Three Things: Good (Family) News, Bad (COVID-19) News

[NB: Check the byline, thanks! / ~Rayne]

It’s absurd that I’m happy my college student child tested positive for strep throat. Whew, what a freaking relief that they only had a bacterial infection which has killed humans throughout history! Thanks to science we have effective antibiotics to treat this kind of infection, one of which is already working away and making said student feel better. …

Literally just heard from my student that Michigan State University now has one confirmed case associated with its campus. I can’t find a published report yet, more details later; so much for the brief respite provided by streptococcus.

Brace yourself for the bad news which so far is the nature of COVID-19.

~ 3 ~

Drugs. Let’s get into them.

Beleaguered Italy is using the rheumatoid arthritis medication tocilizumab off-label to treat patients in ICU. It may become their protocol for treatment of patients who develop acute respiratory distress syndrome (ARDS).

COVID-19 apparently spawns a “cytokine storm” the same way the 1918 Spanish flu virus did. Health care professionals say COVID-19 kills via fulminating viral cardiomyopathy, (inflamed heart tissue), not hypoxia (suffocation due to lung failure).

The onset of inflammation can be sudden with the cytokine action but at a later stage in the infection, which is different from the 1918 bug. The Spanish flu affected mostly younger people whose immune systems over-responded to the virus, where COVID-19 affects older people whose bodies may already have inflammatory responses at work because of cardio vascular disease or diabetes.

(We don’t know yet why some young people without preexisting conditions have become very ill and in some cases have died. Some may be related to smoking, others could be related to an undiagnosed condition. More study will be necessary; in the mean time, young people should protect both themselves and the older and sicker people who could catch COVID-19 from them.)

China tried tocilizumab on roughly 20 patients and found this monoclonal antibody halted the storm, acting on interleukin 6. There’s a preprint unreviewed study online but I can’t open it now or would include it. An immunologist in Italy came to similar conclusion about the use of this med and consulted with Chinese docs. See this story in an Italian news outlet (open in Chrome and translate).

There are other meds being tested in China — antivirals remdesivir (mentioned in a previous post), favipiravir, lopinavir/ritonavir, umifenovir — but there I haven’t seen any information about their application treating COVID-19 cases as detailed as there is for tocilizumab.

Pharma manufacturer Roche has agreed to provide to Italy the tocilizumab which should not only help reduce burden on hospitals’ intensive care units but build a body of data about the drug’s success in short order. China has also approved the drug’s use on certain COVID-19 patients.

I want to emphasize here this is NOT a cure for COVID-19. It’s a treatment for patients whose heart and lungs are in distress, requiring intensive care and a ventilator. What this drug may do for many of these patients is prevent them from needing ICU and ventilation, while their bodies continue to fight off the virus.

~ 2 ~

And more drugs — this time, antivirals.

A number of existing drugs have been revisited for repurposing against COVID-19 instead of their original intended purpose. Antiviral remdesivir and antimalarial chloroquine are among them.

Chinese researchers posted a paper about in vitro results, not peer reviewed (at least I didn’t see that it was).

There’s a paper about chloroquine alone; in vitro studies suggest it may work against COVID-19. Chinese researchers have a number of in vivo studies in progress, but no data has been released.

Chloroquine by itself as an effective therapy would be a miracle in that it’s an old drug now off patent and available as a generic, super cheap to produce. Can’t imagine Big Pharma would like this. But we won’t even face this conflict if we don’t get data from in vivo studies.

What I haven’t seen yet is adequate research related to the ACE2 receptor to which the COVID-19 binds itself to attack the body. There’s a study under way about a decoy protein drug called APN01, but I haven’t seen any details yet. A discussion about the ACE2 receptor can be found at this link.

I’d like to see more work done in related to ACE2 receptor mechanism. I’m worried we’ll end up too focused on antiviral remdesivir because there may be some political hijinks behind this drug.

Gilead Sciences, the drug’s manufacturer, shipped a bunch of this drug to China without federal approval, for tests which I assume mean human experimentation on actual COVID-19 patients.

About the same time this happened two weeks ago Gilead launched a merger/acquisition of Forty-Seven Inc, a clinical-stage immuno-oncology firm. It looks fishy yet likely to go unexamined because of the mounting desperation to have a drug therapy in hand before the anticipated explosion of cases arrives at hospital doors. In short, it’d be too easy to extort the U.S. into using this drug.

What really takes the cake is that a former Gilead lobbyist, Joe Grogan, is now the director of White House Domestic Policy Council. Grogan has already undermined Trump’s drug pricing initiative to the benefit of pharmaceutical companies. How do we know Grogan isn’t still representing Gilead’s interests, perhaps encouraging the government to turn a blind eye to corner-cutting on remdesivir?

~ 1 ~

Now it’s time for some more blunt talk with the family members.

I have a health care power of attorney or a health care directive prepared, signed, witnessed, copies distributed with one copy in my fire safe. If the worst should happen and the doctors need direction if I become incapacitated, my patient advocate is authorized to order what I want done. I have more than one advocate in a chain in case the primary advocate can’t act on my behalf.

I also have a will prepared, signed, witnessed, etc. If I’m picked off this month my kids will be disappointed that I haven’t yet finished Swedish Death Cleaning in the basement, but such is life and death. (Sorry, kids. You’re stuck dealing with all of the grandmas’ china sets and fragile antique lamps. Heh.)

I put the question to you now: are you ready? Have you done the legal legwork to help your loved ones whether family and/or friends if you’re incapacitated or *knock-on-wood* die?

Get it done if you haven’t. Stop putting it off because there’s no more time for lollygagging. We’d all like to deny we could get very sick, lose control of our lives, even die, but nature has a way of having the very last word if you don’t provide one.

Need a resource for that health care directive? See the folks at AARP — they have links to free resources for each state.

Just as important is establishing a plan for what friends/family should do if they can’t reach you. Trusted friends/family members should have current phone numbers, addresses, alternate key locations, emergency contacts, so on. They should also know who the patient advocates are and how to obtain access to the relevant documents if advocates don’t already have them.

This doesn’t have to be heavy; some of this effort we should have been doing all along as part of your disaster preparedness planning. Think about the families and friends affected by hurricanes Katrina and Maria, and imagine COVID-19 as a kind of hurricane which won’t flood your house but could certainly upend your life. You’d be prepared for a hurricane. Be ready for this one.

~ 0 ~

Treat this as an open thread. Tell us what’s in your basement or closets you need to unload because no one in your family wants it.

341 replies
    • Rayne says:

      Saturday 14-MAR-2020 11:40 am —
      Sorry, going to be away from my desk for a while, will check this thread later.

      Right now I am sewing surgical masks since supplies are low. My mother, a former nurse with +50 experience, told me this is what they used to use in the old days “before they made us use all that disposable shit that goes in the landfill,” she assures me.

      Cut (2) 7.5 inches wide x 7 inches high from plain cotton muslin.
      Iron (3) 1/2-inch folds across the length of each square.
      Sew together fabric squares top and bottom across length.
      Turn inside out and re-press folds and seams flat.
      Turn in ends 1/4-inch and pin close, then stitch.
      Use 1/4-inch elastic to sew along short ends to make ear loops.

      YMMV. Tweak as you go for fit because not everybody’s noses or ears are the same. ;-)

      • errant aesthete says:

        Bless you, dearest Rayne.

        My admiration for you has no bounds, although this comes closest to being the topper of all time.

      • 200Toros says:

        Just a thought – wouldn’t neck gaiters work for face masks? Type in “buff” on amazon and there are plenty still in supply for delivery in next couple days. Cover as much of your face as you want. Washable and reusable too. I’m seeing deals like $11 for a 12-pack of them. We have a bunch of them as we are avid outdoors-people.

        • Rayne says:

          Not certain about gaiters, same point I guess in that they cover one’s mouth and nose to limit airborne droplets. My concern would be removal because viruses can get in one’s eyes, too.

          For some of us with permanent hot flashes, a gaiter would be anathema. Far too warm to wear indoors around people. LOL

          ADDER: Link to article in The Guardian discussing effectiveness of masks. Being immune compromised myself, I’d prefer to wear one in settings where other people may be, even if I keep a distance of 6-feet/2-meters.

        • Rayne says:

          That’s super helpful, VG. Might make my 2-ply muslin masks more effective if they are soaked in a NaCl solution, then air dried before wearing. Not using polypropylene microfiber, but I think I could do that with the next batch — first exterior layer PP, second layer cotton next to face, then soak in NaCl solution and air dry.

        • Rayne says:

          Thanks much for these, much appreciated. This agreement and amendment won’t be applicable to COVID-19 since it was written based on a “potential influenza pandemic” for the purposes of stockpiling and selling Tamiflu.

          I’d like to know if there are any agreements like this based on monoclonal antibodies or another antiviral, though, pandemic or otherwise. Wouldn’t be surprised to see something parallel for tocilizumab or remdesivir if either were to become protocol for treating COVID-19.

        • Surfer2099 says:

          I guess my take on this is that the Trump administration has decided have US big pharma profit from this crisis and no one else internationally. Ie…Trump admin decides US companies should benefit from this crisis, so Trump admin refuses WHO tests and meets with Big Pharma who actually have been building infrastructure under Flu pandemic scenarios. Trump then anoints them as the US saviors with his infomercial the other day. Roche and Gilead were prominent as was Walmart, CVS and other distributors in low-income sector for shoppers. This of course is the target market which is outlined in the agreements I posted. The first amendment actually states this in the text.

          In addition, we also know that the CDC and our government was not setup to respond this way. that’s been said repeatedly by Faucci. Trump has refused international help in order to piggyback the COVID-19 response on the back of the Flu pandemic infrastructure created by the Roche-Gilead agreement.

          I suspect the merger is something related to creating additional capabilities for diseases outside the Flu path, like COVID-19.

          Just a hypothesis, but not an unreasonable one.

        • Rayne says:

          Except that “flu pandemic” is the wrong fucking model. The UK has made the same fatal error, its leadership confidently clinging to a flu pandemic response model prepared years ago.

          “But mah flu business model…” ~sigh~

        • Surfer2099 says:

          Trump is an idiot. He’s the kinda guy that looks for the cheapest, quickest fix to get him through the moment. A bullshit artist.

          Something like this would be totally up his alley to do. He, and his administration, are incapable of coming up with an appropriate response. Thus, they piggyback off of something pre-existing in the hopes it will work.

        • Surfer2099 says:

          Just one other thing to keep your eye regarding the merger. Last week, Forty Seven Inc. filed an amended 14D-9 statement adding language about anti-trust deadline review. It says that the offer will expire on March 27, 2020 if not approved by the FTC. Will be curious to see how the Trump administration responds. Will it be fast-tracked, etc?


        • Surfer2099 says:

          Another tidbit for the timeline of events. It seems that On January 7th, Gilead and Forty Seven Inc entered into a confidentiality agreement.

          Very coincidental given the fact that the first reported cases of COVID-19 was December 31, 2019 and the WHO issued a report on January 5th of 2020.

          Here is Forty Seven’s confidentiality agreement:

        • Surfer2099 says:

          More timeline for you:

          On January 10, 2020, Forty Seven inc entered into a material arrangement to have a 3rd party sell shares it recently listed.

          These are placement share, meaning they are meant to be sold in a private placement. It’s limited to $100M for 5M shares, to a private party.

          And these shares cannot be sold until after March 11th. And coincidentally, Gilead announces the merger on March10th.

          So, who is, or will be, the outside party getting shares issued after March 11 to be caught up in the merger? So, the private party in this agreement buys 5M shares on March 11th, and they close the sale/merger by March 27.

          Sounds like an outside party is gonna benefit from getting 5M shares through Forty Seven when the merger happens.

        • Surfer2099 says:

          Rayne, those 5M shares were issued. Forty Seven’s outstanding shares on Nov 5, 2019 were 42M shares.

          Per the amended merger doc issued by Gilead, they are purchasing 48M outstanding shares.

          So, here’s the rub. The 3rd party buys 5M shares for $100M and sells to Gilead for $95.50/share that equals $477M, netting $377M on the deal.

          If you ask me, someone is shaking down Gilead for $377M. And we know who the shakedown king is in this scenario…..(cough, cough, Donald Trump, cough) [subliminal]

        • Rayne says:

          Sooo…was that the quid pro quo: allow Gilead to ship remdesivir to China for human testing without FDA approval, in exchange for the cut?

        • Surfer2099 says:

          I would probably think not. The China shipment went out Feb 3rd and the agreement and decision to sell private placement shares was made by Jan 10. The first contact by Gilead to the FDA for the shipment was Jan 26.

        • Surfer2099 says:

          I would think the quid-pro-quo goes something like this: Forty Seven Inc and Gilead had already been in discussion about a merger. These things take about a year to complete, so the announcement is the end of that year. Gilead has aspirations to capitalize on pandemic or be the government’s outside sole source supplier. So, they want in after hearing about Coronavirus after December 31st and contact their lobbyist Joe Grogan to see how they fit in. And Grogan approaches Trump who says, ‘yea, but how do i profit from that?’. So Gilead lobbyist says they’ll work a deal through the merger to disguise a hidden purchase and sale of shares and for that, Gilead becomes the government’s Go-To point company on Coronavirus. Anyways, that’s how I see it playing out. Not sure how and if the China shipment plays into this. But send out an FOIA request on communications for it.

        • Rayne says:

          I saw Kim Zetter’s tweets (along with tweets yesterday about possible COVID-19 illness) — my first thought wasn’t about exclusivity for the U.S. but the means to obtain a cut off the top AND a possible quid pro quo.

          Did Trump+family+minions try to lock down a quid pro quo to benefit from the vaccine?

          What other companies have likewise been cornered by the administration?

          Really need to communicate with pdaly about this.

        • errant aestete says:

          “U.S. Offered ‘Large Sum’ to German Company for Access to Coronavirus Vaccine Research, German Officials Say”

          Sub Headline: “The United States says it will share any vaccine breakthroughs with the world, but German officials appeared rattled by its reported overture to a biotech firm.”

          According to the German newspaper Die Welt am Sonntag, which first reported the story on Sunday, Mr. Trump offered CureVac roughly $1 billion in exchange for exclusive access to the vaccine. The newspaper quoted an unnamed German government source who said Mr. Trump wanted the resulting vaccine “only for the United States.”

          But another German official, reached by The New York Times, said it was unclear whether the administration simply wanted the research work, and for any resulting production to be on American soil.

    • StarRN says:

      Thank you, Rayne! You and everyone here at Emptywheel have kept me sane for these last few years – you are all treasures. So glad your child does not have COVID-19 (and hoping the strep resolves soon!).

  1. cat herder says:

    Either CA, CO, FL, GA, TX, MI (and maybe others) have received a miracle and all their cases are cured, CURED!, or the JHU tracking map is having a glitch today. Strange that it’s been missing huge chunks of data for 6+ hours, though.

      • Rayne says:

        Shit. Gov. Whitmer sent an email saying there’s now 16 confirmed cases in Michigan.

        My kid who’s studying microbiology reminds me the number of infections will double every 3 days — not to be confused with confirmed cases.

        • Ruth Chase says:

          In the face of what could be a pandemic without real governmental information, I took my own advice and read up on how to defend the body by bolstering the immune system. It is my belief and experience that ordinary people are quite capable of understanding how to prepare for crises. Washing our hands is good advice AND many of us already wash our hands. Ultimately, it’s the body’s inner ecosystem which can be made more resilient and must be made more resilient to interrupt the contagion. Below are some simple strategies to “stack the odds in our favor.” For example, public information about heart health has changed public behavior. If we inform ourselves of what a virus is, how it spreads, what stops it, we can make better choices. No institution can take responsibility for what we can do for ourselves. Below is the definition of virus, followed by simple, available strategies to defeat it.
          Virus: An invasive microorganism that requires a living cell to reproduce and grow. Viruses are smaller than bacteria, and are the cause of numerous plant, animal, and human infections ranging from the common cold, to Aids (HIV), to other rare diseases. Viruses have the ability to mutate when reproducing. Viruses hijack cell nuclei and convert them into factories that produce more viruses. Viruses are susceptible to oxidation.
          Hydration: For every pound of body weight, drink ½ oz of clean water daily (this does NOT include sodas*, tea, coffee, etc.) This is the normal amount of water the body requires for normal healthy functions. Dehydration sets us up for disease. If hospitalized for Coronavirus, one of the most common tools used is hydration via IV. Right now, measuring our intake of water, rather than estimating, is essential to getting it right.
          Move: We’re familiar with info about the cardiac system but not so much on the lymphatic system. The lymphatic system can be imagined as “Waste Management” and is not connected to the circulatory system. The heart does not pump it. It is entirely dependent on the body’s movement to function. Unless we move, the toxins swept up into the lymph cannot be removed and therefore make the body more susceptible to toxicity, disease and malfunction. MOVE!
          Sleep: The immune system requires deep and habitual “good” sleep. Lack of sleep results in stress, depression, and malfunctions in the immune system. Better sleep depends on morning daylight exposure, exercise, dark rooms free of device lights and waves, etc. I use progesterone, passionflower tea, “Snooze-In” from Vitamin Shoppe, and exhaustion. Find your own path and avoid sleeping pills. Sleep stacks the odds in your favor by sleeping well.
          Organic vegetables: The body requires nutritional building blocks. If they are not available, the body compromises until it can’t. Organic vegetables provided higher levels of minerals and vitamins than chemically produced materials. They are safer on endocrine system. As your mother said, or should have said, the more servings of organic vegetables/day, the better your health. Foods with infinite and/or higher shelf life should be avoided. The price of toxic body burden comes due sooner or later.
          Probiotics: Increased focus on gut health in recent years results from understanding that the immune system is largely seated in the gut. There can be 400 species of good bacteria in the digestive tract. In a healthy body, the total number of bacteria in the digestive tract greatly exceeds all the cells in the body. Antibiotics**, sugar, stress, HRT, radioactivity (X Rays), parasites, heavy metals, artificial chemicals etc. can all damage gut probiotic balance. Restorative foods are: raw green cabbage leaves, sauerkraut (raw or living), coconut keifer, fermented foods. If you buy probiotic supplements, the strains most beneficial for immunity: B. brevis, B. breve, B. longum, Streptococcus thermophilus. (All other strains add the immune system by helping to dissolve intestinal plaque, normalizing pH, and reducing inflammation.) Green cabbage stacks the odds in your favor.
          Gut tissue: Aloe vera, slippery elm, marshmallow, okra and similar mucilaginous foods improve health of the alimentary tissue which extends from mouth to anus. Neti pots are popular for cleaning the nasal and sinus tissues.
          Psyllium: Without adequate fiber, our bowels cannot eliminate waste. Our popular food usually doesn’t reach adequate levels of fiber. The system backs up, we gain weight, the waste accumulates and absorption of nutrients is impaired. Psyllium fiber scrubs the intestinal villi and moves plaque buildup. Hygienists recommend 3 bowel movements/day for optimized health.
          Beneficial Vitamins, Herbs, Medicinal Mushrooms:
          Vitamin C is essential for health of connective tissue and synthesis of collagen. According to Pauling’s research, it also hinders the motion of virus particles through the tissues to the cells. (Remember that viruses enter the cell nuclei and reproduce there) Camu camu berries have about 30 times the Vit C as oranges and far less sugar.
          Elderberries are prophylactic to viruses. You cannot eat them raw, but my doctor foraged 4# last summer and makes her own syrup. Elderberries can also be purchased dehydrated or in many “Sambucol” syrups and drops.
          Vit D is a hormone which is produced on the skin when exposed to sunlight. Hormones are the switch masters of the train traffic in our bodies. Vit D deficiency is a major cause of age-related conditions, including susceptibility. If you can’t get sun, organic supplements are available. (Sun to D conversion is destroyed by water. So, don’t wash immediately after sun exposure. Don’t depend on beach time to produce it if you also swim)
          Antioxidants are actually just “colors” in our foods and their mission is to destroy free radicals.
          Essential fatty acids (Omega 3 & 6) are antioxidants are best known for anti-inflammation benefits. They are termed “essential” because they are essential.
          B Complex: Overall health and systemic functions ( eg blood flow, enzyme health, skin health, energy, red cell productions, heart health) .
          Monolaurin: derived from coconut, lauricidin, kills the viral “envelope.” How important is that to stacking the odds in your favor?
          The carrageen in kelp is anti-viral. If you choose to sprinkle kelp on your vegs, you’re just stacking the odds in your favor.
          Cat’s Claw, a South American vine, its root bark stripped and made into tea. It supports immune system because it is especially anti-viral.
          Ashwaganda: Immune tonic. Relieves stress, relieves fatigue without drowsiness and boosts the immune system. Helps promote sleep by better regulating adrenals.
          Astragalus: Stimulates production and maturation of stem cells into active immune cells. Raises level of production of those hormones that signal for virus destruction.
          Gamma globulins are the first line of defense within white blood cells. Hemp seeds are the best source of gamma globulin building materials.
          Reishi is celebrated for its ability to significantly improve the functioning of the immune system. Cordyceps, like Reishi, helps the body resist a wide range of viruses, pathogens, fungi and nanobacteria. Shiitake is a powerful immune-supporting medicinal mushroom. If you stir shiitakes into your soup or stir fry, you stack the odds in your favor.
          Colostrum/ Lactoferrin: The immune factors in colostrums are know to help the body resist viruses, bacteria, yeast and fungi. It also helps with internal transfer factors and immunity “memory.” Lactoferrin, a component of colostrums, inhibits internal virus replication. Healthy gut flora produces its own lactoferrin.
          SUMMARY: We can know strategies and help ourselves. We can share information with each other. We can build upon commonly known information. Some simple choices like raw green cabbage yield better gut-immune response. Some elements lauricidin, kills the viral “envelope.” pinpoint and interrupt cellular viral replications. Do what you can do; stack the odds in your favor. Improve overall health and use targeted, high quality proactive substances. Vitamin C hinders the motion of the tiny virus particles through the tissues to the cells. Lauricidin, kills the viral “envelope,” leaving uncloaked for destruction. Lactoferrin, a component of colostrums, inhibits internal virus replication.
          * A single can of soda depresses parts of the immune system by as much as 50% for as long as 6 hours. Avoid sodas and stack the odds in your favor.
          **If you’re eating non-organic meat, you’re eating antibiotics and systematically ruining healthy gut function.

        • Tom says:

          FWIW, it may sound silly but I’d like to add floss your teeth regularly. Years ago I had a young dentist who would deliver a running commentary on what he was doing and why he was doing it every time he cleaned my teeth (this was before dental hygienists took over this task). During one appointment, he told me that many people have constant low grade infections–or even pockets of pus–in their gums from not flossing properly. It was the “pockets of pus” phrase that stuck in my mind and thereafter I was much more diligent with my flossing. After some time went by, I noticed that I rarely, if ever, had colds or sore throats the way I used to several times a year. I concluded that, if my immune system was no longer constantly battling low grade infections in my gums because I was flossing more effectively, it was better able to ward off colds, sore throats, etc. Anyway, it’s something that’s worked for me.

        • Tom says:

          Thanks for the reference to the article. Many hours have I spent online checking out the five or ten foods to eat or avoid to ward off, say, arthritis. But don’t underestimate the power of the placebo effect. Whenever I feel a cold coming on, I will peel and eat a couple of grapefruit and entertain myself with the mental image of the grapefruit attacking and dissolving the cold baddies invading my system. Most of the time, it seems to work in fending off the cold, though I know there’s probably not much scientific evidence to support my practice.

        • P J Evans says:

          I’m taking meds where grapefruit is a big NO.
          I try to eat lots of veggies, because those are a big YES.

        • Tom says:

          I’ve heard that as well about grapefruit interfering with the effectiveness of certain medications, but I figure all things in moderation. I agree about veggies, too, and include them in just about everything I cook whether the recipe call for them or not.

    • Pajaro says:

      Looked at JHU map and NM cases that were there yesterday are gone today. I’ve been taking occasional screenshots and saving them for later view of the growth in cases. Odd!

      • Donna says:

        The number in Florida is not accurate. There are 2 more in my city alone. One of them is at NAS JAX and the other at a hospital less than 2 miles from my home.

    • Eureka says:

      They have a note up on the page that they are doing maintenance, so I take that to mean that it’ll be coming back.

      • Pajaro says:

        I see the JHU numbers are back up. State lab here is reporting 10 presumptive cases. Six of those 10 were not sustained by CDC. CDC state tracker shows 1-5 for state. However CDC website does say to use state lab results on positive cases where CDC numbers differ. For a minute their I was thinking the administration would dare to deny the numbers at federal level, keeping a lid on or sowing dis-information. Nothing is beyond these criminals.

    • DaveC says:

      CO numbers from the state health department, CDPHE, noon 2/13:

      72 “presumptive positive”
      1 death (today?)–Pz7UD50yQD/pub

      News reports show one positive test in Boulder County, which doesn’t show on the state summary. OTOH, the patient may just work in Boulder County, and live, and be counted as a patient in another county.
      (no private browsing)

  2. Vicks says:

    Thanks Rayne
    My 80 year old mom just moved here and your post made me realize I need to find out if her instructions are still valid in this state,

  3. Pajaro says:

    Thank you Rayne and helpers, good review of mechanism and some possible promising treatments. Glad youre child not positive for Covid19, whew! Thanks for reminder on POA and will, been thinking about that too. In my state a new case shows up daily, when last week we had no detections. That is the nature of it, exponential growth will soon show up here, I believe.

    Has the administration provided any reason or explanation why they rejected the use of the WHO test? Seems that is vetted and widely used worldwide, why not here? I haven’t heard any rational.

  4. P J Evans says:

    I did the legal papers before I started chemo – it was “just in case” then, and is just as valid now. (Pretty much, “if I’m gone, don’t bother getting me back”. No kids, no one close outside family.)

  5. P J Evans says:

    In related news, I just got back from the dentist, a trip on the freeway, and there were almost no container trucks and a lot fewer semis than usual. That’s the result of less shipping coming from China into L.A.-Long Beach.

    • Raven Eye says:

      Sales of new and retread truck/trailer tires are a trailing (confirmatory) indicator of economic health.

    • MB says:

      That’s interesting…I just had my first taste of societal behavior change this morning when I went to Trader Joes at 8:30 a.m. to get a few breakfast items I was missing. The moment I looked in the door, I saw long lines at every cash register and all the register lines were open. I beat a hasty retreat and drove to Ralphs, 2 blocks away. The lines inside there were even longer, just about every shopper pushing around an overflowing cart. Finally found some relief at my 3rd try, Bristol Farms, and got my shopping done there. I know hand sanitizer and face masks have been off the shelves for at least 2 weeks, but now it seems people are concerned that common staples will disappear as well. That can’t be related to the reduction of Chinese cargo into Long Beach altogether. It’s probably more related to Garcetti telling people to stay home and cook or get food delivered, rather than go to restaurants…

      • G Todd says:

        My wife and I were at our local “Da Jewel” topping off our supply of dry-goods. Checkout lines stretched down entire isles of empty shelves with carts piled high. In our 40 minute line nearly everyone was good naturedly sharing handy tips about hand-washing, one-pot meals, viral incubation rates, and spice combinations or the best stores nearby to get the last paper goods. It was a healthy mix of Latinx, African-American, White, Asian, youngish, oldish. Damn … come what may for me and mine, it made me optimistic about our collective future.

      • Eureka says:

        Same here this am, I just kept looking around at the decimated shelves going, ‘holy ish!’ Couldn’t believe it, even though it was kind of expected from the news film.

        After repeatedly being chastised by spouse that I was getting too close to crowds — and I finally learn — we start to head for checkout, I flip down the front seat thing AND MY FINGER STICKS TO A PARTIALLY-DRIED LOOGIE/PHLEGM OF A STRANGER, AND HALF OF IT COMES AWAY AS I PULL BACK MY HAND.

        Possibly the most disgusting experience of my life.

      • P J Evans says:

        P-butter, frozen veggies – I didn’t look at the frozen meals, but I suspect there are a lot of full freezers. (I bought a 16-ounce jar at Ralph’s and one at WalMart. That’s about a two-month supply for me. I should get more cheese and another jar of mayo.)

        • Pajaro says:

          Food, frozen veggies, in freezer, 20 or so free range chickens laying about 2 dozen eggs a day, 11 turkeys also free range, 3 goats…If it comes to it plenty of food available. Still haven’t quite developed a taste for older goat, tho cabrito is wonderful if the cook is experienced.

        • P J Evans says:

          I’ve heard that it makes a good stew. Possibly on the gamy side, but with seasonings that may be not so noticeable.

        • Eureka says:

          Besides having lots of happy family and friends (egg-recipients), you must have a lot of egg-storing recipe ideas. I was just musing about this — all I could think of was this ten-egg chocolate cake I make (coconut flour = why all the eggs), and muffin-tin frittatas as things to make that freeze well. Other ideas?

        • Pajaro says:

          Freezing frittatas is a good thought. They pile up so fast I usually take a few cartons to the staff at my fav brew pub. I wash all in a mild soap/bleach solution. I get good service. Do same with too many zucchini later in summer.

      • Rayne says:

        Saw a tip in Twitter today — suggested going to stock up on staples at Asian grocery stores because they have not had the foot traffic of other stores due to xenophobia.

        • RLHall says:

          That was my experience last night.
          Went to the Korean supermarket near me (in Maryland). They always have a broad selection of fresh vegetables and fruit – and the best fish. Prices were reasonable, as usual. The store was a bit more crowded, but there was plenty to go around.
          Then went to the white-bread super for milk and a browse. The place was ransacked. I got a fancy half gallon for twice as much as I would normally pay, but I needed it. As I walked out, I heard the manager on the phone telling someone there was no truck coming in overnight to restock. She looked really distressed.

        • e.a.f. says:

          In British Columbia, we have the same problem, with the shelves being cleared in box stores. You’d think the stores were closing for months. The news did however, advise us some of the shoppers are re selling on amazon. Featured one guy saying he’d taken in $100K selling those Lysol cleaning wipes. He had a pick up truck full, again and was selling them at 4 times the price on line. Premier was not happy.

          Regular mid sized grocery stores in Nanaimo, B.C. were fine Thursday, stock on shelves, no panic buying, etc. Some of the smaller chains won’t be re supplied like the box stores. One pharmacy in Ladysmith, B.C. simply had a sign up advising one bottle of the alcohol per customer. bought one bottle and was happy.

          Glad to read your son only has strep throat! Congrats!

          As to being ready, better get out the DNRs. A number of people I know have them and they are either on their coffee table or by their front door, so when the paramedics come in, they can see it. Guess I’d better take care of that. Will is made.
          As to unwanted belongings, started that but have a long way to go although its all inside the house. No basement. Around here people tend to keep things in a storage unit or garage.

      • dimmsdale says:

        I figured I was pretty well stocked for 2 weeks self-quarantine but started hearing “well, maybe mandatory 3 weeks s.q. is in the cards,” so headed out to Trader Joe’s at around 8:30 last night, which is when they restock. Walked through the door, and it was empty bins everywhere you looked; NO bread, fresh vegetables, or chips of any kind, darn little cereal, zero meat. Stock guy said the morning line was out the door and around the block TO GET IN THE DOOR. I’d say people here are taking social distancing VERY seriously!

      • P J Evans says:

        Friend drove from Albany NY to Waltham MA, arriving there during what’s normally rush hour. She reports very little backup.

  6. Peterr says:

    I have a health care power of attorney or a health care directive prepared, signed, witnessed, copies distributed with one copy in my fire safe. If the worst should happen and the doctors need direction if I become incapacitated, my patient advocate is authorized to order what I want done. I have more than one advocate in a chain in case the primary advocate can’t act on my behalf.

    It’s great to have a copy in your safe, but distributing copies is ESSENTIAL – kudos for doing that. After all, if you can’t give consent, you probably can’t give someone access to your safe. You might also give a copy to your primary care physician, which may save lots of time and headaches in case it is needed quickly.

    The same goes for any advance medical directives, which allow you to dictate certain decisions in advance. These are things like “Do not resuscitate” orders, or more involved things like when you would or would not want to be put on a respirator, like “If putting me on a respirator for a limited period of time will allow my body to recover to the point that I can live without it, go ahead. If putting me on a respirator comes with no reasonable chance of it ever coming off of it, don’t do it.”

    Doctors need to know these things

    • FL Resistor says:

      If you’re over 60 and in a hospital with more patients who need ventilators than they can equip with one, then you may not have a choice other than to go without.
      Flatten the curve. Stay at home as much as you can. Maybe clean out your drawers, your basement and closets and do those home projects you’ve been putting off for years. I’ve got a few projects in mind, like sanding and restaining the Adirondack chairs, cleaning out and repainting the laundry room.
      Prevention is always the best cure.

      • Tracy Lynn says:

        That’s me. I have a plan for: Detailing my vintage Miata in the garage, cleaning out my closet because I have too much yarn I inherited from my mother-in-law and nowhere to put it, putting up the floating shelves that have been in boxes for several months. And, maybe going out for that (solo) bicycle ride I promised myself.

        • Rayne says:

          Oofdah. That’s me, inherited and hand-me-down yarn and fabric in tubs and tubs. Probably should have bought shares of Rubbermaid back when I bought the first tub.

        • P J Evans says:

          I have like 20 66-quart bins of yarn (and some other stuff), and another dozen with yarn and some books. Bless me, for I have committed STASH.

        • talislope says:


          Although I have to say my mother spun it by hand but my sisters must have stole it before I had a chance to. You must have more respectful siblings :-)

        • Rayne says:

          I’m the only sibling/sibling-in-law who does needlework and fabric craftwork. It’s rather sad; we should be learning and using these skills instead of buying so much disposable product which are often made of plastic.

          Spinning is one thing I would enjoy trying, just to have a better feel for the raw material I used in needlework. Your sisters were smart to steal handspun work.

        • P J Evans says:

          I have a learn-to-spin drop-spindle kid, with several ounces of unspun wool. Could send….

        • harpie says:

          Yarn and fabric hoarder here…keeping it all for now [damit! :-) ] …
          One of these days I may feel creative again….

        • Tracy Lynn says:

          Yep. I never know when the urge to make something will hit, so I like to keep supplies in abundance. I have a few years before I have to start with the Swedish Death Cleaning thing, so….

    • Eureka says:

      Your local hospital, if applicable, will generally be very happy to place a copy(ies) in your medical records there.

  7. Molly Pitcher says:

    The very uncomfortable thought I am having about this, is how much is that directive going to be taken into consideration if hard choices have to be made by medical staff with limited numbers of medical equipment?

    • Eureka says:

      In my experience (past professional and personal) the ideal situation, if available to you, is to have a *person* / health care proxy make those decisions for you based on context, rather than have a living will (advanced directives). (People can have both, and can do whatever they want).

      Even the statements that e.g. Peterr spelled out above are not at all as crystal clear as they might seem now, while not a pertinent situation. And I can say that operating by health care proxy (HCP) worked out in the absolute best interests of, say, my & husband’s mothers’ situations.

      You have to ask yourself if, lacking a HCP (say primary and alternate are also incapacitated), would you be better off with or without a living will/adv. directives. And also ask if those people are around, would it be better for them to decide based on your conversations, knowing you, and unanticipatable medical context and not hampered by a possibly misconstruable if well-intended list of ADs.

      I personally stick with HCP as the most flexible reasoned option. Everyone’s situation is different, though. The HCP can then sign a DNR or DNI (do not intubate) if your condition warrants.

      Apologies — lack of sleep — could be said better, but gist is there.

      ETA: and yes, I believe — and certainly in the case of ‘extreme situations’ like reported for Italy — that certain directives impact providers’ perceptions and aggressiveness, just like, say, age and infirmity do. In my observation / opinon.

      • Eureka says:

        *DNR _and_/or DNI

        [and by the way, you can sign a DNI for an already-intubated person; put colloquially, _generally_ this is to pave the way for “pulling the plug” as the person passes in a planned and DNR event (also put colloquially) and not re-intubating; this all would be discussed in detail with your healthcare provider. For one example, I signed a DNI and DNR for my intubated mother; if her breathing tube accidentally came out before she had received palliative medications/ had withdrawal of life supporting ones, they would put the tube back in so she did not have a protracted suffocation death, suffering for no reason.]

        *the rest of the typos

    • Molly Pitcher says:

      As someone who has been on Chloroquine for 2 1/2 years, I can say that the possible side effects are overstated. It was a miracle in quickly addressing my medical issue. I have asked a couple of my Drs if they thought there was any prophylactic benefit from being on it and one said most likely and the other said maybe. Real definitive.

    • rip says:

      Good recursion – I’ll see your grift and raise you 10. Those trumpfs learned a lot from old grandpa Fred. Wonder if grandkids(*) will inherit the innate knack to screw others.

  8. Savage Librarian says:

    Hey, Rayne, I’m glad to hear the better news about your child. And thanks for putting so much info together for us. Greatly appreciated. Like you say, it’s a lot like getting ready for hurricane season. I’ve stocked my shelves and I’m ready to hunker down and hold on.

    I just got back from picking up some tax forms and early voting at the library. The library will be closing at 6pm and then staying closed indefinitely. But the polling site is supposed to be available over the weekend.

    Anecdotally, my family’s house was quarantined twice when I was a child. The first time I was an infant. My brothers and I had Scarlet Fever. The second time I was 8. We had just read in our 3rd grade science books about communicable diseases. It said that you couldn’t get Scarlet Fever twice. But, sure enough, I had to prove that wrong and get it for a 2nd time. So, my brothers weren’t allowed to go to school. Two were delighted, but one was furious with me.

    Another odd thing that happened was with my smallpox vaccination. I never got the scab and scar that was expected. So, when we moved to another state, the school made me get another one. But still, nothing. Maybe it worked and didn’t show. Or, maybe I have a natural immunity. Don’t know.

    Now that I’ve done my essentials, I think I might stream a movie. I haven’t seen Knives Out. Maybe it will be a good diversion.

    Thanks again!

    • Rayne says:

      LOL Scarlet fever = strep. Can’t build immunity to bacteria, unlike viruses. And it’s pretty infectious.

      Interesting about the smallpox vaccination. I got a nice round scar from mine. But I’m the one kid out of three in my family who had an extremely light case of chickenpox. My siblings were wallpapered with pox and I might have had a dozen. Had the same experience with mumps, siblings looked like chipmunks during nut harvest and all I had was a sore throat. Perhaps that’s why I’m the one with an immune system gone haywire now, though.

      Have fun streaming!

      • e.a.f. says:

        siblings had mumps, me not so much.

        have heard of people not having the scar from small pox vaccine.

    • Eureka says:

      I keep thinking of those old smallpox vax scars, and how (if this hits us as anticipated) in the future people will see some proportion of us olds walking around with healed tracheotomy scars (some percent of those who go on vents will be on them long enough to get tracheotomies before their recovery).

    • Molly Pitcher says:

      Savage Librarian, we really enjoyed “Knives Out”, kind of dry Britishy humor with a good twist.

    • Tracy Lynn says:

      Recommend “Knives Out.” A relevant movie for these times without being preachy. Besides, it was nice to see some of the older Hollywood actors doing their stuff: Jamie Lee, Christopher Plummer, Don Johnson, Toni Collette, and Daniel Craig.

    • P J Evans says:

      When I was a senior in high school, they gave everyone a smallpox vaccination, through the school. I remember it started itching the day after, and itched like crazy for about three days.

    • Raven Eye says:

      Since you’re supporting your local library, see if they participate in If they do, your library card and online registration lets you stream 10 free videos a month from a rotating collection of over 30000 documentaries, classic and indie Films.

  9. Eureka says:

    I’m glad the kid’s illness is identified and on the way to healing, Rayne — sorry about that strep part of it all. Thanks for pulling all of this together on the meds and bringing up our ultimate to-do lists.

  10. harpie says:

    I, too want to THANK YOU, Rayne!
    Getting all of this information into a form I can understand is something!
    Also, great strep news! I hope recovery goes smoothly.

  11. Godfree Roberts says:

    The White House fired the entire US Pandemic Response Team in May, 2018 and did not replace them.

    This timeline describes what happened next (and why the Chinese are demanding to know when we discovered our Patient Zero): https:// www .unz .com/article/coronavirus-the-plot-thickens/

    [FYI, link is “broken” to prevent accidental clickthrough. Site has not been vetted, use with caution. We do not allow site promotion here, Godfree. /~Rayne]

    • P J Evans says:

      I don’t think we know who our Patient Zero is, as far as the virus spreading. Not sure we can find out, now.

    • Tracy Lynn says:

      This website is a Ron Unz project. He was a Republican who ran for California governor in the late 90s. His ideology seems all over the map: He opposed California Proposition 187, a 1994 ballot initiative to establish a state-run citizenship screening system and prohibit undocumented immigrants from using non-emergency health care, public education, and other services here in California. But he sponsored Prop. 227, which created an opt-in structured English language educational system. It was opposed by language education researchers, and created provisions to discipline teachers who refused to teach in English.

  12. Pete T says:

    Ray needs – yes “good” news on your student. And spot on with the other recommendations re: Health Directives and associated docs wrt to ALL family members.

    But I was just watching today’s Chris Martenson video and one of the news bits was the UK delaying elections for a year! Not clear on the details.

    And at least one primary has been delayed in the USA.

    So, perhaps a post about what could and couldn’t happen here wrt to the General Elections this November?!


    • P J Evans says:

      California has ordered L.A. county to do vote-by-mail next fall, for everyone, because they f*cked up the primary so thoroughly. (I’d already opted for mail-in, based on reports about the voting machines.) I think the state might want to just simply switch everyone to it.

  13. cat herder says:

    Is it time to stop pouring resources into mass testing? I think it’s too late. It would have had a chance of working 3 weeks ago, at some point testing will be irrelevant because it’ll already be everywhere.

    My state still can’t confirm a test result on their own, have to send the samples to Atlanta for ‘confirmation’ which means one single test takes more than 3 days to get an answer. Until CDC gives their verdict all our cases remain stuck at ‘presumptive’. Jesus what an utter disaster.

    • cat herder says:

      To clarify…
      “Is it time to stop pouring resources into (cranking up the process needed to enable) mass testing?”, since we still haven’t been able to get even that part of the response functioning yet.

      • paulpfixion says:

        Absolutely not. It is time to start pouring as many resources as possible into getting the tests. South Korea was testing 15,000 people a day and their population is 1/6 the United States. There are many reports that the virus can be passed by asymptomatic carriers and by low symptomatic carriers. When one person tests positive there should be enough available tests so that EVERYONE they have had contact with are tested and then either quarantined or not.

  14. vvv says:

    For this in need of a relevant laugh: has a headline:

      • J R in WV says:

        You obviously don’t know anyone with Crone’s Disease, Irritable Bowel Syndrome, or any of the other common digestive problems.

        I have chronic constipation from necessary medications I am prescribed, so I take a small dose of Miralax every day. I may use more toilet paper than the average person. Shocking, right?

        I’m glad you don’t need to wipe your ass, you probably save a lot of money that way — a roll a month? Really? Amazeballs !!!

        • Rayne says:

          Easy, buddy. The average American doesn’t need to horde TP. Your personal situation is different and should be treated as such.

    • Savage Librarian says:

      Hahaha. I confess, when I was in the madhouse of the grocery store today, a frantic man was yelling at someone.
      “No, “ he said, “I’m looking for the condiments!”
      But, of course, my mind went to the first two syllables and was mulling that over before I finally processed what he was saying. I wonder if I had an amused look on my face.

      • P J Evans says:

        Mine has a sign: pickles, mustard, salad dressing” (the next one over has “jams, rolls, buns” – and bread and PB).

  15. Rapier says:

    I have been astounded that the Cornonavirus is in total retreat in China. Why? How? I mean any relaxation of the lock downs would seem to instantly mean cascading new infections. I mean what percent of people have recovered and are immune. 10%? I don’t get it. It’s a tremendous thing. But how?

    Here is a story today. Ignore the vast amounts being spent on projects. That is a whole other story.

    • greengiant says:

      The question is how did China squelch both the death rate and the case load in China outside Hubei province.
      Self isolating the entire population except for critical workers, surgical masks available, virus test kits available, contact tracing done on all cases, quarantine of travelers and anyone with a fever, temperature checks and virus tests of travelers, personal protective equipment, n95 masks, face masks etc., ventilators. None of this does the US have or shown the will to have or do. In general once the lockdown exceeds two incubation and infectious periods for each small group of people locked down together, no one is infectious any longer, they have either not gotten the virus, died or recovered. Today there are 5 times as many cases found in people traveling to China as found in people in China.

      • Rapier says:

        Thanks, That’s logical. Well to a point. It would seem to me that any residual cases would restart the process of infection, increasing at some geometric rate again,if many people are out and about. Only slower this time as some now have immunity but I would be shocked if that is more than 10% of the populace.

        My instinct, and I am well aware that ‘common sense’ always has flaws, see our president, is that a new round of acceleration of cases would ensue two weeks or so after normal social life returns. I would think that simple mindfulness; clean hands away from face. not touching surfaces, covered mouth, etc. will mitigate subsequent infection spread.

      • Frank Probst says:

        This is one of those situations where “In theory, the theory should work in practice. In practice, it often doesn’t.” China appears to be lifting their lockdown fairly slowly and (I’m assuming) in a relatively organized way. I’m not convinced that we’ve gotten through two infectious periods yet. Maybe we have, and all is well, but this is a new virus, and this is the first time anyone anywhere has started to lift a large-scale lockdown. We don’t really know what’s going to happen next.

        • bmaz says:

          Yeah. I guess they almost have to give their people some careful relief and see how it goes. Which doesn’t mean they know how it’s going to go. Ugh.

        • paulpfixion says:

          We in China are living a period of existential angst. In my province (not hit hard) schools are going back to the actual classroom (as opposed to the virtual classroom) on 3/30. Restaurants opened again yesterday. Each customer must have a temp check and scan in, only 2-3 people per table, must sit 1 meter apart and wear masks when not eating. Shits still real. My guess is that the continued cases are being papered over, the small outbreaks kept under wraps. No one knows if the gov is teetering or fine enough. Not restarting the economy would be nationalist suicide though, so game on. Life in these times.

        • bmaz says:

          These updates are a very good thing, please keep giving them. At some point, it kind of has to be “game on” though, doesn’t it? I do really wish there could be full and open, transparent, understanding and reporting of how it goes. Probably a pipe dream, but it would be good for the entire world.

        • paulpfixion says:

          It makes my blood boil to listen to the benevolent China narrative that is being pushed in many quarters, right now. Transparency and access would have really helped the West’s crisis response. Not to mention, the literal poisoning of Chinese markets poses perhaps a greater threat than anything they have faced since 1989. The double edged sword of authoritarianism.

        • greengiant says:

          The world as we knew it in past tense. It is not just the virus. It is the supply chain crash. Consumer items people can live without. Chinese manufactured items that stop filling the export pipeline could/might be found anywhere in critical US production, think any machinery used in food production, any packaging used in food production that is imported. My impression that almost all spare parts are outsourced to the US import market. I’m not the expert on what the weakest links in the chain are. What happens when you can’t repair the combine? All those lawn mowers and power washers you see at Costco. How long will those or their parts be exported to the US?
          To the extent production recovers China can name their own price when one group is the only supplier and extend both vertically and horizontally in manufacture.

        • greengiant says:

          Thanks. Report to WHO is less than 120 deaths of over 21,000 cases outside of Hubei.
          Recognize that government said any new cases are on the backs of local officials. but maybe having enough hospital beds and people at risk isolating early along with shelter in place played a roll in the low death count.
          Massive invasive temperature checks and punishment for anyone in public with a fever? Or anyone in public with a housemate with a fever or in quarantine.
          NYTimes interview with WHO team lead Dr. Aylward who visited in early February discussed automated contact tracing.
          And how did Taiwan deal with this. How did South Korea plateau the number of new cases.

  16. Frank Probst says:

    Remdesivir is being approved in the US on a “compassionate use” basis. I think there have been three patients treated. Here’s a link to get people started, if they want to dive into this:

    (Please note that I’m linking to this article mainly because it’s recent and it’s in a source that I trust. I’m sure there are better summaries out there.)

    For those of you who are unfamiliar with the term, “compassionate use” usually (but not always) is invoked when someone is probably going to die or suffer permanent disability using currently available treatments. (This is obviously not the technical definition, but that’s my approximation of it. It was discussed a few times when I was working with infants with severe inborn errors of metabolism, but I was never involved in a case where it was actually used.)

    • Rayne says:

      Thanks for sharing that, Frank. This observation from physician in WA mentioned ‘compassionate use’ and that CDC was trying to work with Gilead on changing this criteria. There had been some concern about remdesivir’s affect on liver which might already be under stress from virus.

      • Frank Probst says:

        Ooh. Just read your link about Gilead shipping the drug to China prior to HHS approval. That’s the kind of thing that should NOT happen, even in dire circumstances, if HHS is functioning normally. Given all of the additional evidence we have, it is unsurprising that HHS is NOT functioning normally, so they went ahead and shipped the drug, but this kind of thing still makes my jaw drop. Our response to this crisis is so bad at the federal level that a drug company felt it necessary to do this, even over what had to have been objections from their entire legal department, because HHS was so dysfunctional. Just…wow.

        • Rayne says:

          It’s super iffy. I want to know if Grogan was involved in any way. I get that humanity badly needs a weapon, but on the face of this there’s no safeguards about how this drug will be used. And it’s human experimentation but this lack of authorization seems to fly in the face of the Declaration of Helsinki’s ethical principles.

        • Frank Probst says:

          I’m just…wow. Even if someone at HHS told me, “Go ahead and ship it. We’ve got your back,” there’s no way in hell I’d do this. “Here’s your signed full pardon.” Nope. That’s the kind of bad decision that will haunt you wherever you go. You may not go to jail for it, but you’d never escape from it being forever glued to your name.

        • Vicks says:

          Keep track of what you are casually observing.
          Watch their hands (and wash yours)
          If you are working on harnessing your power of intuition this should be rocking your spidy senses.
          There are solid reasons drug companies can’t ship it’s shit without approval.
          The first step is to dig in and clarify if it is a case of our government being in such a mess that this company felt compelled to ship the drug anyway or did this company ship this drug without approval BECAUSE our government is in such a mess?

        • PhoneInducedPinkEye says:

          You have to wonder how much consent in an authoritarian state the patients had that they tried the drug on. Even if it helped some of them, the Chinese gov wouldn’t have any scruples about consent. Wonder if Gilead has brushed up on the nuremburg code recently.

    • Lurker says:

      Longtime reader and lurker (from FDL days), first time poster. Just wanted to throw out a link to an interview with an expert on cytokine storm:

      I’m sorry I did not clean up the link if it needs any cleaning up. Randy Cron, from the University of Alabama Birmingham, is an expert on cytokine storm syndrome and wrote a book about it.

      A little background about myself…I am an RN working at a hospital system in Texas. I took interest in pandemic flu during the H1N1 outbreak in 2009, although I was not an RN back then. Even though I observed from afar, I remember watching the government’s response during that outbreak and feeling confident that our public servants could manage it. They asked the right questions and covered angles I had not even considered as a public layperson. I knew they were passionate, thoughtful, competent, and truly cared about public health and public safety. It angers and saddens me that the institutions that should have and would have provided such a response during our current crisis were decimated by the current administration.

      I hope to be able to share some insights with the MDs at work. They have a heavy workload as it is without a pandemic, and they may not have time to keep current with the latest information. My advice to the general public would be to please do your part to flatten the curve. Thanks for encouraging that here and sharing valuable insights as a community.

      • Rayne says:

        Wow. Thanks for sharing that, Lurker, and thanks for de-lurking.

        That article you shared mentioned HLH. The last time I saw HLH mentioned was related to the odd death of a young ESPN anchor. Media reported he died of pneumonia the last week of December. The same week I saw the first reference in English-language Chinese media about a cluster of pneumonia cases in Wuhan. I have wondered whether that young anchor really was an index case who had contact with someone from Wuhan. Family had been told he had cancer, but everyone was so surprised by his death that I don’t think that’s what it was. More like he died of HLH and a cytokine storm but they could only explain it as an aggressive cancer.

        This bit is absolutely golden:

        A cheap, simple test, widely available at most hospitals in the United States and worldwide, can help diagnose cytokine storm syndrome, Cron said. “A protein called serum ferritin tends to get very high in this disorder,” he said. “If you are sick enough to be in a hospital and you have a fever, you should get a serum ferritin. It typically comes back in less than 24 hours and almost every hospital can do it, and if it’s high you can work them up for cytokine storm syndrome.”

        So…it looks to me, not a medical professional, mind you, if a patient shows up with a fever, other COVID-19 symptoms and signs of entering ARDS, a serum ferritin test needs to be run ASAP and then treatment with an anti-interleukin-6 agent to halt the cytokine storm.

        May not even need to test for COVID-19, would take too much time and potentially cost the patient their life waiting for results. Prompt treatment could keep them off a ventilator. Next question is whether an antiviral therapy is tolerated with an anti-interleukin-6 agent. Hope China or Italy is learning this and fast.

        Thanks again!

  17. Frank Probst says:

    A quick comment on the “cytokine storm” theory of why the 1918 flu was so devastating to young adults. This theory (a) makes sense and (b) is consistent with what the 1918 virus does to animal models, but I don’t think that there was much postmortem examination done at the time of the pandemic (There could have been, and I’m behind on my reading.), so the evidence here is circumstantial (but quite strong) rather than direct (which would be stronger).

      • Frank Probst says:

        I need to hunt down the paper. The part that raised my eyebrows was the viral cardiomyopathy. That makes sense, too, but it’s hard to be sure about, even with a good animal model, if you haven’t examined the hearts of a number of the patients.

        The Chinese will know if this is happening in their coronavirus population, because the people you do autopsies on are usually the ones that don’t seem to make any sense, but they may not be talking about it publicly. (Most likely because they’re trying to get it published after peer-review rather than due to some sort of malicious motive.)

        • Rayne says:

          Press Release:, 05 OCT 2005 Researchers Reconstruct 1918 Pandemic Influenza Virus; Effort Designed to Advance Preparedness

          Statement:, 05 OCT 2005. Unmasking the 1918 Influenza Virus: An Important Step Toward Pandemic Influenza Preparedness — Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health and Julie L. Gerberding, M.D., M.P.H., Director, Centers for Disease Control and Prevention

          Paper: 18 JAN 2007, Kobasa, D., Jones, S., Shinya, K. et al. Aberrant innate immune response in lethal infection of macaques with the 1918 influenza virus. Nature 445, 319–323 (2007).

          Article: 29 DEC 2008, Researchers unlock secrets of 1918 flu pandemic, by Maggie Fox, editing by Will Dunham and John O’Callaghan

    • orionATL says:

      there is an article in national geographic (which may already have been cited here in the multiple posts) that explains some of what covid-19 does to our body. nice, simple patient education from feb 2020:

      the article touches on xoonotic (non-human animal based) diseases of which the family of sars, mers, and covid-19 are one. it also talks about the cytokine storms (discussed by rayne above) that is a killer in covid-19. cytokines are proteins of the immune system that signal other immune proteins to attack, e.g., the covid virus. sometimes these attacks get out of hand creating a deadly cytokine storm.

      one very interesting mention here is the role of pneumonia. this would be viral pneumonia i presume. it is a serious consequence of the virus, and is now used in testing in china to speed it up:

      “… Confirmed cases rose to more than 60,000 last Thursday, nearly a 50 percent jump relative to the prior day, and the tally has since increased by another 13,000. This leap reflects a change in the way Chinese authorities are diagnosing infections instead of a massive shift in the scope of the outbreak. Rather than wait for patients to test positive for the virus, diagnoses now include anyone whose chest scan reveals COVID-19’s distinctive pattern of pneumonia…” 

      there are two pneumonia vacines available. they cannot be taken together at any one time because they will fight each other. vulnerable individuals are given one and sometimes both as patient circumstances support and time permits. the vacines aren’t fool proof. their claim to value involves a stronger response to pneumonia in the blood stream which can result in organ failure an often fatal result.

        • orionATL says:

          thanks p. j. this is very important.

          both the available pneumonia vacines are for bacterial infections (streptococcus, wouldn’t you know). pvc13 has been extrordinarily successful in squashing some common illnesses in babies.

          apparently the only way either of these vacines could help a patient with covid-19 would be if that patient developed a secondary bacterial pneumonia due to a weakened immune system. i assume that would be in older, chronically ill patients.

          a general discussion of flu-based pneumonia with comments about covid-19 based pneumonia :

          “… The evidence so far points to the virus itself as the cause of pneumonia in COVID-19 patients, the infectious disease doctors agreed. To be sure of that, Schaffner said, “we need more clinical information and very careful observation.” There are no treatments for that virus, although there’s a rush to test drugs used for other viruses like HIV. Because pneumonia vaccines target bacteria, they would not prevent pneumonia caused by a virus. Antibiotics also would not be effective…”

          while the corona-19 virus apparently creates its own viral pneumonia which is said not to be affected by the bacterial infections, this pneumonia does provide a signature pattern of damage to the lungs which is being used to develop a much faster test for the illness.

        • Rayne says:

          I wish I’d snagged a copy of a link to a source which said the Chinese found almost no secondary infections in COVID-19 patients. If they found COVID-19 they wouldn’t find RSV or influenza and vice versa.

          Your previous comment in this thread hits on a key point: CT scans showing evidence of viral pneumonia attributes now seen in COVID-19 are a rapid indicator compared to obtaining results from a COVID-19 test given how challenged our COVID-19 system is right now.

        • orionATL says:

          thanks, rayne.

          from memory the chinese found that only about ~ 3% (3000/100,000) of covid-19 cases involved secondary infections. even there a direct line of causality is suspicious. just inherent, severly worn down or damaged immune systems might suffice to explain.

          every scientist and doctor (they are not mutually exclusive at all) worth their salt is saying “we don’t know diddly for sure yet.” it is mid-march; this disease was picked up in china in december 2019; that’s mas o menos 3 months -TOTAL elapsed time. not much to ramp up research even with human subjects suspended .

        • bmaz says:

          Speaking of CT scans….I read something earlier today that Iran uses CT scans in addition to reagent tests to diagnose corona. But they have a problem because they don’t have enough machines. Why? Because they are made by GE, and the draconian US sanctions prevent them from buying additional machines and parts for the ones they do have. How the fuck do we deny a huge developed country health devices? Can’t find the link, sorry.

        • Rayne says:

          That’s a shame. They’re dealing with the supply chain issue we have with China — too much from one source in a single country.

        • P J Evans says:

          Because people running this country – and some others – think that even humanitarian aid can be used as a weapon…which is what they’re doing by denying it, IMO.

      • orionATL says:

        here is a publication by north american radiologists of a small but clever study by chinese scientists comparing the perfomance of chest ct scans with the standard polymerase chain reaction test for the covid-19 virus which requires more time.

        what is polymerase chain reaction testing?

        as paul krugman would warn, “wonkish” (so don’t expect me to explain it, i just learned to read):

        the steps of the process are outlined and require several hours and some chemicals from a bacterium.

        covid-19 virus may not have dna, so why use the rt-pcr lab process? because the same process can be used for rna viruses as well as dna viruses.

        this test (rt-pcr) is the same one used in crime detection. see, now everybody understands😊.

        • bmaz says:

          Krugman, Lol. PCR has been a theory almost since Watson and Crick. But it has been a real thing thing since at least the mid-80’s. I learned about it from, no joke, the testimony by experts testifying in the OJ Simpson trial. I then engaged Barry Scheck in a deep and ongoing discussion about it and other DNA testing because I had a case it was extremely pertinent to at the time. The science is solid. There may be an issue about the turnaround time; that I cannot speak to. But it is why I brought up the Iranian issue with functional CT machines.

  18. BeingThere says:

    Rayne, that’s very nteresting post re meds for covid-19.

    Re Gilead and their lobbyist now part of Trump white house, if he’s got interest in having more sick people to sell drug to (federal money directly if funds provided for emergency).
    The other day I read there’s talk of $5Billion being loosened up from federal coffers for emergency medical funds.. If that is predominantly spent on their meds it’d bump the Gilead stock up and no doubt Trump (Johnson in UK?) has stock and will make out like bandits. Since Trump treats the US govt coffers, global power, reputation, military strength, or financial leverage as things to trade or funds or means to fill his his personal pocket-book.

    In the UK there’s clearly some shinanigans afoot. The UK Health Secretary, Matt Hancock, and PM Johnson are fence sitting, yes closing schools etc is good / not yet it’s too soon. It reads that they want to get “just the right number” of people sick, or aiming for “60%” for “here immunity”, before flipping the containment switch.
    “Gilead’s planned U.K. expansion was announced by London Mayor Boris Johnson yesterday on the second day of a trade mission to the U.S. by MedCity.”
    “According to an announcement by Mayor Johnson, Gilead reasons that a presence in London will foster closer partnerships with clinicians, patient groups, the National Health Service and government organizations, as the biotech giant continues its efforts to broaden access to its medicines.”
    “Gilead was one of two companies whose plans for expansion in the U.K. were trumpeted by Mayor Johnson and MedCity yesterday.” (Feb 10 2015)
    “The event, also reported on by Private Eye, included private healthcare provider Gilead Sciences, drugs giant GlaxoSmithKline and Aetna, a US private health insurer that manages over 5,700 hospitals. Altria Client Services, the parent company of tobacco company Philip Morris International, was also a sponsor.
    Donald Trump and his ambassador to the UK Woody Johnson have both said that the NHS must be “on the table” in negotiations over a future US-UK trade deal.” (27 Nov 2019)

    Prior to Johnson getting re-elected PM, Tump and Johnson had made a pact on US pharma getting access to UK NHS as part of the brexit trade deal. Much celebrated by pharma post election (and just before news on nCov-2019)
    “Commenting on the election result, Mike Thompson, chief executive of the Association of the British Pharmaceutical Industry (ABPI), noted that the Conservative manifesto “included strong commitments to improve the availability of new medicines to NHS patients, the uptake of vaccines, and to place life sciences at the centre of an innovation based economy.
    “The ABPI supports these ambitions and we look forward to working with our members to bring new investment to the UK to further strengthen our world-leading science base.
    He also noted that Johnson’s Brexit deal “includes an important commitment to exploring close cooperation on medicine regulation. Achieving this will be important in prioritising patients and public health as well as the future of the UK life sciences sector.”” (13 Dec 2019)

      • Raven Eye says:

        And the UK got a pass on Trump’s travel restrictions? Have Trump and Boris Johnson been cooking this up?

        If Johnson’s theory of moving the infection curve into the summer doesn’t work, it puts U.S. state health officers in the position of dealing with the problem (for which I believe they have the authority) once those people step beyond the federally controlled areas of ports of entry.

        This could be a real fustercluck.

      • cat herder says:

        We’re doing the same thing here, just not admitting it out loud in front of the cameras. Our testing program is fucking vaporware.

        • Rayne says:

          Seriously. How is this not a massive scam to steal Social Security and Medicare/Medicaid money from Americans who paid into the system their entire lives? Literally committing passive euthanasia on those most vulnerable by refusing to test the population.

          And I think this isn’t Trump — he’s too addled now. It’s his Nazi-kind who are propping him up like a puppet, throwing him out in front of the media while they ransack the place out of sight of the public.

          I hope they all get the virus so we can boot them out long enough to figure out what they’ve been doing.

        • Vicks says:

          We need look at why Trump keeps pushing this payroll tax cut.
          It has been repeatedly dismissed by his own party because it doesn’t target those in need.
          It doesn’t help his high end pals because It affects the first 75k of a person’s income (yeah I know)
          What does it mean to cut the very taxes that fund our most popular safety nets?
          (6.2% of the first 75k of everyone’s income goes to social security and 2.4% goes directly to Medicare.

        • P J Evans says:

          A lot of the GOP-T management has been wanting to kill SS and Medicare since they started. They got IRAs and 401(k)s in their earlier efforts.

        • Vicks says:

          We need to know how EVERY fucking thing Trump has done has affected his personal wealth.
          It’s unconscionable that our courts are even pretending to consider whether or not taxpayers have a right to see how our leader’s decisions affect their personal fortunes.

        • P J Evans says:

          I wonder if Trmp thinks that “the buck stops here” means that he’s entitle to all the money he can get while in office.

        • greengiant says:

          A common technique to disrupt discussions is to insert falsehoods. The FICA limit for 2020 is 137,700. The Medicare tax is 1.45 percent with no income limit. The employer matches the employee’s FICA. Eliminating FICA would cut employers labor costs by 7.65 percent directly and in a simple model another 7.65 percent as nominal wages moved lower on the supply demand curve to the previous equilibrium point.

        • vicks says:

          I have no problem being corrected, and as you pointed out, I clearly garbled my numbers, it would certainly be more interesting (and useful) if rather than insulting and accusing a person you know nothing about of “inserting falsehoods” to “disrupt the discussion” you used your fact checking skills to address the three points I was making.
          Inserting the correct income caps on payroll taxes does not change the fact that this income is chump change to Trump’s pals and can most likely be dismissed as a motive.
          Inserting the correct salary caps doesn’t change the fact that a payroll tax cut will help a large quantity of people and businesses that don’t need the help.
          Inserting the correct salary caps also does nothing to change the fact that a payroll tax cut will cut the money that directly funds social security and Medicare.

        • drouse says:

          I was indulging in a bit of gallows humor when I made the suggestion about cutting entitlement spending a couple of threads ago. But damn, I really didn’t think that they would try to prove me right.

        • Vicks says:

          IMHO the chance that Trump gets re-elected are collapsing as we speak.
          If someone is keeping their eyes on the ball, it should be easy to spot the reckless behavior that is guaranteed when greed is combined with sense of urgency.

        • paulpfixion says:

          If Johnson actually is pursuing a policy of “herd immunization” it is going to be devastating.

          Just based on Trump’s behavior publicly, and the virus cases at his Bond Villain HQ of Mar a Lago, my gut feeling is that Trump himself isn’t pursuing this policy. However, the US lack of response/seemingly bungled response would be an awfully effective way of pursuing the “herd immunity” response.

          The medical director of the Infectious Disease Center at Princess Margaret Hospital in Hong Kong just reported that a few “recovered” corona virus patients have markedly less lung capacity.

          The fact is no one has a clear grasp on long term consequences.

        • Rayne says:

          Snipping this out of someone’s tweet:

          Jeremy Rossman of Kent University on the potential impacts of the herd immunity response.

          This is utter insanity. The UK has made zero effort to increase social distancing. Bylinetimes’ editor Peter Jukes said,

          This is how quick we have to move. Covid-19 cases in the UK doubling every 2-3 days. Given Govt estimates we had 20,000 cases a day ago (95% untested). Tomorrow that will be around 40,000. By Monday — 80,000. With 5% acute respiratory hospitalisation, mid next week is critical.

          If the UK doesn’t shut down this weekend, it will be Italy. And mortality rate will not be merely the million cited but deaths of other patients who needed emergency/intensive care and couldn’t get it over the next 6-8 weeks.

          Johnson needs to be tarred and feathered.

        • vicks says:

          Am I missing something?
          Won’t people from all over Europe be stampeding to the UK in the hopes it’s a way can sneak back to the US?

        • Rayne says:

          You’re missing the fact the UK is about to explode with COVID-19 and everyone across EU knows it.

          For some reason UK people are frozen in cognitive dissonance and haven’t dragged Boris Johnson down the streets of London decked in tar and feathers. EU is just plain too busy with their own burgeoning cases.

        • Vicks says:

          Yeah, I should have spent more time on my comment.
          What I was meaning to point out was by the U.S exempting the U.K. the fools were all but ensuring people from all over Europe, were first traipsing through the U.K. before they got on a plane to fly home, or worse, stuck there because they didn’t qualify.

        • P J Evans says:

          The WH has banned travel from the UK and Ireland now. And is mumbling about domestic restrictions.

        • e.a.f. says:

          the visual on that had me laughing. with that white hair and the tar, and feathers, running up the street, o.k. he most likely waddles some what like Trump.

          When people just as Trump, Johnston, (Canada) Kenny, Ford are elected, my line is, They elected them. Now they can learn to live with it or die because of it. Its just too bad about the children who didn’t vote.

        • Rayne says:

          It’s too late. Their hospitals will be at maximum capacity already as a result of failing to implement social distancing measures 1-2 weeks earlier.

          Based on Peter Jukes’ scratching, imagine by April 15 the UK having 4000 cases requiring intensive care, most on ventilators for weeks at a time.

          At 2.7, they have fewer hospital beds per 1000 than the U.S. does. Last reported number is 2.77. Compare to overwhelmed Italy which had 3.2.

        • BeingThere says:

          Hearing from family UK is ready to start mobilising army to protect supermarkets, petrol stations, and hospitals. Fortunately the population isn’t armed, similarly in Italy and most European countries. It does raise a concerning question how the US will unfold with the vast number of weapons as hospitals inevitably get over-loaded? :(

        • Eureka says:

          Oh, they are stockpiling ammo and buying guns (local area had some mandated closures, which prompted reporters to tour around local businesses: gun shop owner said business generally was up “5-fold”, for ammo especially, also people buying guns wanting to know the return policy post-COVID-19.

    • harpie says:

      OH MY F’CKING GOD this sub thread! :-{{{{{

      …unfortunately, at this point, very plausible.
      I may just go back to bed. At least those nightmares end.

  19. Ollie says:

    1) Advance Directive DONE
    2) Will DONE
    3) List of bank accounts w/passwords DONE
    4) Cremation paid for DONE
    5) Pet(s) documents for Greenhill Humane Society. They know my pets and my wishes.
    6) Banks are in receipt of survivors so they can have money right away w/o going thru probate.
    7) Password book redone w/clarity, neatness and some humor.

    Just got my binoculars, crank short wave radio and candles, stick matches, flint…3 mos food…water. Cat food and supplies.

    Have headache. Going to bed. Good night all. See you tomorrow!

      • Ollie says:

        oh gOOd morning all! We’re still here!

        So thank you for getting all that done. My ex died in Jan and shiver me timbers if SS didn’t send me condolences for my loss (we divorced in 1981, lol) and to give me more money! It was like the Wheel of Fortune! The docs most important for me are regarding my two pets. My local shelter (and where the REAL Ollie came from at a tinder age of 10 weeks). I filled out a form for both Ollie and Babe. Their habits, likes, dislikes. Who is shy. Together or not? Food. I also was able to tie a donation to help out. It’s like an Advanced Directive for our faithful family pets.

        I just got hired to do the US Census field work. I’ll be curious to see how they keep us safe….First nonresponsive field work begins 4/9. Here in Eugene Oregon we have 0 cases so far. They’re expecting hundreds in a couple of weeks.

        I go to the senior center 3 x’s a week for lunch. Closed. Friday was the last day until further notice. Wheels on Meals sponsors that and not sure if they’re still have the delivery service. New times…sigh.

        Best to all. Back to check in later…be safe.

  20. W Brown says:

    I don’t have the PubMed cite handy, but there’s a journal article describing the 50-year-old tapeworm med niclosamide as a broad-spectrum antiviral likely efficacious to some degree for coronavirus. As far as I can tell it’s practically unavailable in its original form, especially in the U.S. since nobody gets tapeworms anymore. But they make it in China in large quantities as an insecticide and to kill snails in lakes. I ordered a kilo of the ethanolamine salt from a Chinese manufacturer for my cancer (more bioavailable). It shipped door to door in 2 days. Rayne, email me and I’ll reply with the details if anyone is interested.

  21. vvv says:

    My kid has friends in Italy (military) saying it’s not so bad. We argued a bit, she sends this:
    ht tps://

    Music is life.

  22. PhoneInducedPinkEye says:

    Thanks for the drug info, like most older adults my parents have health issues that make them more vulnerable so it’s reassuring there are some things I can pester a doctor about if worst come to worst. Best of luck to all

  23. Eureka says:

    Thank you to everyone here and on recent and related pages for sharing what’s going on in your neck of the woods. Besides being a community thing, it’s so far the best way to get a feel for changes peppered across the US & world, and gives lots to think about and learn from.

  24. OmAli says:

    Where was Trump’s CDC guy Redfield yesterday during the testing confab/presser yesterday? Is he in the doghouse for getting publicly spanked and then agreeing to Rep Katie Porter’s call for free testing? And it appeared to me that Trump was angered when Pence was lauded by one of the speakers. He made a bit of a show of frowning and glancing up and down at a note card in his hand and looking over at Pence. Just plain pissy. I call him POUTS.

  25. it's complicated says:

    I wouldn’t know, the US is a big country with a lot of resources.
    I had another look at what the Koreans did, btw they also don’t use the WHO test but rolled their own.
    Some general informations about their measures and a few interesting timelines can be found in h ttp:// (press conference for foreign correspondents a few days ago).
    From another official source (a PSA for the population, Feb 27, h ttp:// I gleaned that turnaround time for their test is 6 hours, and that the cost (in most cases paid by the government) for rt-PCR-testing one patient is at 160000 KRW (about 130 USD).
    After initial problems, they also reorganized their hospitals into three distinct categories: treating Covid19 patients, treating non-Covid19 respiratory system patients, and treating everything else.
    Seeing a non-authoritarian country of 50 million people seeming to get a grip on this despite a horrible setback caused by religious fanatics is encouraging, and certainly worth having a deep look at.
    I will be watching more vids from the PSA playlist, who knows what else I will find:)
    youtube links intentionally broken.

  26. pdaly says:

    Thanks, Rayne. Fantastic post pulling all sorts of data and planning advice together.

    That CNN interview with a former UK cabinet member is jaw dropping. It certainly provides an explanation for the crazy foot dragging by both Boris Johnson and Trump, alike.

  27. BeingThere says:

    There’s a new approach to testing using the CRISPR gene splicing method to insert a fluorescent protein chain into the covid-19 Gene sequence, the CRISR programed to start the splice at a unique binding site in covid-19. The test can be completed in 30mins and uses off-the-shelf equipment and supplies. The only unique part is the section of covid-19 genetic sequence to configure the splicing (either sourced from the group who demonstrated this method, or make your own as many homebrew gene splicing experimenters do, just need to be sure your detected sequence is unique to covid-19)
    There’s the white paper linked from there outlining equipment, supplies, and method.
    This type of test approach could be being done in every university biochemistry lab in every country / town in short order. While the lab process run time is 30mins start to end, you could have hundreds of samples going through the process in pipelined production line fashion. It’d be easy to set up mobile in a van.

  28. harpie says:

    bmaz retweeted this from WENDELL POTTER earlier…IMPORTANT.
    4:57 PM · Mar 13, 2020

    WORD TO THE WISE>> During this coronavirus crisis, keep an eye on every move of my old industry: health insurers. Behind the PR spin, they will be doing everything they can to deny care & maintain profits, while making it look like they’re heroes. Here’s what to look for: (1/10) [MORE]

    Trump’s presser yesterday was totally disinformation.

    • harpie says:

      See also:
      Trump Caught Google Off Guard With a Bogus Coronavirus Site Announcement
      Google’s not making a nationwide coronavirus testing website. And the company had no idea the president would say it was.
      03.13.2020 08:02 PM [UPDATE 3/13/2020 10:54 PM ET: This story has been updated with comment from Verily. The White House declined to comment on the record.]

      […] A source at Google tells WIRED that company leadership was surprised that Trump announced anything about the initiative at the press conference. What he did say was also almost entirely wrong. There will be a coronavirus testing site, not from Google but from Alphabet sister company Verily. “We are developing a tool to help triage individuals for Covid-19 testing,” Google tweeted in a statement. “Verily is in the early stages of development, and planning to roll testing out in the Bay Area, with the hope of expanding more broadly over time.”
      Even that, though, was not the original plan. The Verge reported Friday afternoon that Verily had intended the site for health care workers only. After Trump unexpectedly publicized the effort, Verily decided it will let anyone visit it, but can still only provide people with testing site information in the San Francisco area. […]

      Maybe this bit of mis-info came from Jared’s sister-in-law’s father.

      • harpie says:
        12:24 PM · Mar 14, 2020

        The flowchart shown yesterday afternoon of the ‘Google’ website is very similar to info released in an Oscar press release from yesterday afternoon

        As @davidgura noted Google sister company Verily has invested in Oscar, co-founded by Jared Kushner’s brother Josh […]

        There’s no evidence that the new Google (Verily) website announced at Trump’s press conference is connected to the Oscar service announced at the same time. But this is an interesting coincidence that should be looked into further

      • earlofhuntingdon says:

        Who could have known that Donald Trump would over-promise and under-perform?

        Everything to him is a marketing script: facts are irrelevant, momentary persuasive is all. Reality is a nuisance best ignored.

    • harpie says:

      From a comment downthread:
      New from WaPo:
      Infighting, missteps and a son-in-law hungry for action: Inside the Trump administration’s troubled coronavirus response
      March 14, 2020 at 4:47 p.m.

      […] Kushner rushed to help write Trump’s widely panned Oval Office address to the nation. His supermodel sister-in-law’s father, Kurt Kloss, an emergency room doctor, crowdsourced suggestions from his Facebook network to pass along to Kushner. And Kushner pressed tech executives to help build a testing website and retail executives to help create mobile testing sites — but the projects were only half-baked when Trump revealed them Friday in the White House Rose Garden. […]

    • e.a.f. says:

      don’t know what presser I watched around noon, pacific day light savings time, but the sibling looked at me and said, trump looks like he is totally out of it Why is he wearing that cap? (navy blue this time) suggested he hasn’t done his hair and hence the cap.

      Then we had the B.C. Minister of Health, Dix and Province’s Chief medical officer, Dr. Bonnie Henry and their presser. Calm, full of up dates and facts. Talked a lot of keeping the curve down. The presser had a facilitator who kept the questions in an orderly manner so journalists on the phone could have their opportunity to ask questions. Very new reporters present, in person.

      The P.M.’s wife has COVID 19, he’s self quarantined as are the 3 kids and the kids are playing lego. B.C. and the federal response has left us feeling O.K. in spite of the pandemic. Alberta’s premier decided a few weeks ago to go to war with the doctors and Nurses. Ontario–Premier Ford is not willing to revoke his requirement that people need med. certs from their doctors if the employers ask for them, to hang on to their jobs. Neither of these Premiers are considered “progressive” in Canada.

      Thank you to those who contributed the awesome medical references. Lots of great information. “Information is Power”. In this case I’d suggest good information keeps us calm.

    • ernesto1581 says:

      slightly OT, but check out Wendell Potter’s extended interview with Jeremy Scahill a couple weeks ago:

      (can someone please show me how to turn that spaghetti into a simple “click here” link on this site?)

      [I did it for you. Unfortunately, our filter protocols override some of the commenter edit availability, and likely will for a while, so it is not a problem. Post your links as necessary – bmaz]

  29. dude says:

    In all this blizzard of information by astute readers of this blog, the following may have already been identified.

    There is a good open-source site that compiles information on Covid 19 spread globally. It may lag a bit on headline statistics (I am not sure about that yet), but it obtains data input from all countries in an effort to track viral spread by tracking how the virus has changed as it passes from place-to-place. MY wife (the public health researcher) is beginning to pay attention to this site.

    I (as a layman) don’t fully understand how the subtle change in a virus that allows it to be tracked across people does not also mean the virus is mutating. But I do recall Dr. Denison (from yesterday’s NPR On Point podcast link) saying the wider a virus spreads across hosts, the more opportunity it gives itself to mutate into something substantially new and different. Therefore, I assume one urgent need to do this sort of tracking of subtle changes in a virus is to identify or predict substantive changes the viral structure and when it changes the nature of its attack on our bodies, and thus change the tests and the treatments accordingly.

  30. orionATL says:

    as cdc’s nancy messonier, cdc’s top immunization and respiratory disease official warned a month ago, there are politically very tough decisions to be made about non-medicine interventions to control covid-19. nytimes’ nicholas kristoff and stuart thompson have an opnion piece on getting people to stay away from each other where large numbers of us pool, e.g., sports events, movies, restaurants, schools, mass trans, large population work sites:

    the first four graphs and each graph’s accompanying blurb are most useful. you can play with a cursor to see for yourself how keeping people apart reduces both deaths and the load on our hospitals.

    • dude says:

      This is from the website itself:

      “Pathogen Phylogenies
      In the course of an infection and over an epidemic, pathogens naturally accumulate random mutations to their genomes. This is an inevitable consequence of error-prone genome replication. Since different genomes typically pick up different mutations, mutations can be used as a marker of transmission in which closely related genomes indicate closely related infections. By reconstructing a phylogeny we can learn about important epidemiological phenomena such as spatial spread, introduction timings and epidemic growth rate.”

      • orionATL says:

        excellent. thanks.

        in general, my understanding is that this same mutation process (error-prone replication) is what makes cancer so hard to control.


        no matter. good stuff is good stuff, but a cite would now be helpful 😉.

      • dude says:

        On the site–scroll to the bottom of the opening page and it explains the concept and strategy behind the site. The part quoted is part of the explanation for how and why of virus tracking.

        • BeingThere says:

          Posted the links up the thread a few places to one of the research scientists running the nextstrain project – David Bedford. Link to his blog some of which is included in nextstrain site content,can’t his Twitter – interesting updates.

    • orionATL says:

      so far no test has been developed for measuring the will of national political leaders when faced with a epidemic that could kill 1,000,000 americans.

      all the leadership i have seen involving keeping people apart by not forming up in groups has been from the bottom up. the local schools and libraries will close monday; i understand schools in kansas city, kansas are closed.

      forget the politico-media crap about “not panicing”. this is controlling bullshit. we don’t panic; we make things happen for ourselves and our families that take valid information into account. that is what makes the emptywheel website so valuable.

      • e.a.f. says:

        This is the test.

        The trump administration has failed.

        Washington State Gov. has passed.

        This website is valuable. Not only does it give accurate information and up dates on what is going on in the U.S.A., but it provides some really good commons sense advise and a few good laughs. Quinn Norton’s opening Q & A. still goes through my mind and makes me laugh.

        This evening CTV news in Canada showed apartment blocks some where in Italy with people at their windows and on balconies all singing and playing instruments. It was organized on social media. It announced people ought to come to their windows Friday night at 6:00 p.m. to sing.

        Their next “event” is being suggested as everyone comes to their windows, again at 6:00 p.m. and simply applaud. the applause is for those working fighting the virus.

        Obviously people are making the best of it.

        Also had a clip on regarding volunteers in China who deliver medications to those at home. Some Aids patients can’t get out to pick them up, so the volunteers are doing it.

  31. orionATL says:

    not to be conspiratorial or anthing, but thinking of the maxim about not wasting a good crisis, what might happen to presidential and congressional voting this coming november, let alone spring primaries, in terms of being skewed for one party or another if this epidemic persists because it is not weather sensitive or because it re-ignites in the fall? how many households don’t keep stamps handy and what might be their demographics?

    now would seem to be a good time to fund and develop competent on-line voting systems, heavy-tested for ease of use, accuracy, and security.

    • bmaz says:

      Or at least widespread vote by mail protocols. Our system here in AZ is wonderful (go figure, we got something right for once) and you get a normal paper ballot that you can copy and keep a record of, and verify online that it was indeed processed and counted. It is fantastic.

      Interestingly, the Maricopa County Recorder, who is ostensibly in charge of elections in Maricopa County, seeing the corona issues, and possible need to close many precincts because of health safety concerns, decided to send every registered voter in the county a mail in ballot. The AG here filed an injunction against him doing so. Our primary is Tuesday, will be interesting to see how it goes, and how many people show up at the polls.

      • orionATL says:

        “send everyone a mail-in ballot.” now that is caring, not to mention politically wise, recorder.

        right this minute we are filling in applications – only applications! – to receive a mail-in ballot for a march 24 primary. an application form must be sent in by each voter for each of the following “general primary, general primary runoff, general election, and general election runoff” unless you are an old codger, ≥65.

        • bmaz says:

          See, now here, you can sign up easily online. And once you vote by mail, you keep getting them for all subsequent elections until you revoke it or don’t vote for a couple in a row. Pretty easy!

        • P J Evans says:

          L.A. county requires a signed paper form, but you can download it. It’s for all the elections they run.

    • vicks says:

      No way on internet voting.
      Mail in ballots, or go to automatically go everyone using the absentee systems that are already in place.
      There can be no argument that there won’t be the people power to get this done.
      No way in hell can this election be postponed.

      • orionATL says:

        yeah. it occurred to me that on-line voting is probably an incomplete idea simply because so many folks do not have ready access to computers. going to the library gor a computer is self-defeating.

        as for delay, on-line would not necessarily create that unless it were deliberate.

        very important – all mail-in ballots should include a stamped, addressed envelope and be treated as priority mail by the post office. the idea is that voting by everyone is top priority among government concerns.

        • earlofhuntingdon says:

          You might include that voting via the Internet is insecure as hell.

          The biggest Internet companies make their money from harvesting data from their users, hypnotized by “free” and “convenient.” That structural problem militates against their making such things more secure. It might lead to lower income, or a model and expectations about its use that would lower it. That suggests that Internet voting will be an “incomplete” idea for some time.

          Rather than build on insecure technology, voting systems should revert to paper and observed hand counting. Verification and the ability to audit are essential, and the hardest attributes for high-tech to reliably produce.

        • it's complicated says:

          Yes, and on a lighter note, later today I will be filling out the ballot papers for our communal elections.
          The biggest ballot paper is the one for city council: 60cm * 166cm (~23.6in * 65.3 in)
          We have quite a lot of options. 80 votes can distributed, regardless of party you can decide to give a candidate 0-3 votes or to bar him, and in the end you can also choose a party that gets all unallocated votes. And yes, all this is being “processed” by observed hand counting, and it works. I’m from IT, and I’m strongly against electronic, or even worse, internet voting.

        • orionATL says:

          thanks eoh –

          that is an important consideration.

          but then i would guess, so is banking by mail insecure, at least without protections. do these even exist?

          at first glance it would seem difficult to track down and manipulate millions of ballots, but determined computer hackers seem to be able to do pretty much anything. maybe the game would be to re-route and collect ballots then change them.

          paper is good. mail-in paper is better. mail-in paper with an addressed, stamped envelope is great. the former sent out to every registered voter so no trucking to county offices would be super. and with wide date limits to vote!

        • e.a.f. says:

          the government could simply direct the P.O. to accept all mail heading for the vote counting office not be required to have a postage stamp on it. In Canada any mail going to your federal politicians can be send with out a postage stamp and it will be delivered. Its the law. It was one of the reasons, back in the day, before computers, people wrote letters to their M.P.s It didn’t cost them anything and organizations sometimes used the mail for their letter writing campaigns. sort of a non electronic thing. (politicians usually considered, one letter, approx. another thousand with the same opinion).

    • J R in WV says:

      ” a good time to fund and develop competent on-line voting systems,”

      Unfortunately, as shown by repeated and numerous failures of internet security in banking and commerce (which one would expect to have the best security available!) the internet is not secure against small-time thieves, let alone secure from massive penetration by foreign nationals like the Russian GRU operating out of St Petersburg. See the Mueller Report for more details.

      Any voting system connected to the Internet is by definition insecure. So in the face of this epidemic I suppose mail-in ballots is the best alternative. My main objection to mail-in ballots is that in a family with traditional patriarchal relationships (all the Theofundy RWNJs for example) there will be no secrecy of the ballot, and everyone will be required to vote as Big Daddy orders. In other words, for Big Daddy Supreme Trump, and his supporting cast of RWNJ Senators and congressmen minions.

      • bmaz says:

        I am not aware of any support whatsoever that “family influence” is any greater for mail in voting as opposed to normal voting. If “Big Daddy” steals the ballot and votes it himself, it is a serious federal felony. And one in most states too.

        • P J Evans says:

          He can tell his family members how to vote, and stand over them while they do it – but signing the envelope, as is required in CA – that might give him pause.

          (I was involved with voting for an award, lo these many years ago, where someone did that: first they got people to send in nominations, with memberships, which got noticed because same address, consecutive money orders, and all for the same person; then, at final voting, the sigs on the envelopes didn’t match the sigs on the nominations. Normally, they wouldn’t get checked that closely, but they’d Gotten Noticed, and they knew it, and still did it.)

        • bmaz says:

          Yes, signing required here too. So, that is a deterrent. But family indoctrination and pressure has been a voting reality forever. Is it really any worse with mail in? Never seen any voting experts indicate that at all.

    • Raven Eye says:

      Good Lord.

      So if you had a high enough population density in an area, one way to do the testing would be to collect a few thousand samples, load them into a Gulfstream, and fly them to Korea or Singapore for the lab work…If those labs would do the work?

      • bmaz says:

        I dunno, but at least they are apparently capable. How can we not be? It is all quite maddening.

        • Frank Probst says:

          I really don’t get what the hell is going on here. It’s a DNA purification step followed by an RT-PCR step. Yes, a lot of things can go wrong, but the whole process can be troubleshot by a trained high school student in under 24 hours. And if your troubleshooting is taking too much time, you can throw everything out and start all over again from scratch. There’s nothing required that HAS to come from the CDC. You can order all of it from other places. What’s the damn holdup?

        • Frank Probst says:

          I ask, and The Atlantic answers:

          The answer is basically that The White House isn’t doing its job. But you shouldn’t even have to have The White House to step in here. I’m wondering if all of this wasn’t previously the responsibility of the White House office on pandemic preparedness, and no one bothered to reassign that office’s responsibilities after they abolished it.

        • J R in WV says:

          The lack of testing is no accident, nor incompetence. It is quite deliberate and ordered by Trump and/or his minions. Trump believes that as long as the CDC totals are low, he can claim to be “beating the Coronavirus like no other nation can or has!”

          The only problem with this is that the lack of test results will create a really overwhelming epidemic, and shortly thereafter we will have the best, the biggest death toll numbers this side of, well, everyone else. And it will be Trump’s fault. And the hirelings who did what he wanted, kept those pesky infection numbers low at the CDC! The whole bunch of them should be rounded up as the war on the epidemic criminals that they are…

          Deliberately allowing a disease to run rampant in a completely vulnerable population sounds way criminal to me, but I am proudly not a lawyer. Just an old guy with a seriously immuno-compromised old wife to care for.

      • e.a.f says:

        I’m sure S.K. or Singapore would be willing to run the tests if they had the capacity. All that needs to happen is for the American government to ask for help. That in my opinion isn’t going to happen. If the trump administration wanted help they could have asked the former Ebola czar and others to give a hand, but the trump administration doesn’t want help. they think they can do this by themselves, or this is going exactly the way they want.
        On the other hand, S. K. or Singapore might respond positively to a State Gov. asking for help.

        In B.C. the provincial government has asked recently retired Doctors and Nurses to come back to work. They have had a good response, with some saying they don’t want to be paid for the work.

      • greengiant says:

        The UW virology twitter site has been giving daily updates.They have ramped from about 300 tests first day to 2,360 samples Friday. The daily percentage of tests positive has fluctuated. Since some tests are for out of state, the Washington state health site is the goto for geographical data. Friday’s cumulative was 568 positive 6001 negative, Saturday’s cumulative 642 positive, 7122 negative, The percentage of positive tests getting smaller may be a leading indicator of the growth of positive cases peaking. 6.3 percent last day to day.

    • Pajaro says:

      Yes, for want of adequate testing available, which many other countries have covered well, the disease is much worse for everyone. Taking out health staff at critical times is frightening for all. Why again did the USA not accept use of WHO tests, which are available to all countries? Back in January when we could see what was coming. Trump and Republican enablers own this, grrrrrr!

      • bmaz says:

        Yeah. And I saw your comment about your son yesterday. How is that going? You probably saw mine about daughter just back from Milan at the first of the month. Getting a test was simply impossible in Phoenix. She could not get one. Not sure it is really much better now, two weeks later.

        • Pajaro says:

          Thanks Bmaz, I did see that of your daughter. I don’t how it is going with my son, yet. He hasn’t texted (that generation only texts) or phoned. He has good insurance and I saw on AZ Health Dept. website that if a Dr. orders the test it will be done. Waiting to hear how his symptoms are now.

        • bmaz says:

          One of my best friends is an ER surgeon, and he gave daughter a letter. Didn’t mean squat it turns out. But that was two weeks ago, and the news here reports it is much better now, but still fairly tight. Best of luck to him and you.

        • Pajaro says:

          Finally did hear from son, he’s sleeping alot. He is getting Dr. appointment. Some symptoms he describes are concerning, but Covid19 symptoms are similar to so many ailments. He does mention ‘mucousy’, which is not typical. He is young and in good health, a biologist too, so should be ok. AZ criteria for test, and other states (CDC derived?) are still too narrow for detecting community spread cases. as are most places. We are still behind the curve on this, thanks to no decent expert (e.g. thinking) opinion in shaping test criteria and the woeful lack of test kits. S. Korea tests more people in a day than we have since day one! Shameful and a National dereliction of our government’s duty to protect it’s people.

        • bmaz says:

          Yeah, it is just sad, if not somewhat terrifying the US can’t do better on the testing. As of yesterday, AZ had done a grand total of 115 tests. Not sure where the figure is today.

        • Pajaro says:

          Wow, as of now NM has tested 495 for 13 positive (presumtive). Some hospitals in Albuquerque are now doing drive-thru tests. We have some top notch Univeristy labs, I wonder if, or when our significant National Laboratory resources and capabilities could be employed. This is, after all, national security interest.

        • bmaz says:

          Turns out that was actually Thursday morning, so maybe they are significantly above that now. That is the last figure I saw and trusted.

        • Pajaro says:

          Good news! Son says Dr. is going to test him. From what he says of symptoms I’m betting he’s positive. He flew to Seattle a month ago and he and his girlfriend have been sick.

        • e.a.f. says:

          It really matter that your kids couldn’t be tested. If a criminal lawyer’s kid, who is an engineer can’t get tested, then how will prisoners, prison staff, the military, the poor, homeless, etc. get tested.

          In discussions with friends here in Canada, I’ve mentioned bmaz’s situation, well the daughter’s, and they were shocked. In British Columbia they are testing in specific areas to find out where the disease is. They aren’t testing all those who come back into the country because many don’t need it. They are to self quarantine. If they become ill, they phone 811 and arrangements are made. They are also setting up more testing sits, looks like it will be the S. Korean model.

    • e.a.f. says:

      Read it and its depressing. Medical staff can’t get tested???? they tested Lindsay Graham and he isn’t that useful in this situation.

  32. Ollie says:

    During Italy’s quarantine, Italian tenor Maurizio Marchini wanted to do something to spread joy amid all the sadness in Florence.

    So he climbed on to his balcony and serenaded the entire town.

    soul soothing…peace

    • earlofhuntingdon says:

      The use of the conditional in that title is not warranted. Trump’s behavior patterns are clear. He will use this crisis to promote his wish list. So will Mitch McConnell. So will America’s extreme adherents to unregulated capital, large and small. As Klein and Mirowski note at length, it’s what neoliberals think crises are for – to make them rich and to impose systems allowing them to keep their wealth and extract more of it.

      We already have examples. Gilead, for one. For another, Wendell Potter warned that insurers, in particular, will use this crisis to manufacture profits and to preclude more universal care. On the smaller end, there’s the greedy nut who bought $100,000 worth of Lysol wipes from his local Costco stores (emptying shelves) and resold them on ebuy at nearly five times the price. He’s proud of it.

      Good arguments for revivifying anti-trust and anti-price gouging statutes. companies will use this crisis as the rationale for greater concentration. As for the latter, I would require recapture of profits and fines that far exceed them. Pour encourager les autres. The opportunity costs from this behavior are considerable.

  33. punaise says:

    I may well regret posting this thought-provoking piece, but hey it’s a slow Saturday morning so why not. This is from a group email sent by someone I know indirectly, a Francophone epidemiologist who works at esteemed institutions in the SF Bay Area. Personally I find that it glosses over the suffering of the covid-19 victims as well as anybody who doesn’t have a white collar job allowing them to work from home. It is naively pie-in-the-sky about any long-term upsides to this crisis. These are not my personal views, but there is food for thought here.

    My quick and unpolished translation from the French:

    Well, I had a complete change of heart today. And I have to say it: The coronavirus is not only a nuisance, a pandemic, or a scourge – it may well be a global blessing. 

    Here is out third World War with (fortunately) only one enemy that is shared by all of us, and against which we can all unite.
    Here is an imminent global recession which, while it is not the plague of the Middle Ages, may also help us advance towards a new Renaissance. 
    Here is a period of time when people will stay home, stop buying and consuming, with a significant reduction in road and air traffic, industry slow-downs, etc.  And therefore possibly a major reduction in anthropogenic pollution. 
    Here is an opportunity to completely changing our behavior and way of life, not only to survive this epidemic (I have no doubts there) but to give our planet a chance to survive. 
    No more meetings, no more offices, no more lectures … can we learn to live completely digitally? Or completely locally? Or both? Or simply reinvent ourselves?
    Here is a unique opportunity to get rid of one (or several?) megalomaniac and dysfunctional world leaders. 

    In short, a great natural experiment is unfolding before our eyes at dizzying speed. I hope it’s not just the epidemiologists and doctors who get out their stethoscopes, their microscopes, and their telescopes – but also the visionaries, entrepreneurs, sociologists, engineers and ecologists. 

    What a beautiful challenge!


    • earlofhuntingdon says:

      Greta Thunberg expresses more awareness and intelligence, and less naivete, than this writer.

    • Rayne says:

      I don’t think this epidemiologist is ignoring the suffering. But we are entering a massive societal change brought about only because of the horror this biological agent forces on us if we wish to continue as a cohesive, working society.

      That bill passed by the House last night would NEVER have made it out of committee if the GOP had not been terrified by an existential threat. It’s only the beginning; we now have to face that national security isn’t limits on liquids carried on planes, but the health of the travelers in toto. The Saudis may have forced the issue by flooding the market with oil to retaliate against Putin’s intransigence about production levels, but the entire fossil fuel industry will now have to deal with a new economy which does not travel as it has until COVID-19.

      This is terra nova. Whether it’s a brave new world remains to be seen.

      • orionATL says:

        rayne –

        yes. fine thoughts. many things, including political things, may become possible that were not before. some for the better. some for the worse.

    • e.a.f. says:

      O.K. that guy is a first “worlder”. He has no idea of he real world. This is going to “unite” people. No its going to kill them. Once prison guards fail to come to work due to illness, we may see some major prison rights. Yes, a prison riot always brings people together. Martial law also brings people together, as does cancelled elections.

      Yes, the environment may benefit from fewer jets in the sky, but once the funeral pyres start burning the air is going to get stinky.

      Get rid of political leaders? What planet is “our” French person living on. He obviously hasn’t studied history.

      I’ll stop now because I could go on for an hour about how crazy this guy is. Wait until some one he loves dies from this virus. Perhaps he will write again.

  34. David B Pittard says:

    Now is always a good time to be prepared for a bad time. One additional document: a durable power of attorney that becomes operative and remains operative during extended or permanent mental disability, taking effect only upon certification a doctor that you are mentally incapacitated. Texas provides a statutory, online fill-in format that would probably serve in other states. If you succumbed to dementia, this would allow your estate to be managed until your death when your estate comes into existence and is managed by an executor or representative of the estate.

    • Rayne says:

      Good point — only thought about death and not incapacitation. Probably need to sync that with appointing a guardian as well for one’s self and for any minors if there is no co-guardian/custodial co-parent already.

    • P J Evans says:

      I think most states have those.
      (I have a DPOA and a medical POA, as well as an advance directive (living will).)

    • harpie says:

      from the article:

      Kushner rushed to help write Trump’s widely panned Oval Office address to the nation. His supermodel sister-in-law’s father, Kurt Kloss, an emergency room doctor, crowdsourced suggestions from his Facebook network to pass along to Kushner. And Kushner pressed tech executives to help build a testing website and retail executives to help create mobile testing sites — but the projects were only half-baked when Trump revealed them Friday in the White House Rose Garden. […]

    • BobCon says:

      The Post article is clear from the lede paragraph that this was dysfunctional. Despite the critical tone, they have lots of detailed information. If they’re making tradeoffs to get their information, they’re not kneecapping their coverage.

      Contrast it to the limited coverage by Mike Isaac and Maggie Haberman, which talks about Kushner’s efforts to get input from Dr. Kloss’s Facebook contacts. It is not until the 16th graf, third from the end, do they acknowledge the firestorm of criticism it raised from anyone, and there is no direct critic7sm of Kushner’s larger role or management abilities.

      The Times political desk is riding their prejudices all the way down.

      • PhoneInducedPinkEye says:

        I figured you’d have something to say about this…

        Was driving from work listening to some NPR show where the host was actually holding Trump admin responsible, asked one of their white house reporters, “isn’t Trump just saying lies?”

        The reporter struggled to answer this and her NPR bothsides solipsism instinct kicked in: “Well… (haltingly), the things that come out of his mouth… end up being false”

        The passive tone focusing on the agency of the words coming out of his mouth, rather than the person speaking them, was shockingly amusing for the first split second, then infuriating

  35. Tom says:

    Can’t help but be reminded of Edgar Allan Poe’s story, “The Masque of the Red Death”, with President Trump in the role of Prince Prospero, vainly trying to preserve himself from the deadly pestilence ravaging the countryside by retreating to one of his “castellated abbeys” with a select group of his courtiers. Prince Prospero even puts his faith in a wall, “… a strong and lofty wall … [with] gates of iron” to keep out the plague, but all to no avail as the Red Death soon makes his fatal presence known in the midst of the Prince’s revelers.

    • punaise says:

      Good one. Backatcha with The Cask of Amontillado, with the antagonist enclosed forever in the corner a wine cellar, bricked in by boxes of test kits. From Wikipedia:

      Montresor lures Fortunato into a private wine-tasting excursion by telling him he has obtained a pipe (about 130 gallons,[1] 492 litres) of what he believes to be a rare vintage of Amontillado. … Fortunato goes with Montresor to the wine cellars of the latter’s palazzo, where they wander in the catacombs. …Montresor warns Fortunato, who has a bad cough, of the dampness, and suggests they go back, but Fortunato insists on continuing, claiming that he “shall not die of a cough”. During their walk, Montresor mentions his family coat of arms: a golden foot in a blue background crushing a snake whose fangs are embedded in the foot’s heel, with the motto Nemo me impune lacessit (“No one attacks me with impunity”).

      Montresor reveals brick and mortar, previously hidden among the bones nearby, and proceeds to wall up the niche using his trowel, entombing his friend alive.

      • Pajaro says:

        Just scored a small keg of my favorite local brewery IPA, in aid of social distancing…. could be cask of Amontillado if you can send me Trump or his spawn, Bannon would be acceptable. Brick and mortar on hand….

    • BobCon says:

      Could also be The Murders in the Rue Morgue, where a subhuman orange killer is on the loose…

  36. pdaly says:

    Dr. Fauci knows, so I wish he would show up soon at a press conference in full biohazard suit. Why is Dr. Fauci taking chances with his own health hanging out with Trump?

    • Ken Muldrew says:

      “If we don’t learn social distancing, we will get destroyed…….and we will deserve it.”
      –Some southern senator

    • Vicks says:

      Could Fauci be putting everything aside and simply be manipulating Trump and his ego to get the best that he can out of our president?
      It’s a strange dance to watch and I think Trump is scared shitless, but that wouldn’t stop him from replacing Fauci with some tv doctor if he felt Fauci didn’t respect his power.

  37. cat herder says:

    re: PJ @ 8:42 pm
    Yes… I know. I thought everybody did. All the news I’ve read up to now knew. Everyone I’ve seen discussing it knew. But apparently, there was a parallel universe I wasn’t aware of that hasn’t heard a word about it.

  38. Valley girl says:

    Seller Blocked By Amazon Seemingly Can’t Unload His 17,000 Bottles Of Hand Sanitizer

    “I’m being paid for my public service,” said Colvin. “But I’m not looking to be in a situation where I make the front page of the news for being that guy who hoarded 20,000 bottles of sanitizer that I’m selling for 20 times what they cost me.” (uhhuh buddy)

    “As Entrepreneur reported earlier this week, Ebay has also banned sellers from offloading surgical masks and other forms of sanitizers due to issues with price gouging.”

    • P J Evans says:

      Maybe people trying to corner the market like that should have it confiscated; repayment at wholesale prices – pre-virus. They want to be a seller, they get to deal with the fallout from Doing It Rong.

      • Eureka says:

        Through the Rong of these nutters, I still haven’t gotten my hands (or eyes) on single bottle of isopropyl (or, obvi, hand sanitizer).

        • Tom says:

          I don’t really care for hand sanitizers. I always feel like I want to wash my hands after I use them.

        • Eureka says:

          Me neither, which is why I don’t have any kicking around the house. But for rare occasions when I must go out for “essential” purposes under the new world order, it seems like a good idea to have some given the conditions.

  39. Jonf says:

    Borrowed this:
    Trump’s desk plaque must read “The buck stops there – way over there. Not here. Never here. It’s perfect here. Over there. Look!”

  40. timbo says:

    There’s spotty information out of Japan that ciclesonide, the corticosteroid, is, when applied properly in treatment, working to help improve survival rates significantly. Ciclesonide benefits patients who have inflamed airways in their lungs by reducing the lung tissue inflammation, permitting oxygen to get deeper into the lungs, both improving healing/fighting of any bacterial infections, and permitting more oxygen exchange. This is a prescription drug. Investigating how much of it is typically on hand now.

    • BeingThere says:

      I’ve been wondering if any of the inhaled corticosteroids used by asthma sufferers would have any effect on susceptibility or symptoms (possibly depending on mutation / strain of covid-19 if virus testing were available, since serum antibody test won’t give details of mutation) . It would be interesting data to examine now, rather than after the fact.

  41. Eureka says:

    This is a ridiculous chain of stories, from the sports news tonight. So we all recall the NBA shut down just last week, followed by the rest of the major leagues, after an NBA player tested positive. Those were the best moves for public health. They announce tonight that a Detroit Pistons player is now positive (that last night of games, they were here playing Sixers).

    The next story: local/other NHL talking about resuming practice NEXT WEEK. What the actual fuck? I know they need ice time, but fit for what (it’s like everyone is acting like these pauses are briefer than they will need to be). They’ve been having the players self-quarantine: next week is not enough time even if that was an adequate or sufficient way to go about this.

    Related, I’ve seen social media PR-y photos from (suspended) spring training where the players/families are all hanging out with things cancelled. LARGE GROUP photos. Not the best role modeling (I know, the perennial discussion as to athletes and so forth…but these are different times).

    It’s not just about games and stadium/arena-sized crowds, but smaller ones, too. MLB (of all orgs) could do a *great* public service promo on *flattening the curve.*

    Eh, but schools are still open all over the country…

    • Vicks says:

      I don’t think starting practices back up is as idea that is being taking seriously the NHL
      A good indication would be if/when players start packing it up and heading back to their home cities.

    • Eureka says:

      Vicks I hope you’re right, it was the stupidest news item I heard yesterday. Surely the mere idea was shot down quickly by plenty of sportswriters with time on their hands, not to mention public health watchers.

      In any case, caught a snippet that MLB now telling players not to engage in group practices.

  42. harpie says:

    Good Morning!

    Via Cheryl Rofer, the “Sterling Professor of Social & Natural Science at Yale. Physician.”:
    5:04 PM · Mar 14, 2020

    Flu pandemics recur reliably but unpredictably every decade or so, and their extent and intensity varies. With COVID19, we may be in midst of a once-every-50-years event, perhaps similar to 1957 pandemic, but not as bad as the 1918 pandemic. Let’s talk about the 1957 pandemic. 1/ [THREAD]

  43. harpie says:

    Scott Gottlieb, MD:
    9:05 PM · Mar 14, 2020

    The same epidemiological surveillance data that public health officials were relying on in February to conclude that there wasn’t #COVID19 community spread in U.S. are now showing an uptick in people with influenza like illness that tests negative for flu. [Bloomberg]

    Then Gottlieb retweets:
    https:// cmyeaton/status/1239146576775458817
    7:09 AM · Mar 15, 2020 [^^ link is practicing social distancing]

    I see a lot of tweets about % ILI visits. @reichlab and I have been working on an analysis that I think is a little more reliable. Cld still be sensitive to care seeking behavior, but I think less so.

    She links to the report here:
    7:22 AM · Mar 15, 2020

  44. harpie says:
    9:52 PM · Mar 14, 2020

    Christ almighty, the point is that Americans *are not* being tested, you simpleton.

    [I’d love to copy the photo she’s responding to here…not sure if that would work. It might be fun to guess whose brilliant idea this was…imo there’s a creepy religious/Easter-like mood]

    [Snagged it for you. Yuck. /~Rayne]

  45. harpie says:

    The Korean clusters How coronavirus cases exploded in South Korean churches and hospitals
    UPDATED MARCH 3, 2020
    UPDATED MARCH 3, 2020

    […] The virus was first confirmed in the country on Jan. 20 when a 35-year-old Chinese woman who flew from Wuhan, China to Incheon international airport, which serves Seoul, was isolated upon entry into the country. In the four weeks following the incident, South Korea managed to avoid a major outbreak with only 30 people contracting the virus, despite many interactions between those later confirmed as being sick and hundreds more people being identified as contacts of the sick patients.
    This changed with the emergence of “Patient 31.” […]

    bmaz retweeted this response to the above:
    12:44 PM · Mar 14, 2020

    South Korea was doing a heroic job controlling #COVID for the first 30 patients. Then #Patient31 did not adhere to #socialdistancing. Caused 2 clusters responsble for 80% of South Koreas infections.
    Don’t be #Patient31. #CancelEverything #medtwitter

    Contacts tracked incredibly for the first 30 patients. Up to 450 contacts for Patient 18. / Attending Church Services and a Hotel Buffet, she exposed thousands of people in a matter of days. / #DontBePatient31

    • harpie says:

      ^^^ This doctor is a cardiologist in Boston/Harvard [[…] Cardiology, Technology, and Human Behavior]

      He was responded to by this Philly ER doc [ER doc, prof […] data/behavioral/decision science for preventing injuries & improving acute care]:
      10:45 PM · Mar 14, 2020

      Replying to @RomitB_MD
      Religious congregations are super high risk venues for #coronavirus transmission. [links to Inquirer Op-ed about] what can be done to preserve the faith and the faithful in this

      …to which @RomitB_MD responds:
      8:28 AM · Mar 15, 2020

      Replying to @kit_delgadoMD
      Great article @kit_delgadoMD. Prescient. But unfortunately the Boston globe is reporting services here are still being held despite good reasons to cancel or digitally broadcast! I’m sure the same is true in Philly!

  46. Tom says:

    Woke up this morning to hear the lead story on NPR news was about “chaos at airports” due to new COVID-19 testing measures and implementation of travel bans. Sounds like the same lack of foresight as there was back in January 2017 when President Trump instituted his Muslim travel ban, which also resulted in crowds and confusion at airports. Unlike lab rats, the Trump crew seem unable to learn from their mistakes.

  47. harpie says:

    1] 3/14/20 [Approx 5pm] Charlie Warzel writes:
    Please, Don’t Go Out to Brunch Today
    Gathering in groups right now is selfish and puts the lives of others at risk.
    [NYT link below] Charlie Warzel March 14, 2020 [approx. 5pm]

    2] 8:24 PM · Mar 14, 2020 Charlie Warzel writes:

    in just over 3 hours this column has set the record for the number of emails received telling me i need to resign in disgrace from my job (believe me, the bar is high).

    lol this wasn’t a sympathy-baiting tweet i promise (occupational hazard, glutton for punishment etc)! just an anecdote that there’s plenty of ‘pry this tallboy from my cold dead hands’ goin around

    Gregory Johnsen suggests reading 1] and then:
    3] March 13, 2020
    A coronavirus cautionary tale from Italy: Don’t do what we did
    Many of us were too selfish to follow suggestions to change our behavior. Now we’re in lockdown and people are needlessly dying.
    [Boston Globe link above]

  48. Pajaro says:

    This State is now testing for COVID19 even if you haven’t been to China, Italy, etc., have flu-like symptoms, and have tested negative for flu.

    “I have not traveled to China, South Korea, Iran, or Italy, but I have fever and cough or shortness of breath that started in the last 14 days and tested negative for influenza. What should I do?
    We are now offering testing for COVID-19 at the Scientific Laboratory Division, NMDOH for persons with these symptoms who have tested negative for influenza. Please contact your healthcare provider and assess whether you should be tested.”

    Previous CDC criteria for testing is far too narrow to detect community spread.

  49. dude says:

    I posted about yesterday and, although I am not a geneticist/virologist, I do understand that tracking the spread of Covid 19 by RNA mutations is the key to understanding spread across the globe or in your backyard. Been playing with the user-driven options this morning. Even as a layman, you can construct really fascinating graphs and video displays about rate of spread and back-tracking each step in the chain using their sources. The software is quite impressive. Their ‘sources’ are the laboratory analyses of Covid 19 samples from around the globe. And this morning, I dug into the site further and saw they recommend another site–the Federation of American Scientists–which has a Q & A feature–“ask a scientist”–in Covid 19 as well as a more conventional FAQ selection on topics:

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