Three Things: Shit Got Real with Family and COVID-19

[Check the byline, thanks. /~Rayne]

I spent last night crying off and on all evening.

Right now some parent or parents are experiencing the nightmare I have hoped and still hope I won’t have to face.

A chemical engineering student at a state university died Sunday. He was only weeks away from graduating — just like my younger adult child at another state university.

This didn’t fucking have to happen. This bright promise didn’t have to be swept away in this human-made disaster. Don’t tell me this was natural, not when that narcissistic wretch in the White House treated the governor of my state like crap this week after her persistent pleading for federal assistance. Not after he failed from the time he was first told of this potential pandemic threat in December.

This death is on that miserable wretch’s head, and on the head of every GOP senator who looked the other way after Trump abused his power and solicited a quid pro quo. He did it again to our governor after the GOP senate gave him a permission slip instead of removing his unethical, greedy ass from office.

The horror isn’t over, either. There’s no telling how many more parents will face this same nightmare because one man just plain failed to do his job in a big and repeated way, because roughly 20 senators are spineless if not equally incompetent and corrupt.

~ 3 ~

You can guess what preoccupied my time last evening when I wasn’t crying. Text messages and phone calls were flying furiously between my house and my two kids’ homes downstate.

A capital city newspaper reported a 65-year-old man was confirmed with COVID-19. Nothing remarkable about this story on the face of it; so far he’s a living statistic.

But to this family this particular story is important. The man lives three miles from from my older adult child. Some of the folks who work with my older child live in the same neighborhood development. While the company for which my child works will implement screening body temperature at the door today, it’s a couple weeks late and pretty useless for asymptomatic cases. It would have been useless on this man up until he became sick, three days before Michigan’s Stay Home order took effect.

The patient developed symptoms on March 21 and has been sick since then. Before he developed symptoms he had been shopping at Sam’s Club, Costco, Meijer — three of the most popular grocery stores in the area. My child and their spouse shop at the latter two stores.

My younger college-student child had planned to go to Costco yesterday.

You might think, “Whoa, big spacious stores, no big deal,” right? But a study from China found two COVID-19 cases in Wenzhou traced shared one common trait — both patients had shopped in the same mall on two different floors. They had a low-intensity indirect transmission without prolonged contact.

COVID-19 appears nearly as bad as measles in terms of transmission. It’s spread mainly by exhalation of asymptomatic/pre-symptomatic people as well as those with symptoms. A recent frequently-cited study showed the virus can hang in the air, active, for three hours. This weekend’s story about a church choir which observed all the social distancing rules — apart from staying home — illustrates how easily this virus spreads in the air in closed spaces.

The 65-year-old patient said he doesn’t know where he was infected. “I don’t go to a lot of parties or hang around with a lot of different people,” he told the reporter, “I probably caught it from a public place.” But he did go to the grocery stores and he visited a rehabilitation facility in Ann Arbor to drop off supplies for a family member. The rehab facility was likely not a source since no known COVID-19 case arising from the facility was mentioned in the article.

Kudos to this gent for wanting to share his situation with the public. He’s been quite sick; he admitted, “I can’t imagine anyone with a compromised immune system, I can’t imagine them going through this…My lack of taking it seriously, versus wearing a mask or gloves or both probably contributed to me getting this. I kind of regret it now.”

So now we wait and wonder whether anyone who works with my older child has a community acquired infection from their neighbor.

And we wonder and wait to see if my older child along with their spouse has been infected, too.

Just stay the fuck at home. Don’t put yourself in this situation where you, too, must wait and wonder. You don’t need any more stress than that wretch in the White House has forced on us.

~ 2 ~

Speaking of that wretch, after comparing notes with Marcy this past week, I have a theory about the White House’s abuses of power denying or obstructing aid to certain states under emergency declarations.

See if you can spot what I think has happened in the context of a table Marcy prepared; I added a few more columns to it.

It’s not just that “the woman in Michigan” was mean to poor baby Trump. Her state has a very tight senate race and no Trump hotel, golf course, or Trump organization business within its borders.

One thing I didn’t add but makes sense to me about the tribal governments’ federal emergency declaration: Marth McSally’s Senate seat. What do you think?

~ 1 ~

This pandemic crisis has pushed our system past its limits, exposing all the cracks in a hyper-capitalist system. I know I’m probably preaching to the choir in saying that, or at least if you’re a regular here you’re unsurprised to see that I’ve written this.

But how quickly people have been pushed to their personal breaking point hasn’t really been plumbed. I’ve written before over the last few years that nearly 50% of Americans haven’t had $400-600 cash for emergencies, that rent across the country was beyond what minimum wage workers were paid, and health care insurance let alone health care was simply out of reach even with the Affordable Care Act.

The emergency is here, and any time now the dam is going to break. One-time checks from the government will come too late for many. Read this thread by Yashar Ali explaining one person’s crisis:

Some of us can’t afford to help; we know this from the data and anecdotes we’ve seen. But those of us who can very much need to right now. Find a local soup kitchen or food pantry and make a donation of cash because people may already be experiencing food insecurity. Hunt down charitable programs delivering meals to children, elderly, and even groceries for hospital workers. As hard as we’re expecting health care folks to work, they may not have time to shop for themselves.

The U.S. didn’t become a great nation based solely on personal greed but by what Alexis de Toqueville called our “self-interest rightly understood.” The diminishment of investment in our country through a combination of taxes and giving to ensure we all do well is why country is falling, why we now find ourselves in this mortal mess. Take immediate corrective action and help others if you can with cash.

~ 0 ~

Keep in mind as we go forward this is both a shared national crisis, and an intensely personal crisis. The odds are stacked against any of us getting through the next 12 months without losing someone we know, like, love, and without someone within our personal spheres suffering hardship.

This is an open thread. Bring it here, back up the truck and dump it in comments.

Craig Simpson [CC BY 2.0])">CC by 2.0

Straddling the COVID-19 Barbed Wire Fence in Kansas

Pro Tip: Don’t sit on this fence. (photo h/t to Craig Simpson [CC BY 2.0])

The Democratic governor of Kansas, Laura Kelly, has put her finger in the eye of conservatives in Kansas by issuing a state-wide stay-at-home order yesterday in the face of the growing COVID-19 epidemic. Out in the western part of the state, the wingnuts have already been saying “this is an urban problem – we’re just fine – we don’t have any Chinese people here – why did she close all our schools?” and now they’ll scream just a little harder.

Note, however, that Kelly does not have the last word on this. When she issued her initial state of emergency declaration at the end of February, it lasted for 30 days. To extend it, the GOP-dominated legislature had to consent . . . which they did, but not without a fight. From the AP’s John Hanna in Topeka:

The [KS] Senate voted 39-0 and the House 115-0 to approve a resolution to extend the state of emergency until May 1 and to allow legislative leaders to extend it further every 30 days. Kelly declared a state of emergency last week, and without the resolution, it would have expired March 27.

But the resolution also requires legislative leaders to review all of Kelly’s executive orders and allows them to overturn many of them within days. It also prohibits Kelly from having guns and ammunition seized or blocking their sale.

The unanimity of those two votes is almost unheard of these days in Topeka, and it was a sign that the GOP was willing to go along with closing the schools for the rest of the year and take other measures as the COVID-19 outbreak began to surface across the state. But they sure didn’t like it, and wanted to make damn sure that they could shut down an out of control governor (in other words, a Democrat) when they did something they considered outrageous. The guns and ammo provision is another sign of how fearful the rightwing is of folks coming for their weaponry.
That was ten days ago. As soon as Kelly’s Stay-At-Home order came out yesterday, so did the folks on the right, waving around that provision that provides for a veto those orders. Again from John Hanna:

Conservatives in the Republican-controlled Legislature said Kelly overreached this month when she ordered public schools closed for the rest of the semester and complained that the state’s economy was being damaged too much. Legislative leaders have the power to revoke her orders related to the coronavirus pandemic.

Kansas House Speaker Ron Ryckman, Majority Leader Dan Hawkins and Speaker Pro Tem Blaine Finch, all Republicans, said in a joint statement that the new order “will no doubt impact our families and our businesses. As members of the Legislative Coordinating Council we have a duty to carefully assess this executive order and the reasons for it. Over the coming days we will consult with the Attorney General, health care professionals, the business community, and the state’s emergency management team to make sure we are on the right path.”

Kansas Senate President Susan Wagle, a Wichita Republican, said she was concerned about a “one size fits all” solution.

“I want to assure Kansans, particularly those in rural areas, the legislature is actively working to thoroughly review the Governor’s orders and ensure the specific needs of rural Kansans are addressed,” Wagle said in a statement.

Kansas Congressional Districts

[Note to the folks worried that the state’s economy was being damaged too much: a virus does not care.]

Speaking of those rural areas, let me direct your attention to OB-GYN Roger Marshall, who also serves as the US Representative from KS-01 (the large green area on the map to the right). Marshall is running to replace Pat Roberts in the US Senate, and he is trying to straddle a barbed wire fence on all this. He’s been loud about backing Trump’s “close the borders” stuff, but he’s still enough of a physician that he realizes that science actually matters. He doesn’t like the “big government” approach at all, but he has conspicuously not condemned Kelly for closing the schools. From an story two weeks ago in the Manhattan KS paper “The Mercury”:

Following Gov. Laura Kelly’s recent decision to close K-12 school buildings for the rest of the school year, halt mortgage foreclosures and evictions, and ban gatherings of more than 50 people, Marshall said he would rather people exercise an overabundance of caution at the moment.

“We have to assume that the virus is out in every community,” he said. “I hope there’s not, but we have to assume that. Kids and young adults, they’re super infectors so if one child has the virus, they’re going to transmit it a bunch more often than say an older person who just doesn’t have as many social contacts. Think of senior citizens, for the sake of people with illnesses.

“I hope in a couple of weeks you can say we did too much,” Marshall continued, “but I think right now, it’s so critical that this is the acceleration phase of the spread of this virus. Every virus we prevent spreading today is going to prevent dozens in the future and save many, many Kansas lives.”

Yesterday, Marshall retweeted John Hanna’s story about the Stay-At-Home order to his followers, perhaps trying to signal them that the GOP is watching this. He did not, however, attack or even question Kelly’s judgment for ordering this. To borrow from Sherlock Holmes, this is the dog that did not bark, and the silence is deafening.

And then there’s Marshall’s big opposition in the GOP primary (this was before Kelly’s order was issued yesterday):

U.S. Senate contender Kris Kobach reached for campaign gold amid the coronavirus pandemic by promising to intensify construction of a border wall to defend the country against illegal immigrants from China who may import deadly viruses.

“Over 12,000 Chinese nationals snuck across the border into the United States last year,” Kobach said in a video fundraising appeal delivered Thursday to potential voters in Kansas. “No checks. No visas. No health screening. In times of global pandemic, borders matter.”

The fence in Kansas between science and wingnuttery is made of very sharp barbed wire. Kobach is planted firmly on the Wingnuttery side of that fence, and Marshall does not want to cede all those voters to him by planting his feet firmly on the side of science. But Marshall is is going to find that straddling a barbed wire fence is not comfortable, to say the least.

The KS senate race will be very very interesting this November.

 

New Orleans Is Drowning. Again.

August 29 will mark 15 years since Hurricane Katrina struck New Orleans. The next day the country watched in horror as the levees broke and thousands of residents who could have been evacuated but were neglected by many levels of government and public safety officials, were forced onto rooftops to await rescue. Many of the rescues were not by government agencies but by fellow citizens with boats in what became the Cajun Navy. For days, people pleaded for rescue. Many did get moved to safety. Many did not. The “official” death toll states that 1577 died in Louisiana. That figure is widely believed to be a large underestimate, as many of the dead and missing came from the neglected fringes of society.

I often return to Mary Gauthier’s poetic description of the the losses and displacement suffered by those affected by the flooding, with many of them evacuated as far away as Houston with no means to return and nothing left in New Orleans to return to after their homes were destroyed.

Although there were too many to count, one of the most tragic developments during the flood was at Memorial Medical Center. The hospital was not evacuated before the storm. It appears that there were at least 45 deaths at the hospital during the time that it was marooned and without electricity, supplies or rescuers. The choices the marooned staff faced were stark and ugly. From a New York Times description in 2009:

Within days, the grisly tableau became the focus of an investigation into what happened when the floodwaters of Hurricane Katrina marooned Memorial Medical Center in Uptown New Orleans. The hurricane knocked out power and running water and sent the temperatures inside above 100 degrees. Still, investigators were surprised at the number of bodies in the makeshift morgue and were stunned when health care workers charged that a well-regarded doctor and two respected nurses had hastened the deaths of some patients by injecting them with lethal doses of drugs. Mortuary workers eventually carried 45 corpses from Memorial, more than from any comparable-size hospital in the drowned city.

Charges were filed by the state in 2006 against the doctor and two nurses. The Times continues:

The physician, Anna Pou, defended herself on national television, saying her role was to “help” patients “through their pain,” a position she maintains today. After a New Orleans grand jury declined to indict her on second-degree murder charges, the case faded from view.

In the four years since Katrina, Pou has helped write and pass three laws in Louisiana that offer immunity to health care professionals from most civil lawsuits — though not in cases of willful misconduct — for their work in future disasters, from hurricanes to terrorist attacks to pandemic influenza.

I don’t want to go into details of what might have led Pou and the nurses to hasten death for these patients or even if they did. Instead, let’s just focus on the fact that in such a situation, the health care workers are faced with helping those they can help while knowing that there are some who are destined to die no matter what they do. Further, with such limited resources, effort spent on those destined to die runs the risk of harming those who have a shot at recovery.

Doesn’t that sound familiar? Right now, various hospitals are drawing up their priority lists for allocating life-saving resources when the COVID-19 outbreak overwhelms staff, space and equipment. Note that even in this 2009 article, Pau mentions how the Katrina situation will not be unique and that a pandemic could lead to the very same scenario.

And with that, we come to the NOLA.com story from which the feature image of this post is derived:

A woman who identifies herself an Ochsner Medical Center nurse has published a gut-wrenching post on social media, going into detail about how she has seen coronavirus overwhelm a patient and pleading with the public to say inside “as if your life depended on it.”

Claudia Griffith’s 416-word Facebook post explains how the disease can take over a person’s lungs and kidneys. And “if it makes it to your kidneys, you’re lucky to be alive because your liver is next,” Griffith explains.

The story continues:

“As a nurse you cry at the window knowing there’s nothing you can do,” she writes.

/snip/

“You spend hours in your (patient’s) room gowned up head to toe sweating and not able to breathe. Then you realize…this is it. I can’t save this patient anymore. You sit there and say your goodbyes while they pass without family or loved ones because nobody is allowed in the hospital for everyone’s safety. You are their only contact and hope. You sit and watch as the (heart rate) and (blood pressure) can’t read anymore. You lost your patient to COVID19. You don’t even know how this virus works but you watch as it kills your patient,” she says.

In a very real sense, those patients she is describing are drowning as the pneumonia from COVID-19 relentlessly fills their lungs just as relentlessly as the Katrina floodwaters rose.

The best I can tell, Ochsner Medical Center in Jefferson and Memorial Medical Center in New Orleans are only four miles from one another. It is such a tragedy that they find themselves in the same dilemma just shy of 15 years apart.

Note that Louisiana doesn’t even make it into the list in the Washington Post article detailing huge disparities in how the Trump Administration is allocating emergency reserves of supplies and ventilators. And you can read here about the dire situation Louisiana hospitals are facing, with maximum capacity likely to be reached by this time next week. The people of New Orleans and all of Louisiana desperately need help, but I fear that we as a country can’t find the way.

Rural Roulette: The Three-Day Church Event

CNBC posted a list of the highest COVID rates per 10,000. In general, it includes two kinds of places: metro areas (NYC and environs, New Orleans, and Detroit), and ski resorts (the counties where Sun Valley, Crested Butte, Park City, Vail and Beaver Creek, and Aspen are).

There are two exceptions to that rule (though I expect Otsego County, MI may soon be on the list, based on a cluster I don’t yet understand): Dougherty County, GA, which I noted in this thread. That’s an outbreak tied to two funerals, especially that of Andrew Mitchell.

The service was for 64-year-old Andrew J. Mitchell, an Albany native who worked in custodial services and who died from what his family believes was heart failure. Mitchell came from a large family, and on Feb. 28 as many as 100 people came by the funeral home for visitation. The next day, seven of his siblings attended the funeral, along with dozens of his nieces, nephews, cousins and their own families. Some guests traveled in from as far away as Louisiana, Washington, D.C., and Hawaii. They greeted each other with tight handshakes, long embraces and kisses.

“The minister, he was shaking pretty much everybody’s hand, just giving the family comfort and condolences,” Mitchell’s niece Chiquita Coleman said. “The funeral home officiants, they were kind of doing the same thing. That’s kind of their job, to give comfort. So there was a lot of touching and hugging and hand-shaking.”

Afterward, chapel workers at the exit handed out memory cards. Later, there was a repast at Mitchell’s house and a gathering at the home of a sister.

In the days and weeks following, at least two dozen Mitchell family members fell sick with flu-like symptoms.

The other is Cleburne County, Arkansas, a county of just 25,000 people. That cluster is tied to a 3-day event at a local church.

Nearly three dozen cases of covid-19 have been diagnosed in people who share a connection to a church in Cleburne County, while others at the approximately 80-member congregation have been tested and are awaiting results.

[snip]

“It appears, from what I know at this time, most of the cases that we have in our county” are related to the Greers Ferry church, said Jerry Holmes, county judge of Cleburne County, who restricted public access to county offices last week and shut off access completely as of Monday.

Cleburne County, population 25,000, had 28 positive tests and 35 negative tests as of 7:35 p.m. Monday, according to the Arkansas Department of Health. Only Pulaski County, population 393,000, had a higher number of positive tests at that time, 62. All five counties bordering Cleburne had at least one positive test, including Faulkner County, which had 10.

Shipp’s count of 34 people is an updated count after reaching out to church members Sunday evening to check on them. Before then, Mark Palenske, the church’s pastor, had said in a Facebook post on the church’s official website Sunday that 26 people linked to the church had tested positive, including himself and his wife, Dena. The Palenskes could not be reached for this article.

Shipp said all but three of the people at the Kids Crusade were members or staff at the church. The three nonmembers who later tested positive for the virus were Thomas and Angela Carpenter, missionaries who had brought the three-day program to the church, and a child.

The Carpenters are listed as missionaries for Word of Grace Assembly of God Church in Hope on its website, and could not be reached at the church Monday.

The county has just one hospital and it has no ICU beds. And Arkansas is one of the states that has done least in response to this crisis, which makes it likely the disease will continue to spread from this one cluster.

Tourists, visiting missionaries, grieving friends and relatives of a long-standing community member. These are the ties that link rural communities across the country to a global network of virus. While many people in these rural towns believe they’re a world away from the outbreak in NYC, and therefore have to take none of the drastic measures to stop the spread, these same rural communities are even less prepared with the aftermath. Not only don’t their local healthcare facilities have the resources to treat this disease, but residents are more likely to be older, in ill health, and lack health insurance.

Update: The same kind of event — a church event — seems to behind a cluster of cases on the Navajo Nation.

A church gathering here earlier this month may be linked to a dozen confirmed cases of coronavirus and at least two deaths.

The participants in the large gathering that congregated March 7 at the Chilchinbeto Church of the Nazarene Zone Rally — a meeting in which pastors deliver messages to their members — may have all been exposed to coronavirus by at least one person who later tested positive for the disease.

Several people who attended the rally or who had family members who did later tested positive for the virus.

Before they could be tested, two people — one in LeChee, Arizona, and one in Chilchinbeto — died of respiratory symptoms, according to local sources.

[snip]

Confirmed cases of COVID-19, the disease caused by the coronavirus, in the Navajo Nation on Tuesday evening rose to 49 from 26 late Saturday. Cases include 30 from Navajo County, seven in Apache County, six in Coconino County, four in McKinley County, and two in New Mexico’s San Juan County.

Most of the 30 coronavirus cases from Navajo County are tied to the zone rally, where one pastor was coughing as he gave a sermon, according to sources.

The rally ran concurrently with a “Day of Prayer” event at the Chilchinbeto Chapter House where chapter officials and some members of the church had a prayer service in response to the coronavirus outbreak. Everyone — pastors and members of all churches — were invited to the prayer service.

The LAT has an article about how poor communication and limited resources (including no running water in some cases) add to the challenges of a poor population with little access to medical care.

Dispatch from the War on COVID-19 [UPDATE-1]

[Check the byline, thanks. Update at the bottom. / ~Rayne]

If you’re a regular here you know I don’t like to share stuff from Fox or affiliates. But local station Fox5NY picked up and republished a video online I haven’t been able to capture elsewhere. It’s extremely important.

She isn’t the only nurse we’ve heard from here in Michigan about the “war zone” in which they now work. I shared a link earlier today in a previous post; I’ll share it as an embed here so you can hear these health care workers back to back.

 

View this post on Instagram

 

Dear Family, Friends and Complete Strangers, Please STAY HOME!! Love, an ER Nurse

A post shared by Mary Macdonald (@marymac019) on

Now, a word to Sen. Lindsey Graham who denigrated nurses because of the possibility they may collect $24 an hour on unemployment.

Senator Graham:

Nurses are degreed professionals who not unlike lawyers must pass a state licensing test and earn continuing education credits on top of their regular job. The ICU nurse has had very specific training as has the ER nurse; both have likely had to add more training to cross over to do the jobs they’ve performed this week.

They are our foot soldiers in the war on COVID-19. We will not have enough of these soldiers because they will get sick from a combination of exposure to high viral loads, especially when they don’t have adequate protection, and from the heightened, sustained stress of this pandemic war.

They do not deserve your disrespect. These professionals will treat every patient as someone worthy of their efforts. They will do their level best to save whomever they can provided they have the resources. The least you can do is treat them with the same respect they’d treat you as a patient. For all you know you will find yourself sick with this virus and you’ll be on the business end of one of these professionals who are in such high demand there won’t be any unemployed nurses in this country for more than a year.

Get over yourself, Graham. And stop taking social cues from that rude, nasty cretin in White House. Your friend McCain would be ashamed of you if he were still alive.

To whoever is bashing Governor Whitmer about her performance, a word:

Just like these health care workers who are pleading for supplies, so has Whitmer pleaded for assistance. Her constituents in the state of Michigan deserve all the services they’ve funded their federal government to provide. They are already getting what the state of Michigan can provide because Whitmer is ensuring this happens.

You cannot hide the fact that the federal reserve for supplies should have been ordering and collecting materials in January after China told WHO that a novel coronavirus posed a pandemic risk. Attacking Whitmer won’t change the fact that it is the federal government, directed ultimately by the president, which was responsible for detecting pandemic risk and responding proactively to it, informing states of the risk as early as possible.

That didn’t happen and now governors like Whitmer are forced to do both the job their states have elected them to do and more, taking responsibilities which belong to federal agencies, while Trump denies states the Honest Services they are entitled to because he has not received some sign of obeisance.

To use an aphorism well-known former Michigander Lee Iacocca enjoyed, “Lead, follow, or get out of the way.” Bashing Governor Whitmer is none of those things. Pick one of the three.

To everyone else: pay heed to what these health care workers are saying. Overall mortality will go up, not just from COVID-19, because first responders will be overwhelmed by both the demands this virus places on our systems, and by illness and death as their own ranks are infected and sickened. Stay home. Keep your distance. Heighten your hygiene practices to reduce risk of infection. Wash your hands. Help your loved ones, friends, community as best you can.

To health care workers and all other first responders: do the best you can. That’s all we can ask of you. If the best you can do is allow someone you cannot save to die in peace, so be it. We should have done more for you before this war began.

And someone should have told us all when that war started instead of lying to us until it was nearly too late.

UPDATE-1 — 7:00 P.M. ET —

I am suitably chastened by this video by a doctor at Emory:

YOU are the frontline, the foot soldiers. What you do during this period of necessary social distancing makes the difference counted in lives. We may have to be patient longer because we didn’t start early enough, but our loved ones, friends, their futures depend on it.

And the lives of health care workers also rely on us. We’ve lost a number of nurses and doctors, people like these women in these videos. We can’t afford to lose more.

Trump Can’t Turn the Economy Back on Without Overriding Executive Orders of 28 Governors

Update: I’ve updated this and reposted. At least six states have added stay at home orders since Trump said he wanted to reopen the economy by Easter. This post was originally published on March 24, just before mid-day.

As noted, yesterday Trump signaled that he wants to turn the economy back on, perhaps 15 days after his original Emergency declaration on March 13 (which would mean the emergency would end on Saturday, March 28). As Ron Klain just noted, though, Trump doesn’t have that ability: Governors, not the President, have been the ones to shut things down (along with a number of mayors and corporate executives).

It will be governors, not Trump, who decide when to reopen the economy.

Over the last week, a set of governors (currently 28) have issued stay-at-home orders; another (MA) imposed a suggested stay at home declaration, and a number of cities and counties have similarly shut down. This NYT story has a great map and numbers showing how many people are affected (though without durations or governor party affiliation).

As the list below makes clear, Trump can’t turn the economy back on without finding a way to rescind the executive orders of a bunch of governors, including those of Republicans Eric Holcomb (whose order goes until April 6), Mike DeWine (whose order goes until April 6), and Jim Justice (whose order doesn’t have a termination date).

Update: Trump just said, “I would love to have the country opened up and raring to go by Easter.”

Update: This has been updated through March 27. This is the most comprehensive list of orders I’ve seen, including those closing businesses as opposed to ordering people to stay at home (though as of today it is missing a business closure from AL’s Kay Ivey).

Update, March 30: Maryland’s Larry Hogan and Virginia’s Ralph Northam, whose initial non-essential business shutdowns had stopped short of a stay-at-home order, have both now issued the latter.


Full stay-at-home orders

  1. Alaska (Republican Governor Mike Dunleavy): Imposed March 27, effective March 28, in effect until April 11.
  2. California (Democratic Governor Gavin Newsom): Imposed and effective March 19, in effect “until further notice.”
  3. Colorado (Democratic Governor Jared Polis): Imposed March 25, effective March 26, in effect until April 11.
  4. Connecticut (Democratic Governor Ned Lamont): Imposed March 20, effective March 23, effective through April 22. (Order)
  5. Delaware (Democratic Governor John Carney): Imposed March 22, effective March 24, in place until May 15 or public health threat eliminated. (Most recent order)
  6. Hawaii (Democratic Governor David Ige): Imposed March 23, effective March 25, effective through April 30.
  7. Idaho (Republican Governor Brad Little): Imposed and effective March 25, effective 21 days (though April 15).
  8. Illinois (Democratic Governor JB Pritzker): Imposed March 20, effective March 21, effective until April 7. (Order)
  9. Indiana (Republican Governor Eric Holcomb): Imposed March 23, effective March 24, effective until April 6. (Most recent orders)
  10. Kansas (Democratic Governor Laura Kelly): Imposed March 28, effective March 30, effective until April 19.
  11. Louisiana (Democratic Governor John Bel Edwards): Imposed March 22, effective March 23, in place until April 13.
  12. Maryland (Republican Governor Larry Hogan): Imposed and effective March 30.
  13. Michigan (Democratic Governor Gretchen Whitmer): Imposed March 23, effective March 24, in place until April 13. (The state announcement, but not the order itself, states the order will be in place “at least” three weeks.)
  14. Minnesota (Democratic Governor Tim Walz): Imposed March 25, effective March 27, effective until April 10.
  15. Montana (Democratic Governor Steve Bullock): Imposed March 27, effective March 28, effective until April 10.
  16. New Hampshire (Republican Governor Chris Sununu): Imposed March 26, effective March 27, effective until May 4.
  17. New Jersey (Democratic Governor Phil Murphy): Imposed and effective March 21, effective until further notice.
  18. New Mexico (Democratic Governor Michelle Lujan Grisham): Imposed March 23, effective March 24, in place until April 10.
  19. New York (Democratic Governor Andrew Cuomo): Imposed March 20, effective March 22, in place until April 19. (Most recent orders available here.)
  20. North Carolina (Democratic Governor Roy Cooper): Imposed March 27, effective March 30, effective for 30 days (until April 29).
  21. Ohio (Republican Governor Mike DeWine): Imposed March 22, effective March 23 in place until April 6.
  22. Oregon (Democratic Governor Kate Brown): Imposed and effective March 23, effective until terminated. (Order)
  23. Rhode Island (Democratic Governor Gina Raimondo): Imposed and effective March 28, effective until April 13.
  24. Vermont (Republican Governor Phil Scott): Imposed March 24, effective March 25, effective until April 15.
  25. Virginia (Democratic Governor Northam): Imposed and effective March 30, effective until June 10.
  26. Washington (Democratic Governor Jay Inslee): Imposed March 23, effective March 26, effective until April 8.
  27. West Virginia (Republican Governor Jim Justice): Imposed March 23, effective March 24, effective until terminated. (Order)
  28. Wisconsin (Democratic Governor Tony Evers): Imposed March 23, effective March 25, effective until April 24.

Non-essential business closures

  1. Kentucky (Democratic Governor Steve Beshear)
  2. Maine (Democratic Governor Janet Mills)
  3. Nevada (Democratic Governor Steve Sisolak)

Trump Threatens to Withhold Disaster Declaration for Michigan because Gretchen Whitmer Was Mean to Him

Update: According to NBC’s Geoff Bennett, Trump has now approved the request.

Last night, Donald Trump suggested that he might withhold a disaster declaration for Michigan requested by Governor Whitmer on March 26 because he doesn’t like Governor Whitmer’s public comments about the Federal government’s failures.

“We’ve had a big problem with the young — a woman governor. You know who I’m talking about — from Michigan. We don’t like to see the complaints,” President Trump told Sean Hannity during a FOX News interview on Thursday.

Gov. Whitmer has been openly critical of the federal response to the coronavirus outbreak, voicing her frustration with not having enough COVID-19 test kits and a lack of “clear and concise guidance from the federal government.”

The comments from President Trump come on the same day Gov. Whitmer requested a major disaster declaration for Michigan over the coronavirus outbreak.

“She doesn’t get it done, and we send her a lot. Now, she wants a declaration of emergency, and, you know, we’ll have to make a decision on that,” President Trump continued. “I don’t know if she knows what’s going on, but all she does is sit there and blame the federal government.”

Here are the states for which Trump has declared an emergency with the number of positive cases on the date Trump made that declaration and the party of their governor.

As of yesterday, Michigan has had 2,856 people test positive for COVID-19. Dr. Deborah Birx pointed to SE Michigan’s Wayne County (which includes Detroit and the mostly working class suburbs), along with Cook County, IL, as the alarming hotspots in the country.

And yet Trump doesn’t want to approve a disaster declaration because a girl was mean to him.

Trump’s Death Panel Comes for Detroit [UPDATE-1]

[Update at bottom of post, thanks. /~Rayne]

Ordinarily I wouldn’t step on Marcy’s posts by putting another one up so soon and one so short, but I am both FURIOUS and scared sick about this.

Since last night, Detroit Free Press confirmed yesterday’s rumors about the number of ventilators at one chain of Detroit hospitals — that area hospitals had run out of ventilators and patients were notified on arrival they may not have access to a ventilator if needed.

Without ventilators, those suffering from acute respiratory distress syndrome in critical need may die.

Trump decided to kill Detroiters by withholding essential equipment. He’s chosen not to act in a timely fashion and interfered with the state’s ability to obtain equipment, while trash talking about Michigan’s governor in the process.

Welcome to Trump’s death panel.

Michigan’s Governor Whitmer couldn’t make it any more plain how urgent the situation was, just as Governor Cuomo has.

Trump’s gross negligence isn’t hurting just black Detroiters, either — yeah, I went there, you know damned well Trump doesn’t care about the woman who is our governor or the black people who are the majority in Detroit.

Trump is hurting rural white Michiganders in areas that voted for him in 2016.

If this is how he’s setting out to win swing states, I hate to see what more harm he’ll cause to solidly blue states.

UPDATE — 1:10 P.M. ET —

You need to watch this video produced by an ER nurse in Oakland County, Michigan. The county straddles four congressional districts, two of which recently flipped blue. This is where white flight settled pre-2000, leaving Detroit behind.

They don’t even have acetaminophen to give patients when they put the ventilator tube down their throats — assuming they still have ventilators right now.

Trump’s death panel won’t just kill you. It will make sure you suffer along the way.

 

Trump Fighting for Floating Petri Dishes but Not Life-Saving Ventilators

Trump’s response to learning that the cruise industry — which is almost entirely flagged overseas, in part to avoid US taxes — would not be eligible to tap the $500 billion slush fund for large businesses was to work to find a “legislative fix” so these floating petri dishes could survive a pandemic exacerbated by their industry.

Sr. admin official says bipartisan Senate grp working to ensure they can access one of the facilities–or else will seek a legislative fix in the next package.

He proposed adopting Josh Hawley’s offer, which is that if they registered here they could qualify for this loan package.

Meanwhile, on the same day Trump went out of his way to think creatively about how to fund an industry that has almost no societal value that isn’t already being addressed with extended unemployment benefits, outlets reported that the Trump Administration was balking on a plan — which both Trump and Mike Pence had already celebrated — to back a joint venture between General Motors and ventilator manufacturer Ventec Life Systems to produce up to 80,000 ventilators in Kokomo, IN. The problem: $1 billion was too much to spend to address the acute shortage of ventilators in the country.

The decision to cancel the announcement, government officials say, came after the Federal Emergency Management Agency said it needed more time to assess whether the estimated cost was prohibitive. That price tag was more than $1 billion, with several hundred million dollars to be paid upfront to General Motors to retool a car parts plant in Kokomo, Ind., where the ventilators would be made with Ventec’s technology.

By the end of the day, both Trump and Dr. Deborah Birx questioned the number of ventilators New York Governor Andrew Cuomo has consistently said his state will need.

“I have a feeling that a lot of the numbers that are being said in some areas are just bigger than they’re going to be,” he said. “I don’t believe you need 40,000 or 30,000 ventilators. You go into major hospitals sometimes, and they’ll have two ventilators. And now all of a sudden they’re saying, ‘Can we order 30,000 ventilators?’”

New York has become the new epicenter of the coronavirus outbreak in the United States, with hospitals struggling to keep up with larger patient numbers and limited supplies, including masks, gowns and ventilators. In severe cases of Covid-19, the illness caused by coronavirus, ventilators can allow patients to breathe with incapacitated lungs — a common outcome of the disease.

Dr. Deborah Birx, the White House coronavirus response coordinator, said earlier on Thursday she was told that New York had enough ventilators to meet current needs. While there may be shortages in urban areas like New York City, Birx said, there are other parts of the state “that have lots of ventilators and other parts of New York state that don‘t have any infections right now.“

“There is still significant — over a thousand or two thousand ventilators that have not been utilized yet,” Birx said. “Please, for the reassurance of people around the world, to wake up this morning and look at people talking about creating DNR situations — do not resuscitate situations for patients — there is no situation in the United States right now that warrants that kind of discussion.“

Trump’s interest in thinking creatively to fund the cruise industry as compared with his stinginess regarding crucial medical needs is not just malpractice during a pandemic.

But it doesn’t even serve his own stated priorities.

Trump has said he wants the economy to resume as soon as possible — he has been pushing for an Easter restart. Both WA (where Ventec is headquartered), MI, and IN are under state-wide stay-at-home orders, permitting only essential workers in the state to leave their homes to go to work. With some exceptions, the stay-at-home orders in the Midwest have shut down much of the auto industry.

Redeploying a parts plant in IN to produce ventilators would be a way to shift a facility and its workers from the non-essential category to the essential category, potentially getting them working before the stay-at-home orders are lifted.

Indeed, pushing manufacturers to shift production to items deemed essential, via whatever means (in this case, the venture would be supported only by a purchase agreement, but the Defense Production Act could be used to do even more of this). And even if Cuomo is overestimating how many ventilators he’ll need (there’s no reason to believe he is), if there’s a surge in COVID cases in the southern hemisphere as it shifts into fall, there’ll be plenty demand worldwide to pick up the slack.

Even if it led to a glut, one of the best employment policies right now would be to shift as much short- to medium-term production from goods deemed non-essential to goods deemed essential. Even if the US government overpays for those products, it’d be a better jobs program than restarting the cruise industry.

Trump continues to fool himself about where capitalism ends and state support begins. But he’s also adopting a policy that undermines his own hopes to get as many people back to work as he can.

Trump’s Blame the Governors Strategy and Rural Roulette

The other day, I laid out how, even if Trump wants to open the country back up by Easter, at least fifteen governors may prevent him, including OH’s Republican governor Mike DeWine, who in the wake of Trump’s comments tweeted out defending his approach again. The WaPo did a similar piece this morning, confirming that the governors aren’t on board with Trump’s hopes.

That said, it’s clear that Trump plans to pressure governors, not just to do his bidding, but also to demand fealty before he heeds their pleas for help. Ultimately, it may be a bid to blame the upcoming crisis on the governors — disproportionately Democrats — struggling most directly with the crisis.

And that could work.

Though I doubt it, for a number of reasons. As US numbers continue to spike, it’s likely the governors who’ve taken more aggressive stances (with the possible but very notable exception of Andrew Cuomo, largely because of NYC’s density) will be able to show significantly better outcomes than those states that have adopted a hybrid approach, shutting down affected cities but not the entire state, to say nothing of those who were doing nothing (this Politico piece shows what each state has done or, in the case of OK and MS, not done at all).

Right now, almost all the identifiable clusters are in big cities, with both the international travel and density that would lead to early exposure. But some (not all — Detroit is an exception) of those cities actually have relatively low levels of the preexisting conditions that make the population more susceptible to the virus and more likely to have an extreme case if they get it. By contrast, much of America’s more rural areas have a higher instance of those pre-existing conditions. And those rural areas don’t have the hospital beds, much less ICU rooms, to treat seriously ill patients. This map, from an MIT project, shows where current outbreaks are and where particularly vulnerable populations are for the country as a whole.

That means in states where governors have not imposed state-wide stay at home orders, there’s a significant risk that clusters will arise in areas that are less prepared to deal with an outbreak. Effectively, the governors who’ve adopted such an approach are playing “rural roulette,” assuming that a focus on the cities will mitigate the biggest risks, even though the rural areas would be easily overwhelmed even with a smaller number of infections.

And that may have an important dynamic given the election. A number of the key swing states — MN, WI, MI, OH — have instituted full state stay-at-home orders. But many of the rest — PA, FL, NC, CO, GA, TX — have not. And in some of the states where that decision is riskiest — GA, FL, and AZ — there’s a Republican governor adopting those strategies in part to adhere to Trump’s views.

Take Georgia. It has had an outbreak in the more rural southwest part of the state, and municipalities are trying to force Governor Brian Kemp to impose a state-wide shutdown.

But the rest of the state has high incidences of some of the preconditions that make the population particularly susceptible to infection. In other words, while Atlanta has the medical resources (including CDC) to respond to the medical crisis, Georgia is already exhibiting an atypical pattern of rural spread in ways that might make Kemp’s refusal to do a state-wide order particularly costly. (As I was writing this, Kemp announced that schools will remain closed through April 24, which suggests he may be budging on a state-wide approach.)

Then there’s Florida.

Jim here.

As the New York Times notes, the municipalities of Miami and Miami Beach have stay home or shelter in place orders that went into effect this week. Also, Alachua, Leon, Orange and Pinellas Counties have stay home orders. Note that while Orange County holds most of the Orlando metro area, Pinellas is only the St. Petersburg portion of the Tampa Bay region. Tampa is in Hillsborough and the population stays fairly high going north into Pasco and south into Manatee and Sarasota Counties.

A very interesting aspect of the Alachua County stay home order, which went into effect here at 12:01 am Tuesday, is that, as noted in the Gainesville Sun, “Non-medical businesses may only allow one customer inside per 1,000 covered square feet, per an Alachua County emergency order.” Here is the line outside a grocery store Tuesday morning in the Sun’s photo accompanying the article:

As the Tampa Bay Times notes, despite multiple public health authorities pleading for a statewide shutdown, DeSantis has instead been listening almost exclusively to business interests, and their message to him has been exactly the one Fox News and Trump have been flogging:

The Florida Chamber of Commerce have spoken frequently with the governor and his staff, urging him not to take drastic measures that might shut down the state’s economy. The Florida Restaurant and Lodging Association has been asking for ways to help their industries stay afloat.

Their message: don’t let the cure be worse than the disease.

But this is ignored:

Public health experts say that a three-week limit on public movement is required to stop the spread of the virus, and they point to a statistical model that shows that Florida may have only one week to act before hospitals become overwhelmed.

Instead, he hears a Republican telling him just how responsible he is to ignore the public health requests:

Sen. Tom Lee, R-Thonotosassa, said DeSantis was under “a tremendous amount of pressure,” but the idea he’s making decisions based on politics — and not public health — was “irresponsible.”

“He’s hearing from a lot of self-interested actors right now who are acting out of self-preservation,” Lee said. “With every executive order, there’s another industry being impacted. Those people are pretty aggressive and pretty vocal, and I think he’s done a pretty good job of ignoring all that.”

What could go wrong?

/Jim

In Florida, on top of the vacation traffic that DeSantis only belatedly shut down, it has significant numbers of seniors and its rural, more vulnerable communities do not have the beds to treat patients in if an outbreak happens (the gray circles here are senior facilities).

To make things worse, DeSantis is not sharing information about which senior facilities have had positive cases, which is likely to lead to clusters outside of locked down areas that lead to community infection. So on top of the rural/urban mix, DeSantis has the likelihood of a breakout at senior facilities.

It’s not just Republican governors who’ve adopted a hybrid strategy though: Pennsylvania Governor Tom Wolf  locked down PA’s major counties without imposing stay at home in their more rural areas. PA is going to experience the community spread of the Eastern Seaboard; it’s a real question what happens as the virus spreads west from the Philadelphia metro area. Plus, it also has a concentration of senior facilities (the family member I’m most worried about now is stuck in one until April 1 fighting several other preexisting conditions).

In bmaz’s Arizona, something that has the possibility of being worse is happening: Republican Governor Doug Ducey is using his authority to prevent cities from imposing more stringent stay at home orders. Thus far, this order strives only to impose a state-wide standard for what amounts to essential businesses (something that has led to confusion even in states with full state-wide orders). Most of his businesses match those adopted by state-wide orders. His order specifically includes golf courses (but not their restaurant facilities) as essential businesses, which I this is reasonable, in AZ, in the name of exercise; bmaz says that the crowds on urban hiking trails, which are also exempted, are far worse. Ducey’s order could override school closures.

Or, the order as a whole could suggest he’s being pushed closer to where other states are, full stay at home orders.

Arizona faces a particular rural challenge, but one Ducey can’t manage: the Native American reservations, which already have cases and which have a real dearth of health resources. But they’re sovereign.

North Carolina’s Democratic Governor Roy Cooper is another person who is having to be pressured to impose a more stringent state-wide stay at home order.

If states can access adequate testing, it’s still unproven whether state-wide or city-by-city orders will be most effective (though the testing is clearly not there yet).

What is clear, however, is that there will be at least as much political pressure on the states that have incomplete stay at home orders as those with statewide orders. And that just happens to include many of the states where November’s election will be decided.

Update: Trump has just sent a letter to governors suggesting the Feds are going to roll out new standards for identifying high and low risk counties, suggesting he wants to adopt the piecemeal shutdowns of the states discussed here. Such a regime will make orders like Doug Ducey and Mississippi Governor Tate Reeves’ orders standardizing shut-downs at the state level dangerous in a way they aren’t now, because both cite Trump’s guidelines for protective measures.

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