This is the North Dakota Department of Health’s COVID positive rate graph (the bottom one is a 14 day moving average). Note the artfully drawn red line — that’s when Governor Doug Burgum obtained a microscope to locate his testicles and instituted a statewide mask mandate. But wait, what’s going on in South Dakota?
We all know that Dollar Store Sarah Palin, Governor Kristi Noem, has no intention of vacating her lair deep in the recesses of Trump’s ass to issue a mask mandate, so it has to be due to cities getting a clue:
When it comes to masks, Brookings took the lead. It was the first city to enact a mandate in South Dakota. […]
In mid-November three more of South Dakota’s larger cities enacted mandates. Huron was first, followed by Mitchell. […]
A Sioux Falls mandate took effect at midnight on November 21st.
SDSU Epidemiologist Bonny Specker has been tracking the numbers and says those four mandates appear to be making a difference.
“What is interesting is what happened with the seven-day running averages of new cases per day in the 10 counties with the most populous cities based on whether the largest city passed, or did not pass, a mask mandate before December 1st, a time that changes should be apparent by mid-December,” Specker said in an email.
She says Brookings, Beadle [Huron], Davison [Mitchell] and Minnehaha Counties [Sioux Falls] saw a 69 percent decrease in cases between November 15 and December 14. She says the six counties without a mask mandate before December 1 saw a 40 percent decrease.
I’d call this good news if I were able to ignore the deaths, and absolute devastation of the hospital systems, that preceded it.
SOMEONE has to be the adult here. Glad to see the city mayors aren’t all taking their lead from their feckless leader.
Gin & Tonic
“three more of South Dakota’s larger cities”
That would imply at least four large cities in S.D. Who knew?
I saw “Rage Positivity Rate” on the first graph and thought the drop-off was a lot sooner than the January 20th I would have expected. But then I read the post.
Kansas did a natural experiment a while back. Some cities instituted mask mandates, others did not.
In the mask mandate cities, pandemic markers went down significantly. In the non-mask cities, they doubled.
In the many doctoral theses and studies like David’s institute does, after the pandemic, the effects of different interventions will be teased out. I suspect that when officialdom orders masks, people start taking other measures as well, like cutting down on drinking parties and staying home more.
It’s important for those in charge to be responsible.
How does the old adage go – “X will eventually do the right thing, after trying all the wrong ones”?
The Invisible Hand of the
MarketVirus at work.
Four Seasons Total Landscaping mistermix
True. Burgum, who is not an idiot but certainly acted like one for a while, defended his inaction by stating that you can’t force people to wear a mask. But, obviously, the opposite is true: making something law influences law-abiding people, who are the vast majority. Also, from talking with relatives, there’s a lot of mask shaming going on (people wearing masks taking shit from others who aren’t). To say “I’m just following the law” is a pretty powerful response.
First, just wearing a mask is a signal that you need to keep distance. So a mask is almost always accompanied by greater distancing, which probably amplifies whatever effectiveness the mask imparts.
Second, with respect to the Dakotas and other less populous states — officials kept pointing out how “different” they were from NYC or other northeastern states that had early, high death rates — no mass transit, lower density, fewer multigenerational housing arrangements, etc. They did not consider the ways in which they might be similar — nursing homes, church congregations — and they totally seem ignorant of the fact that even in a “low density” state like North Dakota, more than 70% of the population can be found in just 10 cities. Okay, they are small cities and people live further apart, but it’s not like you can take the number of square acres in a state and divide by the population to give you a total picture of how people could infect each other.
Even with improvements, ND and SD are going to rival Massachusetts for third and fourth highest death rates. Only they had months and months to prepare and get it right. It’s like Kristi Noem is conducting a eugenics experiment so she can own the libs. It is just grotesque.
@Four Seasons Total Landscaping mistermix: Being able to say to someone, “Please wear your mask. [I could get in trouble/My business might get closed down/etc.] if you don’t,” is pretty effective.
West of the Rockies
So you’re saying that wearing a mask works? Weird. I wish we knew this back in April…
Just to add regarding South Dakota, it might not surprise you to learn that it has one of the lowest Medicaid nursing home reimbursement rates relative to cost of living in the nation — to the point that many have closed with patients being transferred hours away from the cities where they had lived with their families. They are probably especially ill-equipped to deal with the added expense of COVID testing and staffing adjustments. When you drill down in many locations, it will be no surprise to find that they have fared as poorly as they have.
But, but, but . . . We have had a statewide mask mandate in California for months and we are currently suffering a devastating surge of cases and deaths.
Mask mandates only work if people wear them. And the limit to the number of people for social gatherings only works if people limit the number of people in their social gatherings. And having a family bubble only works if people understand what a family bubble is . . .
I don’t have all the answers to why California is such a mess right now. Lots of selfish people???? It’s really discouraging.
Walmarts. Or in the smaller towns, the single grocery-hardware-drug store that serves the same purpose, and where everyone goes to do their Saturday shopping.
@Scout211: Yes, California is frustrating, but consider that the death rate in California is less than half — and closer to 1/3 — of what it is in ND and SD (along with some other more recent poor performers, like RI). And the rate of infection is less than half of what it is in those states. California’s recent performance relative to its earlier performance is in the wrong direction, so of course, it needs to do better. But you should consider its track record with a certain amount of perspective.
Four Seasons Total Landscaping mistermix
No surprise – the company running the nursing home in my home town, and another one 20 miles away, ran out of money and closed both down. The one 20 miles away was owned by the town so I think it may have reopened. It’s terrible.
Thank you for this.
And here in the socialist hellhole that is Maryland, the shaming goes the other way. Even here in Confederate Southern MD!
Ingrained societal expectations have played a large part in the outcomes of 2020.
Jim, Foolish Literalist
@Cheryl Rofer: did you see the (Republican) mayor of Dodge City resigned after she issued a mask mandate and was flooded with threats of violence ? I think she said on one of the MSNBC shows yesterday that she’s leaving the R party, too.
@Barbara: There are also people that are alive today that wouldn’t be without the more successful masking. The current outbreak is starting from a lower base, also good. Granted, the current state is not ideal, but it’s still better than it could have been.
Major Major Major Major
Proud to have been a masking crank from the start.
My grandpa seems to be doing pretty okay, he’s on dexamethasone but for an old dude with emphysema I think the developments are mostly non-negative.
Confederate cannon fodder:
@Major Major Major Major: Glad to hear.
@oatler.: I wonder if they’ll turn on God now.
Enhanced Voting Techniques
@Scout211: Go look at the what the state has to say about in counties. It’s almost like the Redder the county in California the worse it gets and then there is Imperial County which has been one like spike up.
Enhanced Voting Techniques
@Barbara: California the typical COVID patient is a Latino ages 18-49, so younger population being infected and the lower death rate.
Meanwhile, Californians, who seemed relatively sane earlier on, apparently somehow decided they were safe and threw caution to the winds at Thanksgiving. New cases in California have been rising steeply ever since, hostpitals full, deaths rising fast.
Bottom graph, highlight California
@Four Seasons Total Landscaping mistermix: Yes, as I have watched SD I have wondered more than once whether uncontrolled infection is Noem’s strategy for solving SD’s nursing home catastrophe. I actually think that what we are witnessing is the fall out from Sturgis. If 27 infected attendees at a conference in Boston can be responsible for thousands of subsequent infections, imagine what the impact of Sturgis is likely to have been.
@Enhanced Voting Techniques: Ditto in Utah, which has a relatively high rate of infection but whose residents have a lower than average age. A lot contributes to death rate.
Depends on your definition of “large”. Per Wikipedia, the four biggest cities in South Dakota by population (2010 Census) are:
The whole state’s population was 810k in the 2010 census which makes them 46th, ahead of only North Dakota, Alaska, Vermont, and Wyoming.
@Baud: I say game on!
@Jim, Foolish Literalist: Good for her.
The violence against public health and other officials who are trying to deal with the pandemic is appalling.
And all the death threats – for whatever reason – seem to be coming from adherents of the right. Another point for future researchers.
Or maybe even today’s reporters, but I’m not holding my breath.
Just wear masks and stay apart, you fuckers
I don’t have all the answers to why California is such a mess right now.
I ascribe it mostly to a combination of pandemic fatigue and magical thinking about extended gatherings at Thanksgiving.
But Newsom’s “closure” orders have, for months, been heavily influenced by calculations of political pain, instead of being based urely on epidemiology. Some excellent public health officials, such as Santa Clara County’s Dr. Sara Cody, have taken independent action that has mitigated those mistakes, but they can only do so much.
@joel hanes: I am not congratulating California, but its high percentage increase in deaths is from a lower base. On a deaths per 100,000 basis, its increase in the last week has been among the lowest, but as a percentage increase, it is in the top quadrant.
@Gin & Tonic:
10 Largest Cities in South Dakota
Big enough for all the basics, not exactly bustling metropolises.
@Doug R: The point is that if you take the top 10, they probably account for 70% or more of SD population. When I flew to ND (Fargo) you go for miles and miles without seeing even buildings or animals. It’s a huge state by landmass, but like Canada, for instance, a high percentage of its population lives within the four corners of its largest cities. They aren’t large but they are places where people congregate.
“Proud?” You’d probably do more good by being less cranky. Scolding people just prompts them to dig in their heels.
I’ve had some luck speaking with people wearing their masks incorrectly, specifically, with the nose exposed. I start out rather mildly**,
And if I get the chance, I continue:
** I’m a lot less surly F2F than I am on this blog. Probably because I expect a lot less in the way of intelligent behavior from the average Baltimoron (yes, that’s what we call ourselves) than I do from the peanut gallery here.
Urban areas subsidizing rural trumpers, yet again.
@Uncle Cosmo: While waiting to vote yesterday, I had on my mask but forgot my shield. Someone came out of the voting room without a mask. ugh
@Cheryl Rofer: Didn’t we already know this from the 1918 pandemic?
I think there are some school districts near me with larger enrollments. I know the high school nearest me has over 3,000 students.
Two senators, huh?
Yes, but remember there are some governors who don’t understand quarantines, and that’s been known since the middle ages.
Abbott knows what works and what doesn’t. He could make the situation in Texas much better if he had the stones to stand up to the crazies in his party. But he doesn’t, so the needless deaths continue.
I went to the dermatologist yesterday and this very overweight nurse or some kid of assistant was walking around with her mask below her nose. I told the doc, “I don’t want to be a pain in the ass but I’ve tried hard not to catch this shit and I expect more in a medical facility”. He was all apologetic and shit and I assume he corrected the situation.
I was supposed to get my overdue dental checkup and cleaning tomorrow — just cancelled. Although NYC’s numbers are better than most of the country’s right now, they’re still a lot higher than they were, and I just don’t want to sit anywhere indoors with my mask off and and my mouth open for an hour. Maybe I’m being overly cautious, but I kept thinking that after being so careful for so many months, I’d feel awfully dumb if I caught Covid now just because I second-guessed myself on this.
I’ll get my teeth cleaned after I’ve been vaccinated.
J R in WV
@Major Major Major Major:
Glad to hear about your Grandpa. I was surprised how many masks I found around our house when I looked back in February or March. Eventually I dug up my woodworking/herbicide respirator, and read up on the filters for it. N100 was the first great thing I saw.
I look like I’m from Mars wearing it, the twin filter packs are bright lavender/pink, but I got over worrying about that the second or third trip into town. Now on the third set of filters. Got a mask for Wife too.
Allen HS, in the suburbs north of Dallas, has almost 7,000 students. That’s just unimaginable to me.
@arrieve: We paid at least $75 more last week but our dentist is pretty cautious. New PPE for the hygienist for each patient, mask and shield and limited polishing.
I don’t have answers, but I have ideas. One is the “secret slums” of California. Those “single-family” homes with nice front yards (enforced by city codes and HOAs) frequently have different families in every bedroom, necessarily sharing bathroom, laundry, and kitchen facilities in buildings with shared ventilation and minimal air filtration. They are likely hotspots for transmission, and also provide a “web” of a second set of connections for spreading.
If there’s only one big mode of spreading – say house parties – there’s some limit to spreading from the structuring of the population. There’s a lot of overlap between attendees of each party any given person attends, which limits spread. But if there are two modes – like cryptic slum housing – , the second mode can spread it to new social groups, which spread it to new housing, etc.
I have to give blood for lab work tomorrow. Not looking forward to it.
BTW, since we’re peripherally discussing state populations, the Wednesday XKCD has a 2020 election map. The mouseover text makes an important point, which I’ll try to remember next time I’m tempted to say “just let them secede, then”.
@JPL: IMO those shields aren’t all that effective – common air turbulence will still send some droplets containing Thuh Varss under it.
I think you would better prevent exposure through the eyes with a pair of wraparound safety goggles that go over your regular glasses. (Like the dark glasses the optometrist gives you after they dilate your pupils**, but clear or lightly tinted.) I’ve seen these for sale in hardware stores. You just have to remember not to touch your face and then your nose or mouth before sanitizing your hands, and to wash your face and hands when you come in from your errands.
**If you have a pair of those as well, keep them handy for use outdoors in crowds.
What weird circumstances lead to Puerto Rico having 100% positive test results? Are they only testing people with symptoms?
Cary Tennis, the writer who moved to Italy a few years ago, made a 6 min podcast after leaving the hospital last week. (Covid and an emergency surgery, doctors saved his life.) His thoughts about slowing down.
@arrieve: not overly cautious at all! Every time we leave the house we should ask ourselves “is this something that really has to be done now”? If the answer is not a resounding yes, do not do it.
Martin was right when he said we should all have the absolutely smallest public footprint we can.
Saw that. He doesn’t say it quite directly but the most Trump votes were cast in California–6 million. Since it’s a Trumper talking point beginning in ’16 that “He wins if you just don’t count California” [narrator, not in 2020 he doesn’t] I have that handy number ready.
Not to worry folks, Biden got 11 million. Tulsi would have nabbed 13.
@WaterGirl: Thanks for the reinforcement! So I go a year without having my teeth cleaned — people do that all the time. I just don’t want to contribute to the problem when relief is in sight.
I try to aggregate as many tasks as possible into single trips. IDK if it ultimately helps, but I’m at least better organized.
Major Major Major Major
Perhaps you misunderstand. I am proud that I was on the “masks work!” train as early as February. At the time, it made one a crank.
@Uncle Cosmo: there is a person that lately has been not wearing her mask. She says she already got sick so why should she have to.
It is so discouraging. She’s young and i understand that she is getting tired of this. But i am old and can’t find a way to explain to her .
The truly terrifying thing about Civil War 2.0, should it ever be fought, is that the opponents won’t be south of the Mason-Dixon-Ohio Rive line and east of the Texas – New Mexican border – they’ll be in the next state or county or neighborhood or street or block, and quite likely armed to the teeth. And they might be people you know – or thought you knew.
Unfortunately we have neither the scientific moxie to construct a “Coventry” where those as don’t agree to live by civilized norms could go “free range” without hassling the greater society, nor the consensus of a sufficient supermajority of the citizenry as to what those norms even are. :^(
Major Major Major Major
@Fair Economist: My impression is that the worst California outbreaks have always been in or near Orange County, which can’t be a coincidence given the demographics.
My daughter sent me a pic of her three kids in front of Santa (who was behind a large plexiglass shield, wearing a mask). They had to make an appointment to visit Santa this year and masks were required. It was a cute pic, because of course, grandkids! The oldest was wearing one of the giraffe print masks that I made for her, too. So cute.
When I looked at that cute pic (because grandkids!) it kind of hit me that we are in an unusual period of time, historically. It made me wonder just how this period of history that we are all living right now, this pandemic, will appear to historians and future generations.
Like Water Girl’s idea of the Christmas Past pics, will my grandkids be able to explain to their kids why everyone was wearing a mask in the Christmas pics in 2020?
It boggles the mind. . .
@Major Major Major Major:
Tried like hell to mask up back in March, but couldn’t get our hands on any until…May? Danbanas in the meantime. Very glad stores are back to strict enforcement, it was getting spotty for awhile.
Looking at the numbers from afar, it mostly just looks like LA is a mess. Except for a few other hot spots like the central valley, the rest of the state looks pretty ordinary.
@Major Major Major Major:
LA. 566,000 cases.
@raven: my dentist installed an extra HEPA filter unit with ducts snaking thru the hallway and into each of the exam rooms, not ideal when one is a bit hard of hearing but it’s effect is very much appreciated. I’ve had two covid era visits there so far.
@Major Major Major Major: OC’s major hotspots are in Santa Ana and Anaheim, High number of service workers and minorities. They’re not the aholes from the richer work-from-home cities like Irvine, newport, and Laguna.
That’s a choice so they can win state championships in football. Other nearby communities like Frisco that are similar size went the opposite direction and built a bunch of smaller high schools. The UIL (HS athletic commission) should ban high schools that are so much disproportionately larger from all their competition. Force them to build another HS. They have the money, they spent $60 million of it on a new football stadium that rivals many D1 college stadiums: https://en.wikipedia.org/wiki/Eagle_Stadium_(Allen,_Texas)
When I taught in Texas my own HS (2200 students) was forced to play against Allen as we were in the same size classification. It was ridiculous.
@Richard: The answer is, we really don’t know who is infectious, although evidence shows that people are probably most contagious early on in the disease cycle. Even more to the point, the people coming in contact with her or anyone else have no way to gauge who has already been sick. It puts them in an impossible situation. We do this for others, not primarily ourselves.
@joel hanes: I posted this on another thread probably, but my daughter was in Temecula (in SoCal) and said all the restaurants were open, filled elbow to elbow, minimal masking anywhere. It is a very right wing religious place. Maybe this should be posted on restaurant doors (from the WaPo) “Gov. Gavin Newsom (D) laid out the state’s “mass fatality” plan on Tuesday: Sixty refrigerated storage units, each 53 feet long, to store the bodies that won’t fit in morgues and 5,000 more body bags.”
Let the good times roll.
Ours put free-standing HEPA filters in each exam room and the waiting room. Double-masks and face shield for the dentist and hygienists, teeth cleaning but no polishing. Two visits so far, one and possibly two more before normal, whatever that means.
Had my annual eye check yesterday. He closed two months, opened at 50% patient load and is back to 70%. They were very well organized, beginning with the prescreening before entering the building.
Whatever else the outcomes of COVID may be, the medical profession deserves praise for adapting. I’ve been xrayed, CT scanned and ultrasounded, saw my primary and several specialists all in the last few months. The biggest departure from the past has been NO WAITING. I pray they keep that up.
@Doug R: My hometown is number 10! Really moving up in the world, it seems. I go back to visit increasingly infrequently and only to see my relatives.
I’ve done a couple of dentist visits this year, but thinking of cancelling a Feb. visit for the same reason–with the vaccine so close, be more cautious. I’ve been pretty homebound the last couple of weeks and have several meals coming for delivery on Monday (Farmers Fridge from Chicago).
In economics one of the exceptions to diminishing marginal utility is set completion–the nearer you get to completing a set of something, the higher the utility is for each unit. I’m sure there is a corollary here that the nearer one gets to the vaccine, the more cautious the behavior, but I haven’t put my finger on a good name for it.
Increasing marginal potential regret
I skipped my annual eye exam and they haven’t asked but maybe once.
Major Major Major Major
@VeniceRiley: ah, that’s too bad.
@trollhattan: another big departure was the ease of getting an appointment in November/December. Usually those months are booked solid with people making the most of their insurance before the year end. I called Tuesday for an appointment and had the choice of either today or tomorrow.
Le Comte de Monte Cristo, fka Edmund Dantes
Yeah, dental practices are a special case. It’s not so much about the dentist or hygienist working close (mine are generally double masked and shielded, with gloves). It’s about the spinny things – drills, polishing wheels – and water spray.
The reason CA is such a mess is that in a lot of areas a lot of people are acting just like SD or other areas are – irresponsible and stupid. I live/work in the northeast end of LA county and it looks like there’s nothing going on other than normal life, other than all the restaurants have outside seating areas. And some of those are actually closed off with plastic, so eating outside really isn’t. The number of mask wearing people outside of stores is maybe 25%, which is higher than a lot of places, but then the number of people per square mile is a lot more than many places. Business looks rather normal, other than restaurants. Where I work is considered necessary to stay open because we build things for industries that are critical, medical – agricultural – tooling for COVID, although I have no idea what the items do.
“Who wants to be the last man to die for a mistake?” — John Kerry
I’ve had to call out two people this week for wearing their masks below their noses. First was at my dad’s. They fucked up something at his place and we couldn’t get a door open. Had to call them to come back and fix their mistake and three of them came. One was wearing her mask below her nose. I was probably not very nice when I pointed at her and said in a rather loud voice, “DO NOT COME IN HERE WITH YOUR MASK BELOW YOUR NOSE!” To her credit she apologized and fixed her mask. But seriously. In a place with a bunch of old people they are wearing masks incorrectly. Fuck that shit.
Second one was today at a medical appointment. An elderly woman was waiting with a young woman helping her. The elderly woman’s mask was below her nose. I spoke with the person at the front table taking temps and told her and she went over and told both of them that the masks had to be worn over their noses. The intake table woman was about as upset about it as I was because she works there and is exposed to these idiots all day. We had a bit of a chat about how the nose is the worst for transmission and getting the virus and how people are so dumb or careless or whatever reason they don’t wear their masks right.
@Yarrow: Loudly so you are overheard.
“You know….wearing your mask below your nose is like wearing your underwear below your penis. It pretty much defeats the purpose”
@Kent: I could do that but I don’t think it would have worked with these violators since they were both women. The elderly woman didn’t speak much English, either. Would probably work better with the asshole white guys I see wearing their masks wrong, though.
As a part-time library assistant, I’ve worn a mask for eight hours straight (with a half-hour break for lunch or dinner). I’ve driven halfway home before remembering that I can take the mask off. It really seems that the more you wear it, the less you think about it. I wish there were a way to get past the usual complaints–“I can’t breathe,” “I hate the feeling of something covering my face,” etc. — and convince people that those feelings will pass if you give it a little time. I’ve had no problems wearing masks, but lots of problems dealing with patrons who don’t wear them correctly.
Yeah, it doesn’t zackly roll off the tongue, but….
@Uncle Cosmo: You remind me of this re-creation of the Western Front on November 11, 1918. Everyone knew the fighting would be ending, but they kept up until the stroke of 11 AM. (Which itself was an arbitrarily-chosen deadline that could have been hours, or days, earlier.)
@Kent: Or, you could just tap your own nose and growl, “Slip it back in the Speedo, buddy.” They should get the point.
The standard 3-ply mask doesn’t significantly restrict breathing or muffle your speech, nor is it uncomfortable even in the tropics. Yet here in Malaysia, where going maskless in public incurs a fairly stiff on-the-spot police fine, you still see people leaving their nose and/or mouth uncovered when not eating or drinking. Or taking it off to talk on the phone, which is completely unnecessary.
@Richard: Is she familiar with the tale of Typhoid Mary? Not sick herself, but spread the disease everywhere she went.
@Major Major Major Major:
At the time, and into March 2020 and later, advocating for masks was saying that the CDC and WHO were wrong and that their guidance would kill a lot of people. It was definitely a lonely position in the US. CDC shifted to recommending face coverings in public places in early April 2020 after solid evidence for asymptomatic transmission was published.. Some states like NY instituted face covering requirements within a few weeks. Not sure when the WHO shifted but it was much later; too much institutional anti-masker sentiment in their advisory groups I’ve read.
Basically, there were no randomized trials at large geographic levels providing solid evidence that universal masking for source control can help control pandemic spread. Anyone proposing such experiments would have been a monster. “Fortunately”, we have a bunch of natural experiments like the Kansas experiences with local jurisdictions with varying rules.