Post #825: Have we stopped being stupid yet? Part III

Posted on September 26, 2020
  1. Source:  This image is copyright Bill Griffith, and is used without permission.  But with the notation that “Are we having fun yet??” in fact originates with Bill Griffith/Zippy the Pinhead, but has been so frequently copied that many people incorrectly believe the source is apocryphal.




I think by now you know the answer to this one.  Not even close.  Not even if it allows a few ignorant souls to put our children’s welfare at risk.

What set off this rant was the news, yesterday, that the Governor of Florida has identified a new fundamental freedom, the defense of which is crucial to the Nation.  And here, I am of course talking about the newly-identified “Right to Party”. 

That’s party, as a verb, not as a noun.  As in, the right of college students to party any way they choose.  Without fear of penalty.  He was quoted literally framing his proposed executive action as a bill of rights.

DeSantis said Thursday he’s willing to consider a college students' “bill of rights” that would preclude state universities from taking actions against students who are enjoying themselves.

Source:  Cited above.

For those of you who are graduates of a Florida university, I’ll explain that this is a reference to the U.S. Bill of Rights.  A document largely authored by Virginia’s James Madison, and modeled on the Virginia Bill of Rights.  Which then (eventually) became the first 10 amendments to the US Constitution.  The amendments that (used to) guarantee you your fundamental freedoms as an American.

Now, to be clear, many Florida universities are having a COVID-19 problem.  As you can see if you just query Google News today.

Or take a peek at the Florida State University COVID-19 dashboard, where eight percent of those tested were positive.  (These counts are out of a total enrollment of about 33,000.

By contrast, the current positivity rate at William and Mary is 0.14 percent.  (Knock wood).  And at Colgate, which had re-opening policies similar in some respects to William and Mary, it’s 0.3%.

More on that in a moment.  But let me finish this section.

Rationally, faced with a problem of a COVID-19 outbreak on campus, administrators at these Florida universities took action.  As with every other U.S. college COVID hot spot so far, virtually the entire problem can be traced back to students holding big, crowded, mask-free parties.  So various Florida university administrators got tough and started (e.g.) expelling the most egregious violators.

Which apparently did not sit well with the Governor.  And his rationale?  Well, college kids don’t really get sick, very much, when the catch COVID-19.  So you really shouldn’t do much to prevent them from catching it.

Apparently, this line plays well in Florida.  Though, if I were the parent of a Florida university student, I’m not sure I’d agree with that.

Some statistics on community residents of college age, and some important things that we don’t know.

Just to make sure we know what we’re dealing with, let’s look at statistics for Virginia.  Among community residents, age 20-29 (my best analogy for college students, given what Virginia reports), for those diagnosed with COVID-19, the odds are:

  • 1-in-65 chance of being hospitalized
  • 1-in-4000 chance of dying

These statistics cannot be translated directly into estimates for college campuses.  They reflect testing practices in the community.  In theory, the only community residents getting tested are those with significant COVID-like symptoms, or close contacts of individuals known to be infected. By contrast, colleges with a systematic testing program are apt to identify far more total infections, and far more mild infections, particularly given that about 40 percent of US infections are now thought to be asymptomatic (never have significant symptoms).

As a result, you’d expect to see lower rates of hospitalization and death, per diagnosed case, among college students.  But just how much lower seems all-but-impossible to say.  I have yet to come across a college COVID-19 tracker that even lists hospitalizations specific to students. (Although some do list hospitalizations, but if you read the footnotes, they will typically be all hospitalizations for all ages with a specific area or health care system).

Across all ages, it appears that the overwhelming majority of those hospitalized for COVID-19 take a very long time to recover fully.  If ever.  This study from Italy found that 88% of those hospitalized for COVID-19 (and surviving) had significant residual symptoms two months later.   At the minimum, for a severe case (requiring hospitalization), some lung scarring (fibrosis) seems to be almost inevitable (> 90%, per this reference), although severe long-term scarring is reported to be rare.

What has not been quantified well, at all, is the potential for short-term and long-term organ damage, both for the hospitalized population and for those not sick enough to require hospitalization. 

First, the presence of long-term organ damage from an acute viral infection is not a new concept.  This has been widely recognized for Epstein-Barr virus, and Zika, and the earlier SARS viruses (SARS 2003, MERS),  all frequently led to long-term problems.  So it’s unsurprising that COVID-19 would generate some damage of that sort.  As did the last two SARS epidemics.

And, for COVID-19, some types of lingering (though not necessarily permanent) organ damage clearly occurs in a non-negligible fraction of the populationThis reference has several quantitative estimates of organ damage from COVID-19, mostly from small studies.  Typical values seem to be that 20% of people have measurable organ damage to any one organ, though some of those studies focus on hospitalized patients only.  This small study found that, among a random sample of 100 patients treated or COVID-19 (of which only one-third were hospitalized), 78% had noticeable cardiac issues (including 60% with ongoing inflammation of the heart muscle) two months afterwards.

But there seems to be no systematic set of estimates by age group.  So there is no absolutely concrete way to assess risk for college-age individuals treated for COVID-19.

Many individuals might not notice reduced capacity from COVID-19 organ damage.  But college athletes certainly would.  Consistent with the small study cited above, a separate analysis of college athletes shows that COVID-19 frequently results in cardiac symptoms for months or longer, and measurably reduces performance (e.g., create shortness-of-breath) for a non-negligible fraction of individuals.  That’s the upshot of this article in JAMA.  In that light, at least among college athletes, it seems irrational to take the possibility of infection lightly.

And so, granted, your typical Florida college student is quite unlikely to die from COVID-19, even if infected.  But, on paper at least, that’s a fairly decent chance that he or she would require hospitalization.  And then there’s an unknown chance of having short-term or permanent organ damage, of various types.  And  there seems to be a particularly high risk of reduced athletic performance.  Though whether or not that’s a permanent reduction, nobody can say at this point.

And for sure, the epidemiological evidence strongly suggests that they’ll spread it to older, more vulnerable populations.  (Reference 1, Reference 2).   So while there may not be much obvious damage within the college-age population, creating breeding grounds for COVID-19 seems like a remarkably stupid thing to do.

So it all depends on your perspective, I guess.  When I put all that in a pot and stir it, I can’t believe that any sane person would be cavalier about COVID-19 infections among college students.  Yeah, almost none of them will die.  Most will probably do just fine, even if infected.  Some will not.  For some, you won’t know the full extent of long-term effects for quite some time.  And they then go on to put the entire community at risk.

But hey, it’s Florida.  Party Uber Alles.

But are they educable?

Source:  Collins English Dictionary

Not the students.  I mean, are Republican governors educable?  Can they learn from their mistakes?

After studying a lot of college re-openings, I can tell you the one thing that most failures have in common.  They didn’t have enough time to find the idiots and kick them off campus before those idiots were able to spread disease.

This is where universal testing prior to arrival on campus is key.  The more rigorous the testing, the lower the prevalence of COVID-19 for the incoming class, the more robust your re-opening is to the presence of a handful of “non-compliant” students.  (By “non-compliant”, I mean the idiots who insist on having large, crowded, mask-free parties.)

With a sufficiently low COVID-19 prevalence, that inevitable first round of such parties will not automatically lead to significant spread of COVID-19 in the student population.  So you can let your idiots have their first round of parties.  Then identify them, and kick them off campus.  Without having your re-opening fail.

By contrast, without such pre-arrival testing, the same density of idiots per capita will result in widespread dissemination of COVID-19 before you can identify them.  And kick them off campus.

The end result for the idiots is the same.  As with (say) murderers and thieves, society has no choice but to isolate them from the general population, for the good of all.  No college can afford to tolerate people who flout the rules that were designed to limit spread of COVID-19.

Every college will have some.  Every college will have to weed them out somehow.  The only difference is that colleges that can guarantee low COVID-19 prevalence will have the time to find them and kick them out to prevent further spread of disease.  So the outcome for the idiots themselves is a foregone conclusion.   It’s only the idiots’ ability to screw up the entire college campus that varies.

Except Florida.  Where the non-compliant idiots will be granted a Right to Party.  By the governor.  Contrary to what absolutely every university in the U.S. is trying to achieve right now.

I can’t even imagine how much ego it takes, to think that you know better than all the administrators of all the universities in the country.  But hey, it’s Florida.  With a Republican governor.  Say no more.  Completely consistent with our national strategy regarding COVID-19, it’s a good guess there’s not a whole lot of rational thinking behind the proposed Right to Party.

Hogan’s Theorem

Let Π represent the number of partying idiots per capita.  Let Γ represent the prevalence of active COVID-19 cases per capita.  Then you can express likelihood of successful re-opening, for a residential university setting, as:

Π x Γ < threshold value.

As long as you don’t have too many idiots, or too many COVID-19 cases, you’ll be fine.  But too many of either will put you over the threshold.  So, think of universal pre-move-in testing as a way to allow for more initial idiots per capita, before your campus re-opening goes down in flames.