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Negotiating a New Routine in the Time of Pandemic

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My youngest has now emerged from quarantine within quarantine (henceforth QwQ) in our household. They were restricted for two weeks inside our house once they came home from college after having health problems during finals week.

This meant open windows and masks worn during the most mundane conversations — on my part, slapping on a mask before yelling that dinner was ready, and on their part slapping on a mask before picking up their dinner tray outside their door.

I can tell you two weeks of room service, three meals a day and occasional snacks, delivered outside the bedroom door or placed on the deck table outside is no fun for either the cook or the eater.

But now that they’ve emerged from their confinement suite we have to negotiate a new routine within the household. I’ve had to remind somebody a couple times they no longer have QwQ room service.

We also have to negotiate new approaches for an adult child living at home with parents, unable to go about living as young people did before this pandemic forced Stay Home orders.

How does one date when one can’t leave the house? How does one conduct one-on-one dialog with a romantic interest while across the room from one’s parents?

Awkwardly.

This past Friday was a dinner date. I was warned in advance this was a regular event before QwQ. We’d been discussing options to plan dinner later in the day — the adult child told me I didn’t need to plan for them because they were going to have dinner with their romantic partner.

Okay…you may imagine my eyebrows in my hairline.

Apparently these two lovebirds have been cooking together on Friday nights since they can’t go to restaurants. This time they can’t even meet in person to cook in the same kitchen, but cook together they would.

“Are you going to Zoom a meeting? Will you need a tripod set up in the kitchen?” I’d asked.

These are not exactly the kinds of details for which one designs and builds a kitchen, but here we are, thinking about methods to retrofit my kitchen into a Food TV network set for two.

No extra work needed this time; just a set of headphones with mic and their cell phone along with full use of the kitchen.

In other words, get out of the way, mother.

Not exactly easy since the kitchen is at one end of the family great room and my office is in the middle of the same space. Which means while I am poking around online and moderating comments here, my spawn is cooking away while engaged in discussion with their romantic partner.

The really awkward part: partner can hear me, I can’t hear them, and my adult child isn’t prefacing questions to me or to their partner so that we can’t tell who the question is aimed at before we both answer.

And then after dinner is done and the adult child flees with a prepared plate in one hand and the phone in the other, I’m left with the dirty dishes and other cooking detritus.

As I said, we have to negotiate a new routine within the household. Looks like I need to find something to do every Friday night in the garage, the basement, or the garden. And it looks like the adult child needs to clean the kitchen before taking off for the private part of the date.

~ ~ ~

Another aspect of pandemic life in a multi-generational household I hadn’t anticipated: the late night snack attack.

I dozed off while reading in my lounge chair sometime around 11:00 p.m. last evening, rousing in a heart-stopping fashion when someone banged LOUDLY on my front door. Stumbling toward the door I realized I had no mask with me, couldn’t open the door safely, flailed around in a groggy state, heart pounding, wondering if the lights in the driveway were the police or some other authority figure.

The lights began to back out of the drive as I turned on the porch lights and opened the door slowly. The vehicle pulled away just as I noticed a fast food bag on my porch.

What the hell? Did I get a neighbor’s midnight meal by accident? I looked up and down the street and could see no lights on, no one looking for their — at this point I checked the slip on the bag without touching it — burgers and fries.

The tumblers of awareness clicked into place.

Yelling for my adult child to come down and handle the fast food delivery was nearly as annoying as being jolted awake. They couldn’t hear me with their headphones on while gaming online, requiring yet more pounding on another door.

“Oh — the meal was 45 minutes early, sorry about that,” they said. “How do you want me to handle this?” they asked.

“Good gods, you ordered food with packaging you would have to decontaminate and you didn’t plan ahead for that?”

Much scowling and hand washing ensued, sprinkled with questions and feedback about the delivery service and tipping and how to handle future food deliveries.

Yes, we have to negotiate yet another new routine within the household.

~ ~ ~

I felt really old after the fire drill of late night food delivery by way of app. It never occurred to me to have french fries delivered to my doorstep.

Sure, I’ve joked for years now about a business plan for drone-based app-ordered deliveries of chocolate and alcohol and condoms. I didn’t imagine we’d still use cars for deliveries like this, or that orders would be so mundane instead of pricier upscale items.

But then I didn’t imagine business models relying on a permanent underclass ferrying products instead of flying machines.

I also didn’t imagine an adult child of mine would become so inured to such exploitative business models that they saw delivery of a milkshake or burger as entirely normal and acceptable.

Perhaps the profits are greater in the density of a college town and this now-former student had become too accustomed to a different norm at university, especially since friends also worked for delivery firms. But we’re at the edge of suburbia in what many Americans might consider a small town. This shouldn’t be the norm without green transportation.

Some of the negotiations we need to have are about the ethics of our expectations both in the time of pandemic and in the years ahead during a new normal.

Imagine as this pandemic pushes us deeper into an economic depression how easy it will be to exploit increasingly desperate people. We’re privileged to be able to think about this — we need to use this privilege for good, beginning with greater consciousness about our spending choices and making more donations to local food pantries.

And someone here may be learning how to cook those late night french fries at home, alone or perhaps with their partner or gaming opponents online.

I might even be able to sleep in my armchair through that.

 

This is an open thread.

John Galt Is Impotent In A Pandemic

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Discontinuity.

Abrupt change.

Collapse.

Chaos.

Whatever term you might choose to use, there’s no disputing that if the epidemiologists are correct, the COVID-19 pandemic will be the largest, most impactful world event since 9/11. How we respond to the pandemic will define our society, likely for generations to come.

The response to 9/11 was close to exactly the opposite of what I would consider best. Instead of asking why small groups of people felt so ostracized and minimized that violence was their last resort and then acting to address the root causes, the US chose to demonize and further ostracize Muslims in generally, thereby creating a much larger and endless supply of new terrorists to fight. Over a million people died, many more millions were displaced and an entire generation of US military lives were wasted. But a handful of people got filthy rich off it.

The business and political worlds of today live for these discontinuities. Back when I was running an agricultural biotechnology startup, we were instructed that Monsanto and their spin-offs were so successful because they stood ready to respond to market discontinuities in their areas of operation. Regular, 1-3% annual changes in markets were for chumps. Giant change is what mattered, and so be it if mom and pop seed operations were obliterated by consolidating the entire seed industry. Likewise, in business generally in that era, the rise of the big box store was seen as a John Galt-like hero development as the parasitic small stores disappeared. Today, Big Bezos seems to be feasting off even those big boxes.

On the political front, Naomi Klein laid out in excruciating detail in Shock Doctrine how various disasters have been exploited by the political class to advance the interests of the oligarchy. Both civil rights and economic opportunity for huge portions of the population have been eroded.

Naomi Wolf warned us a few days ago to be on guard against deterioration of our rights in the COVID-19 outbreak:

Today, CNN reports on ongoing discussions between the Trump Administration and the airline industry. It appears that at least some in the industry are concerned that data collection being demanded under a public health guise will be used “for other purposes”:

The US aviation industry and the Trump administration are in a pitched battle over the response to the coronavirus pandemic, three sources familiar with recent calls between officials from several government agencies and US airlines have told CNN.

In a series of contentious conversations, agency officials and aviation executives have clashed over the administration’s demand that airlines collect new kinds of data from passengers to help officials track potential virus carriers.

Okay, on the surface, I’m all for public health officials being able to access information quickly on who was sitting near whom on a flight with an infected person and quickly contact those who need to self-quarantine and get tested. But how do we make sure that data doesn’t wind up being misused? Also, it appears that the Trump Administration also wants the airlines to collect information on recent other travel by passengers:

This industry official says it took the US aviation industry two years to meet post-9/11 requirements, which also involved data collection.

Airlines are concerned that the Federal Register gives no clear end date on the data collection and worry that the US government could continue forcing them to collect it “for other purposes.”

“It seems they want us to do this for forever and we are pushing back,” the first source familiar said. The airlines — particularly their lawyers — are worried about what Customs and Border Protection officials will do with the information.

Yeah, I wouldn’t trust the Trump Administration on that, either. I will leave it to Rayne to address what seems to be a real argument between the administration and the industry on just what information the airlines already have and whether their existing technology can provide it to the government. And Marcy can address whether it’s feasible or even possible to have any kind of effective firewall between public health officials and intelligence, criminal or immigration investigators when it comes to access to this information. There are serious competing interests here and recent experience suggests it won’t be resolved in favor of civil rights for many groups of people.

But what of the COVID-19 disruption? Rayne’s post yesterday provided much of the stark data. This tweet thread from Eli Pariser even goes so far as to suggest that we are just days away from the point at which Italy shut down large regions:

When hospitals are completely overwhelmed, there will be no Galt’s Gulch where heroes can wait out the outbreak. If we really see 20, 30 or even more than 50% of the global population being infected, the concept of isolation breaks down. No heroic action can be taken, because every single individual will be at risk for infection.

This impotence against the virus is because public health, in the end, is a social exercise. Will the outbreak become the discontinuity needed to convince the US to join the rest of the civilized world in making health care a social effort rather than a perk reserved for the very rich? If this doesn’t do it, it’s hard to imagine how it will ever happen.

US COVID-19 Cases Now Spreading Due To Trump’s Testing Restrictions And Dismantling Of Pandemic Response Teams

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Back on January 31, Pulitzer Prize winner Laurie Garrett warned us how Donald Trump has dismantled the country’s ability to respond to a pandemic. Her Foreign Policy piece, headlined “Trump Has Sabotaged America’s Coronavirus Response“, Garrett opened with a description of the extreme measures taken in China:

The epidemic control efforts unfolding today in China—including placing some 100 million citizens on lockdown, shutting down a national holiday, building enormous quarantine hospitals in days’ time, and ramping up 24-hour manufacturing of medical equipment—are indeed gargantuan. It’s impossible to watch them without wondering, “What would we do? How would my government respond if this virus spread across my country?”

The problem, though, is that although Barack Obama built a working pandemic response structure during the Ebola outbreak (which of course Trump criticized incessantly on Twitter), that structure has now been obliterated:

In the spring of 2018, the White House pushed Congress to cut funding for Obama-era disease security programs, proposing to eliminate $252 million in previously committed resources for rebuilding health systems in Ebola-ravaged Liberia, Sierra Leone, and Guinea. Under fire from both sides of the aisle, President Donald Trump dropped the proposal to eliminate Ebola funds a month later. But other White House efforts included reducing $15 billion in national health spending and cutting the global disease-fighting operational budgets of the CDC, NSC, DHS, and HHS. And the government’s $30 million Complex Crises Fund was eliminated.

In May 2018, Trump ordered the NSC’s entire global health security unit shut down, calling for reassignment of Rear Adm. Timothy Ziemer and dissolution of his team inside the agency. The month before, then-White House National Security Advisor John Bolton pressured Ziemer’s DHS counterpart, Tom Bossert, to resign along with his team. Neither the NSC nor DHS epidemic teams have been replaced. The global health section of the CDC was so drastically cut in 2018 that much of its staff was laid off and the number of countries it was working in was reduced from 49 to merely 10. Meanwhile, throughout 2018, the U.S. Agency for International Development and its director, Mark Green, came repeatedly under fire from both the White House and Secretary of State Mike Pompeo. And though Congress has so far managed to block Trump administration plans to cut the U.S. Public Health Service Commissioned Corps by 40 percent, the disease-fighting cadres have steadily eroded as retiring officers go unreplaced.

But it’s even worse than that. Until sometime over this last weekend, the Trump Administartion, through the CDC, blocked all entities other than CDC from running tests for COVID-19. They only allowed testing under such extremely narrow circumstances that pitifully few tests have been carried out to this point.

In an interview yesterday on KPFA (that I’m only halfway through listening to but just had to stop and write this part up) Garrett pointed out that New York City has had its own dedicated lab ready to go for testing for the past six weeks. Coupling that with the various reports coming out today on just how long it’s going to take for testing kits to get widespread distribution now that manufacturing is FINALLY kicking into high gear, we are presented with direct evidence of just how much damage Trump’s COVID-19 policies have done.

As Garrett points out, we are now seeing “community transmission” of the virus, meaning that cases are appearing in patients who have not traveled to known hot spots and who are not known to have had direct contact with someone confirmed to have the virus. Once community transmission is seen, the correct public health policy with respect to testing is to switch from narrow testing criteria to widespread testing. China was remarkably quick in developing and mass manufacturing DNA-based tests for the virus as soon as the sequence became available. That this was not done in the US is criminal, and the mounting death toll, now at 9, will drive this point home. That’s because, if you listen to the early part of Garrett’s interview, she compares COVID-19 to the 1918 flu pandemic. She describes characteristics of the spread of the virus that make widespread testing an incredibly important tool in containing its spread. Today’s news says we are weeks away from widespread testing. I fear just what we will see when wider testing is available.

 

H7N9: A New Influenza Virus Emerges

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This post is in two parts. The first part deals with the news that a new flu virus has emerged. The second part, which comes below the fold, provides a bit of biological and public health information to help put the news into perspective.

According to the latest reports I can find, there are now three confirmed deaths and ten confirmed cases of people infected with a new strain of Type A (bird) influenza virus that has been designated H7N9. All cases have been in eastern China. The good news is that there is not yet evidence to suggest that this virus can spread from one person to another (although that question has not yet been fully answered), which is a prerequisite for a pandemic. The bad news, though, is that the animal host from which the infections were acquired has not been identified.

Earlier this week, Laurie Garrett began assembling what is known about the emerging cases of H7N9 infection and putting those cases into the context of mysterious mass die-offs of pigs and birds in the same general region of China (Garrett is asking important questions here since previous flu pandemics have come from swine or bird hosts):

By the end of March, at least 20,000 pig carcasses and tens of thousands of ducks and swans had washed upon riverbanks that stretch from the Lake Qinghai area all the way to the East China Sea — a distance roughly equivalent to the span between Miami and Boston. Nobody knows how many more thousands of birds and pigs have died, but gone uncounted as farmers buried or burned the carcasses to avoid reprimands from authorities.

While environmental clean-up and agricultural authorities scrambled to remove the unsightly corpses and provide the anxious public with less-than-believable explanations for their demise, a seemingly separate human drama was unfolding. On Feb. 19, a man identified by Xinhua, China’s state news agency, only as Li, an 87-year old retiree, was hospitalized in Shanghai with severe respiratory distress and pneumonia. On March 4, Li went into severe cardio-respiratory failure and succumbed.

On Feb. 27, a man identified only as Wu, a 27-year-old butcher or meat processor, fell ill with respiratory distress, was hospitalized, and died on March 10. The day Wu succumbed a third individual, a 35-year-old woman identified as Han, was hospitalized in the city of Nanjing, though she came from distant Chuzhou City, in Anhui province, about 300 miles northwest of Shanghai. Han is reportedly in critical condition, in intensive care. To date, no connection between the three individuals has been found.

The key question of whether person-to-person transmission of the virus can occur is made somewhat murky by the family of Li:

The elderly Li may have been part of a family cluster of illness, as his 55-year old son died of pneumonia in March, and another 67-year-old son suffered respiratory distress, but has survived.

On March 31 — Easter in the United States — China’s newly created National Health and Family Planning Commission (which includes the former Ministry of Health) announced that 87-year-old Li, Wu, and Han all were infected with a form of influenza denoted as H7N9 — a type of flu never previously known to infect human beings. The commission insisted that Li’s two sons (one dead, the other a survivor) were not infected with the flu virus — their ailments were reportedly coincidental, though they occurred at the same time as the elder Li’s demise.

Garrett goes on to point out that Chinese authorities have blamed a non-influenza virus for the pig deaths, but she casts some doubt on this claim, since the virus cited by the Chinese is known to kill young piglets but not adult pigs. The dead pigs found tossed into rivers primarily were adults.

Garrett rightly states that our knowledge of what is going on here is highly dependent on the accuracy of the tests that authorities are carrying out:

If the pigs, people, and birds have died in China from H7N9, it is imperative and urgent that the biological connection be made, and extensive research be done to determine how widespread human infection may be. Shanghai health authorities have tested dozens of people known to have been in contact with Wu and Li, none of whom have come up positive for H7N9 infection. Assuming the tests are accurate, the mystery of Li and Wu’s infections only deepens. Moreover, if they are a “two of three,” meaning two dead, of three known cases, the H7N9 virus is very virulent.

“At this point, these three are isolated cases with no evidence of human-to-human transmission”, the WHO representative in China, Dr. Michael O’Leary, told reporters on Monday. But, O’Leary added, the possibility of a family cluster of illness could not be ruled out, and, “We don’t know yet the causes of illness in the two sons, but naturally, if three people in one family acquire severe pneumonia in a short period of time, it raises a lot of concern.”

 

The key phrase above is “Assuming these tests are accurate”. When a new virus emerges, it is difficult to know what tests to conduct to detect the virus and how to conduct those tests. More detail is clearly needed to know what level of confidence can be placed on the Chinese claim that Li’s family members were not infected with the same virus that killed him.

Garrett puts these questions into more context in the Reuters article linked above:

However, China has yet to find any animals infected with H7N9, meaning how the humans got it remains a mystery.

“We know that it was originally a bird virus. We also know that it has taken on some genetic attributes that are not seen in bird viruses,” Laurie Garrett, Senior Fellow for Global Health at the Council for Foreign Relations, told Reuters in New York.

“In other words, it seems to have adapted somehow to mammals, to humans. How that happened, we don’t know,” added Garrett.

 

Update: Via Twitter, Laurie Garrett points out that Chinese authorities now have evidence that pigeons in Shanghai have been infected with a version of the H7N9 virus that is a genetic match to the viruses isolated from humans, so pigeons may be the source. More can be read here.

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