Tuesday, March 31, 2020

March links

A few quaint events of interest happened in March before the virus hit.

Before the primaries ended. A stroll down memory lane with the winners and losers from a debate.  Biden won the South Carolina primary, won most of Super Tuesday, and won again the following Tuesday. Everyone other than Sanders dropped out.

Russian interference charges dropped. I'm not sure if it's real or a pretext--good reasons to believe either way. It probably never would have gone to trial.

Watch him end his career. ...and on to a well-deserved retirement. Chris Matthews of MSNBC won't believe a woman candidate about sexual harassment. Dumb move. 'I just don't believe it' doesn't fly anymore because it's generally very believable.

Rift in the left. Alexandra Ocasio-Cortez is actually trying to be more pragmatic than the garden variety far leftist.

Trolls can be controlled online. Not a March item, but something dear to me and my dislike of trolls. Reddit managed to greatly reduce trolling. A confession of someone who was addicted to trolling and wised up on  his own.

Everything else is covid-related.

Image; cbsnews.com

Monday, March 30, 2020

How the US dropped the ball with this pandemic

Hahahaha. This is way out of the area of my expertise. I see lots of people that don't let that issue stop them though as they weigh in forcefully on whether Trump disbanded a critical task force or reasonably 'streamlined' it. I couldn't say which is more accurate so I won't try.

However, I can look back and try to detect signs or significant information. Using Google with a limited window on dates showed me that school closures were considered well before social distancing became the watchword. This was true in Massachusetts, but also true in Italy, where schools were closed on March 4, but orders to avoid contact weren't issued until 3/9, if I'm not mistaken. By that time, Italy had had 366 deaths due to covid-19 and the hospitals in Lombardy had been slammed.

The school closures in Italy should have been on the radar in the US, but they weren't. However the lockdown in northern Italy did finally penetrate the thick skulls in North America, and the topic of the week from 3/9 - 3/14 was closures--colleges and universities closing, schools closing, sports events cancelled, etc.

But how about before that? What was on the radar in January and February? Too much confidence, like this:
In coming weeks, if the virus begins to spread through U.S. communities, health authorities want to be ready to adopt school and business closures like those undertaken in Asian countries to contain the disease... The CDC is taking steps to ensure frontline U.S. healthcare workers have supplies they need, she added, by working with businesses, hospitals, pharmacies and provisions manufacturers and distributors on what they can do to get ready.
The reality was quite different. Local entities and governments took the lead, with governors announcing closures without guidance from the CDC. Leadership at the federal level was sorely lacking.

Trump suddenly changed tack on 3/16, having daily press conferences starting then. But his lack of leadership had already been demonstrated. There will be plenty of time to dissect what Trump did wrong though of course it's already started. The head of the CDC is a political favorite of religious conservatives. And here's a blistering account of how the Trump administration disrespects scientists, again and again and again and again. I couldn't read it all.

Italy was a wake-up call to me. However, the federal government is supposed to be more aware than a single individual, what with all its resources and intelligence gathering. This has been quite a failure, even worse than 9-11 because the virus wasn't hiding. Thank God for the governors who did take the lead. They are more the model for our next president.

Image: ourworldindata.org

Extras. A resource of states' healthcare capacities, and how they are likely to fall short. I switched my dashboard to this one.  Also, I only look at deaths. The number of cases is too dependent on test availability, whereas deaths are more solid. However there can be undercounts (for those who die at home with no test) or even overcounts (attributing deaths to covid-19 without ample evidence).

Update 3/30/20. While New York City is slammed, ICU usage in Los Angeles doubles overnight. LA appears to be managing it thus far. How Congress was distracted in January and February. Trump has a short attention span when he's supposed to be saving the country. But he gives up and takes the experts' advice. These are the times that try men's souls ... especially libertarians. A supermarket chain that carefully prepared for a pandemic.

Update 4/2/20. I started wondering about the cruise ship overrun by covid-19, and found this overview of several cruises and this firsthand account from a worker. The story of another cruise ship and one of its passengers who died.

Herd immunity wasn't ever the plan in the UK--it was bad communication and maybe someone picked up on the wrong term. Well, maybe. I'm not convinced because it looks like the plans got changed rather swiftly to 'shelter-in-place.' One of the big names in the confusion thinks there's some good news. Been there, and then tomorrow came and smashed it. Canada did good! Hungary declares Orban as dictator indefinitely. Wisconsin's governor won't/didn't take the fucking step to postpone the primary. Uhhh, clueless. (I got this wrong. It was the GOP-led legislature that wouldn't act. They put partisan power above the good of the citizens.) And don't have a cardiac arrest in New York City right now. You won't be going to a hospital. However, bear in mind that the survival rate is less than 10% in these circumstances in the best of times.

I'll check back here when I want to compare covid to the flu.

Friday, March 27, 2020

Epidemic progression... past Easter

Hospitals are have now been slammed in several cities: Seattle, New York, Los Angeles, San Jose, Atlanta, and New Orleans. Nine states saw significant increases in deaths just today, which is a sign that the we are riding the death curve up to where it could get steeper due to lack of medical resources. This happened in Italy and Spain, and there's no reason to think it won't happen here. The nine states are: New York, New Jersey, California, Michigan, Florida, Louisiana, Georgia, Colorado, and Connecticut.

First-person accounts. In previous posts I linked to accounts from Italy (one, two, three) and New Orleans. This time I have accounts from Washington (older account but good details) and New York City (one, two). Another account from New Orleans. Video from an pulmonary specialist in New York City with practical tips to avoid infection.

We know from all these accounts that about 10-20% of those infected with the virus need hospitalization, so the hospital can jammed up beyond capacity. The virus might have a death rate of 5-10% of those hospitalized in ideal situations, but the death rate goes up to 8% or more in overloaded hospitals. In Italy, many people just stayed home and died there.

The hospitals in northern Italy got slammed about March 8, and the country instituted a quarantine. Eighteen days later and the death toll is still at a peak. There may be some relief after three weeks, which is the average time between exposure and death.

That means for New York City there probably won't see any relief until April 13... if New Yorkers were as blase about contacts as NY mayor DiBlasio was. (DiBlasio didn't close schools until 3/23.) Probably enough New Yorkers started being careful about contact by 3/14 that there might be a noticeable decline in deaths by April 4. But New York has a huge population that is a large reservoir for infection, so the peak may last many more weeks. The example of Italy is that we don't know how long to expect the peak to last.

All these shutdowns are so annoying--to those who want a strong economy going into the elections this fall. It's terribly inconvenient and unfair to have a pandemic spoiling the economy (and election chances). So some, including Trump, are suggesting that we get back to normal as soon as possible, pandemic be damned! Young people should go back to work and elders stay home (one suggestion). The recovered should go back to work. The exposed should go back to work if they aren't having symptoms. Maybe even the older should go to work and the young stay home.

All these ideas ignore some basic facts that can't be fudged. More exposures means more people getting infected, and passing it on. Most jobs are skilled, and absences mean that the workplace will be disrupted. The idea that people can continue working ignores that many will get sick, so soon the workplaces would be closing anyway due to lack of workers and patrons. It's hard to say how soon this would happen. The infection is more concentrated in cities at this point, but it's also inexorably spreading. So will medium sized cities in Ohio have too many sick in 4 weeks or in 8 weeks? We don't know. It's hard to explain why so many GOPers don't understand this--maybe happy-thinking is the mantra and endemic. One contrarian is Liz Cheney, but she doesn't have much of a voice.

So the upshot is that this pandemic, and the way this virus spreads, was always going to be highly disruptive unless it was contained extremely quickly. In the US, we missed that window, so we are taking the huge economic lumps for that. There is no avoiding it.

Image: omfif.org

Tuesday, March 17, 2020

Corona virus pandemic and the US bungled response

This is the biggest contagion of my lifetime. History is unfolding so it's important to pay attention. I have a lot of links below and I don't want to expend the effort to put them into a narrative. The big narrative is countries that handled the situation well versus those that didn't.

Countries like Singapore, South Korea, and Taiwan have handled the epidemic well, with good public health measures to prevent the wildfire spread. The US had a fairly long warning period, but it didn't have the political leadership to put together a good plan to sharply reduce the effect.

Some countries in Europe are in even rougher shape. Italy has had over 2000 deaths and its hospital system was overwhelmed.Today (3/16/20) it appears Spain is headed that way.

The US might be headed that way too. We were slow to identify carriers, don't have an aggressive testing and followup regime, and we have cases spread widely over the country. Perhaps we started some containment/quarantine efforts early enough to prevent an explosion, but we won't know for a few weeks. On 3/8/20, not many news outlets nor the government were closing down crowded venues to prevent the spread. Just 5 days later, many states had closed schools and banned gathering over 100 people.

The change came about because the situation in Italy exploded starting on 3/8/20. Luckily some people in the US paid attention. However a lot of conservative commenters I saw had reasons or excuses why people shouldn't cut back on their socializing. These included: it's only panic; don't be hysterical; what about the waiters who dependent on tips; this is no worse than the flu; and Obama handled the swine flu (H1N1) much worse. These contrary arguments irk me so much. They are stupid and will hurt or kill people if heeded. And they are based on nothing but partisanship and spiting the other side.

I'm hunkering down, everyone is working from home, we've cancelled our RSVPs to parties, and we're limiting our trips to stores. Luckily I realized the situation with certain supplies, and we have enough toilet paper on hand--bought on 3/8/20 before the hoarding started just one day later.

FINALLY, on Monday 3/16/20, Trump sounds like he gets there is an imminent crisis. The covid task force has a long press conference, and the experts are the people talking the most. Thank God there's an end to the denial. Both the New York Times and New Yorker magazine report that the change is due to a major report out of the UK concerning how high the death toll could be. The New Yorker report is more detailed.

The pandemic will affect so many lives and the entire world economy. Smaller than World War II, but possibly bigger than the 2008 recession or 9-11.

Image: euronews.com

Extras. Trump's misinformation machine. Drezner on Trump's incompetence and predictable consequences. Politico also discusses this with a lot of detail. Some of the failures of the administration. Administration hampered Washington state when they had known cases. Trump makes himself irrelevant. Governors move ahead without him. This might be another reason why Trump changed his tune. The House, Senate and administration can't write a bill. Oh well, they'll get to it eventually. Days later (3/17/20) and still no new bill.

Hong Kong and Singapore handled it much better. South Korea too, which improved after being badly hit by H1N1. The UK had a plan that they dropped. Act now before it's too late.

What China did to slow it down. Readable with plenty of data.

Fast worldwide overview. Hospitals in the west likely to be overwhelmed. Another overview. The dashboard I'm using. It's got daily new cases and new deaths which is info I really want.

Doctors in Italy give accountsFocus on Italy and why it happened there. Summary of the situation in Italy. By March 7, there were approximately 550 people in ICU beds. The projection for March 20 to April 3 ranged from 900 to 14000. Yikes. More from Italy. More.

Scroll down to see graphic on which ages are dying.

Biogen company meeting that spread the virus. Ohio, with a Republican governor, gets honest and makes a painful guess about its situation. A brief overview of their plans.

Trump Jr. knowingly lies about Dems, again. What a weasel.

Update 3/18/20. A bunch of info from an ICU doctor in Seattle. The course of the disease and some of its quirks. What Fox News said then versus now. Fucking hypocrites. Trump's nonchalance. Trump finally starts to get it... after ignoring experts and the evidence but getting an intervention from Tucker Carlson. Oy vey. We're dependent on Fox News anchors doing the right thing. That's not good. Upon further research, I'm not sure Carlson had that big an effect. His meeting with Trump was 3/7/20. The tone started changing 3/13, with the biggest change coming on 3/16. So perhaps it was the projections from Britain.

A small Italian town stops it by doing 100% testing and lockdown. Not applicable to most of the US. For posterity, a typical daily news update. Will this Lancet report be born out? We shall see.

Update 3/23/20. Straight talk and no whitewash from NIH director. Warning signs that were missed, including those from a pandemic exercise. Trump isn't following through on defense authorization to direct industry to make needed equipment; governors are scrounging as best they can. Florida waited too long to shut down social venues. Trump touted a particular drug as a treatment, incorrectly. Turns out it's rather dangerous, not safe as he claimed. Bad details lead to bad outcomes. Trump and Fox News are already tiring of the lockdown and don't understand why it's important. Short attention span isn't good.

My predictions. There should already be a surge in hospital admissions but information is being held  tightly. On or around 3/26/20, we should have a surge in deaths, which will be reported. By 3/30/20, we should be seeing over 400 deaths per day in the US. This level of deaths will probably last at least 8 weeks. Since the level of deaths will be high, the lockdown won't be cancelled after the initial 15-day period.

Update 3/25/20. Two stories from ProPublica: how covid-19 is different from the usual winter pneumonia by an overworked respiratory therapist in New Orleans. Doctors are writing prescriptions and hoarding chloroquine, the medicine that may fight the virus. A slice of life with the pandemic--a nursing home in New Jersey with 94 patients evacuated. New Jersey is beginning a steep rise in deaths. NIH technical description of covid-19.

Update 4/6/20. I stumbled on an explanation for the run on toilet paper. It started on 2/26 in Hawaii with a message to stock up because of the spread of the virus. This might make sense if Hawaii doesn't have paper mills, and it seems (per a Google search) that maybe they don't. From Hawaii the panic buying migrated to Japan and Australia, then Europe and the US.