Category: Health Policy

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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Monday Wake Up Call – April 27, 2020

The Daily Escape:

Harvest Moon over Bisti Badlands, south of Farmington, NM – 2019 photo by navidj.

Question: How many Americans have died from COVID-19? A: 54,024 as of Sunday.

Question: How many Americans died in the Vietnam War? A: 58,220.

Barring a miracle, we will pass that Vietnam milestone this week. By then, there will be more than one million confirmed cases, and 60,000 deaths in the US. Can we take a minute, and try to place the Coronavirus in the context of the dead and broken bodies from Vietnam?

Vietnam took ten years to reach that horrible number, while COVID-19 has met it in less than three months. Wrongo served during the Vietnam War. It was a trying time for all Americans. We were disunited at home, at much at war with each other, as with the Viet Cong. It scarred at least a generation, and there are still victims of both the domestic and foreign fights among us.

Today’s fight against the Coronavirus may become the current generation of 20-something’s Vietnam. Jobs won’t come back quickly, friends and family are dying, and the lack of testing and a vaccine will make life scarier for young people than for any other group.

Like Vietnam did to the boomers, Coronavirus could scar young people for years to come.

As we head into month four of the outbreak, we know that we are undercounting deaths. The Economist reported on one aspect of the undercount early in April, comparing cardiac arrest deaths in NYC to the historical average:

Are the increased rate of cardiac arrest deaths really COVID-19 deaths? A strong case can be made that they are. Back to the Economist, who says that the outbreak will be worse in the South: (emphasis and parenthesis by Wrongo)

“Places with older residents and more diabetes, heart disease and smoking have higher CFRs (case-to-fatality rates)…..Counties with lots of poor or black people tend to have more health problems, less social distancing and fewer ICU beds. Yet CFRs in such areas are even higher than you would expect from these factors alone.

Together, these variables leave a geographic footprint….the highest death rates will probably…be…in poor, rural parts of the South and Appalachia with high rates of heart disease and diabetes. Worryingly, the three states that announced plans this week to relax their lockdowns (Georgia, Tennessee and South Carolina) are all in this region.”

It didn’t have to be like this. There’s plenty of blame to go around, but in the end, the single most important factor in America’s disaster of a response was the lack of early testing. That will be a greater disaster if we fail to keep growing testing as the lockdowns end.

One thing that’s difficult to comprehend is the lack of empathy for the dead and their families and friends by some Americans. Most can rouse themselves to celebrate the first responders, health care workers, and “essential” workers, but not all can.

The WaPo has analyzed all of Trump’s Coronavirus briefings, and found this:

“The president has spoken for more than 28 hours in the 35 briefings held since March 16, eating up 60% of the time that officials spoke….Over the past three weeks, the tally comes to more than 13 hours of Trump — including two hours spent on attacks and 45 minutes praising himself and his administration, but just 4½ minutes expressing condolences for coronavirus victims.”

Trump has not even ordered American flags lowered in tribute to the dead, while some governors have. New Jersey’s Governor Phil Murphy and New York’s Governor Andrew Cuomo both did in April. As Susan B. Glasser said in the New Yorker:

“Trump, who has in the past personally asked for the flags to be lowered after a shooting or a politician’s death, can’t even bring himself to do this much for victims of the coronavirus.”

Time to wake up, America! We must tread carefully for the next few months, because we truly know very little about the virus. For example, there’s no evidence that Coronavirus antibodies prevent reinfection.

To help you wake up, listen to “Road to Nowhere” written by David Byrne for the 1985 Talking Heads album “Little Creatures”. Here, it’s performed in 2012 by David Byrne and St. Vincent, live in Paris with a brass band:

Sample Lyric:

Well, we know where we’re going
But we don’t know where we’ve been
And we know what we’re knowing
But we can’t say what we’ve seen

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

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Sunday Cartoon Blogging – April 26, 2020

From the WaPo: (brackets by Wrongo)

“President Trump on Friday threatened to block an emergency loan to shore up the U.S. Postal Service unless it dramatically raised shipping prices on online retailers…“The Postal Service is a joke,” Trump told reporters in the Oval Office. [In order] To obtain a $10 billion line of credit Congress approved this month, “The post office should raise the price of a package by approximately four times…”

The USPS is enshrined in the US Constitution. BTW, killing it might accomplish a few things for Trump:

  • It obstructs any Congressional effort to mandate mail-in voting.
  • It rewards private sector delivery carriers like FedEx and UPS that compete with the USPS. Many of them have donated both to Trump and Republican candidates.

The USPS is entirely self-funded. If you buy stamps, you’ve funded the Post Office. Its operations are profitable. It loses money on paper because of Congress’s unique requirement for the USPS to pre-pay all future pension liabilities, something no other American corporation or institution is required to do. That was imposed by Republicans in 2006 in the Postal Accountability and Enhancement Act.

He’s trying to make the Postal Service unprofitable. And when it’s a shell of its former self, sell it to UPS or FedEx who would be delighted to have one of their biggest competitors destroyed. On to cartoons.

Our grim future:

MAGA-ites drink the healing Kool aid:

Your lockdown inconveniences my freedumb:

Georgia takes aim at the lockdown:

Nursing homes account for 25% of US COVID-19 deaths. Remember the elderly and infirm:

The oil glut has forced the oil companies into the suburbs:

 

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Flattening the Curve May Take Time

The Daily Escape:

Dying Tornado, KS – photo by mattgphoto

When it comes to ending the lockdown, the theory is that once we’ve “flattened the curve” we can ease up on social isolation, mask-wearing and get back to work. The problem is that when we think about the downside of the curve, we think parabolas. This chart demonstrates that even with the “flattening”, we’ve been told to expect a sharp drop-off in cases:

But as Cathy O’Neil says: (brackets by Wrongo)

“The dying won’t be over nearly as soon as it [a curve like that] suggests.”

O’Neil looked at the curves for Italy and Spain. Both had uncontrolled outbreaks and climbed the curve about two weeks ahead of the US. They also turned to lockdowns late, leading to overburdened hospitals. So, they offer a decent indication of what to expect in in America:

 “Their curves…are not symmetric curves. They go up fast, flatten out and then descend slowly. How slowly? It’s still hard to tell, but the shape strongly suggests that the bad news won’t go away nearly as quickly as it arrived.”

Here’s Italy for example:

It’s too early in the virus’s growth in the US to know what the right side of our curve will look like, but the evidence from Europe suggests that the descent will be slow. More from O’Neil:

“New York Governor Andrew Cuomo has said ‘the worst is over’ and ‘we’ve reached the peak.’ He should have followed with “now comes the long wait.”

She’s saying that the far side of the curve is likely to be a long, slow slog. This is food for thought for politicians who must decide when to end the lockdown.

It should also be food for thought for all of those protesting the lockdowns. In addition to the shape of the curve, we still have almost no idea what the actual prevalence of the virus is in the general population.

Abbott Labs has developed a 5 minute serology test that it says has 100% sensitivity and 99.6% specificity (Sensitivity means the test detects the presence of antibodies triggered by the COVID-19 virus; specificity means it successfully avoids mistaking that virus for similar coronaviruses).

The test was used in the Boston suburb of Chelsea. It found that of 200 randomly sampled residents who were stopped on the street and asked to give some drops of blood, 64 had antibodies. That’s 32%. The study was conducted by physicians at Massachusetts General Hospital.

John Iafrate, a pathologist at Harvard and the study’s principal investigator, said:

“We don’t know at this point what percent of these antibody-positive individuals are still carrying virus, but a fair estimate is likely 30-50%.”

Soumya, a health reporter for the LA Times, tweeted: (emphasis by Wrongo)

“LA County just released the results of their antibody study. Tests found that 4.1% of the county’s population has antibodies to the coronavirus. That figure is 55 times higher than what is suggested by the official case count.”

This suggests that there are many more infected, but asymptomatic people than are in the official numbers.

So, we need to be more sensible about both the shape of the curve, and about how little we know about who has the disease, and who doesn’t.

We’re still flying almost totally blind, four months after the government found out this was coming.

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Sunday Cartoon Blogging – April 19, 2020

One week ago, the cumulative US COVID-19 death toll was 15,000. Seven days later, the death toll is now 36,000. That means in a week, about 21,000 Americans have died, a growth rate of 140%. In the past two months, here’s how US coronavirus deaths have grown:

  • Feb 17: 0 deaths
  • March 17: 111 deaths
  • April 17: 36,997 deaths

Although deaths are a lagging indicator for how successful we are in our efforts to contain the Coronavirus, and despite all the happy talk about flattening the curve, this looks like a rocket ship leaving the launch pad.

The Navy has now tested about 94% of the crew on the USS Theodore Roosevelt, the aircraft carrier that was sidelined with a Coronavirus outbreak. As of Friday, 660 crew members (of about 4,865) have now tested positive for Coronavirus.

However, of those 660 who were positive, 60% have not shown any symptoms associated with the illness. This should cause us to question the true rate of infections in the US. The proportion of people who are asymptomatic carriers worldwide remains unknown, but at 60%, the Theodore Roosevelt’s figure is higher than the 25%-50% range Dr. Fauci laid out in early April.

Taking these two data points together, America should proceed carefully as it leaves the lockdown.

On to cartoons. Another day, another spin of the big blame wheel:

With big business, some things never change:

If not his signature, then certainly his fingerprints:

The right’s narrative that can kill:

Individual responsibility has consequences:

John Roberts has to live with his Wisconsin voting decision:

 

 

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Saturday Soother – April 18, 2020

The Daily Escape:

Rainbow appears over NYC at 7pm, the time of change of shift for NYC’s health workers – April 13th 2020 photo by Steve Braband. Thanks to reader Shelley VK.

An argument by those who want to end the lockdown about those who think we should keep it is:  “You have shut down the economy because you think even one death is too many.”

That is a misrepresentation of what America’s governors have done. They really have said: “We reduced the economy and restricted daily activities because otherwise, as many as a million people might die.”

What is missed by the “live free or die” folks is that these actions were taken to reduce the risks to human life from the pandemic. They say, you shouldn’t ask us to stay locked down, because “life is full of risk anyway”.

To a degree, they are correct. Lockdowns only work for the privileged. They don’t work for everyone, because the level of income support and debt relief provided by the government is inadequate to the need. If landscapers are not essential in a state, they don’t work. But since they live paycheck to paycheck, they won’t be able to buy food. And when they see others working and earning, that’s got to be angering.

If we ask people for sacrifice and compliance, the country must at least secure their short term needs.

Since the government isn’t providing adequately for those needs, rebelliousness, non-compliance, and virus denialism are on the rise, as we saw in Thursday’s large demonstration in Michigan.

In Connecticut, Wrongo’s home state, the major issue every spring is passing the town budget. With a COVID-19 shutdown in effect, Governor Ned Lamont (D) issued an executive order suspending in-person voting for the next fiscal year’s budget. And there is no vote by mail option in CT.

His order has been met with livid anger on the right and left, conjuring up “no taxation without representation” and calls to “stand up for your rights”. People are saying if they can shop using social distance, why can’t they vote using social distance?

What angers many in town is that voters have rejected several budgets in recent years. The town then lowers the numbers, and it goes back to voters who eventually approve it. They could simply roll over last year’s approved budget, but instead, they’re going to pass a budget increase along with an increase in taxes, without ratification by voters.

The executive order seems wrong-headed, and it’s making people very angry. And so non-compliance will grow, as will denialism that the virus is a serious health problem.

All of this may help the virus flare up again soon.

In a comment, blog reader Terry McKenna brought up the concept of the “Tragedy of the Commons”, the idea that all individuals have a right to consume a resource even if it comes at the expense of other individuals. If demand overwhelms supply, every individual who consumes an additional unit directly harms all others who can no longer benefit from it.

Most Americans don’t think about how their actions impact others. Most are unwilling to even temporarily comply with limitations placed on them for the common good. With Operation Gridlock in Michigan, we’re seeing more proof that when human health and safety go up against the almighty dollar, humans will lose.

People should remember that finding a vaccine for the virus is not a sure thing. There’s also little reason to believe that once a vaccine is found, that it will be completely effective. The longer people are allowed to think that universal Coronavirus immunity is just around the corner, the angrier they will get when that isn’t the case.

Until we know if a vaccine is likely or not, the current political climate won’t be conducive to rational discussions about difficult decisions. The virus can’t spread itself, but it seems to have plenty of helpers.

On this spring Saturday, let’s forget about non-compliance and the Coronavirus for a few minutes. Let’s have a brief respite, and indulge in a Saturday Soother.

Start by inviting your besties to a Quarantini video conference. The term “Quarantini” was actually coined several years ago on the podcast “This podcast will kill you”, hosted by two disease ecologists/epidemiologists. Wrongo prefers Irish single malts, but pour whatever makes you happy. And make a toast: Confusion to our enemies!

Next, settle back and spend a few minutes watching and listening to a parody tribute to NY Governor Andrew Cuomo, from Randy Rainbow, “ANDY!”:

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

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Should America Be Reopening Now?

The Daily Escape:

Poppies, Antelope Valley, CA – 2020 photo by user_greg. Part of the annual spring “super bloom” in CA.

Given Trump’s decision to open the country to walking around while infected, it’s becoming clear that for the administration, the business of America is strictly business.

But this is wrong. In a pandemic, the business of America is not business; it’s public health. Absent public confidence that the virus is at least under control, many businesses and workers won’t be comfortable heading back to work, no matter what politicians say:

“More than eight in 10 voters, 81%, say Americans “should continue to social distance for as long as is needed to curb the spread of coronavirus, even if it means continued damage to the economy…. Democrats (89%) are more likely than Republicans (72%) to say Americans should continue the “social distancing” measures”

Looks like Trump holds a minority view. To see if there was any concrete basis for saying the US was in a position to reopen soon, Wrongo looked at the COVID-19 Tracking Project’s state-level numbers, and subtracted the terrible NY numbers from the rest. Here’s the result:

The conclusion is that NY isn’t all that terrible compared to the rest of the US. It has a decreasing share of America’s total infections and deaths. But the highlighted rate of increase in deaths in the rest of the US since April 12th should concern the White House.

In fact, the seven-day average for growth in new cases shows that cases in the rest of the US are growing faster. NY is growing at 5.27%, while the rest of US is growing at 5.83%.

And the news from the places without lockdowns isn’t good. Politico reports that hot spots have erupted in farm belt states where governors insist lockdowns aren’t needed:

“The only hospital in Grand Island, Neb., is full. The mayor…asked for a statewide stay-at-home order that the GOP governor insists isn’t needed. More than one-third of those tested for coronavirus in the surrounding county are positive — and there aren’t enough tests to go around.

Grand Island is the fourth-biggest city in a state President Donald Trump and his top health officials repeatedly [say is]…keeping the virus at bay without the strict lockdowns 42 other states have imposed.”

New cases in Nebraska and in Iowa, South Dakota and other parts of the heartland are starting to spike. This should be raising concerns about whether we’re controlling the disease. Here’s Nebraska’s Republican Gov. Pete Ricketts saying that voluntary social distancing is working: (emphasis by Wrongo)

“This is a program that depends on people exercising personal responsibility and their civic duty….This is about making that decision, not the heavy hand of government taking away your freedoms.”

All of a sudden, as if they saw the bat signal, Republicans want to do the “Live Free or Die” thing. From the Daily Beast:

“A protest movement is taking hold targeting states that have extended social-distancing rules, closed schools, and restricted access to large religious gatherings. And it’s being fed by loyalists and political allies of President Donald Trump.”

This seems to be “spontaneous” support for Trump’s effort to reopen the economy.

In Michigan, a demonstration called “Operation Gridlock” protested Governor Whitmer’s shelter-at-home orders. Michigan has the third-highest number of COVID-19 cases in America, and the lockdown lowered infections. But Republicans criticize the order. Several thousand cars blocked the Lansing streets to protest what they see as an infringement of their liberty.

A lot of calories are going into the open vs. lockdown debate. It’s all a waste of time. How will we get a healthy economy if we eliminate the lockdown before we have any chance of stopping the mass transmission of this disease?

People aren’t staying at home because governments told them to. They’re doing it because it’s not safe to be out there. They aren’t going to go to work willingly in crowded offices, or travel, or attend concerts unless the danger is visibly lessened. And the economy will not recover until people are willing to do these things.

It’s not about flipping a switch. Businesses reopening will happen in small steps, as public health officials and political leaders, especially mayors and governors (and businesses), work to establish the basic conditions for a return to economic activity.

The bottom line is that the people are in control. We had to be convinced to stay home, and now we’ll have to be convinced to go out.

You go first, should be the people’s mantra. Trump should go back to holding MAGA rallies immediately. He should put his life and those of his supporters, where his mouth is.

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