Category: Health Policy

Trump Says: “What Coronavirus?”

The Daily Escape:

DH Day Barn in Glenn Arbor, MI photo by seedy_reedy_photos

From the WaPo:

“The presidential campaign was roiled this weekend by a fresh outbreak of the novel coronavirus at the White House that infected at least five aides or advisers to Vice President Pence….With the election a little over a week away, the new White House outbreak spotlighted the administration’s failure to contain the pandemic as hospitalizations surge across much of the United States and daily new cases hit all-time highs.

The outbreak around Pence, who chairs the White House’s coronavirus task force, undermines the argument Trump has been making to voters that the country is “rounding the turn,” as the president put it at a rally Sunday in New Hampshire.

Further complicating Trump’s campaign-trail pitch was an extraordinary admission Sunday from White House Chief of Staff Mark Meadows that the administration had effectively given up on trying to slow the virus’s spread.”

The WaPo reported that one of Trump’s top staffers acknowledged on Sunday that he (Trump) had tried to avoid disclosing these new White House cases to the public. Some in the VP’s office suggested that White House doctors should release a statement saying that [Marc] Short [Pence’s Chief of Staff] was positive, and that Pence was still okay to travel. But that idea was scuttled by Meadows and others. Meadows later said:

“We’re not going to control the pandemic,” Meadows said on CNN’s “State of the Union.” “We are going to control the fact that we get vaccines, therapeutics and other mitigations.”

There is no plan, and no strategy. Trump again said on Sunday in New Hampshire that the country is “rounding the turn”, but there’s no truth to that. Here are the 7-day average Covid statistics as of October 26: (emphasis by Wrongo)

“Yesterday there were 60,789 new confirmed cases, 16,222 recoveries, 340 deaths. The current 7-day rolling average of 68,768 new cases/day grew 38.8% from 14 days ago, while the average of 794 deaths/day grew 13.3%…”

If cases continue to grow at those rates, the number of cases will look like this:

9,221,976 cases in 7 Days; 9,888,654 cases in 14 Days; 12,042,648 cases in 30 Days

Even if you accept the view that: we can’t stamp out the virus, so we’ve just got to live (or die) with it, this just leads you to the other big idea: We knew back in March that even if we couldn’t stop the virus, we had to slow it down enough so that it doesn’t overwhelm our so-called “Greatest Health Care System in the World”.

If the GOP invested as much energy into fighting COVID as they do in voter suppression, we would have fewer cases and they wouldn’t need to suppress votes. Everyone expected that the virus would spread. But the least we should have been able to expect from Trump was an honest effort to inform the public; to do whatever it would take to contain it like the majority of other countries did; and to stop trying to blame someone else for it.

The Covidusa web site says that we’ve already reached a quarter of a million deaths (225,495) in this country. It’s clear that we’re being led by a pack of liars who think it’s more important to win an election than it is to save American lives. And they have the gall to call themselves “pro-life.”

And remember, there are 78 days after the election for Trump to fumble the Coronavirus before he leaves office.

Here’s another Trump delusion: This sheet was left on the seat of every member of the press on Airforce One yesterday. (Hat tip: Automatic Earth)

This suggests that the Trump camp expects a Red tsunami on Election Day. That may be true, but it will be very difficult to undo the massive early voting that is already in the books in all the battle ground states.

Every four years we say “this is the most important election of our lives.” This time, it’s true.

Why? Because if Trump wins again, we may see the freedoms we’ve long taken for granted curtailed, or in some cases, eliminated. You may think that Wrongo is well, wrong, and an alarmist. But do you REALLY want to take a chance that this isn’t the most important election of your life?

Your job is to vote for Biden, and to elect Democrats to the Senate.

There are seven days to go until the election. It’s certainly possible that you may never cast a more important ballot in your life. We have no control over what may happen in the future, but we can control what happens in seven days.

We can elect competence, sanity, and a reaffirmation of our democracy, but only if we all vote.

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The Closing Arguments

The Daily Escape:

Autumn on Icefields Parkway, Jasper Alberta, CN – September 2020 photo by Argen Elezi Photography

Welcome to the longest 14 days of our lives! The way actual time has blurred between Trump and Covid, November 3 has remained the one date that has stayed fixed in our consciousness. As the calendar days tick off, it gets closer and closer. Now, we’re all sitting in the backseat yelling “Are we there yet”?

The next two weeks will feel like an eternity.

As time winds down to the election, the polls tell us that maybe we’re at least momentarily, a tiny bit less polarized than we were pre-Covid. Many Republicans say they are voting for Biden. Certain groups, the majority of whom supported Trump in 2016, are moving in significant numbers to supporting Biden.

There is growing agreement that controlling Covid and restoring our economy are the top two issues facing the next president and Congress. There is less agreement about what should be done to move us down the path to achieving both.

The big question post-election will be: What do we agree on? Or more accurately, what will the majority of us agree can be done to repair the damage done in the past few years? The next two weeks will have Biden and Trump making their closing arguments on why they deserve our votes.

Crucially the same NYT/Siena College poll referenced above says that Americans see Biden as more capable of uniting the country by nearly 20 points.

Both candidates’ arguments may become clearer after Thursday night’s debate, but as of now, Trump’s closing argument is: Covid doesn’t matter, people are tired of hearing about it. He said on Tuesday that “People aren’t buying it” as America’s biggest problem.

It’s worth noting that despite Trump’s boredom with the virus, there were more than 64,000 new cases just yesterday. And the death toll passed 220k. So, maybe people actually are buying that it’s a big deal.

Trump’s second argument is that he has grievances: Against Fauci, the media, and Joe and Hunter Biden. When Trump talks about his personal grievances, few voters outside the Trump/GOP bubble agree that these are problems that need the time and attention of the next president.

Biden’s closing argument is likely to be “Let’s end the chaos”. That’s totally an anti-Trump argument. But to Biden’s point, we’ve never had a President wage war on America during a national crisis by actively working to undermine the country’s health and well-being.

According to a recent Cornell University study, Trump represents the “the single largest driver of misinformation around Covid” in the world.

Over the weekend Twitter took down a tweet posted by Dr. Scott Atlas, a neuroradiologist who is the latest Trump coronavirus guru, when he linked to an article that claimed wearing a mask does not help slow the spread of the virus. The article also referred to the virus as “some seasonal flu.”

Biden is also likely to say in closing, as he did in his Gettysburg speech on October 6, that some semblance of bipartisanship is necessary to defeat the COVID-19 pandemic and rebuild a battered economy. He also said then that the country must “decide to cooperate” toward the necessary recovery of our public health, and our economy.

Wrongo is reminded of this, written by Jan Flynn in June:

“We now live in a nation where tolerance of our differences is no longer an assumption in the social contract. Hate and judgment are normalized, but no less destructive than they’ve ever been. We retreat further and further into our ideological bunkers, from which we lob fearful words, memes, posts, rocks, bottles, rubber bullets, or actual bullets at our countrymen on the other side.”

How will we build tolerance for our differences? In the real world, we can’t unfriend or turn off the comments of Facebook friends we disagree with.

If Trump wins, the lobbing of words, memes, rubber bullets and actual bullets will continue, and likely get worse.

If Biden wins, he has a massive job ahead of trying to find a coalition of voters and politicians who will work cooperatively, helping bind up our self-inflicted wounds, and moving the nation forward.

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Saturday Soother, What If It Never Goes Away? Edition – July 25, 2020

The Daily Escape:

Water Lilies – 2020 photo by Betsy Zimmerli

Happy Saturday, fellow disease vectors! Wrongo is beginning to think that COVID will be with us for a very long time, possibly forever. We seem incapable as a society of following two simple rules: Mask up, and practice social distancing. So we won’t even muster a basic defense against it.

The virus needs new hosts all the time, and if you keep potential hosts sufficiently separated from each other, it can’t spread. This isn’t unknown, and it isn’t difficult. Asian and South Pacific nations successfully implemented it.

Now even America’s denier-in-chief is tumbling to the reality that the virus will be with us for a long time. Back in March, Wrongo asked:

“What unpleasant decisions would our federal and state governments be willing to take to get us out of a deep recession, if the virus is still around a few months from now, and still killing a lot of people? Is restoring our economy, and putting Americans back to work worth a million lives lost? Is it worth 300,000?”

Well, we’re now halfway to 300k deaths, and we could lose 200,000 by Election Day. The pace of virus infections is growing, although the US COVID death rate has fallen. Having said that, we’re dying at a rate that’s 10 times faster than the Europeans.

Here’s a screenshot from CNN:

It was almost 100 days to our first million cases, and just 15 days to our fourth million! After a slowdown in the Northeast, American hospitalizations today are about the same as they were on April 15.

Politicians have largely gambled that some form of effective vaccine will be discovered, and that it will be available in large enough quantities to halt the epidemic by next year. If they’re correct, they figure that they can allow more of us to die today in order to keep the economy bumping along at least at its current stagnant pace.

In a way, they are saying that the illness and deaths of the little people are less important than the health of our current economic system. So, let’s experiment with reopenings, and play down the need to mask up. Worse, America’s checker-board response, where each state and each county takes a different approach, is perpetuating the likelihood of a bad outcome.

But, what if there is no vaccine? Who’s doing the planning for that downside risk?

Should Americans simply throw up their hands and wait to get infected? Of course not. The virus needs uninfected humans to propagate. A social system that isolates the infected from the uninfected must be instituted, along with universal quick daily testing, masking and social distancing.

If the virus is going to be around permanently, we’ll have to protect the most vulnerable Americans, the old and the young. We locked up the elderly in the petri dishes we call “senior living centers” and they died at staggering rates. We let kids stew in their homes without much chance at getting a real education.

Neither can be allowed to continue if the virus isn’t going away.

And the physical damage seems to go well beyond the lungs. A study reported in Australia covered patients sick with COVID in 69 countries across six continents. It shows that more than half of all COVID-19 patients were found to have damaged hearts. It surveyed 1216 patients, aged 52 to 71, 70% of them male, so it’s a small but troubling sample of what can happen. Ilargi asks:

“So what happens to your health care system if you let half the population catch the virus, and half of those end up with heart damage in one form or another, to one degree or another?”

Knowing all this, are you willing to go with: It’s not that bad, it’s not that deadly, and those old folks would have died anyway?

If the disease is going to be with us for a long time, do you think that kids should just go back to school? We all should get back to the office? That we should just open up the bars?

Wow, these thoughts make us need our Saturday Soother more than ever.

Here in Connecticut, we’re in for another hot dry spell. Wrongo picked our first tomatoes and jalapenos yesterday. Also, we saw a deer with three fawns, a rarity, since one or two are usual.

Let’s take a minute and open a Guji Uraga Nitro Cold Brew coffee from Denver CO’s Corvus Coffee Roasters, pour it over ice and settle back at an appropriate physical distance to contemplate just how far away COVID seems from you.

Now, listen to the late Ennio Morricone’s “Peace Notes from Cinema Paradiso”. Here Morricone directs in a 2007 live performance in Venice:

Those who read the Wrongologist in email can view the video here.

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What’s Behind Refusing to Wear a Mask?

The Daily Escape:

Hideaway Beach, Kauai, HI – photo by alohabaltimore

The message from health officials and local governments seems simple enough: Wear a mask in public to help control the spread of the Coronavirus; and the majority of Americans do. But a recent Pew survey showed that 15% only wear masks sometimes, while 20% said they don’t wear masks at all.

When the virus hit, we scared everybody into staying home. Then, we worried about the impact on the economy, so we pushed our governments to reopen too early. Finally, we decided that wearing masks would protect us from the virus after saying they weren’t that effective.

Most people want to do the right thing, but far from everyone. We’re no longer a “can do” country. Now we’ve become more like: “won’t do”.

Mask wearing has become a tribal badge. Trump mocked mask wearers for appearing weak. He’s said wearing a mask is a political statement against him, so it’s no surprise that mask refusers are more likely to be politically conservative. That’s an ominous trend when new coronavirus cases and hospitalizations are increasing steeply in some red states, the very states where mask-wearing mandates are least likely to be adopted.

The mask refusers have also allied with the anti-vaxx’ers in a “you’re not the boss of me” stance versus the government.  As Kris Kristofferson said, “Freedom’s just another word for nothing left to lose”, but with Coronavirus, that freedom to not mask up gives you plenty to lose.

And it gives the country plenty to lose as well. Wrongo wears masks in accordance with his state’s laws. Apparently, that makes Wrongo a liberal.

This story from Oregon shows the depth of the problem. A trooper of the Oregon State Police refused to wear a mask while patronizing a coffee shop, despite a mandatory order by the state’s governor, Kate Brown, that masks were to be worn in all public indoor spaces throughout Oregon.

The shop’s assistant manager told the trooper that he needed to wear a mask. The Statesman Journal reports that the trooper said:

 “Governor Brown has no authority to take our civil liberties. We aren’t going to wear masks.”

The manager recalled that the trooper then placed his order, offering this foul-mouthed retort to the governor’s mandate:

“He said, F— Kate Brown”.

This story carries a lot of baggage. First, the trooper is one of America’s anointed class of cops, for whom there is little consequence for bad behavior. Second, the trooper is a man. Men are more likely to opt out of wearing masks, even though men are at higher risk than women of dying from coronavirus infection. Third, Governor Brown is a Democrat, and a bisexual woman, so it’s unlikely that the trooper was a fan.

FWIW, the trooper was fired.

Most people understand that a mask protects you while offering real protection to other people. The message seems to have gotten across that masks are mainly about protecting others, but those troopers in Oregon, and many other people across America, are simply choosing not to participate in their own, or in your protection.

The recent increases in confirmed Coronavirus cases across the US South and West are being driven by young people who are not social distancing. The young are also least likely to wear masks.

We compel all sorts of behaviors. Seat belts while driving. No smoking in restaurants. No t-shirts with inappropriate text in high schools. But compelling mask-wearing for safety? That’s a bridge too far.

Here’s the thing: Encouraging people to wear masks hasn’t worked. Shaming people who won’t wear masks hasn’t worked. Reassuring people that masks are not a political statement hasn’t worked. Informing people about the serious health consequences of COVID-19 hasn’t worked. Reminding people they aren’t invincible, that the Coronavirus has killed young, healthy people hasn’t worked.

Begging people to wear masks, if not to protect themselves, then to protect others, hasn’t worked.

If we can’t convince anti-maskers to care about their own health, then we certainly won’t convince them to care about other people. It didn’t have to be this way: Pandemic, death, and depression. Things getting worse because we argue and won’t work together.

People are saying, we quarantined for three months, that’s enough. If your boat capsized, and you swam for three minutes, would you say that’s enough, you’ll stop swimming and drown, even though you can see the shore?

The solution isn’t elusive, but it requires more social cohesion and less faux grievance about freedom.

You want kids back in schools? You want the economy to restart? Wear a mask!

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Saturday Soother – June 27, 2020

The Daily Escape:

Mt. Rainer from the Whiteriver campground – 2020  photo by np2fast

Good morning fellow disease vectors!

Now that Florida and Texas have again closed their bars, you’re probably wondering: “Can Joe Biden’s lead in the polls get any bigger”?

Here’s your answer. On Thursday, the Trump administration asked the Supreme Court to invalidate the Affordable Care Act. They did this without any plan for replacing it, at what appears to be the height of new cases of the COVID pandemic. From Charlie Pierce:

“Imagine, for a moment, you’re a Republican. You already know that your party has hitched its wagon to the biggest ass in the history of American politics, and that he has proceeded to bungle a response to the worst public health crisis in a century, touching off a deep recession in the bargain….Perhaps you’re thinking to yourself this morning, y’know, maybe this isn’t the best historical moment to take healthcare away from tens of millions of Americans.”

Political gurus say that timing is everything.

Trump is doing this despite the fact that 487,000 new people signed up with HealthCare.gov last month after losing their company-provided health insurance coverage because of the pandemic-induced recession. That was an increase of 46% in sign-ups compared to the same month last year.

And Trump’s trying this stunt in the week when the US hit a new record for the highest daily total of reported COVID-19 cases – more than 45,500! He’s picked the perfect time to try again to throw an estimated 20 million Americans off of their insurance coverage.

This has been the GOP plan all along: we’re trimming the rolls of people on entitlement programs. We’re doing it through the courts, through legislation and by allowing the COVID-19 infection to spread.

It’s no longer clear which is the greater threat to lives in America: The Coronavirus, or Donald Trump.

This should remind all of us that we need to make Medicare for All, or another form of single payer insurance, a top priority after the November election.

Biden said it all in a speech this week: (brackets by Wrongo)

“Amazingly, he [Trump] still hasn’t grasped the most basic fact of this [COVID] crisis: to fix the economy we have to get control over the virus. He’s like a child who can’t believe this has happened to him. All his whining & self-pity…his job is to do something about it.”

We desperately need new leadership. Maybe we’ll get it next January.

Now it’s time to forget the Sahara Dust storm for a few minutes. You should also ignore the fact that the Dixie Chicks changed their name to “The Chicks”. How exactly does THAT rebranding improve our world, or their career?

Time to take our masks off, sit at an appropriate physical distance, and kick back: It’s time for our Saturday Soother.

Let’s start by brewing up a huge mug of Ethiopia Nano Genji Agaro Gera coffee ($21.00/12oz.) from Sacramento CA’s Temple Coffee roasters. The roaster says you will experience notes of nectarine and apricot with your first sip.

Now find a comfortable lawn chair, and settle in to listen to “Summertime”, written by George and Ira Gershwin, and Dubose Edwin Heyward, in 1935. It’s performed here by George Winston from his album “Restless Wind”:

It was also memorably performed by the late, great Sam Cooke in 1957, released as the B-side on the single of Cooke’s big hit, “You Send Me”.

Those who read the Wrongologist in email can view the video here.

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Pandemic Is Getting Worse

The Daily Escape:

Sunrise, Green County WI – June 2020 photo by Keith D. Leman

Last Tuesday, VP Pence rejected the idea that the country was seeing a second spike in coronavirus cases as the pandemic continued. He wrote an article in the Wall Street Journal, entitled “There Isn’t a Coronavirus ‘Second Wave’”.  

Maybe he thinks that’s the case.

The US and the EU have comparable populations, but the current state of their respective COVID-19 outbreaks are vastly different. New data released by the European Center for Disease Control and Prevention show that there are around 3,000 new COVID cases in the EU each day.

In America, we’re now recording about 30,000 new cases of the virus each day, ten times higher than Europe. And while some US politicians in the US say the difference is due to discrepancies in testing, the US and the EU are conducting roughly the same number of tests per million people.

And new cases are growing in the US. Here’s a look at the seven-day rolling average of new COVID cases in the EU and the US since March:

It looks like a second US wave is on its way, regardless of what Pence or Trump says. Everything out of the White House on the pandemic has been bullshít. The pandemic has revealed that we have no leadership, no self-control, and no willingness to sacrifice for the common good.

The federal government’s response to the virus has been misguided. We could have undertaken a national effort to produce N95 masks for every person. With those masks, which reduce the chances of inhaling the virus by 95%, along with proper instructions on how to wear and handle them, the country could have remained open, and people remained safe. Of course, that assumes mask wearing isn’t considered an affront to our freedoms.

Now, the country has opened back up. We are almost as ill-prepared as when the pandemic started. Many of us have gone back to our former ways, pretending the virus is gone. Yes, we can go back to work, but we need the protection of high-quality masks.

Here’s Calvin with some truth:

America is doomed.

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Monday Wake Up Call – June 15, 2020

The Daily Escape:

Bright Angel Trail, in the middle foreground, Grand Canyon NP – photo by glowrocks

The chickens are coming home to roost. Michael Flor was originally the longest-hospitalized COVID-19 patient. Somehow, he survived. He came close enough to death that a night-shift nurse held a phone to his ear while his wife and kids said their final goodbyes.

Today, he’s recovering at home in West Seattle, WA. That’s the good news. The bad news is that he just got the bill. From the Seattle Times:

“The total tab for his bout with the coronavirus:…$1,122,501.04, to be exact. All in one bill that’s more like a book because it runs to 181 pages.”

More from the Seattle Times:

“…the charge for his room in the intensive care unit was billed at $9,736 per day. Due to the contagious nature of the virus, the room was sealed and could only be entered by medical workers wearing plastic suits and headgear. For 42 days he was in this isolation chamber, for a total charged cost of $408,912.

He also was on a mechanical ventilator for 29 days, with the use of the machine billed at $2,835 per day, for a total of $82,215. About a quarter of the bill is drug costs.”

Those charges don’t include the two weeks of recuperating he did in a rehabilitation facility.

Since Flor has Medicare, it is unclear how much he will actually have to pay out of pocket. Further, since Congress set aside more than $100 billion to help hospitals and insurance companies defray the costs of the pandemic, it’s possible that Mr. Flor may not have to pay even the out-of-pocket charges normally billed by his Medicare Advantage policy, but that remains to be seen.

The insurance industry has estimated treatment costs of COVID-19 could top $500 billion, so unless Congress steps up with more money, co-pays for COVID will soon become injurious.

One outcome of the pandemic may be that America takes a closer look at universal health insurance. There are many detractors in Congress, but the sticker shock that so many families will see from COVID-19 cases may restart the discussion. Medicare for all could work: A single payer with a set system of prices would be good for employers and employees alike.

It will be hard. Universal health insurance is such a tough problem to solve that only 31 out of 32 developed nations have managed to do it.

A second issue for today is the killing of Rayshard Brooks in Atlanta over the weekend. From the Atlanta Journal-Constitution:

“Officers were called to the restaurant after receiving a complaint about a man asleep in his vehicle, which forced other customers to go around his car to get their food at the window. The man, Atlanta resident Rayshard Brooks, was given a field sobriety test, which he reportedly failed…”

Brooks grabbed a cop’s Taser. More:

“…surveillance footage from the Wendy’s appeared to show Brooks turn toward the police and attempt to fire the Taser as he ran away. That’s when the officer chasing Brooks pulled out his gun and shot him…”

Tasers are a form of de-escalation instead of using firearms. The Taser momentarily incapacitates, but ultimately doesn’t threaten life. So shouldn’t it follow that if a suspect steals a cop’s Taser and threatens to use it, the cop can’t just shoot him dead since he’s being threatened by an ultimately harmless weapon?

The cops had his car, it’s likely they knew where he lived. They could have picked him up at any time. Instead, they killed him. The police tried to do something, the suspect resisted, and in the heat of the moment, the cop escalated to show that he’s in charge. It was a terrible reason to kill someone.

Time to wake up America! We have both out-of-control policing and out-of-control capitalism harming our society. To help you wake up, listen to Sly and the Family Stone’s 1969 song, “Everyday People”. This is Playing for Change again, along with Turnaround Arts students. Trust Wrongo and watch:

Sample Lyric:

Sometimes I’m right and I can be wrong
My own beliefs are in my song
The butcher, the banker, the drummer and then
Makes no difference what group I’m in
I am everyday people, yeah, yeah

And different strokes for different folks
And so on and so on and scooby dooby doo-bee
Ooh, sha sha
We got to live together
I am no better and neither are you
We are the same whatever we do

Of course there was racism back in 1968, but the musicians were preaching integration. Despite the racism back then, people were optimistic. Compare that to today.

Those who read the Wrongologist in email can view the video here.

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Sunday Cartoon Blogging – May 24, 2020

From the Atlantic’s article, How Could the CDC Make That Mistake?: (brackets and emphasis by Wrongo)

“The Centers for Disease Control and Prevention is conflating the results of two different types of coronavirus tests, distorting several important metrics and providing the country with an inaccurate picture of the state of the pandemic.

The agency confirmed to The Atlantic…that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons. This is not merely a technical error.

States have set quantitative guidelines for reopening their economies based on these flawed data points….Viral tests, taken by nose swab or saliva sample, look for direct evidence of a [current] coronavirus infection.…Antibody tests, by contrast, use blood samples to look for biological signals that a person has been exposed to the virus in the past.

A negative test result means something different for each test. If somebody tests negative on a viral test, a doctor can be relatively confident that they are not sick right now; if somebody tests negative on an antibody test, they have probably never been infected with or exposed to the coronavirus….The problem is that the CDC is clumping negative results from both tests together in its public reporting.”

The CDC stopped publishing a complete database of daily test results on February 29. When it resumed publishing test data, the website explaining its new COVID Data Tracker said that only viral tests were included in its figures:

“These data represent only viral tests. Antibody tests are not currently captured in these data,”

On May 19, that language was changed. All reference to disaggregating the two different types of tests disappeared.

The change has made the CDC’s testing data look more favorable. Last Monday, a page on the agency’s website reported that 10.2 million viral tests had been conducted nationwide since the pandemic began, with 15% coming back positive. But on Wednesday, after the CDC changed its terms, the same page said that 10.8 million tests of any type had been conducted nationwide, and the rate of positive tests had dropped by one percent.

Blending viral and antibody tests will drive down the rate of positive tests dramatically. It makes it look safer to reopen the economy. On to cartoons.

Reopen the economy. What could go wrong?

America needs a better role model:

Social cohesion used to be a thing:

Trump demands churches reopen. Where will he be on Sunday?

After WFH ends, will there be regrets?

Biden’s doing great by doing nothing:

We shouldn’t get cocky. Remember that Trump “won” in 2016 when just 25.5% of eligible American voters voted for him.

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World’s Most Expensive Health Care System Can’t Provide Minimum PPE

The Daily Escape:

Tim Hunter, BSN, in Brooklyn, NY – April 2020 photo by Tim Hunter

Tim Hunter, an acquaintance from the world of show dogs, is a nurse living in Buffalo, NY. In early April, he accepted a traveling nurse assignment at Kingsbrook Jewish Memorial’s ICU in Brooklyn, NY to help out on the front lines of the COVID-19 fight. Tim posts on his experiences, and he graciously agreed to share this dispatch from earlier this week:

“Wednesday May 6th starts Nurse’s Week 2020

The last time we worked, we were informed that we will, moving forward, only be getting our body suits and can no longer get a disposable gown to put over the suit. Big freaking deal right? Wrong. What does this mean? This means we will enter rooms “protected” but after leaving a room we will be tracking COVID all over the unit. Nurses are buying spray alcohol to try and kill whatever lands on the suit so we don’t risk getting each other sick. Or do you take off the suit in between care? Absolutely not. What if you need to intervene right away? There’s no time to get it on.

People who have no relevant education or experience are protesting having to sit at home, while we watch people who have been intubated for weeks struggle, while we’re standing in patient’s rooms and intervening we’re looking at posters of patient’s family, of these people who are dancing at their daughter’s wedding and giving their grandson a piggy back ride. People that were once fine and people that should be able to still be doing those things.

We drive to work in dead silence because we have no idea what we’re in for. Maybe it will be a super typical hospital shift, or maybe it will be the worst night you’ve ever worked.

We’re watching people get tracheostomies after weeks of intubation in hopes that MAYBE someday they’ll be okay enough to have their life back. We’re drying patient’s tears when they wake up from their sedation and they’re terrified!

We’re watching people who we were once hopeful would maybe get off of the vent sustain lung injuries from not being able to handle the pressures of mechanical ventilation any longer.
We listen to family members cry because they don’t know if they will ever see their loved one again, and they mourn that they’re going through this alone.

We see patients grabbing our hands begging us not to leave rooms because they’re lonely, and scared.

We walk past tractor trailer trucks full of dead bodies on our way in and out of work every night. Because there is no way to manage, no morgue can keep up with the amount of people dying. Even now with the “down swing”.

And the end of a shift we feel like our head is in a vice grip, and literally crave a breath of actual fresh air after rebreathing CO2 all night.

We wake up in the middle of the night with a panic because of a headache or any symptom and literally fret over that one time we did compressions or were a part of an intubation, because of how high risk those events are.

You know what nurses want for nurses week?
To know they’re safe, to know that in AMERICA that we can be afforded a shitty disposable gown to help protect ourselves from sitting in a virus. To not become so neurotic that our hands are completely raw from washing them so much. We want you to have enough respect for human life to not make stupid decisions. We want you to pay attention to science and not stupid conspiracy theories.

We don’t want to be called heroes, we don’t want shitty pizza, or signs. We want to be safe, well-staffed, and to not feel like every day we’re risking our own well-being.

Returning to the bedside has been the most amazing thing I’ve ever done, but after this I will go back to my job with an insurance company. While people that actually deserve your accolades keep fighting this.

So think this status is for attention, likes, call it fear mongering or whatever. But really it’s just so maybe for a second you’ll take this seriously. I have 33 days left in my contract to keep fighting with these people, and I honestly hope that things are headed back towards normal when I drive home. But with all of the small gatherings that pop up on social media that you’ve convinced yourself are fine, masses of people standing outside of a damn Dairy Queen, and seeing all the people in streets ignoring social distancing measures, it’s honestly unlikely.

Happy Nurses Week though…”

#EndRant

This is the state of American health care in 2020. Tim, thanks for your bravery and insight.

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Can We Get Our Act Together?

The Daily Escape:

Hummingbird with bee balm – 2014 photo by JH Cleary. Hummingbirds arrived on the fields of Wrong yesterday.

When was the last time that America got its act together when it needed to? It’s been a very long time, probably not since WWII, or possibly, during our effort to immunize everyone, once there was a polio vaccine. That’s between 65 and 75 years ago.

We didn’t get our act together during the Vietnam era. We’re reminded of that with yesterday’s 50-year anniversary of the Kent State shooting in 1970, when four unarmed college students were killed by soldiers of the Ohio National Guard. It was a small, but significant tragedy that became a part of a greater national tragedy, the Vietnam War.

We didn’t get our act together after 9/11 when we attacked Afghanistan and Iraq. Like Vietnam, we’ve been losing to people who wear sandals and fight with antique weapons, for 50+ years.

These aren’t the only examples. New Orleans was whacked by Hurricane Katrina, but a week later, survivors were still sitting on roof tops surrounded by floating corpses. Even now, 15 years later, there is still evidence of damaged buildings in the city’s 9th Ward.

We haven’t gotten our act together to fight the COVID-19 pandemic. We’re currently seeing 1,750+ deaths per day. While the death toll is dropping in NYC and NJ, it’s rising pretty much everywhere else.  Here’s a chart showing the growth in cases, not deaths:

The dotted lines are a 7-day moving average, which allows us to see the trends more clearly. Politicians outside of the NY metropolitan area who are busy relaxing restrictions look like they’re simply giving up and pretending it’s over, when it isn’t. Ohio Gov. Mike DeWine (R) is dropping requirements that residents wear masks. It is now a “strong suggestion”. Kentucky Gov. Andy Beshear (D) wants residents to wear masks starting May 11, but will not enforce it.

Getting our act together has never been a feature of America’s Coronavirus fight. A depressing story in the New Yorker, “Seattle’s Leaders Let Scientists Take the Lead. New York’s Did Not”, sheds light on Seattle’s response vs. New York City’s. Although the initial coronavirus outbreaks emerged in both cities at roughly the same time, by the second week of April, Washington State had about one recorded fatality per 14,000 residents. New York’s death rate was nearly six times higher.

The article describes how Seattle’s political leadership followed a tried and tested CDC playbook for epidemics, called the CDC’s Field Epidemiology Manual, which places public health and scientists at the core of the response. New York’s mayor DiBlasio cut NYC’s public heath bureaucrats out of the loop. In early March, both NYC’s mayor and NY’s governor Cuomo were giving speeches de-emphasizing the risks of the pandemic, as the city was announcing its first cases.

This partially explains why Washington State has less than 2% of coronavirus cases in the US, while NY has 27%.

We’re all familiar with the confusion of message and policy sown by Trump as the primary national spokesperson for the pandemic, a person notoriously hostile to science. His team includes Mike Pence, Dr. Fauci from the NIH, Dr. Deborah Brix from the State Department, and Jared Kushner, from the family. With contributions from Mike Pompeo and Steve Mnuchin.

The New Yorker quotes Dr. Tom Inglesby, director of the Center for Health Security, at Johns Hopkins:

“When there are so many different figures, it can cause real confusion about whom to listen to, or who’s in charge of what….And, if the response becomes political, it’s a disaster, because people won’t know if you are making recommendations based on science or politics…so there’s the risk they’ll start to tune out.”

From the NYT:

“As President Trump presses for states to reopen their economies, his administration is privately projecting a steady rise in the number of coronavirus cases and deaths over the next several weeks. The daily death toll will reach about 3,000 on June 1…nearly double from the current level of about 1,750.”

Math tells us that this will amount to about 81,000 more deaths by then, making the total somewhere around 150,000, assuming that the death rate remains on its current trend.

Should we expect that America will continue to flub it’s response to the pandemic? If so, Aaron Sorkin and Jeff Daniels will have to re-do the famous opening scene from “The Newsroom” where Daniels says “America is not the greatest country in the world anymore”:

Since we haven’t gotten our act together for so long, a failure to control the 2020 COVID-19 pandemic will be depressingly similar to the tragedies of the past.

Failures of leadership, coupled with warring political factions who refuse to work together for a common good.

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