The Tick-Tock to COVID-19’s Explosion
[Check the byline, thanks! /~Rayne]
When epidemiologists, virologists, and public health officials first began talking about flattening the curve — using social distancing to reduce the number of COVID-19 cases needing hospitalization at any one time to prevent collapse of hospitals and massive mortality — I kept a running mental tick-tock, resetting this clock as data emerged and events unfolded. We learned from Washington state how the virus spread rapidly because of cryptic transmission, but tracking the virus’s dispersion hasn’t been clear to observers let alone elected officials and business leaders. Missing a concrete picture of how the virus emerges and spreads over time to affect our health care systems, officials have been easily badgered to issue delayed and weak containment orders to suppress COVID-19’S contagion.
The Biogen management conference offered a discrete example of how COVID-19 contagion spread and the time from exposure to illness to new infection:
26-27 February — Biogen, a biotech company, held a management conference in Boston at the Marriott Long Wharf hotel [Day 1-2]
01 March — Biogen employee of Chinese heritage who attended the conference developed a cough. [Day 5]
02 March — A Biogen employee from Indiana developed symptoms; they traveled to Biogen’s facility in Research Triangle Park, NC.
03 March — Biogen conference attendees were notified of a potential COVID-19 exposure [7 days after conference began]
06 March — Attendees received confirmation that they were exposed to COVID-19. Four cases were identified in Boston; two had symptoms. The Biogen employee from Indiana drove home. [10 days after conference began]
09 March — At least 32 cases of COVID-19 of 41 total in Massachusetts on this date were associated with the Biogen conference. [13 days after conference began]
11 March — Chinese Biogen employee flew from Boston to Los Angeles with spouse and child.
12 March — Chinese Biogen employee flew from LA to Beijing with spouse and child.
12 March — 82 cases in Massachusetts have both been confirmed and associated with the Biogen conference. The Marriott hotel at which the conference was held closed for disinfection.
13 March — Chinese Biogen employee tested positive for COVID-19 on arrival.
14 March — 104 of 138 total COVID-19 cases in Massachusetts were associated with the Biogen conference. Two new cases related to Biogen appeared in the cities of Worcester and Malden.
16 March — Spouse of Biogen employee tested positive for COVID-19 in Beijing. [20 days after conference began]
The case of Biogen’s Chinese employee is incredibly important. The woman visited a hospital in Boston repeatedly for her symptoms, potentially infecting multiple people including health care workers, was given an ineffective antiviral (technically off label for COVID-19), and ended up flying to China, exposing other passengers and airline employees to COVID-19 en route because she couldn’t get tested for the virus until she arrived in Beijing. She risked prosecution by Chinese authorities for failing to disclose her health status in order to get tested.
The U.S. literally exported two new cases of COVID-19 to China because Trump has dicked around with testing and lied to us about their availability since he first learned about the virus and risk of pandemic.
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I’ve made up a calendar — not exactly pretty, mind you, since I didn’t quite know how I wanted to present this when I started. But you’ll see the Biogen-based outbreak, the airport terminal debacle thanks to the Trump EU travel ban, and the last holiday during which people gathered en masse in closed quarters (that’s St. Patrick’s Day).
Four states with the largest populations out of the top 11 most populous states issued shelter-in-place/stay home orders after March 17. You’ll see those effective dates noted on the calendar here as well.
Note carefully the weekend of March 14-15 when airports across the U.S. were crammed with people, many of whom were likely exposed to COVID-19. As I said in a previous post, this is a hurricane; the mounting deaths over the last couple of days are only the leading edge of a hurricane-like explosion fomented by Trump’s minions’ ineptitude. Every death is on their heads and hands.
The reason for my mental tick-tock and the calendar is the course of the virus and its contagion: exposed persons are contagious about five days after infection; infected persons may begin to show symptoms from 5 to 14 days after exposure; persons who recover are contagious for at least another seven days.
The total 21 days from exposure to the point where an infected person is clear of virus is optimistic. The WHO China mission report indicated persons may shed COVID-19 for 4-5 weeks in total.
Which brings me to the ultimate point of this post: In no fucking way is it safe to assume the risk of contagion will have been broken by Easter.
No matter what Trump wants or needs to believe, especially since shelter-in-place/stay home orders have not been given across the entire country and not to a uniform standard since states assumed the responsibility to issue these orders and not the federal government.
Perhaps the contagion will be stemmed by the states which gave shelter-in-place/stay home orders, but COVID-19’s spread could resume as rapidly as a trucker can cross a state line or an airplane land at an airport.
A partial lifting of the shelter-in-place/stay home orders might work if everyone had been screened with an antibody test for exposure, and only those persons with active COVID-19 infections were quarantined for the full 4-5 weeks.
But no — we don’t yet have antibody tests. We still don’t have adequate numbers of tests for COVID-19 infections.
Without testing and uniform shelter-in-place/stay home orders across the country, lifting shelter-in-place/stay home orders by Easter only increases the odds there will be another wave of infections on the heels of the first wave. Hospitals and health care workers would not have a break between these successive waves, further stressing the system.
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Let’s cut through the bullshit here. If Trump wanted to look like a hero to the American public, he’d listen to virologists, epidemiologists, and public health experts.
He’d make sure the health care system had the resources it needs to protect themselves, to treat those who were ill, and to test everyone so the public, their first responders, and their elected state officials knew the status of the virus and where to direct their attentions most effectively.
He’d make sure every American stayed home and had no reason to leave until the contagion was broken.
But this is exactly what he isn’t doing.
He’s even withholding funds from states which are battling to save Americans’ lives from COVID-19 while containing the virus’s spread.
Why is Trump not doing what he’s supposed to do to insure domestic Tranquility, provide for the common defense, promote the general Welfare as executive of the United States?
Why has he ignored the hundreds of deaths to date, all of which can be blamed on his ongoing failures?
Why has Trump only been able to maintain kayfabe — the appearance of being a president without actually being one, like professional wrestlers who don’t actually wrestle?
If this was the reality TV show The Apprentice, Trump should have been fired already for dereliction of his duties and escorted off studio property by security personnel for deliberately hurting cast and crew.
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Finally, two more groups of people need to be asked why they aren’t acting in the best interests of the country, let alone their constituents whether voters, donors, or shareholders.
Republican senators have rejected the math — like that selfish yard-waste-pile Rand Paul who continued to use the Senate pool in spite of his exposure to COVID-19.
Why are they actively refusing to do the right things to save Americans’ lives including their own?
Corporate leaders like Lloyd Blankfein whine about getting American workers back on the job instead of worrying whether there will be an economy left if workers continue to get sick in the workplace and die.
Extreme measures to flatten the virus “curve” is sensible-for a time-to stretch out the strain on health infrastructure. But crushing the economy, jobs and morale is also a health issue-and beyond. Within a very few weeks let those with a lower risk to the disease return to work.
— Lloyd Blankfein (@lloydblankfein) March 23, 2020
Why can’t a fucking investment banker like Blankfein and other business leaders responsible for P&L figure out the numbers?
Fire them all come November.