to having more information through an app," she said.

The need for help is great, and getting greater, as more Americans have face issues including job loss and food insecurity. Among the client base that UPMC works with to provide health care, the population saying their mental health was negatively impacted jumped from 32% in March to 58% in August. "That one statistic alone is a massive amount of individuals," said Jim Kinville, senior director of the LifeSolutions group at UPMC.

Can AI and chatbots be helpful? Absolutely and partially.

Bill Duane

former Google wellness and performance guru

Wellness and prevention apps offering access to skills, and cognitive behavioral therapy techniques, to help people manage stress and anxiety are now widespread. Some apps like Talkspace provide a way to connect with a human therapist online, or combine digital tools with live support, like UMPC's RxWell.

"There is lots of unmet need out there and people we call the 'walking wounded' ... functioning OK, but could benefit more from digital tools," Kinville said. "These tech tools can start the process and get people engaged."

The recent VC deals in the space show that the bets on mental health business models using AI are not limited to the creation of compelling chatbots. Ginger raised $50 million August, including funds from major insurer VC arms at Cigna and Kaiser Permanente, for its on-demand behavioral health platform offering access to coaching, video therapyand self-guided activities. In early 2020, Spring Health raised $22 million for what it describes as "precision mental health care" which uses a proprietary machine learning approach to diagnose conditions and identify the best therapy options for individuals.

While core AI technology including natural language processing underlying chatbots has advanced in the past few years, research shows algorithms continue to analyze the same data sets and come to different results, predicting different outcomes.

That makes Harvard's Youn cautious beyond what she is comfortable saying a chatbot can do today: the equivalent of a first session with a therapist, in which the goal is an understanding of what an individual is going through.

"Hopefully with the push of the pandemic we will get there much faster, and there is huge room and space and need for these chat-based apps to deliver help and relieve distress through the power of AI," the Harvard psychologist said.

For some experts working at the intersection of technology and human performance, choosing a side in the battle between human mental-health professionals and machines risks missing how serious the battle has become and the fact that we need to throw all we have at our disposal at it.

The recent increases in serious mental health struggles, especially among younger adults who say they have felt suicidal, speak to the importance and poignancy of improving access to mental health care, especially for people of color and lower incomes.

"The demands on mental health are massively increasing," said Bill Duane, former Google wellness and performance executive who now runs his own consulting firm. "Existential fear, financial insecurity, nebulous boundaries between work and home ... fear of job security causing people to try and push through and work harder, which only works for the short term. I'm heartbroken at everything going on. But I am extraordinarily optimistic about ways AI can be involved."

Woebot is experiencing increased usage during the pandemic, "huge increases," Darcy said, and it has tracked more need for support among younger users, which the recent research shows to be at elevated levels of risk. At the time of its August deal, Ginger noted "skyrocketing demand" for anxiety and depression care among U.S. workers.

More employees are willing to ask for help because there is a greater shared sense of going through a difficult experience as a community, Oracle's He said, and tech-based support for mental health is a logical extension of how people already interact with machines fitness apps support better physical health and have edged into other areas of wellness like sleep patterns.

But UPMC's Serio said that once an initial assessment has been done, there is no AI replacement for the "nuance and cues, and all those things human beings do. ... What people need is empathy. Anyone who says that will be fully automated one day, I don't know what reality they are grounded in."

Duane thinks people should not understate the value of how far the technology already has come not needing to make an appointment or deal with a doctor as a first step, eliminating feelings of shame or discomfort. It is a stigma workaround, a Band-aid on the larger problem of getting more individuals to seek help, but he said it also speaks to the fact that chatbots already are part of the solution.

"To everyone feeling the weight of 2020, it's a reasonable response to what's going on and the massive increase in demand. Access and timeliness are really important when we look at the quantity of people who need mental health care. .... Can AI and chatbots be helpful? Absolutely and partially."

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A Covid-19 surge of depression and anxiety is being treated by robots - CNBC

Human Behavior

Utah failed to flatten the curve: these two numbers show why – Deseret News

The novel coronavirus has infected more than 10 million people in the United States nearly the entire population of Sweden.

As of Sunday afternoon, more than 237,000 Americans have died 659 in Utah.

As striking as those numbers are, experts have long worried that a second wave of COVID-19 cases in the fall and winter would be even worse than the first, said Dr. Steven Woolf, a social epidemiologist and director emeritus and senior adviser at the VCU Center on Society and Health at Virginia Commonwealth University.

As states loosened restrictions, the spring surge was never fully controlled and instead of an epidemiological curve we got a staircase. That means the impending second wave is more like a very dangerous third surge, Woolf said. Growing case counts are being fueled by pandemic fatigue, decreasing vigilance and colder weather pushing gatherings indoors.

Utahs figures are especially concerning:

The states current seven-day average for new confirmed cases is 2,290, which in a state of 3.21 million translates to 71 cases per 100,000 per day.

In New York, at the peak of its crisis in April, the Empire State was averaging nearly 10,000 confirmed cases a day. In a state of 19.45 million that translates to 51 cases per 100,000 per day.

In terms of cumulative cases, there are more in New York, said David Dowdy, an associate professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, but in terms of when we would have said New York was on fire thats where Utah is right now.

As the country marches toward Thanksgiving, per capita cases is just one of two figures that epidemiologists and statisticians say offer a more nuanced and well-rounded view of the pandemic and its impacts. The second is excess deaths, a number that captures just how far-reaching those impacts are.

Most years, there are zero excess deaths in the U.S. deaths above and beyond the number officials were expecting but this year, theres been nearly 300,000 so far, with two-thirds attributed to COVID-19.

This story explores the true human cost of COVID-19 and the forecast for winter. Because if changes arent made, even more people will die.

The spread is happening in our homes and it is killing people and overwhelming our hospitals, Spencer Cox, Utahs governor-elect said Thursday. This is crunch time. ... The next two months are absolutely critical. We are in a dire situation and we cannot emphasize that enough.

Despite pleas from the governor and from Cox since summer that Utahns wear masks and socially distance, not all are willing to wear face coverings (some remain adamantly opposed) and many continue to gather, closely. Case numbers continue to climb.

And its not just in Utah.

The New York Times tracker shows a positive cumulative case rate for North Dakota of 7,127 per 100,000 residents one of the highest rates in the country right now.

Thanks to advances in treating the disease, the number of people dying of COVID-19 isnt increasing at the same speed as the number of cases, said Dowdy, but at some point, the number of cases goes up so dramatically that deaths cant help but follow.

The mostly rural North Dakota is currently at 8 deaths per million the only state besides Montana glowing red on the daily COVID-19 death rate projections from the University of Washingtons Institute for Health Metrics and Evaluation. Utah is at 1 to 1.9 per million.

The fact that the virus has seemingly moved from politically left-leaning blue states to more right-leaning red states, and states like North Dakota and Utah are now topping charts for all the wrong reasons isnt entirely surprising, said Dr. Ali Mokdad, a professor of Health Metrics Sciences at the Institute for Health Metrics and Evaluation and chief strategy officer for Population Health at the University of Washington. Rather, it reflects the reality of how diseases spread.

The novel coronavirus first hit large urban hubs with international airports, wreaking havoc in big cities while giving folks in smaller cities a false sense of security (that) this is not us, he said. Hes seen the same thing happen with tobacco and HIV, where big cities were hit first, then rural communities which are still struggling.

By definition of epidemic, its going to hit everybody, Mokdad said. COVID-19 doesnt know age, it doesnt know geography, doesnt know race. (Its a) stubborn virus, opportunistic virus. Make a mistake, let down your guard, this virus is going to get you.

Utah, which staved off a major spike in the spring, is now dealing with the virus running rampant.

Masks are now required in 22 (of 29) counties where transmission levels are high and hospital officials are teetering on the edge of entering crisis levels of care, which means care rationing and even more exhausted providers the very things flattening the curve was supposed to prevent.

But Utahs numbers no longer portent a curve just a line headed north.

In the latest Institute of Health Metrics and Evaluation projection, 2,121 Utahns will die from COVID-19 by Feb. 1, 2021.

In the United States, deaths are projected to total 399,163 by Feb. 1, with nearly 2,250 COVID-19 deaths a day by mid-January three times higher than current daily deaths. (The institute usually issues new projections weekly.)

Those numbers are based on states locking back down when they hit 8 deaths per million people what 90% of states did in the spring when they reached those same levels.

Under that timeline, Utah would be locking down again sometime in December along with Kansas, Oklahoma, Minnesota, Louisiana, Alabama, Pennsylvania, New Jersey, Connecticut and Massachusetts.

If states choose not to, or even loosen restrictions, numbers just climb higher: Utah potentially loses 2,932 people to COVID-19, the nation nearly 513,657.

IHME predictions about hospital beds considered facilities under extreme stress if more than 20% of regular beds or 60% of intensive care units are filled by COVID-19 patients. Utah is projected to hit extreme stress for both bed types by the end of December.

However, the projections also calculated that if 95% of people wear masks the rate seen in Singapore closures could be delayed and nearly 62,000 lives could be saved nationwide by Feb. 1.

The best strategy to delay reimposition of mandates and the associated economic hardship is to expand mask use, the IHME Oct. 22 finding brief explained.

In Utah, masking at 95% would mean a total of 1,381 deaths by Feb. 1 about 740 fewer COVID-19 deaths than the current prediction.

For Mokdad, whos been in public health for more than 30 years, these upward trends are painful and discouraging. He would love to see people wear masks, limit mobility and stay distanced, and have his teams numbers prove to be drastic overestimates.

We hope that people will change their behaviors, he said. I pray that I am wrong, that people will make me wrong.

And its possible.

Projections and models are good at predicting what will happen under certain circumstances, said Fred Brauer, a professor emeritus of the University of Wisconsin and currently an honorary professor of mathematics at the University of British Columbia who studies epidemiological modeling. However, they have a harder time capturing human behavior, which can change rapidly when faced with a serious disease.

Brauer notes that during the 2014 Ebola outbreak in Africa, the models predicted millions of deaths, but by the end of the crisis, the death figure was around 11,300 still tragic, but significantly less than feared.

The best explanation Ive heard so far is people really changed their behavior and avoided the very dangerous funeral practices, said Brauer, even before there was any government move to encourage this behavior.

Peoples behavior changed because they took Ebola seriously, he said, which he hopes will finally happen with COVID-19.

You dont know what influences them, he said, whether its the number of cases, or the number of new cases or the number of deaths, we just dont know.

One new alarming number is 299,028.

Thats the number of people who died in the United States from late January to Oct. 3 above and beyond the number of deaths officials were expecting, according to a recent Centers for Disease Control and Prevention report.

Excess death is calculated by comparing all the deaths during a certain time period against the average number of deaths during that same time period in previous years, considering both population dynamics and seasonal fluctuations. Anything above the expected number for a specific time and place is considered excess.

Last year, like most years, there were zero excess deaths in the U.S., said Dowdy, but this year, theres been nearly 300,000 so far, with two-thirds attributed to COVID-19.

We have had a higher mortality rate on the U.S. level than in any recent year in history, Dowdy said. We know that this is a deadly disease.

Excess deaths is an important metric because it adjust for flaws or gaps in record keeping thats been disrupted by a crisis, said Nancy Krieger, a professor of social epidemiology at the Harvard T.H. Chan School of Public Health.

It also cuts out worries about politicization or manipulation of data.

Perhaps a state isnt testing enough. Not a problem.

Faulty tests? Doesnt matter.

What if a death is labeled a stroke instead of COVID-19 or vice versa? No impact.

None of these record-keeping problems affect the excess death figure, because its a measure of mortality stripped of all other factors. A death is a death.

During most Januarys in the United States, statisticians and epidemiologists project an average of 60,000 weekly deaths both from natural causes like old age, influenza and other health conditions, plus nonnatural causes like car accidents, homicides and even skiing accidents.

They also calculate a worst-case scenario number, shown in the CDC excess death graphs as a red-orange line, meaning the highest number of deaths they would expect in any given week in a year.

The last time U.S. deaths broke through the orange line was late December 2017 likely due to a particularly virulent flu season. But the peak subsided after January 2018 and deaths dropped below the orange line for the next two years.

Then COVID-19 hit.

By March 28, roughly two months after the first U.S. case, the observed number of weekly deaths was already punching through the orange line, peaking on the week ending April 11 at nearly 79,000 deaths 36% higher than even the worst-case scenario of 58,266 deaths.

For more than six months, weekly U.S deaths remained abnormally high.

The week ending October 24, 2020 was the first time since late March that deaths fell below the worst-case scenario level though deaths still remain above average.

From March to Aug. 1, Utah saw 953 excess deaths, with 311 or 33% due to COVID-19, according to Woolfs research recently published in JAMA. His findings echoed the CDCs: U.S. deaths have increased 20% during 2020.

In 13 of the last 17 weeks in Utah, CDC week-by-week death data show the state has surpassed the worst-case-scenario number of deaths ranging from 13% to 26% increases this year over years past.

But if only two-thirds of the U.S.s excess deaths and one-third of Utahs deaths (as of Aug. 1) were caused by COVID-19, what else is causing so many people to die?

Utahs Chief Medical Examiner Erik Christensen is busier now than hes ever been during his 12 years in this position.

Thus far in 2020, hes seen 300 to 400 more non-COVID-19 deaths (not every death is reviewed by his office) than last year. While he doesnt know all the reasons why numbers are so high, he has a few theories.

First, some of the gap deaths may be unclassified COVID-19 deaths.

Doctors are continually learning about COVID-19s effects on the body, leading to more accurate labeling of such deaths now compared to what happened during the first months of the pandemic.

Christensen said hes both diagnosing COVID-19 in previously undiagnosed deaths, (around a quarter of the 300 to 400 deaths) and removing any COVID-19 designation if its unwarranted (around a dozen times).

However, he along with many other public health officials believes the bulk of excess deaths are collateral COVID-19 damage: people dying as a result of disruptions from the pandemic.

Woolf further divides this group into three categories.

The first is people experiencing acute emergencies someone with chest pain whos afraid to call 911 because of COVID-19 and dies of a heart attack. Or the reverse, someone who actually calls 911, but medical personnel are too busy with COVID-19 patients to respond.

The second group is anyone with a chronic disease diabetes, cancer, HIV who, because of the pandemic, cant stay in control of their illness, develops complications and dies.

The third group includes those with behavioral health concerns like depression or substance abuse disorders who, under stressors produced by the pandemic develop fatal complications, said Woolf, noting that the opioid epidemic didnt stop when the virus arrived.

Woolf said their research also found a spike in deaths from Alzheimers and dementia within states hit first by the pandemic. He noted nursing home residents are more likely to be dealing with those two diseases, and many nursing homes have been hit hard by the novel coronavirus.

These deaths may not carry a COVID-19 tag, but they will show up in excess death numbers the collateral damage of a crisis and a view into how this pandemic is shaping peoples risk of dying, said Krieger at Harvard.

Other potential causes for the gap between the number of excess deaths and counted COVID-19 deaths are those who died as a result of domestic violence or homicides results of being locked down with abusers or stuck in volatile situations during pandemic restrictions.

While theres some validity to the concern that our reaction to the virus and our steps to protect public health have these immediate harms, its a mistake to back off on trying to nip this in the bud and control community spread, Woolf said, because in the end, (failure to do so) will even cost even more lives.

Having any mortality data at this point in the pandemic is helpful, considering mortality stats arent normally finalized until up to 18 months after the year in question, said Michael Staley, suicide prevention research coordinator with the Utah Department of Health. (Hes still waiting for official 2019 mortality data.)

Nearly every expert the Deseret News spoke with mentioned how time will prove a great clarifier for death data. Even the CDC notes on their graphics that data in recent weeks are incomplete, and that it can take up to eight weeks for mortality data to be at least 75% complete.

In the meantime, heres a look at what Utah officials know about deaths in the state this year:

There was a 30% decrease in the number of people seeking medical attention for suicide ideation during the first few months of the pandemic, but returned to normal levels around mid-June, said Staley. However, the number of suicide deaths hasnt changed significantly in 2020 compared to 2019 or 2018.

The drug overdose death rate has been going down since its peak in 2015, but did start to increase in April, said Staley. However, drug overdose counts are still within the average range.

In 2020, there have been 29 domestic-violence related deaths. Last year at this time, thered been 32. However, calls to the Utah Domestic Violence LINKLine (1-800-897-LINK) have increased 25% to 50% since March, with an increased need for shelter and longer shelter stays, said Liz Sollis, spokesperson for the Utah Domestic Violence Coalition.

By late October, 233 people had died on Utah roads. Last year at this time, it was 191, and in 2018 at the same time there were 234 traffic deaths, said Jason Mettmann, communications manager for the Utah Highway Safety Office.

Officials will continue to gather and sort death data for months, looking for ways to show the pandemics full impact on the state. Yet, even if the data arent perfectly clear yet, Christensens message is.

Just wear a mask, he said. It doesnt reduce things to zero, but every one we dont have to deal with is somebody thats still going home.

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Utah failed to flatten the curve: these two numbers show why - Deseret News