Why should you wear a mask? Wrongo’s FB friend (an MD) explained it well:
“We don’t wear the mask to keep ourselves safe or even to make other people comfortable. We wear masks so the germs that spill out of the holes in our faces via water droplets and aerosols get caught in the mask and don’t get into other people’s eyes, nose or mouth or land on their wounds, clothes, hands or face….That way transmissions end with us. We stop the spread and can go about life almost like usual. Masks are also a great visual reminder of what’s going on…people stay back a bit. I actually wonder if that visual reminder is what so many people hate about masks. Do they want to pretend this is not happening or not a big deal or that they aren’t utterly failing society in every way?”
“Democrats and Democratic-leaning independents are about twice as likely as Republicans and Republican leaners to say that masks should be worn always (63% vs. 29%). Republicans are much more likely than Democrats to say that masks should rarely or never be worn (23% vs. 4%).
Republicans also are less likely than Democrats to say they have worn masks in stores or other businesses always or most of the time in the past month.”
Fact Tank says that only 49% of conservative Republicans say they have worn a mask all or most of the time in the past month, compared with 60% of moderate Republicans.
All of this explains where the virus is expanding:
Wearing a mask is more threatening than an attack by terrorists:
Europe thinks we should wear masks:
A tough year gets tougher:
Times like these call for better drinking choices:
The presidential race is shaping up to be a real fight:
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.
“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.
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.
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.
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.
Wrongo was unaware, but some Catholics are praying to the 2nd century St. Corona (d. C. 170) thinking she’s the patron saint of plagues and epidemics. She, along with St. Victor, a soldier, were tortured and killed around 170 at the order of a Roman judge, according to an account written in the 4th century.
Americans are starting to peek out of their nests again. Governors have decided, and 30 of them are re-opening their states. Those states are not exclusively Republican; there are a few Democratic states too. The logic behind reopening is that of risk assessment and risk management. Somewhere between prudence and overreaction lies today’s American toxic politics.
We judge risk versus gain for everything, including for other causes of death. We try to model healthy behaviors. Most of us wear seatbelts, most watch our diets, and have stopped smoking years ago.
We also have to judge the risks associated with whether to end, or continue the lockdown. That means deciding which steps to take that will minimize both the spread of the virus, along with minimizing the crushing economic hardship being experienced by many Americans.
Ignore that the government isn’t currently taking care of healthcare and housing if you are unemployed.
The lockdown could go on for much longer if the federal government was willing to underwrite living costs for those who are out of work, until such time as it was safe to go back to work. But they have no intention of doing that.
So, from the Trump perspective, the choice is clear: Businesses need to open and their workers need to go back to work, despite the risks. Their argument is that living with COVID-19 isn’t as risky as it seems. Twenty-two states have had fewer than 100 deaths. So far, only 15 of 50 states have had total deaths for the crisis that are higher than NYC’s current rate of 500 a day.
The original goal of lockdowns was to keep the health care system from being overwhelmed, and in the largest cities, that risk seems to be behind us. Whether that will be true in rural America where few hospitals operate, remains to be seen. Derek Thompson said in the Atlantic:
“This crisis represents an existential threat to America’s small businesses. Almost half of all job losses in April occurred in leisure and hospitality, where small businesses are overrepresented in companies like restaurants and stores. The decimation of small business would have long-lasting implications. It would destroy jobs that would be unlikely to return quickly, while creating a crisis of long-term unemployment.”
And all of those restaurants, cafés, theaters, community centers, and specialty shops that are part of the local fabric of our towns and villages could be wiped off Main Street. Losing many of them would be an economic tragedy. More from Thompson: (emphasis by Wrongo)
“The virus is real, the hospitalizations are real, the deaths are real, the need for masks and social distancing is real, the threat to millions of restaurants and shops is real, and the incomparable levels of unemployment are real, too. The White House plan to reverse this cavalcade of horrors is to “reopen” the economy. But 20 million Americans just lost their jobs in the past few weeks, not because the government shut down the economy, but because a pandemic scared millions of Americans into staying at home. There is plenty to be wisely afraid of, but Washington thinking that a pandemic economy is like a garage door that it can reopen by pressing a button might be the scariest thing of all.”
No one knows what will happen between now and Election Day. It’s not just a matter of businesses opening up. For people to go back to work, schools must be open, day care must be open, public transportation must be safe, and customers must show up.
Are you up for all of that?
In the Great Depression, we learned that unemployment at today’s scale required massive government intervention to address: Jobs programs, infrastructure investment, and a robust social safety net.
It required an FDR to galvanize the country. Needless to say, neither Trump nor the Republican Party have the desire to provide that leadership. They will be every bit as uncaring and incompetent at rebuilding our economy as they have been at stopping the pandemic.
Time to wake up America! The economy has been opened, and you need to protect yourself whether you’re back to work, or trying to find a new gig. And you know that Trump isn’t going to help you protect yourself and your family, and he’s certainly not going to help you find a new job.
To help you wake up, listen to Guns ‘n Roses cover Paul McCartney’s “Live and Let Die” which played during Trump’s visit to an N95 mask manufacturing plant in Phoenix:
Remember all of this in November.
Those who read the Wrongologist in email can view the video here.
The National Bureau of Economic Research (NBER) has an interesting new report showing that New York City’s subway system was a major disseminator of COVID-19 during the coronavirus’ initial infection of the city during March 2020.
They show that subway ridership correlates directly with new cases, particularly in Queens. The near-shutdown of subway ridership in Manhattan (down by 90%) at the end of March correlates strongly with the reduction in the rate of increase in new cases in Queens thereafter.
They superimposed maps of subway station turnstile entries with zip code-level maps of reported coronavirus incidence. That showed Coronavirus propagation followed a process strongly consistent with subway riding. Moreover, local trains appeared to have a higher propensity to transmit infection than express trains, perhaps because people spent longer on those trains. Bus hubs served as secondary transmission routes out to the periphery of the city.
It never ends. On Fox and Friends, Trump said there is “no question” the video of the Ahmaud Arbery shooting is troubling. But, he hinted that further evidence might emerge that could possibly exculpate the shooters:
“You know, it could be something that we didn’t see on tape. There could be a lot of — you know, if you saw things went off tape and then back on tape”
The Second Wave, Coyote Buttes North, AZ, bu\ it’s easiest to reach from Kanab, UT – March 2020 photo by thatstheguy
“You know, that might be the answer – to act boastfully about something we ought to be ashamed of. That’s a trick that never seems to fail.” – Joseph Heller
Happy Saturday, fellow disease vectors! That’s quintessential Trump. He’s doing with the Coronavirus what was patented by Richard Nixon in Vietnam: “Declare Victory and Get Out”.
Trump had no intention of using the agencies of the US government as a positive force to deal with the pandemic, and now he’s backing out of any role helping the country to recover. From Eric Boehlert:
“Trump has no plan to “reopen” the country and he has no plan to manage this pandemic moving forward. The way I see it, the press dutifully starts each day assuming today is the day Trump gets serious and finally provides serious leadership. It’s not going to happen, though. We’re on our own, yet the press stubbornly pretends otherwise because presidents are supposed to provide leadership in times of crisis.”
Boehlert refers us to Jay Rosen, an NYU journalism professor, who writes:
“The plan is to have no plan, to let daily deaths between one and three thousand become a normal thing, and then to create massive confusion about who is responsible— by telling the governors they’re in charge without doing what only the federal government can do, by fighting with the press when it shows up to be briefed, by fixing blame for the virus on China or some other foreign element, and by “flooding the zone with shit,” Steve Bannon’s phrase for overwhelming the system with disinformation, distraction, and denial, which boosts what economists call “search costs” for reliable intelligence.”
Trump’s playbook is to have his re-election ride on manufactured confusion. There won’t be a plot for us to expose, it’s happening right before our eyes. We all know that Trump has no intention of leading. That he has no desire to get involved in helping to solve the greatest American crisis since 9/11. And the disconnect is, that a president acting like this would have been inconceivable before Donald Trump.
It isn’t debatable: Trump has washed his hands of the pandemic, and plans to blame the governors when things go wrong, while taking credit for anything that goes right. He isn’t even trying to hide that anymore.
We heard this week that Trump buried the CDC’s detailed advice about reopening. The administration doesn’t want the public to know what the scientists are recommending. That means people won’t be in a position to hold their employers, or their local governments, to a standard that they either can’t, or don’t want to meet.
At this point, all we can do is grit our teeth, and try to protect ourselves and our loved ones as best we can.
It seems likely that Trump, because of opting out of what a president is supposed to do in a crisis, will be the proximate cause of the deaths of thousands. All as a cover for his callous ineptitude.
And there’s little that we can do about it, except hunker down and be careful as we try to get through it.
We need a break from all of this negativity.
We need to settle back in a comfy chair at a socially distant spot, and de-stress from another difficult week. It’s time for another Saturday Soother, those few moments when we move to a different and better emotional plane. This weekend includes Mother’s Day, so it’s also a time to think about family and how we got to where we are.
To help with that, take a few minutes and listen to some of the world’s biggest current musical artists who collaborated on a BBC Radio 1 cover of the Foo Fighters’ “Times Like These”. Each performing from their own homes, as has become the standard these days. The group was dubbed the “Live Lounge Allstars” and included the Foo Fighters’ Dave Grohl:
Wrongo knows very few of these artists, perhaps showing his age. But this also shows that they should make more music outside of their usual genre. Those who read the Wrongologist in email can watch the video here.
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.
The key difference between the US and Canada says David Fisman an epidemiologist at the University of Toronto:
“We have a federal government that is supporting provinces’ responses….You have a chief executive who is directly undermining the public health response.”
Politics and politicians by definition, are always in the loop in a national emergency. Yesterday, we talked about how civic-minded politicians stand aside, letting the experts decide strategy. Then they help the experts by making the government work to support the strategy. And they then help with communicating priorities to citizens.
Our national response to the pandemic has been mostly incompetent. The wealthiest, most scientifically advanced country in history has been brought to its knees by a virus it knew was coming. As late as 2016, we had a coordinated national strategy to combat pandemics.
What can we do to insure we do a better job in the future?
This has been a hot topic in pundit land for the past few weeks. There are two threads of discussion: First, make the US military the leader in fighting pandemics. Alternatively, an “empowered” civilian agency or possibly, an empowered public-private partnership should direct the fight.
Let’s start by talking about how civilian government agencies might do a better job, if they were “empowered” and also funded. In 2005, GW Bush said: (emphasis by Wrongo)
“If we wait for a pandemic to appear, it will be too late to prepare….we need medical personnel and adequate supplies of equipment…In a pandemic, everything from syringes to hospital beds, respirators masks and protective equipment would be in short supply….If a pandemic strikes, our country must have a surge capacity in place that will allow us to bring a new vaccine on line quickly and manufacture enough to immunize every American against the pandemic strain…”
Bush thought it would take $7 billion to build out his plan, plus annual appropriations thereafter. But that wasn’t supported by Congress. Obama built on Bush’s plan, but his efforts also were not sustained by a Tea Party Congress. Trump’s FY 2021 budget proposal reduces CDC funding by 16%. It was submitted just 11 days after the WHO declared the Coronavirus a public health emergency.
What should we be doing? First, we need to invest in ourselves, to break our reliance on offshore sources of PPE and pharmaceuticals. We saw that China stopped exporting PPE to the US, husbanding it for their own needs, and subsequently, showing a preference for shipping these goods to nations they perceived as friendlier.
Second, we need to empower an elite governmental team to combat a pandemic. The 2014 Ebola outbreak told us we needed a health security infrastructure. By 2016, America had coordinated an “all-government response” to the next pandemic. Laurie Garrett, a science journalist summed up the infrastructure created by Obama as a:
“…special elite corps inside of the National Security Council, the Department of Homeland Security, Health and Human Services and CDC…an emergency capacity for surge drug approval at FDA… a lot of co-ordination with the states… a division that was doing nothing but training hospitals in infection control and appropriate epidemic responses… and…Study on how to surge hospital beds, how to surge physicians out of retirement…”
Sounds great, no? It needs to be rebuilt if we are to have effective control of our pandemic response.
The story of using the military also begins with Garrett. In September 2014, she briefed the Joint Chiefs of Staff on how the US military could help the countries affected by Ebola. She says that this was:
“…unprecedented in US history; we’d never mobilized US military for a medical response like that before”.
“To many lawmakers, the Defense Department is an attractive place to fund medical programs, partly because the defense budget is so large and enjoys support from both political parties, especially Republicans.”
Congress not only funds the NIH, it also provides $1 billion a year for DOD research labs looking into cures and treatments for cancers and other diseases.
Going forward, the military would like to see an increased focus on health as a part of national security. The debate is not a matter of either health security, or military security, it has to be both.
With a new administration, we need to think beyond stimulus packages, to fundamentally rethink what national security means. In the next pandemic, we can’t be scrambling for enough face masks to protect our medical professionals and hoping that the military can save us.
Remember when we had fifteen COVID-19 cases, and they were just going to be gone, like a miracle?
If you ask Trump, that’s where we are, plus a few orders of magnitude. All of the recent happy talk about reaching or being past the peak have omitted the detail that so far, “flattening the curve” isn’t substantially reducing the number of cases, or deaths.
The theory was that once we “flattened the curve”, we could ease up on social isolation, mask-wearing and get back to work. When we think about the downside of the curve, we think bell curves, with a sharp rise and fall from a high peak. As Wrongo said on April 20, that was unlikely to be the outcome, because it didn’t happen like that in countries that started fighting the virus long before us. And that’s how it seems to be working out. Here is where we are:
The chart tracks a 3-day average of cases, since that smooths out some of the big day-to-day variances. As of April 29, it seemed clear that we have reached a peak, but we’re not showing any real signs of a rapid decline. This means the COVID-19 curve could remain elevated for a long time.
And we should remember that 878,839 cases are still active.
Politicians are obsessed with “the peak.” Are we at it? Are we past it? When will it come? Has it come? Now they’ve turned to communicating their plans for reopening the economy. That makes sense. Re-opening is becoming urgent, with more than 30 million Americans out of work, but it’s dismissive for politicians to say we’re past the worst of it “medically” while more people go to the ICU every day.
“Baker focused on hospitalizations and ICU admissions, saying, we’ve basically been flat for 12 days. We’re flat at a high level. But 12 days, 13 days counting today — you’re not going to find a lot of other places that just sit like this for 13 days.”
Former FDA Commissioner Scott Gottlieb MD, an advisor to Baker, tweeted:
IHME (mentioned in the tweet) is a closely watched model from the University of Washington Institute for Health Metrics and Evaluation.
What we do over the next few weeks will determine whether we get this right, or whether COVID remains a large ongoing threat. We need to understand the potential risks that come with a decision to reopen, and make plans to mitigate these risks as best we can. Some states, like Connecticut, are planning carefully.
If we look state by state, in about half of the country, the numbers of cases are still rising. In about another third of the country, there is a leveling off. Only in a minority of states are the numbers actually coming down on a daily basis. New York, Washington, Louisiana and Idaho have had reductions of more than 50% from their peaks in new infections.
According to STAT, there are several possible outcomes: Recurring small outbreaks, a monster wave of cases, or a persistent crisis. And no one knows which outcome is most likely. We should expect new infections to start rising again in states without much testing, but with large populations that opened early like Texas, Florida and Georgia.
We should also realize that in some states, cooking the books about new cases and deaths will happen. Newsweek reported data compiled by Florida medical examiners was no longer being reported by the state government. The official state data has not been updated in over a week.
Acting like we’re flattening the curve when we really don’t know if we are, is likely to create a San Andreas-sized political earthquake if cases spike again.
But let’s try to get past all this, because it’s time for another Saturday Soother, when we stop checking Twitter, and think about spring.
Here on the fields of Wrong, the pear, plum and cherry trees have flowered, while the crab apples are soon to bloom. We have bluebirds nesting in both bluebird houses. Our weather remains cold and wet, so stay indoors and brew up a hot mug of Bengal Spice tea.
Now grab a socially distant chair and have a few minutes of fun with a song parody by the Opera Guy, Matthew Ciuffitelli. Here’s his parody of “Phantom of the Opera”, called “Phantom of the Quarantine”. Wrongo promises you won’t be disappointed:
Those who read the Wrongologist in email can view the video here.