The Burden II

[Mark Kindt]

The West Shore Press & The Normalization of Covid-19

Please recall that tens of thousands of dollars were spent in recent years by various entities to "normalize" the closing of Lakewood Hospital as a "new model of healthcare".

This is nothing new. We all observed that happen as it happened. There is now no public acute care hospital services in Lakewood. Just that giant void in the heart of the City.

With "The West Shore Press" we can now observe the efforts of unknown business entities to "normalize" the threat and risks of Covid-19 in our community.

This is not an isolated effort. I was chagrined to learn that our State Senator is co-sponsor of a bill in the Ohio legislature that would return bars to full hours of operation.

This is all part of an effort to minimize or normalize the threat and risks of Covid-19 in our community.

This is one of the primary issues that I am monitoring in this Deck essay.

Please study the CCBH graphics that are posted here -- especially for our zip code (44107) and remember that Cuyahoga County is at Level Three on the Ohio rating system for Covid-19 risk.

[Mark Kindt]

My Topic Is Bars

Over the weekend I learned that many Northeast Ohio legislators are co-sponsors of legislation that would overturn the Governor's time-of-closing order for holders of Ohio liquor licenses.

The closing time is now 11pm. "Last-call" is 10pm.

Before I go much further on this topic, I want to remind everyone that those local residents that contract Covid-19 have all been deprived of their normal civil rights to bring injury claims for negligence in our courts.

Yes, even doctors, nurses, and other healthcare professionals upon whom we all rely. -- Yes, even all of our first responders.

Let me be very clear, a legislative goal to overturn the Governor's Order on bar hours during a declared official State of Emergency during a worsening pandemic is irresponsible and dangerous.

Are they crazy?

[Mark Kindt]

Again - Crowded Bars - Community Spread

On the right of this graphic we could easily add another bubble called "all of us".

ODH Graphic on Community Spread 10-28-2020.jpg (47.09 KiB) Viewed 9158 times

[Mark Kindt]

I Know What I Don't Want

I don't have any public policy recommendations for bars. (Like many of us, I do enjoy the occasional cocktail).

But I do know what I don't want.

As a citizen here, the last thing I want to see are the corporations that hold liquor licenses trying to dictate their healthcare policy preferences to any elected official, state or local, during a pandemic where careless contagion from a crowded bar could bankrupt my family, incapacitate me for weeks, or collapse the healthcare systems into calamity for other people in dire need of care.

I decided to start this new Deck essay after I met with some ER doctors, ER nurses, EMS personnel and some other medical professionals; it became clear to me that these essential professionals must not be taken out of their duties as a result of some mindless Covid-19 contagion from crowded bars, half-crowded bars, or even from standing-room-only bar patios.

[Mark Kindt]

Our Zip Code Leads In Cases

CCBH-COVID19-Epi-Brief_10.30.2020 - Map.jpg (146.85 KiB) Viewed 9122 times

[Mark Kindt]

Here is the full CCBH Report for October 30th

Please take the time to download and read the attached file.

CCBH-COVID19-Epi-Brief_10.30.2020.pdf

(691.86 KiB) Downloaded 349 times

[Dan Alaimo]

So what does the Mayor/Council have to say about it?
What do they propose to protect us?

[Jim O'Bryan]

So what does the Mayor/Council have to say about it?
What do they propose to protect us?

Last I noticed was a new park, that will be taped off, and a couple new murals picked out by a committee of volunteers.

Oh and working to keep bars open late and bringing crowding to the sidewalks.

I imagine soon they will be looking for bids on the Solstice Steps, and Lakewood Park Pool maintenance work. So perhaps that counts.

Schools get money and spend it on astroturf, and playgrounds.

I feel like I am reading different news journals.

.

[Mark Kindt]

Bars Top The List For Covid-19 Risk

Bars top the list for Covid-19 risk.

See this link:

https://www.healthline.com/health-news/ ... f-covid-19

Now Lakewood Tops the List for Covid-19 Cases in our County

As of October 30, 2020, Lakewood (44107) tops the list for cases in Cuyahoga County per the CCBH report posted above.

[Tim Liston]

Is it not the case that the "case" numbers are not adjusted for the size of the population within these zip codes? All I looked at was the map. But if I'm right, the overwhelming reason that 44107 leads the county in cases is because 44107 has a very high population. And that actually 44145 has a higher case rate (1.8%) than 44107 (1.5%). And that 44114 has almost twice the case rate (2.9%). Am I right?

[Mark Kindt]

Thank you, Mr. Liston for your comment.

I thought for certain that you would call me our for my lack of critical thinking in that my most recent post contains a logical fallacy related to causation. It does and I admit that. My post today is to make a point of contrast, but not causation.

I do not have enough data to correlate population, liquor licenses, and cases. That will have to wait another day. Perhaps, another lifetime.

I have spent the morning attempting to compare cases by zip code and community. I started with Parma and its aggregated cases by zip code are still lower than Lakewood's; similar results occur when you aggregate other zip codes with high case rates. They all seem to be lower.

One reason that I recommend the re-establishment of the Lakewood Health Department is to have civil infrastructure that can manage its own data.

It doesn't have to be a health department per se, but the idea that Lakewood might have one of the highest case rates in Cuyahoga County remains troubling to me.

As I am sure you know, I am just a lawyer, not an epidemiologist, and conflicting data on Covid-19 has been a source of confusion for me and others.

[Mark Kindt]

I am certain that your calculations are correct for the Zip Codes that you tested.

Unfortunately in many cases Cuyahoga County Zip Codes overlap multiple municipal boundaries making it difficult to correlate cases and boundaries by population with Zip Codes.

That's why I chose Parma to test. It has 3 Zip Codes and a population of 80,000.

On an aggregated basis, Parma has more cases than Lakewood, but no single Zip Code in Parma has more cases than Lakewood. (Zip Codes 44129, 44130, and 44134)

Even this simple analysis may be faulty because of municipal boundary differences in these Zip Codes.

I also highlighted Lakewood because it has only one Zip Code AND it is where there has been a professional analysis of the healthcare needs of its population on a neighborhood-by neighborhood basis (May 2018).

The City of Lakewood may now have multiple indicators based on healthcare analytics that it has sub-populations uniquely vulnerable to Covid-19 contagion.

That is why I continue to write on these topics. I know many individuals and families within these sub-populations.

Unfortunately, I lack both the information and the time to ensure that my presentations here are more robust.

[Tim Liston]

The charts you keep presenting provide no useful information whatsoever. The reason 44017 has more cases than other zip codes is because 44017 has a higher population. That's why (for example) California has more cases than Ohio. Not because California has somehow failed where Ohio has succeeded.

Population by zip code appears to be easily obtained, that's why I used 44114 (population 5,225) as an example.

I hesitate to come on here and point out the obvious. That runs counter to the prevailing narrative. But there comes a time when the lack of critical thought and numeracy results in bad policy and needs to be pointed out.

[Mark Kindt]

Obviously, I have two other biases. I reside in Lakewood and I am within the vulnerable populations for Covid-19 (Age & Asthma).

If I resided in Westlake (44145), I would be equally concerned about Covid-19, but as a Lakewood resident I have a very good understanding of two elements that I might lack in Westlake.

1. The City of Lakewood has access to and copies of numerous professional studies related to the healthcare needs of its residents going back as far as 2013 and as recent as 2018; and,

2. I have an anecdotal appreciation for the plethora of bars here as I expect most readers have as well. --Remember my topic is bars!

Perhaps, Covid-19 should not be a concern in Lakewood, but given my personal biases and my own economic self-interest, it is unlikely that I will review the County map data in an arithmetically neutral fashion as it may impact other municipalities in the County.

While your figure of 1.5% for Lakewood as of October 30th may seem low in comparison to other Zip Codes in the County, Dr. Allan of CCBH has already told members of city council that he expects 60 to 70% to contract Covid-19 and that is what his agency is planning for.

Hence, I am alarmed by the map published by his agency. The Governor has called upon local officials to be more aggressive in the implementation of steps to reduce contagion and I have the reasonable expectation that elected officials in Lakewood will heed that call.

[Mark Kindt]

The charts you keep presenting provide no useful information whatsoever. The reason 44017 has more cases than other zip codes is because 44017 has a higher population. That's why (for example) California has more cases than Ohio. Not because California has somehow failed where Ohio has succeeded.

Population by zip code appears to be easily obtained, that's why I used 44114 (population 5,225) as an example.

I hesitate to come on here and point out the obvious. That runs counter to the prevailing narrative. But there comes a time when the lack of critical thought and numeracy results in bad policy and needs to be pointed out.

Of all the intellectual offenses that I have been accused of across my life, the offense of innumeracy has never been one of them. For me this is grandly ironic. I hope we meet some day so I can explain.

Mr. Liston, I have no sources of information that are not public. I have to live with the information that is published by Lakewood, Cuyahoga County, and the State of Ohio. I have no independent sources of information that are not publicly available.

At no point in this thread have I ever mentioned California in any context.

Nor am I cognizant of the "prevailing narrative" or that your post runs counter to it or is intended to run counter to it.

I think your choice of 44114 was itself something of a "cherry-pick" and I think you know it.

I addressed your choice of Westlake and, furthermore, made the point that the use of Zip Codes by CCBH comes with its own set of rationalizing problems.

Trust me, I understand the data that I am missing that I would like to have here to establish my argument:

1. The number of liquor licenses in Lakewood by class;

2. The number of conditional use permits issued;

3. The number of Covid-19 cases in Lakewood, the number of hospitalizations of Lakewood residents, and the number of fatalities to Lakewood residents.

I have taken the time today to identify both my biases and to correct a logical fallacy in my post.

Mr. Liston, I want to be very clear to you that I understand that I have a non-insignificant risk of contracting Covid-19 over time and that the statistical risk of hospitalization for that incident is not a risk that I am prepared to take for my family, so that local bars can be fully operational. The only way that I can engage these risks is through my review of public information. I have not found it comforting.

You may have a different model of uncertainty analysis or risk analysis.

For me I have considered this issue more deeply and more profoundly than any other situation in my life and I have found little comfort in the sorts of analyses offered by the WSJ.

I think you know that the data issues are more complex than you presented today. Let's not pretend they aren't.

Finally, I have expressly stated previously that I have no public policy recommendations to make on bars. From my own direct experience with our local officials, I know that neither my lack of critical thought or numeracy will have any impact on public policy, good or "bad".