Category Archives: Education

learning in America

COVID-19 compared to the H1N1 Virus

COVID-19 compared to the H1N1 Virus

There has been considerable discussion about comparing the current virus to the 1918 Influenza pandemic. There also has been a lot of misinformation. In 1918 the Spanish flu terminated the lives of an estimated 35 million folks. Despite the name, the H1N1 virus started in Kansas. At the time, no one knew how it was transmitted, and there were no NPIs (Non-Pharmaceutical Interventions) in place. Items like social distancing, closing establishments based on group settings, contact tracing, and other measures were not even considered. Our ability to provide testing and track the sources of the virus was extremely limited. About 35% of all people living at the time contracted the virus, and the mortality rate was estimated at 2%. If our current NPI, testing, and tracking procedures been in place at the time, there is no doubt that the number of cases would have been just a small fraction of what occurred.

We really do not know the actual mortality rate of COVID19. The reported rate in the U.S. is 6%, but that is not accurate. The best estimate based on countries that have done a better job on testing is that it is about 2% or about the same as the Spanish Flu. This is about twenty times the mortality rate of the common flu at .09% (a bit under one in a thousand will die from the flu.)

What is alarming is that, as of May 2020, the USA has 4.5% of the world’s population but almost 29% of the COVID19 related deaths. We can learn a lot from studying both the countries that are doing a better job as well as those few that are doing worse.

Healthcare Revisited – Relative Quality of Life

Healthcare Revisited – Relative Quality of Life

More important than longevity is the length of time that we experience “quality” life experience. The following chart again shows how we compare to other countries.
Following was taken from http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
 
 

– HEALTHY LIFE EXPECTANCY (HALE)

Health attainment, level, and distribution in all Member States
Disability-adjusted life expectancy at birth (years) Adjusted for years spent in disability. When compared to longevity, the chart is revealing. It indicates that the last ten years of life are not pleasant (on average) and also likely very expensive.
   
 Rank  Country                Total      Male     Female
1       Japan                                   74.5            71.9            77.2
2       Australia                              73.2            70.8            75.5
3       France                                  73.1            69.3            76.9
4       Sweden                                73.0            71.2            74.9
5       Spain                                    72.8            69.8            75.7
6       Italy                                      72.7            70.0            75.4
7       Greece                                 72.5            70.5            74.6
8       Switzerland                         72.5            69.5            75.5
9       Monaco                               72.4            68.5            76.3
10    Andorra                                72.3            69.3            75.2
11    San Marino                          72.3            69.5            75.0
12    Canada                                 72.0            70.0            74.0
13    Netherlands                        72.0            69.6            74.4
14    United Kingdom                 71.7            69.7            73.7
15    Norway                                71.7            68.8            74.6
16    Belgium                               71.6            68.7            74.6
17    Austria                                 71.6            68.8            74.4
18    Luxembourg                       71.1            68.0            74.2
19    Iceland                                70.8            69.2            72.3
20    Finland                                70.5            67.2            73.7
21    Malta                                   70.5            68.4            72.5
22    Germany                             70.4            67.4            73.5
23    Israel                                    70.4            69.2            71.6
24    United States                     7 0.0            67.5            72.6

It is interesting to note that all of the five baseline countries rank well above the United States and 3 of the five rank in the top 5: Japan, France & Spain.

Healthcare Revisited – Health Education

Healthcare Revisited – Health Education

We spend about $8 billion a year on health education and yet average health in our country is not improving. Obesity & overweight continues to increase, and longevity is decreasing despite our best efforts to extend life (we currently rank 57th in projected longevity). It is not unusual that a person’s medical cost will be more in the last year of life than all of the preceding years combined.                                                                                                             

The key to health is the condition of the immune system. Admittedly, there are hereditary factors that predetermine certain events, but even in these instances, longevity will improve with a high functioning immune system.  Defenders of the current health education program claim that the condition would be even worse if we abandon education.

I am not proposing that we abandon efforts to improve health, just that we refocus our efforts and reduce spending. I would eliminate spending at the Federal level and Cap the overall spending at $4 billion. I would push the spending down to the community level. Communities could apply for grants that require 1/3 local funding (in-kind services allowed) which would be limited to a maximum of $5 per capita per year (a city of 50,000 could apply for a maximum annual grant of $250,000. The proposals must contain both exercise and healthy eating components. The maximum duration for any grant proposal would be three years. After that, the community would be expected to maintain and fund the effort locally.

I would also aggressively address the obesity issue in two ways. There would be a phase-in period of 3 years. Persons that are currently obese would be given three years to reduce their BMI to 32 or below. Source: https://www.medicinenet.com/script/main/art.asp?articlekey=11760

“BMI (Body Mass Index) of 30 and above. (A BMI of 30 is about 30 pounds overweight.) The BMI, a key index for relating body weight to height, is a person’s weight in kilograms (kg) divided by their height in meters (m) squared.”

The only exception would be in the rare cases where obesity is a result of a medical condition or disability, and in all those cases would require a physician certification. There would be heavy financial penalties for false or forged certifications. Obese persons who bring their BMI to under 32 in the 1st year would receive a $1,000 tax credit in year two and year 3. Those that achieve the goal in year two would receive the credit in year 3. Commencing in year four all persons with a BMI of 32 or over would be subject to a $500 annual Income tax penalty. The penalty would apply to each obese person in the household. Further, obese persons would not be eligible for any federal government subsidies such as food stamps (EBTs).

The single most effective activity for improving and maintaining the immune system is an effective exercise regimen. What you consume is important, but exercise is the key. An effective exercise program involves a minimum of 30 minutes a day that includes elevating the heart rate to at least 50% above the at-rest rate. Example: if your at-rest rate is 60 bpm then ensure that your exercise rate is at least 90 bpm. For the average person, this would mean brisk walking at about 3.5 mph. You can easily gauge your walking speed by the distance covered in 30 minutes which would be 7/8 mile (1,400 meters) at 3.5 mph. This rate of speed will likely not be possible for many obese persons, but it is one that is attainable in less than 30 consecutive days of walking. This routine will easily take a person with a BMI of 35 to below 32 in less than six months as long as their caloric intake does not increase. Walking is free; it only requires time. My favorite reference on this topic is a video called 23 ½ hours at https://www.youtube.com/watch?v=aUaInS6HIGo.