Wednesday, April 08, 2020

Doctors explain their own experiences dealing with getting COVID19



Subverse News offers a personal account by an infectious disease specialist in Birmingham AL, where he says he had heard about the novel virus in December 2019.  This is Michael Saag, MD, at the University of Alabama at Birmingham.

He developed symptoms early in March.  They were mild at first and then worsened, and he was ill about two weeks. But he did not have to be hospitalized.


He maintains that the complicated and variable response of people to a new pathogen is basic biology, because the virus is novel to the immune systems, so some people go into overdrive with a cytokine storm.

He says he knows that there are conspiracy theories and a desire to blame China and even Trump for early neglect, but he says there is no point to this:  novel viruses and the difficulties they pose for animals and humans are a natural part of biological evolution.

The UK Mirror (Amber Hicks)  has a discussion of why the virus has such a varied response among people.

Angela Rasmussen of Forbes (April 7) puts the concerns about surface transmission in a reasonable perspective. Catherine Pearson discusses asymptomatic transmission in Huffington Post (Apr 3). Julia Ries discusses persistent positive tests from persons apparently recovered. 

We will pay more attention to the racial (and economic) disparities in the outcomes of COVID. 

 Many people with lower economic status do service jobs, can’t be done at home, and they are put in more danger than the rest of us are. That can be morally problematic (who are you staying home for? As by Andrew Cuomo). 

Picture: Birmingham, downtown church, my visit, 2014 

Sunday, April 05, 2020

Will the US economy go through a halfway house? Will asymptomatic positive people?


Ross Douthart in the New York Times speculates on the “halfway” back route to normalcy from COVID-19, as curves flatten and start to run downhill even in May in most places, a piece he calls “The Road to Semi-Normal”.  
  
He suggests flying with mid-seats not used, making it very expensive. Theaters not using all their seats (which on weekdays is not usually a problem).
  
He also suggests that “Covid hotels”, run by communities,  where COV2-Positive people with no or mild symptoms are sent.  They would be provided meals, housekeeping (I guess, although I wonder how workers could handle the risk), Internet (I hope, although Verizon hotspots would work for me), and even mild socializing among the positive (which might be medically riskier than he thinks).  Nurses would visit every day and check symptoms and keep records.  Patients who seemed recovered would be given the usual swab virus infection tests (same rules for negative tests) and blood tests for antibodies.  The recovered might be invited to do plasma donations.
  
  
The hotel would be something like a rehab nursing home stay for ordinarily active people and it would have to be thought through very carefully lest it become a trap.  Lowrise properties that open to the outside might be more desirable.
   
 One reason hotels might be needed is that there is some concern about apartment building sewage and especially ventilation systems, especially central air and heat (HVAC is supposed to be safer). This will become a developing story (Stanford University is working on it.) 
   
Washington state has already done this by renting a motel in the Kirkland area.
  
 The Washington Post also mentions the hotel idea in its "16 ideas" piece today. 


Friday, April 03, 2020

University of Washington shows projected outbreak peaks by state



The University of Washington has a site showing the modeledpeak and resource use by state

The graphs show all beds, ICU, deaths projected.

Many state reach a peak in late April.

The charts show the stay-at-home situations for each state.

Washington DC peaks in late April, yet Muriel Bowser, mayor, says it is in early June.

Virginia has a flatter curve than others and peaks in mid or late May.

Thursday, April 02, 2020

Laurie Garrett warns America of a long lockdown; virus is transmissible through speech and breath (in small amounts)


I would normally put this on the International blog, but it seems to apply to the CNN argument for “locking down the entire country”.
  
Here is Laurie Garrett’s warning to everyone, March 18  in Foreign Policy (paywall), “Sorry, America, full lockdown is coming”. 

At one point she suggests it could last eight months, as like house arrest.

She also describes rather extreme personal hygiene in the home that would be required (as if there would be military inspections?) 

A “lock down” is different from a stay-at-home in that it prohibits movement out of a certain cordon under any circumstances. 

  
So far, Mike Pence has suggested that he still thinks governors know what is happening in their own states and can make their own decisions on flattening the curve.  But CNN has practically been ordering the country into lockdown by itself.  (I have to turn to Fox for relief from the moralizing.)

As part of the mask argument, experts now tell the White House that the virus can spread, at least in small amounts (from asymptomatic people) through talking and breathing (CNN, Elizabeth Cohen). 
   
A pattern emerges: small infections produce asymptomatic people who may effectively get vaccinated (a good thing) but the virus concentrates when they spread it to others unknowingly.  Something like this happens with a fictitious virus in my novel – good god, this is really happening. 

Monday, March 30, 2020

Virginia, Maryland governors issue formal stay-at-home orders; what is considered "essential"?


Today both Virginia governor Northam and Maryland Governor Larry Hogan issued stay-at-home orders.  Washington DC had already issued a stay-at-home order with a cell-phone alert on March 25.  (DC’s order could invoke 90 days in jail.)
  
Gov. Hogan’s order was indefinite and would theoretically jail a violator for one year and/or a $5000 fine. Northam’s presentation  little less punitive but last until June 10, unless he changes it, and still theoretically offers a one-year jail term  (and people could get coronavirus in jail).  Both governors were incensed at overuse of campgrounds and some specific gatherings in their states over the weekend.
  
   
The critical orders for Virginia are 55 (issued today) and 53 (Issued March 24).    As worded, Order 55 refers to 53 and allows travel to retail businesses deemed essential, like obviously grocery stores and pharmacies (and takeout from restaurants is allowed).  Those businesses include computer or iPhone or communications retail stores.  So as I read it, if your computer breaks you can still replace it.  (For home cable users I really recommend having a smartphone hotspot as a backup Internet sources, especially now.  They’re almost as fast as cable and pretty usable for ordinary Internet.   I also recommend you use and check your devices frequently.)

Maryland’s order today also refers to an earlier order regarding essential businesses. His list merely makes a generic link to CISA to identify companies considered critical infrastructure. That appears, when tracked, to include the normal network of server farms that, for example, support social media. (In this Metro area most of those facilities are near Ashburn VA in Loudoun County, but some for cable companies are in other counties.)   Cox has a statement on how home users can help reduce overuse of resources (most of these are pretty simple).
  
Neither state’s orders (or DC’s) seems to have a “Mathilda’s Law” or to prohibit seniors from shopping for themselves (without asking or pleading for assistance). Most grocers and pharmacies now have some seniors-only hours.  (I don’t know why Gov. Cuomo didn’t suggest this for New York State).
  
The Baltimore Sun editorialized on Hogan’s order as not that significant.
  
Ford Fischer (News2share) has a Twitter thread noting the potentially punitive aspects of the orders. 

Saturday, March 28, 2020

More sources say most people should wear at least improvised masks when out in public; WHO and CDC look at this as cultural and apply it to caregiving, healthcare settings


The New York Times now has an op-ed suggesting that persons out in public should wear masks if using public transportation or coming into contact with others. The story by Knuvl Sheikh is here, “More Americans should probably wear masks for protection”.   This contradicts official CDC and WHO guidance. I actually couldn’t find a clearcut CDC page on ordinary public use (outside work). WHO’s link leads to a downloadble PDF that does ratify the need for masks in caregiving and healthcare settings and maybe crowded places but not in open space in public away from crowds.
  
The Boston Globe, in an article by Robert Hecht et al, expresses a similar idea. 

Laura Geggel of Live Science offers a more balanced view.  
   
Some of the more rational reasons include discouraging you from touching your face (particularly after touching a surface). There is also “emotional solidarity” with others and remind them that we all share troubling times.  I am not one for group emotional expression. That is more common in Asian culture.  In China people were wearing masks outside even when a long way from others in cities outside Hubei.
  
Some say you should not talk to others in public now unless you have at least a homemade mask.
  

But Peak Prosperity (Chris Martenson) practically orders everyone to ”wear a mask”. Many sources encourage use of homemade masks for informal situations and believe everyone should learn to make them.  This reminds me of a line in “Cold Mountain” – “I can embroider but I can’t darn”. 

Update: March 31

The CDC contemplates recommending the use of masks to stop transmission from asymptomatic people, NYTimes

NYTimes offers a home-sewing lesson on making a mask. 

Huffington Post offers ideas for making masks without sewing

It takes about 10 days to get a mask from Amazon right now.  That could put some non-handy people in the bad proletarian situation of being required to wear an adequate homemade mask to enter a property.  



Friday, March 27, 2020

Bill Gates wants a national lockdown of 6-10 weeks to drain all the infections


Bill Gates, former Microsoft Chairman, has appeared on various media and has, somewhat unofficially, called for a nationwide lockdown of 6-10 weeks.

Oregonlive has a good report (from March 25) and he is also quoted on a Reddit.

The call for lockdown seems to be a reaction to Trump’s desire to reopen businesses in less affected (more rural) places in the country by Easter Sunday, April 12.

It is not clear how absolute the lockdown would be.  Even Virginia, Maryland and Washington DC has been in a “stay at home” mode (with light travel to groceries, pharmacies, etc, permitted) officially since March 24 but practically speaking since March 16 when most non-essential businesses closed.  Restaurants can still do drive-thru takeout only.

Does he mean absolute lockdown, with no leaving an apartment building or a residential street without a “hall pass” from police? 


This could lead to extreme proposals, like forcing seniors to move into special hotels.  Louise Aronson has a rather disturbing perspective on Vox

But Ian Millhiser writes that there are limits on what Trump or Congress can do in a “national lockdown”. 
  
 But the president does have considerable arbitrary powers under a national emergency. So farm he has been reluctant to use them, surprising people, but that can change in an instant.
I would wonder, would Internet companies continue as they have now so far?  So far it has held up, but there have been slowdowns due to bandwidth, and some support problems with tech companies working from home and probably having more absences and being caught by the suddenness of all this.  Would they be forced to block non-essential sites? (like mine).  After the lockdown ended, would they be allowed to go back to normal?  Would the Internet return as it had been?  Maybe this would be the final breaking point (with all the other issues like FOSTA, net neutrality, radicalization, fake news, etc) for amateurism.   People have to go to work, mostly from home, but already there are some slowdowns and support problems creeping up.
    
It is possible to imagine opening up “resilience zones” where people from outside them are not allowed to enter (but this is getting to be rather dystopian).

Thursday, March 26, 2020

Respectability discusses how effective Congress's coronavirus stimulus will be for people with disabilities


Respectability sent me a press release on the stimulus package in Congress, with respect to persons with disabilities, but also with respect to other kinds of worker as in the gig economy.  The link is called “Stimulus passes stimulus package, but will it help people with disabilities?
    

It will not count as toward asset limits but it may complicate recipients of SSI.

The article also notes that it runs only through July.  The assumption is that the social distancing will have flattened the curves to an acceptable level and the economy can more or less run.

The site notes that actor Daniel Radcliffe (Harry Potter) grew up with dyspraxia (so did I). 

Picture: lower Manhattan, my photo from Freedom Tower, Nov. 2015. 

Wednesday, March 25, 2020

Commission recommends women be subject to Selective Service


Timcast IRL reports that a special commission has recommended including women in the registration requirement for Selective Service.
  

It’s feminists who are most affected.

Tim’s show includes Adam Crigler.

Lara Seligman’s story on Politco reports the commission report. 

There is practically a “draft” of retired medical personnel now.

Tim discussed the idea that men are more expendable as individuals than women if society is itself threatened, like on a rescue spacecraft.

I am contemplating the idea of a film about “The Demands of Others” and include topics like the draft and now quarantines and lockdowns because of biothreats.

At 15 minutes in the video, Tim says he thinks, if a biothreat actually killed 20% of the people, he would get a national security letter saying what he had to say as propaganda on his program!  Actually, I've talked about this quid pro quo before.  

Chapter 2 of my DADT-1 book (and 7 of DADT-3) cover the draft in detail.  

At 19 minutes Tim says what he really believes, and I concur. 
   
Coronavirus has shut down the social justice warriors! 

Sunday, March 22, 2020

No, Trump can't cancel the November election and stay in office (and other rumors)



“Can Trump cancel the November election?”  Ian Millhiser says, on Vox, No.  The New York Times urges a system now to vote entirely by mail


The president’s term end on Jan 20, 2021.  There is an intricate procedure more ensuring that the electors meet in December (specified in the Constitution, and I'll leave it to Vox to explain the legal details).  Were the November 2020 general election to be very difficult to have, there are still some ways to determine the electors, as covered in the article.

David Pakman, in the article above, discusses the same question and pretty much has the same answer. But he is a political science professor. 
  
Tim Pool talks about the martial law rumors (as did Pakman in the video) and notes that Big Tech seems to be trying to shutter talk of it (video), at 8:33. Pool also explains that the Daily Mail article describes a largely theoretical scenario.



Saturday, March 21, 2020

Trump DOJ wants new powers to detain individuals indefinitely in emergencies when courts are closed


Betsy Woodruff Swan reports in Politico that DOJ wants new emergency powers to detain persons (especially immigrants, probably) during emergencies if court cannot convene because of the health emergency, story here


It would have to go through Congress, and a Democratic Congress probably would not approve.

It’s possible that the powers could be used if an individual’s behavior were somehow perceived as a public health threat, perhaps a potential "super spreader".

Thursday, March 19, 2020

Could asymptomatic "carriers" be "rounded up"? Not yet, but I wonder


A couple of serious questions keep coming up, which, if you connect the dots, have frightening implications.
   
One is the asymptomatic carrier issue, well explained in a March 17 article in Health. 
  
This has been debated ever since an early case in Germany, and later with a superspreader who visited sky lodges in Europe and himself had only very mild illness.


Today, after one of Trump’s briefings, the idea was floated to make mandatory testing for everyone when that is possible (not yet) and remove everyone who is positive to some facility that sounds to me like a Diamond Princess petri dish. You could well just do quarantine at home (as with normal contact tracing now).  Carnival Cruises is already reported offering its cruisers to house quarantined (aymptomatic) patients?

Previously, the idea of rounding up seniors for their own protection has been tossed around (at least in the UK).  The recent reports of younger adults getting severe illness may have put away that idea (for building "herd immunity" in the young). 

But as you ponder this, remember that it seems to have started "accidentally" in a foreign, ideologically hostile state.  It certainly makes a case for forced collectivism, upon the western world. 
  
By the way, Italy right now has more deaths than China.  
    
In China, people who have tested positive have, according to some reports, had all their possessions destroyed by force because these could be contaminated by fomites. I gave the link to the NEJM story in yesterday’s post. You can imagine how quickly you could destroy lives (however “privileged” in the mind of the Left) and make everybody start over in a Maoist purge.  If you were taken by authorities to a quarantine center until you became negative, what would happen to the rest of your life when you returned?  It's likely that infection occurs after touching a surface only if you then touch your face or eyes. 

Wednesday, March 18, 2020

Providence Health in Washington State wants volunteers to make masks for healthcare


Providence Health Team in Renton, WA (near Seattle, and a town that I have a reason to remember because of a particular incident in 1976) has initiated a 100 Million Mask Challenge, where volunteers will sew and make masks for health care teams. The website is here.


I heard about this on Chris Cuomo’s hour on CNN tonight (Wednesday March 18).

I have never heard of volunteers making professional medical equipment, not since maybe WWII. 
It would seem that the workspaces for the volunteers would have to meet cleanliness standards that would be difficult for many homes to meet (including mine).

This rather blows my mind.

I’m a little surprised that they are already short of masks.

Young adults may be at higher risks (The Hill) than thought before, based on CDC studies of hospitalizations in the US and at least anecdotal reports from France, Italy, and Belgium.  There are even reports of young adults recovering with reduced lung function and fibrosis. 
   
Here’s the controversial report about the SARS COv2 virus on surfaces, relevant especially in hospitals.

Update:  March 20 

Peak Prosperity, at 35:28, wants everyone with a sewing machine at home to make masks. Governor Cuomo is encouraging small manufacturers in New York State to make medical equipment (press conference today) but these are companies with factories. They're essential, not confined by work from home.  Cuomo also said "the Internet has to work".

 Update: April 6

Here's a video that tells you how to make N95 masks for health care workers at home (almost). The idea that this would be expected of a person or family and not a manufacturer is shocking. 

Tuesday, March 17, 2020

What does "shelter in place" mean?


CBS has a valuable discussion of “shelter in place” as it applies to coronavirus in San Francisco and might apply in New York   
   

On San Francisco, it means you stay inside your residence except to go out for essential purposes, as for groceries and pharmacy, maybe work if an essential occupation.  If you work for a tech company, is keeping a social media site running an essential occupation?  Oh, I guess you do that from home.  But a few people would have to be in the building.  Several Bay Area counties are included, which would house the tech companies, which I visited in Sept. 2018.
  
Governor Cuomo said that the city probably can’t completely quarantine itself without the state’s permission. 

Nevertheless, Di Blasio says that some NYC hospitals are already under stress, with 60 serious cases right now (source).  Somehow this reminds me of the movie title "Take Shelter".   But the normal meaning of the phrase (a more obvious disaster like a hurricane or tornado, or radiation) seems inapplicable;  it's a collective danger, not one to yourself merely by going out. 
 
Picture:  Along the Castro in San Francisco, Sept. 2018, my trip; now this is closed. 

Sunday, March 15, 2020

Reuters analyzes the financial markets' stability with the coronavirus detection


While Trump, Pence et al and a blue chorus had another briefing today, the main announcement was the Fed’s lowering interest rates to 0.25%.  Futures were still down Sunday evening.
  
Elsewhere, NYC closed schools, Ohio and Illinois closed bars and restaurants (and the Illinois governor scolded young adults for partying and indirectly putting their elders at risk).
  
Washington DC closed 35 places and posted rules limiting the seating capacities and arrangements in bars.
  
   
Reuters has a sobering article by Tommy Wilkes, The plumbing behind world’s financial markets is creaking. Loudly”.  There are technical comparisons (including Libor) to the crisis of 2008.  Only a medical solution will provide stability.  

Peak Prosperity is warning (ordering) everyone to be prepared for a national lockdown – practically martial law. 

A Facebook friend shared this article on the morality of social distancing form the American Conservative, on what it is like to be on a ventilator.  Your immortality v. someone else's morality?  I put it more in military, national security terms -- vulnerability and health care. 

Courtney Vinapal of PBS is imploring people to assist the food banks now.  But social distancing might make most volunteerism difficult (especially for over 60). 

There will certainly be charities to help those who lose employment from the social distancing, but it's hard to see how the needs will be administered by normal non-profits, which themselves are hampered now by social distancing. 

Friday, March 13, 2020

Trump declares National Emergency, Congress seems to approve coronavirus relief; mainstream media looks at loss of civil liberties and social distancing



Donald Trump sounded sleepy as he rambled through a press conference this afternoon.  Incredibly, he said "I take no responsibility". 
  

He declared a National Emergency and invoked the Stafford Disaster Relief and Emergency Assistance Act
  
A declaration of the emergency could give him police powers, including closing down Internet access or severely restricting people by various groups, an idea discussed in the Books blog in Jan 2019 based on an Atlantic Avenue.   David Pakman livestreamed it and a couple callers asked about martial law.  It is even possible for a president to freeze personal bank accounts (although that could be challenged);  you can imagine a sufficiently Leftist president using that power for expropriation from the undeserving rich, so it's an idea to remain aware of. 
     
Wall Street liked it, the Dow recovering 1985 points.

But the loss of civil liberties to flatten the curve bears on a lot of our minds.
  
Angela Dewan of CNN has a sobering article examining the existential psychological threat to the loss of civil liberties if there are true China or Italy style lockdowns, but they work.  
  
Sheri Fink of the New York Times examines how variou ssocial distancing measures could measurably affect the models of future deaths, which in the very worst scenarios   could be over one million in the US, many more than in China. 
  
Congress entertained the Family First Coronavirus Relief Act this evening. 
   
Trump was mistaken in the credit he gave to Google/Alphabet for a website assisting patients fining screening, story in the Verge, by Dieter Bohn. 
  
On Smerconish CNN Saturday morning, a caller suggested absolutely complete shutdown for two weeks after the national emergency, but I don't see that in mainstream news accounts (yet).
       
 Another idea that I would watch for could be some systematic effort to separate out seniors over a particular age (maybe as young as 60 or 65) because of increased vulnerability to this particular virus.  But if you think about it, that sounds likely counterproductive. 
   
Artwork gallery:  MGM Grand at National Harbor MD.



Wednesday, March 11, 2020

Congress hear testimony from Fauci, others today on coronavirus; a usable vaccine is over a year away; some want national social distancing and mitigation standards now


The Washington Post, as well as many other news outlets, are livestreaming the testimony by various public health officials before Congress this morning.
  
  
Dr. Anthony Fauci testifies at about  20 minutes from the beginning of the livestream, and Dr. Redfield follows. On Feb. 25 there were more cases outside of China than inside.
  
Some speakers on CNN want national standards of social distancing now, such as a limit on gathering sizes.  Washington State is limiting gatherings of more than 250 people.
  
Major League Baseball has not delayed the start of the season, believing that the fact that most games are outdoors changes everything (but some stadiums are enclosed). I wouldn't hedge my bets;  it might have to delay; it start too early in late March as it is. 

Tom Bossert, a former Homeland Security adviser, has a sobering op-ed in the Washington Post March 9. He compares the experience of Singapore and Hong Kong in flattening the curve, with that of Italy, where it got out of control very suddenly. The main problem seems to be sudden demands for ICU care on the health care system.  The point of social distancing is to “flatten the curve”. 
  
CNN has a rather moralistic article, “Coronavirus is about to change your life”.  I also want to give an evidence-based article on how the Sars-Cov2 virus spreads compared to measles and flu, in Livescience. Apprarently the droplet particles can travel a few feet before gravity pulls them to the ground.  Transmission through touched objects in a building is not thought to be as important.  Transmission from fecal remains in toilets might be possible,  There is research in sewage and building ventilation that does not seem to be definitive yet.  APNews has another story by Marylyn Marchione about the virus on surfaces, that seems inconclusive now. 


Tuesday, March 10, 2020

Cuomo locks down hotspot in New York State; British man describes what a full blown case is like


New York State Governor Andrew Cuomo has created a partial containment zone in New Rochelle NY, NE of the Bronx toward Connecticut, of a circle of radius 1 mile around the synagogue that seems to be the center of the coronavirus outbreak.  Forbes has a summary of all of the major developments today. 
  
  
The National Guard will provide some food and essentials deliveries to residents.  The area is being managed in a manner similar to a natural disaster (like Hurricane Sandy in 2012).

Picture: from 2014 along the Harlem line 

Thursday, March 05, 2020

Can coronavirus spread inside apartment buildings from a unit where someone is quarantined or isolated?


A particular concern happens if someone is quarantined at home because of exposure to a close contact and lives in a high rise apartment building, and the person has not “themselves” tested positive and has no symptoms.
  
Most apartment buildings are supposed to vent air through the roof, but often there can be problems in ventilation systems.  It would seem that if a person is allowed to stay home in the apartment there could be, at least in more extreme cases, “cruise ship” problems. 
  
A site called Brickunderground has a good discussion.
  
Joseph G. Allen has information in the New York Times, and suggests that if building ventilation is not good, that portable air purifiers of certain quality (they may cost around $100) may help.

Some buildings, even condos, may not be well set up to allow home isolation and it doesn’t seem as though this topic is well researched yet.
  
WJLA7 in Washington DC, on March 4 late news, mentioned a question to the Arlington County VA health department on the building issue and the official thought most modern buildings have proper ventilation to allow isolation at home.  But WJLA7’s website doesn’t have the story.

Update: March 6

On a post on the retirement blog, I embedded a video by Peak Prosperity, and he mentions the ventilation issue at about 38:00.  Maybe not good. 

Wednesday, March 04, 2020

Texas laws that crimped voting in minority areas caused long lines yesterday in black communities


Mother Jones in an article by Sam Van Pykeren, notes how Texas has “gutted the Voting Rights Act” with the blessing of the Supreme Court, link here
  
Texas removed many polling places in heavily minority populated areas, making lines longer and driving distances longer.
  
  
Students waited in line for more than three hours to vote at TSU in Houston yesterday, also a burden on election officers who don’t get paid for the extra time (See IT Job market post today).