An Appalling Milestone

Posted: December 16, 2021 | Author: | Filed under: Uncategorized | Tags: , , | 2 Comments

Our country passed an unfathomable milestone as we recorded over 800,000 deaths in the United States from Covid-19. The most in the world. Many experts believe that the real number is much higher. Ironically, we are passing this horrendous marker just about exactly one year after the first American got the first dose of a vaccine that can prevent, or at least significantly reduce the impact of, the disease.

On 2 April 2020 I wrote about the pandemic in depth for the first time. At that point, the President’s Covid Task Force under the direction of Dr. Deborah Birx was projecting 240,000 deaths (total!) from Covid, if we did everything perfectly. Her projection was that if we did not, then we could lose over 1.2 million Americans. The shrieks and cries and accusations of scare tactics, hoaxes, and socialism (yes, socialism) surrounding these projections and the steps needed to protect ourselves were unleashed far and wide. It was thought to be a gross exaggeration meant to hoodwink us all into becoming “sheep.”

And yet, here we are. The combination of the delta and omicron variants of the coronavirus could easily leave between 837,000 and 845,000 dead by 8 January 2022 according to the CDC ensemble forecast (a combination of multiple models). Many fear that by spring, we will have lost over a million Americans.

For comparison, our last big pandemic, the 1918-1919 Spanish Flu, caused about 675,000 deaths in the U.S. In those days, there was no vaccine, and scientific understanding of the disease was woefully inadequate compared to today.

The good news is that we can protect ourselves. As everyone should know, a series of three vaccines significantly reduces the chances of serious illness. Wearing masks aids in stopping the spread of the disease. And on, and on. We know the routine, like it or not. We thought we had it beat, but we don’t and I am not sure that any responsible scientist or physician is willing to say when we return to pre-Covid days. Perhaps never.

To me, one of the two most inexplicable developments of the last two years is the politicization of efforts to control the spread of Covid and to protect individuals. Mind numbingly stupid. I am gobsmacked whenever I think about how many lives are lost through a stubborn refusal to comply with measures that in years past would be welcomed rather than vilified. Studies indicate that without the vaccines, an additional 1.1 million Americans would have died by the end of November 2021 and there would have been 10.3 million additional hospitalizations. As it is, about 300,000 Americans died from the pandemic before vaccines were available. That means that about 500,000 American deaths from Covid were largely preventable. Vaccines were made available to all adults on 19 April 2020 and yet the death toll continues to rise. An unvaccinated person is six times more likely to test positive than a vaccinated person, nine times more likely to be hospitalized, and fourteen times more likely to die.

The U.S. has over a sixty percent vaccination rate. But that still leaves over 100 million people unvaccinated. I do not get it.

Politicians and media pundits that push people to protect their “freedom” and fight against masks, vaccines, and common sense steps to protect themselves have blood on their hands. Even as they get themselves vaccinated. Shameful. Unfortunately, in one sector of today’s politics, shame no longer exists.

I will never understand it.

A Humble Anniversary

Posted: March 12, 2021 | Author: | Filed under: Uncategorized | Tags: , , , | Leave a comment

Thursday was the “official” one year anniversary of the COVID-19 pandemic. On 11 March 2020 the World Health Organization (WHO) declared it one. At the time of the declaration there were 118,000 known cases world-wide and 4,291 deaths. On that day, the NBA suspended its season, the NCAA said that there would be no fans for March Madness (the Division I championship — the next day the tournament was cancelled), and Tom Hanks and his wife Rita Wilson announced that they tested positive for the Coronavirus. On that day the now ex-president addressed the nation on developments, tried to reassure the nation (“the risk is very, very low”), and banned travel from the European Union (EU) (except the United Kingdom) for 30 days, causing mass confusion due to a lack of warning or coordination with our European allies. Unfortunately, the virus was already here and spreading quickly.

On that day there were just over 1,000 known cases in the U.S. and 31 dead, mostly in Washington state. Dr. Anthony Fauci testified to Congress that day and warned that the outbreak was spreading and that “it’s going to get worse.” We were also in the midst of a stock market collapse. On 11 March alone the Dow Jones Industrial Average (DJIA) dropped over 1,200 points, continuing a downward trend and closing about 20% lower than its peak the month before. The nation was in the midst of a crisis that few had experienced in our lifetimes. The economy tanked almost overnight following a spate of shutdowns and lock downs and no one was sure as to what precautions each of us should take to prevent the spread of the disease.

One year later, there are roughly 118 million known cases around the world and 2.6 million deaths. Unfortunately, the U.S. is number one in total known cases and deaths — as of today, we have experienced approximately 29,287,876 cases and 530,977 deaths. We lead the world in both categories. And yet, many of our fellow citizens do not take the pandemic seriously, or worse yet, some still think that it is a hoax. Like so many issues over the last four years, we Americans have managed to politicize a deadly disease that took far too many of us over the course of one year.

Just think what the reaction would be a year ago if any scientist or doctor or other health expert predicted that one year after declaring the pandemic, the U.S. would have over 530,000 dead Americans. Outrage! Scare tactics! Using the numbers to gain a political advantage! No one would have believed it. At the time, our worst case predictions were in the 100,000 to 200,000 range. Worst case. We would be in the lower end of the scale if precautions were taken, in the upper end if they were not. It was hard to imagine. Some Americans argue that “they would have died anyway” and that the figures are inflated. Well, in one respect, the critics are correct — every living thing dies eventually. But those 530,977 died before their time and many of them died alone without comfort or love from families or friends. But for arguments sake, let’s say that the numbers are twice as high as “the real” pandemic death toll. That is still over 265,000 dead Americans. How is that really any better? It still means that we did twice as bad as the predictions from one year ago. It also ignores the long-term impact on the health of people that were sick, but survived. Some have been hospitalized for months. We just do not know what the second order impact of the disease might be over time.

Here is what bothers me the most. These days people talk about “over 500,000 deaths” to date. That means that 30,977 dead Americans are a rounding error. We should be appalled if that was the total number of human beings lost to the disease. Now it’s just a rounding error. That is where we are today. Perhaps the full measure of the huge number is difficult to comprehend. Think of it in individual terms. All of those families, friends and acquaintances that were impacted by that number of dead Americans. It is staggering.

No one is responsible for the pandemic coming to America. Plenty, however, are responsible for lying to us, misleading us, politicizing the disease, actively undermining common sense measures to stop the spread, and generally providing poor leadership in refusing to take the easiest steps to slow down the spread significantly. This was the greatest health disaster in our country in at least 100 years. We should have been better, smarter, united and focused in combatting this scourge. Didn’t happen. There were no “miracles.” No bleach injected into bodies. Hydroxychloroquine did not make it “just go away.”

Instead, people lost their lives and livelihoods. Went hungry. Fell behind in their educations. Created massive food lines that differ only from those of the Great Depression by the fact that you can drive through instead of line up on the sidewalk. Many of us have seemingly lost a year of our lives without the benefit of friends or family to carry out even the most basic of our social rituals. And it didn’t have to be this way.

Thankfully, if we can stay the course and stay smart in taking precautions, we are nearly through the worst of it. Only a few more months to go as more and more people are able to receive the vaccinations that appear to be very effective. Compare the presidential speeches of 11 March 2020 and 11 March 2021. Leadership is back. More importantly, technically and scientifically competent people are back in charge within the Administration, working day and night to fight to get us out of this mess created by a silent killer.

Stay safe. We are almost there. No one wants to be the last war casualty before the Armistice goes into force.

It was a long tough year. A lot has changed, a lot has not. I trust that a year from now we will be able to memorialize those that we lost, without having lost a lot more.

He Lied and People Died

Posted: September 10, 2020 | Author: | Filed under: Uncategorized | Tags: , , , , , , | 1 Comment

“This is deadly stuff.”

Donald J. Trump on 7 February 2020 to journalist Bob Woodward

In the course of writing his book Rage, Bob Woodward talked directly with the president eighteen times and recorded those conversations with Mr. Trump’s permission and knowledge.  The tapes and available excerpts from the book clearly show that Mr. Trump knew from the beginning that the coronavirus was deadly and yet he continually took no action and played down the threat through much of January, February and March.  In important ways he still ignores the severity of the crisis.

Mr. Trump clearly is not responsible for the outbreak of the COVID-19 pandemic, but his belated and inconsistent response cost tens of thousands of Americans their lives.

The timeline of Mr. Trump’s private statements to Mr. Woodward, matched up with his public statements about the state of the pandemic, demonstrates his callous disregard for American lives and his deliberate deception to prevent coherent actions in the early days of the crisis.

For example, Mr. Trump was briefed by his National Security Advisor Robert O’Brien that “this will be the biggest national security threat you face in your presidency.  This is going to be the roughest thing you face.”  His Deputy added that this was going to be at least as bad as the 1918 flu pandemic that killed 50 million people worldwide.

The briefing was given to him on 28 January 2020.  On 7 February he told Mr. Woodward,

“You just breathe the air and that’s how it’s passed.  And that’s a very tricky one.  That’s a very delicate one.  It’s also more deadly than even your strenuous flu.  This is deadly stuff.”

Meanwhile on 26 February he compared the coronavirus to the flu and talked about how much worse the flu was in our country.  He downplayed the threat and again compared it favorably to the flu on 9 March.

On 19 March he told Mr. Woodward,

“Now it’s turning out it’s just not old people, Bob.  Just today and yesterday some startling facts came out.  It’s not just old — it’s plenty of young people.”

On 24 March, 6 May and 5 August he downplayed the threat to young people and focused primarily on the threat to senior citizens.  In fact, during an interview in August he said,

“If you look at children, children are almost — and I would almost say definitely — but almost immune from this disease.  They don’t have a problem.  They just don’t have a problem.”

There is more, but you get the idea.  I suppose it should not be surprising that a president that lied over 20,000 times while in office continually lies about the pandemic.  But the brazen, uncaring, callous way he treated our society is breathtaking.  In the excerpts of the tapes that I have heard, I am struck most of all by the nonchalance and indifference in his voice.  He truly does not care.

His avowed reason for lying to all of us (he calls it “downplaying” the impact) is that he did not want the public to “panic.”  That would be hilarious if the results were not so horrifying.  This from a president that creates fear and campaigns on panic be it “MS-13 caravans” flooding the border, or “destroying the suburbs” or a hundred other things he has injected into our lives.

The only panic he was trying to prevent was a panic in the markets on Wall Street.  He tied his reelection to the economy and he was afraid that if he told the truth, if they took the required precautions early, that there would be an economic impact.  He thought he could ride it out and therefore took no action.

Put this in perspective.  According to a Columbia University study, if social distancing efforts had been put in place even just one week earlier (8 March instead of 15 March) 36,000 lives in the U.S. would have been saved and there would have been 700,000 fewer infections.

That is still a month after Mr. Trump told Mr. Woodward that “this is deadly stuff.”

Remember, since he was briefed in January about how the coronavirus spreads, Mr. Trump conducted campaign rallies, belittled people that wore masks, pushed for restaurants and bars to open, recommended injecting bleach into bodies, pushed hydroxychloroquine and generally brushed off all of the known precautions to stop its spread.

Based on his words and actions in pushing to reopen the economy, millions of Americans forswore masks and social distancing, gathered in bars, partied hearty, and otherwise facilitated the spread of the disease and the consequences we still feel over seven months after Mr. Trump knew the dangers inherent in this new disease.

Every American, Trump supporter or not, should be outraged.  It is not hyperbole to say that his actions and inactions, with full knowledge of the threat, resulted in the loss of life.

Just as bad, his staff and advisers had the same information and said nothing.  Shame on them all.  They are just as guilty.

Mr. Trump failed in his primary duty as president.  The president first and foremost must put the health, safety and security of all of us above all else.  He still refuses to do so.  His enablers continue to lie for him, cover up for him, and allow him to put himself above all.  He insults us by saying he was just trying to be a “cheerleader” for our country.  His enablers say he was just doing what any good leader does by projecting a calm demeanor.  They even dare to compare him to President Franklin D. Roosevelt.  Hogwash.

Their words and actions are despicable.  Tell that to the families and friends of the nearly 200,000 dead Americans.

He lied and people died.

 

Groundhog Day

Posted: August 2, 2020 | Author: | Filed under: Uncategorized | Tags: , , , , , , | 2 Comments

For quite some time now, life seems like an episode in the Bill Murray movie “Groundhog Day.”  Day after day after day we hear the same things.  If you watch the news regularly at some point during the day, an expert clinician, a physician or a nurse in an overwhelmed hospital, an established epidemiologist or other recognized health care expert will come on to be asked how to stop the spread of Covid-19.  Given that we have passed 4.5 million cases and 155,000 American deaths since 1 March, it is an important question.  The response, day after day, is to wear a face covering, social distance, wash one’s hands and don’t hang out in large crowds especially inside.  Not hard.  Every day there is also someone who recovers after a severe bout of Covid and says “I thought it was a hoax.”  Or, “I’m young and I didn’t think it would really be that bad.  But it was.  The worst feeling in my entire life.”  Sadly, we often hear the loved one of a person dead from Covid say something similar.

I can only think that we are a country of morons or losers or both.  How hard is it?  We know what to do.  Why don’t we do it?

Today’s news is that the virus is spreading into every corner of the United States.  It is only a matter of time and it is going to be bad.  Real bad.  In just the last week alone there were 453,659 new cases in the United States and the rate of hospitalizations grows everyday.  Over the last six days we averaged 1,233 deaths a day.  At that rate we will have approximately 37,000 more Americans dead by the end of August.  Remember when people thought that estimates of a 100,000 deaths total from this pandemic was considered to be too high and a lot of hyperbole to scare people?  At the current rate we will be at or over 200,000 dead around Labor Day.  Time to celebrate the beginning of fall!

Increasing numbers of experts (you know, real ones like scientists and doctors not the ones that say to inject bleach into your lungs) believe that we need to start over from the beginning.  Reset the stage.  Shutdown uniformly across the United States for 4-6 weeks — an actual shutdown, not a “if you want to” shutdown — to stop the spread and to be able to have a significant drop in cases so that “testing, tracing, isolation” actually has a chance to change the equation.

But no, I’m bored. I don’t want to do this anymore.  I think I’ll hang out with all my friends for a little pandemic party.  Haven’t seen you for awhile.  Here’s a hug for you and a hug for you and a little Covid for you, and hey buddy, here’s a little Covid for you too.  And then be surprised when people get sick.

It turns out that we cannot merely wish it away or ignore it.  It is not business as usual.

On top of the pandemic, but because of it, our economy is in the proverbial toilet.  For the quarter ending 30 June, the U.S. saw the worst decline for a single quarter since at least 1875 — perhaps in the history of the U.S.  Way to go guys!  We even beat the Great Depression of the 1930’s.

Don’t worry, though.  The Senate is on top of it.  The House passed a bill back in the middle of May to extend unemployment benefits, protect people from being evicted because they can’t pay their rent and other assistance for those that have lost their jobs through no fault of their own.  Called the Heroes Act (H.R.6800), it passed and was sent to the Senate on 20 May.  And sat. And sat. And as of 31 July, all the worker benefits passed by Congress to help the economy during the pandemic expired.  But rest assured, someday the Senate will act to help those in need.  Maybe.  They don’t want people to get too comfortable with this easy lifestyle.

One of the main concerns of those critical of the Heroes Act is that it continues the $600 weekly supplement to existing state unemployment insurance.  The argument is that it is too much because people can make more money by staying home rather than by going to work, which is why some businesses are struggling to reopen.  Let’s take a closer look.

Yes, the money is in addition to state unemployment, but most states pay roughly 35 to 40% of one’s salary up to a limit that varies by state.  However, when you do the math, $600 breaks down to $15/hour for a 40 hour work week.  As a national average, babysitters make $20.30 an hour for two kids. Not exactly the stuff of aspiring millionaires.

Such thinking also avoids the difficult issues.  Perhaps people staying home and not exposing themselves or their families during a pandemic is a good thing.  It helps to stop the spread of the virus.  Additionally, the “too generous” argument ignores other issues such as those workers are staying home because they may not have access to child care during the pandemic or because with schools closed, they need to stay home and help give their kids an education.  Perhaps they rely on public transportation which has been halted or is experiencing severe service cuts due to the pandemic.  Maybe it’s all of those and more.  And of course it presumes that their place of business reopened and is willing to hire them back.

With the economy already in the dumpster how is it going to recover if people don’t have any money to spend?  Have you seen the food lines around the country? (In the 30’s they were called bread lines but now you can stay in your car and also get a healthier selection of food!  Isn’t progress amazing?)  In the greatest country on earth?  Yep.  A bunch of freeloaders according to some.

Perhaps you could just follow Ivanka Trump’s new initiative for out of work Americans to “Find Something New.”  In her position as a Senior Adviser to the President she is advocating that roughly 15 million unemployed Americans go back to school, or develop IT skills or use on-line learning or sign on to learn a new skill as an apprentice (no she was not referring to her role on a TV show).  Mostly, her initiative is just a web site with links to a lot of other web sites with information that has been out in the public for months or years.

As my favorite saying goes, “Nothing is impossible for the person who doesn’t have to do it.”

As I predicted back in April, in this country it’s every person for themselves.  There is no political will to institute the steps needed to get the pandemic under control.  Without that active effort, the economy cannot recover.  All those bars and other super spreader events will eventually close again when a large amount of their patrons and employees are sick or dead.  But, hey!  It was great while it lasted.

Dire measures are needed.  It will hurt, it won’t be fun, it isn’t what we want but unless you want one of your friends or family to get sick and possibly die, suck it up.

Testing Kills

Posted: June 17, 2020 | Author: | Filed under: Uncategorized | Tags: , , , , | Leave a comment

“If we stop testing right now, we’d have very few cases, if any.”

Donald J. Trump on 15 June speaking of the number of coronavirus cases.

Really?  Just like if we stopped pregnancy tests there would be no more pregnancies?  Or if there were no cancer tests there would be no more cancer?

I suppose that I should not be surprised at Mr. Trump’s comments by now.  He failed every leadership test that the pandemic threw his way so what would change now?  His plan seems to be to pretend that there is nothing wrong and to resume business as usual.  What else to expect from the Worst President Ever?

Just when you think it cannot get any worse, of course it does.  As we know, Mr. Trump decided that the best way to prevent anyone thinking that we still have a COVID-19 problem is to pretend that we don’t by holding a rally with some 20,000 people in a closed space in a state that is one of the current pandemic hot spots.

Unfortunately, this appears to be the strategy for the entire Trump administration.  Yesterday Vice President Mike Pence authored an article in the Wall Street Journal that said, in part:

“In recent days, the media has taken to sounding the alarm bells over a ‘second wave’ of coronavirus infections.  Such panic is overblown.  Thanks to the leadership of President Trump and the courage and compassion of the American people, our public health system is far stronger than it was four months ago, and we are winning the fight against the invisible enemy.”

Most public health officials agree that we are not in a second wave of the pandemic.  They believe that we are still in the early stages of infections and that the second wave is a few months away.  This of course, is page one of Mr. Trump’s playbook.  When things are not going well, yell “hey everybody, look over there, the nasty media is at it again.  Pay no attention to my incompetence.”  Most preposterously, the Vice President went on the claim that:

The media has tried to scare the American people every step of the way, and these grim predictions of a second wave are no different.  We’ve slowed the spread, we’ve cared for the most vulnerable, we’ve saved lives, and we’ve created a solid foundation for whatever challenges we may face in the future.  That’s a cause for celebration, not the media’s fear mongering.”

“Cause for celebration”?  Shameful.

The man is pandering to one man and one man only.  Mr. Trump.

On March 15 of this year there were roughly 60 deaths known to be a result of the pandemic.  As I write, we have more than 119,000 Americans dead.  Americans dead.  In three months.  And we should celebrate?

By any measure we have failed in this crisis.  Take any metric that you choose; total deaths, total cases, deaths per capita, whatever, and the USA is in on the wrong side of the power curve.  There are 7.94 million known cases in the world.  The US has 2.18 million of them.  Roughly 28% of the world’s cases.  There are 435,000 deaths world wide.  The US has about 119,000 of them.  Roughly 27% of them.  In what is supposed to be the greatest country in the world with the greatest scientists, doctors and public health facilities we are doing very poorly indeed.

But, yeah, go to Oklahoma and celebrate.

Following the administration’s logic as espoused by the President and Vice President, if there were no testing there would be no coronavirus deaths.  Therefore, testing kills.  We should stop testing immediately.

 

The Road Ahead

Posted: April 10, 2020 | Author: | Filed under: Uncategorized | Tags: , , , , , , , | Leave a comment

It is obvious that we are not yet through the terrible ramifications of our pandemic and resulting economic crisis.  Public health concerns need to be balanced with economic concerns in order to reach some kind of “new normal.”  I am sure that none of us know what our country will look like in the next six to twelve months but what is clear is the need for some kind of road map for our national recovery that is consistent with the necessary steps to keep all of us safe and to prevent a second major wave of disease that could result from lifting current restrictions too soon.

The president is, according to his remarks on his daily Trump Show, looking forward to reopening the country to business as usual with a “big bang.”  Aides suggest that the date will be roughly 1 May or perhaps earlier in parts of the country.  This makes it sound like some kind of ribbon cutting at the grand opening of a new mall rather than a sober analysis of the pros and cons of particular actions.

As the death toll passes 16,000 Americans, we are still deep into this crisis.  The good news, if it can be called anything like that, is that models seem to indicate that the total death toll by August will “only” be about 60,000.  Imagine.  Only 60,000 Americans dead. That is down from 100,000 to 240,000 but nothing to rejoice about or to suggest that we have this crisis under control.  We are not even a third of the way towards that horrible number and the president seems to want to do away with the measures that have helped to get a small grip on the horrors of this pandemic.

Americans of all political stripes, age groups, ethnic groups and socioeconomic means seem to have come together to embrace, for the most part, social distancing and accepting that things will be tough economically for awhile but that the only way to get this outbreak under control is by working together.  Patience is a virtue.  The results of what we do today will not be seen for two or three weeks down the line.

I have no trouble with the president and his administration looking ahead to what we should be doing in the next month, six months or a year.  I hope that someone or some group of professionals is in fact doing that.  But I see no evidence of a coherent, realistic plan.

During his daily reality show, the president seems intent on focusing only on the next 15 minutes rather than the next 15 months.  He continues to spread lies and misinformation.  For example, health care professionals uniformly declare that the only way to get the country back on its feet is to have a robust testing regime in place to determine who is sick, who is not sick and who may have already recovered from coronavirus without ever going to a doctor or indeed, without ever knowing they had it.

The Trump Administration has made continual promises on testing that have come nowhere near being factual.  As just a few examples, remember that on 10 March Vice President Mike Pence said that over a million tests had been distributed and that by 14 March four million more would be available.  A few days later the president said that 5 million tests were available.  And of course a week before that on 6 March the president said that, “Anybody that wants a test can get a test.  That’s the bottom line.”

A month later roughly two million tests have been administered so far in the entire country.

The president continually points out that the United States has tested more people than any other country in the world, and he is correct.  But he misses several key contextual aspects to that. The state of New York has more confirmed cases than any country on earth.  All by itself.  Obviously the United States as a whole is the sickest on earth so far.  This includes China (which nearly certainly under reported the number of cases), India, Indonesia and several others with much greater populations.

Most importantly, per capita we are failing badly.  Well less than one percent of our country has been tested.  In my state only medical personnel on the front lines and those with a referral from their doctor based on symptoms can get tested.

Just by the force of numbers alone, it is clear that the United States, the greatest country on earth, badly bungled this crisis.  Dithering and wishful thinking frittered away a chance to get ahead of the pandemic and here we are.

So, my question.  What is the long-term strategy?  I have heard nothing from this administration that looks ahead to how we know we are “winning.”  What are the measures of effectiveness (MOEs) that will determine how we are doing and whether it is safe to open up parts of the economy?  So far we only hear about flattening the curve — an indicator that social distancing is working — but not what “safe” numbers of infected may be.  If the curve flattens out at 1500 dead a day is that a good thing?  I think not.  The numbers are not dropping everywhere and across the country the totals continue to increase.

Numbers are great.  To say we have tested more people than any other country is nice, but meaningless. Since this all began, we have tested roughly 2 million people.  Total.  If we test one million Americans a day — a day mind you — it will still take roughly nine months to test everyone.  And a test only shows whether you have the illness at the time of testing.

Am I advocating for every American to be tested and until then we keep our daily lives on hold?  No.  Not realistic.  But what is realistic?  What are the MOEs?  When is the risk/reward equation in our favor?  How do we know when it is safe to eat in a crowded restaurant or go to a sold out college football game? What percentage of testing is adequate to give a good sense of the pervasiveness of the disease in a particular area?  What number of sick people in an area is an indicator that it is safe to go out in a crowd? Are certain precautions sufficient to reopen a particular business that may not work in another?  Until we have some measurable indicators beyond the number of people currently in the hospital we don’t really know where we stand.  This is especially true as we know that some people are asymptomatic carriers that unknowingly pass the virus to others who then become very sick.

Psychologically I think it will take a long time for many of us to feel totally safe in a crowd.  Having actual data from the experts rather than “cheerleading” “aspirational” statements that turn out to be false from the president would go a long way in helping each of us to understand where we stand.

Life has risks in everyday endeavors.  Nothing is perfect.  However it is possible to understand our world around us when presented with facts, not lies, or wishes or wannabe situations.

Many pundits in the right wing media are starting to attack the medical professionals claiming that they are part of the Deep State or to opine that some kind of Social Darwinism is at work with COVID-19 and it should be allowed to run its course. Weed out the weaklings. The president has at times opined that it is not as bad as the media says it is and that they are only trying to hurt his re-election.  Might I suggest that those people go to work in a hospital or a grocery store or a pharmacy without proper protection?  Or perhaps the president could visit a COVID-19 ward without PPE?  Cheer up the troops.  Oh right.  No one can now come into contact with the president and vice president without being tested for COVID-19.  Yesterday they even required testing of the White House press pool before they could attend his daily reality show.

Nothing is impossible for the people that don’t have to do it.

It is time to listen to the experts.  Health care professionals should take the lead and economic professionals base their analysis on what is healthy — literally impacting one’s health — for the country as a whole.  Perhaps a regionally focused approach would work, although I would be concerned that folks with “cabin fever” in stay-at-home states would gravitate to those open for business.

A national approach, based on facts and realistic MOEs is the only way we will find our way out of this crisis.  The worst thing that could happen is to prematurely lift the measures we know are working only because the president is impatient and has a gut feeling that everything is good to go.  A second wave of pandemic would do even greater damage to our country.  If there is a time for a very conservative approach, this is it.

Patience coupled with verifiable facts is the only way to go.

 

 

The Price of Imperfection

Posted: April 2, 2020 | Author: | Filed under: Uncategorized | Tags: , , , , , , , | Leave a comment

The numbers are difficult to comprehend.  100,000 to 240,000 Americans dead from COVID-19 if, as Dr. Deborah Birx from the White House Coronavirus Task Force said, “we do things perfectly.”

There is ample evidence that as a country we have most definitely not done things perfectly, and sadly I see little evidence that we will do it perfectly as we move forward.  As I write, the U.S. passed the 5,000 mark in deaths from the virus.  Most experts do not expect the pandemic to peak until late April or early May.  Recall that the day after the peak likely will be the second most cases, the third day the third most, and so on.  The peak is only a measure of how far along we are in trying to mitigate the impact of the disease, not an indicator that the crisis is over.

In difficult times is it hard to know what to criticize and what to praise.  How to stay positive when things look so bleak.  Does one leave criticism of our leaders out of the conversation because we need to focus on the future and not the past?  Do we dissect what could have been done so much sooner to lessen the impact on our fellow Americans or just deal with the present and see what the future brings?  There is so much that could be said but does it help?  I think so.  If we are to deal with the crisis as it unfolds then we need to learn the lessons it is teaching us in order to deal with what comes along in the course of events.

Good leaders enter the fray with a plan.  As I have written in this space before, no plan survives contact with the enemy.  One must be able to adapt and alter the plan as events unfold, which is easier to do if beforehand the leader has thought through possible outcomes, surprises, and has the resiliency to adjust to circumstances as they unfold in order to bring the right resources to bear at the right time.

As resources start to deplete, it is necessary to assess the gravity of the situation in each sector of the battle.  Some places may need more of one thing rather than another.  Some forces are not currently engaged so extra attention is given to the places that are actively engaged while keeping some things in reserve for when the battle moves to a new front.  Forethought, tenacity and resilience are called for in order to vanquish the foe.

I see that leadership ability with governors in New York, Maryland, Ohio and elsewhere. Mayors and other local leaders are showing themselves to be able to cope with the situation by thinking imaginatively and using ingenuity to face the overwhelming impact of this virus.  Unfortunately, it is not evident throughout the country.  Even as we see the horrible impact of the virus in New York, Louisiana and elsewhere, some governors refuse to tackle the issue head on.  Some put in half measures while across the river in another state very stringent requirements are in place.  Both lose out as people are free to cross state lines and they will seek out what they want where they find it.  Consequently, both states will suffer as the virus spreads when people from different areas intermingle and interact.

Likewise, as the White House Coronavirus Task Force claims that states and cities are getting the supplies they need, we see countless reports, most from front line health care providers, begging for more help in acquiring supplies to keep them safe and healthy so that they can take care of their patients.

All of us have learned a new language and new words that we freely throw around when just a few weeks ago we had no clue about such things.  PPE.  COVID-19.  Social distancing.  Ventilators.  Pandemic.  And on and on.  We have learned a lot but we have more to learn.  So who to trust?

Sometimes two things can be true at the same time.  For example, if the White House claims that they shipped 500,000 masks to New Jersey, it seems like a big number.  It is a big number.  But if hospitals in the state are going through 750,000 masks in a few days then it is not enough.  In addition, many hospitals in hard hit areas have already thrown out best practices in order to save PPE.  Gowns, gloves, and masks should be changed for each patient in order to protect the sick as well as the providers.  Most places now issue one set for a shift.  Some now issue one set for a week.  Regardless of the numbers the White House claims to have provided, it is clearly not enough when it comes to the front lines.  If our first responders and health care workers go down, the entire house of cards will collapse.  Unfortunately, PPE do not help them with the emotional and physical toll this crisis is exacting.  What are the plans to relieve those who have been on the front lines for weeks on end?  Where are the psychiatrists and psychologists to help them deal with the stress and pain of losing so many people they pledged to help?  These issues should also be addressed on a large scale.

It does not help when the president gets up before the cameras in his daily reality show and hints that doctors and nurses are selling the masks on the black market and that is why there is not enough to go around as he did on Monday.  “Are they going out the back door?”  “I don’t think it’s hoarding.  I think it’s maybe worse than hoarding.”

It does not help when the president gets up before the cameras in his daily reality show and says “I don’t believe you need 40,000 or 30,000 ventilators” as he did last week.

It does not help when the president gets up before the cameras in his daily reality show and says that the governor of New York should be “grateful” to him for supplying ventilators and that he hit “paydirt.”

It does not help that president gets up before the cameras in his daily reality show as he did a few days ago and brags about his “ratings” being better than “The Bachelor” while saying that some projections are for 2.2 million dead in the U.S. and “so if we have between 100,000 and 200,000 we all have done a very good job.”

It does not help when the president tweets as he did just hours ago that “Massive amounts of medical supplies, even hospitals and medical centers, are being directly delivered to states, to hospitals by the Federal Government.  Some have insatiable appetites & are never satisfied (politics?).  Remember we are a back up to them.”

Funny thing.  When your citizens are dying one expects leaders to pull out all the stops to save them.

Maybe if you give everyone a ventilator that wants one pretty soon nobody will breathe on their own?

Again, two things can be true at the same time.  But here’s the rub.  The hospitals, mayors, governors are on the ground and know how much they need.  More importantly, we are dealing with a situation that projects that upwards of 240,000 citizens will die if we do everything perfectly.  That same projection from the president’s Task Force indicates that it could be between 1.2 million and 2.2 million if the right steps are not taken.  The key fact is that the worst is yet to come.  It does not matter whether current needs are being met if there is nothing left for the future.  Governors and mayors realize that if they are barely meeting demand now, there is no way they can meet it when things get really bad.  On top of that, multiple reports indicate that officials at the Department of Homeland Security report that the national reserves are nearly depleted.

Why is the federal government “a back up”?  This is a national crisis.  Why are states, cities, and even individual hospitals all competing against each other to get what they need?  Profiteering is certainly taking place.  Governors report that orders they expect to have delivered get cancelled because another client offered more money to the manufacturer for the same shipment.

The primary function of the federal government is to provide for the safety and security of its citizens.  All else is meaningless if people are not safe or secure.

It is beyond appalling that the president continues to refuse to step up and organize our response on a national scale.  There should be a centralized procurement and distribution system.  There is an old saying, “lead or get out of the way.”  I think it time for the president to get out of the way.  He has a Task Force formulating the medical response to the crisis.  Daily he puts out misinformation, lies or revisionist history and uses the briefing as a substitute for his rallies.  Just stop it.  Let the scientists and professionals give us the straight information.  What they know — good or bad, what they don’t know, and what are facts versus opinions.

Set up a similar Task Force for procuring and disbursing the needed supplies.  Then get out of the way.  The military is skilled at logistics, let them handle it if no one else in the administration knows what to do.

This is a national problem.  While the media’s and president’s focus seems to be on the New York region, the fact is currently Louisiana has the highest per capita hospitalization rate.  The highest per capita infection rate is in Idaho.  A national problem needs a national, coordinated response.

On a personal note, please keep those suffering on your minds and in your hearts.  This is going to be a long haul.  Remember the first responders and health care professionals that so far have been able to keep this pandemic at a crisis level rather than a national collapse.  Finally, keep yourself safe.

Stay calm and wash your hands.

We Knew It All Along

Posted: March 24, 2020 | Author: | Filed under: Uncategorized | Tags: , , , | Leave a comment

Regular readers know that I am not a big fan of our President.  When the world-wide COVID-19 pandemic arrived at our national door step I took it upon myself to be quiet. I would give him a chance to deal with this crisis.  I would refrain from taking potshots at every mistake he makes.  It is a new situation that requires new solutions to beat it.  Some will work, some will not. I did not want to get too caught up in the day to day developments.  I gave him the benefit of the doubt and truly hoped that he would rise to the occasion, pull the country together in a common effort and actually lead from the front.

Boy!  Was I wrong.

Mr. Trump proves daily what many of us knew and others suspected.  He is in way over his head with no real idea of what to do as a president facing a crisis.  Great at rabble rousing campaign rallies, bad at leadership.  Textbook bad, in fact.

The president is not responsible for COVID-19 coming to the U.S.  It is his response to the crisis that demonstrates his total inability to deal with facts and to put together a coherent plan of action.

The examples are many but let’s start with the most obvious.  Mr. Trump unilaterally calls himself a “War Time President.”  In that respect he signed an Executive Order (EO) under the 1950 Defense Production Act (DPA) that can be used to direct industries in the United States to manufacture and produce materials or equipment necessary to meet our national security requirements.  So far, he has failed to do so for a variety of reasons.  As I write this, his Director of the Federal Emergency Management Agency (FEMA) Pete Gaynor claims that it will be used to procure test kits and Personal Protective Equipment (PPE) for health care workers.  Then he said it will not be.  The president said it would be before he claimed that it was not needed.  Both say that they really do not need to use the DPA because the EO gives them “leverage” and therefore companies are voluntarily beginning to switch their production lines to meet the need.

Besides the obvious “who’s on first” confusion within the ranks of the nation’s leaders, there are practical problems with that approach.  Instead of a comprehensive nation-wide plan for procurement and distribution — which the federal government, especially the military, excels at doing — they are having the states individually buy their own equipment.  This creates unhelpful competition, excessive prices,  and a survival of the fittest narrative as each state competes one against another to get badly needed ventilators, PPE and test kits.

Put another way, we do not have individual Air Force squadrons go to Boeing or Lockheed and procure aircraft on their own.  Marine Corps battalions do not go to weapons manufacturers and buy their weapons and ammunition on their own.

States. like squadrons and battalions, are at the point of attack and know the best tactics to fight the enemy in front of them but the strategy comes from the top.  Likewise, the military departments through the Department of Defense are tasked with raising, training and equipping the force as a whole.  Without coordination and the prudent deployment of assets where needed, the amount of confusion, disarray and waste rises to levels that are detrimental to the overall goal.  And people die.

There is also a business reason for needing to implement the DPA.  If I am GM or 3M or any other manufacturer that wants to help out with producing ventilators, for example, I will put a lot of money into converting my production lines, finding the labor to run the machines, raw materials, etc.  I need to know that there will be a market for my 10,000 ventilators with an average cost of $25,000 a few months from now when we’re cranking them out.  Only the federal government can guarantee that those costs are covered.

Mr. Trump, for whatever reason, refuses to do what is right.  He does give us clues as to why.  In discussing the DPA he talks about it as “nationalizing” U.S. industries and says that such a move is “socialism.”  As he said on Sunday, “Call a person over in Venezuela.  Ask them how did nationalization of their businesses work out?  Not too well.”  The DPA nationalizes nothing.  It is not socialism.  The companies revert to their previous undertakings when the crisis is over or the need is met.  Think Detroit automakers turning out tanks during WWII.  Either Mr. Trump’s advisers are woefully ignorant of the law or the president is.

I have a different explanation.  It is all about Mr. Trump’s re-election bid.  If he centralizes the response to the pandemic under his leadership, and it fails, he will have to shoulder the blame.  This way, he can point the finger at mayors and governors for, as he’s already said, “not doing their job.”  Remember, this is the man that when asked about his responsibility as president replied, “I don’t take responsibility at all.”  War time president indeed.

Also connected to his re-election is the fact that one of his campaign themes is to call all the Democrats socialists.  If he actually (cough, cough) believes that using the DPA constitutes socialism, then he cannot use that accusation against Democrats in the election.

“America First” actually means “Trump First.”

And now this.

He is so concerned about his re-election chances being hindered by the state of the economy as we battle for our families and friends lives, that he announced today that the country will be back to business as usual by Easter, 12 April.  He is ignoring the best advice of 99 percent of health care professionals in this and many other countries.  No one knows how this is going to turn out but there is near unanimous agreement that for the U.S. and other nations, the worst is yet to come.  Think about the circumstances right now in Italy, Spain and other first world nations.  I am not even sure what business as usual will look like in three weeks.

His argument, first espoused by Fox News talking heads, is that the “cure is worse than the disease.”  Rather than suffer some — maybe even a lot — of pain up front to get this under control, he is willing to open the country up to the potential for continuing waves of deadly disease.  Many people when first diagnosed with cancer feel fine.  Chemotherapy and other treatments are not at all fun and can be quite painful.  In the beginning, it is worse than the disease.  However, people understand that in the long run they will be better off with a much higher chance of survival if they submit to the treatment.  Seems pretty basic.  But perhaps it is too much for Mr. Trump to grasp.

With his constant comparisons to the flu and car crashes that kill tens of thousands of people a year but we don’t shut down for them, it is apparent that he does not at all realize what he and we are dealing with today.  Besides the fact that COVID-19 has a much higher rate of transmission, and a higher death rate for those that contract it than does the flu, it impacts all other health care areas.  As a country we do not have thousands of intensive care beds, nurses, doctors and technicians standing around waiting for a pandemic.  The surge capacity is very, very limited in civilian hospitals.  To take on the COVID-19 patients means that someone with a heart attack, or in a car crash or some other emergency may not get the level of care that they otherwise would have gotten.  Those deaths are not attributed to the pandemic but are very real issues of collateral damage.  Some of those people would not have died under normal circumstances.

Life is hard.  Dealing with a crisis is hard.  Dealing with COVID-19 is hard.  But it is harder when you don’t have a clue.  Or worse.  You don’t care to have a clue.