John Galt Is Impotent In A Pandemic

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Discontinuity.

Abrupt change.

Collapse.

Chaos.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Three Things: Endemic COVID-19 Edition

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

By now we’ve all seen that disastrous presser with dementia-addled Trump at the Center for Disease Control yesterday, his yes men all standing around him bobbing their heads like useless bobble-head dog figurines folks used to put in their car’s rear window deck.

It was really bad when my 79-year-old mother, a retired RN, SCREAMED about that presser in her email this morning, yelling, “He has NO business spouting anything about this health situation!”

Yup. The man should leave it to the public health experts.

Mom’s not a Democrat. Neither is my dad. They will NOT be voting for Trump this November, if they manage to stay away from COVID-19 on their own.

Here are three things that I consider must-reads. We need to know more about what we’re up against.

~ 3 ~

Here’s a tweet thread which runs the numbers based on our current understanding of COVID-19.

If you don’t get through this, the kicker is that this is an engineer running the numbers. She calls herself an engineer but this is a minimization of a Chemical & Biomolecular Engineering degree from Johns Hopkins and her PhD from UCSD. This is no lightweight assessment.

The follow-on gut punch: if the states and federal government do not develop and implement a comprehensive plan to mitigate contagion, the U.S. will run out of hospital beds in early May.

That’s in a little over eight weeks.

If we don’t have adequate beds let alone mechanical ventilators and intubation equipment, the mortality rate will jump from an estimated 2-2.3% to at least 5%.

~ 2 ~

Jackasses like Rep. Matt Gaetz will make fun of the numbers, calling it overreaction. (By the way, how’s that crow tasting today, Gaetz, after one of your constituents died of COVID-19 since you made fun of it by wearing a gas mask the day before?)

But hospitals are taking COVID-19 seriously. They have also run the numbers and discussed among themselves what the increasingly endemic virus will demand of them. Here’s a summary from a presentation made in a webinar on February 26 by the American Hospital Association (AHA):

Here’s a comparison between influenza burden on hospitals versus AHA’s anticipated COVID-19 burden:

COVID-19

Influenza, 2018-2019 season
96,000,000 infections 35,500,000 infections
4,800,000 hospitalizations 490,600 hospitalizations
1,900,000 ICU admissions 49,000 ICU admissions
480,000 deaths 34,200 deaths

Flu data from CDC.

Grim — 14 times more deaths than the flu based on data currently available about COVID-19.

What the hospitals see confirms we will run out of hospital resources and more if there is no more aggressive effort made to slow contagion.

We don’t need to wait for proof. We can see it in Lombardy region of Italy as they quarantine 10-16 million people to prevent worse from happening.

~ 1 ~

We know something has been very wrong about the way in which the Trump administration responded to COVID-19, particularly its approach to testing. What’s not clear is why this was such a problem when the U.S. has responded to SARS, MERS, Ebola, Zika, H5N1, so on. Clearly this administration is not up to the job; clearly Trump is an idiot who shouldn’t be allowed near crises like hurricanes, fires, and pandemic threats. We can all see something is very off each time there’s a report that a credible claim of COVID-19 infection has been denied testing — including first responders.

But something more is going on here besides a bunch of yes men propping up a malignant narcissist with dementia. Jon Stokes laid down his thoughts in a tweet thread:


Has the delay in testing been due to Trump’s dementia-addled decision making, waiting out what he believes is a different kind of influenza? Has he been told by some hostile entity, foreign or domestic to wait and let the virus burn itself out? Has one of the crypto-fascist end-times Christianists around him advocated letting God take the wheel?

Or is the failure to act a result of Trump’s manifold conflicts of interest, this time a possible investment in a drug or testing manufacturer?

Amee Vanderpool wonders if Trump or his family is poised to profiteer from COVID-19:

Axios reported this evening that Gilead Sciences shipped an antiviral drug to China — without CDC approval required by law.

Does some member of Team Trump have an interest in Gilead? Or has Gilead invested in Trump, perhaps through his campaign?

Or is this some dark means of fucking with the Census, anticipating urban centers which trend blue to suffer the worst of this pandemic, killing off people who’d rely on government funding and congressional representation in the next decade?

Is this a means to ratfuck voter turnout this fall, literally killing voters by neglect with the anticipation of depressing turnout?

Is this a shadowy method to weaken the public before Team Trump decides they aren’t going to vacate the White House should they be voted out of office? You’ll note CBP has ramped up and militarized their presence in sanctuary cities — why now?

Whatever is driving Trump and his minions to do nothing to deter contagion and help the public already suffering from COVID-19, it’s a dereliction of his duties to the nation, a rapidly growing national security threat which demands Congress’s immediate attention.

Investigate Trump right now and find out why he’s failing the country yet again.

And every member of the GOP congressional caucus owns this disaster because they’ve failed their oath of office.

~ 0 ~

A lagniappe, if not a happy bonus: watch this video interview from Channel 4-UK with Dr. Richard Hatchett, CEO of the foundation Coalition for Epidemic Preparedness Innovations (CEPI).

Distasteful as the idea may be, a war footing may be necessary to fight this pandemic.

COVID-19: The Gift of Family Discussion Topics [UPDATE-1]

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[NB: Note the byline – I’m stepping on Jim White’s beat today. Updates will appear at the bottom. /~Rayne]

There’s nothing quite like receiving an email from my father first thing in the morning. He’s not a chatty dude; I can count on two hands the number of emails I’ve received from him in the last five years. When he pops me a note I know he’s been stewing on whatever he sent.

Today he sent me and my siblings a link to a report about study of CT scans used to screen COVID-19 patients:

CT provides best diagnosis for COVID-19
Date: February 26, 2020
Source: Radiological Society of North America
Summary: In a study of more than 1,000 patients published in the journal Radiology, chest CT outperformed lab testing in the diagnosis of 2019 novel coronavirus disease (COVID-19). The researchers concluded that CT should be used as the primary screening tool for COVID-19.

Dad was also worried about the reliability of Chinese tests. Okay, so noted — if I go to China any time soon I’ll treat them with suspicion. Thanks for the email, Pop, and thanks to my siblings for the flurry of follow-up messages.

~ ~ ~

I’m far more worried about the U.S. tests which are still extremely limited after the CDC’s screw up by devising its own test instead of using effective tests already available.

The CDC designed a flawed test for COVID-19, then took weeks to figure out a fix so state and local labs could use it. New York still doesn’t trust the test’s accuracy.
by Caroline Chen, Marshall Allen, Lexi Churchill and Isaac Arnsdorf Feb. 28, 12:13 a.m. EST

There’s been a contamination issue in the government lab responsible for the tests as well — negative control reagent not handled properly in kits.

By Jon Cohen Feb. 28, 2020 , 5:45 PM – ScienceDaily

. . .

by Jonathan Swan, Caitlin Owens for Axios
Updated Mar 1, 2020 – Health

I don’t have a lot of faith this problem will be fixed promptly. FDA is supposed to approve the tests, but…

Sent to help the administration’s coronavirus response, a test specialist was stopped at CDC’s door and made to wait overnight.
By DAN DIAMOND 03/03/2020 03:23 PM EST – Updated: 03/03/2020 03:53 PM EST

We’re also seeing continued problems with testing due to lack of supply affecting first responders. Here’s a letter from a quarantined nurse in California who has had symptoms matching COVID-19, whose doctor and county public health officer signed off on getting her tested, and the CDC refused to test her.

The key symptom distinguishing COVID-19 from influenza is the chest pressure and cough. Influenza has a productive ‘wet’ cough where COVID-19 infection is more likely to manifest a dry cough with more chest pressure and shortness of breath as the virus moves down the body. From WHO’s China Mission report:

Symptoms of COVID-19 are non-specific and the disease presentation can range from no symptoms (asymptomatic) to severe pneumonia and death.As of 20 February 2020 and based on 55924 laboratory confirmed cases, typical signs and symptoms include: fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia (14.8%), chills(11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestion (0.8%).

People with COVID-19 generally develop signs and symptoms,including mild respiratory symptoms and fever, on an average of 5-6 days after infection (mean incubation period 5-6 days, range 1-14 days). …

(Source: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf, page 11-12)

Because we can’t expect adequate numbers of test kits for weeks — no matter what those goddamned lying jackasses in the White House say — asking for a CT scan if you need treatment can be a good move. Haven’t seen other reports yet whether other forms of imaging like chest x-ray will work. However, the results of CT will change during course of infection:

Varied CT, clinical findings
In the second study, researchers at Sun Yat-sen University in Guangzhou, China, detailed the CT findings and clinical characteristics of six women 27 to 63 years old with COVID-19.None of the patients had such underlying diseases as diabetes, cancer, or respiratory disease. Five had had Wuhan or Hubei exposures.

They found that COVID-19’s wide variety of manifestations on CT can vary over time. Early in the disease, lesions can appear round and nodular in the central lung, unlike their common patchy appearance between the membrane surrounding the lung and the body wall. One patient had 3 follow-up scans 4 to 14 days later that showed diverse lesions and that the primary lesions had been absorbed and replaced elsewhere by new ones.

On testing blood samples, the researchers observed normal or slightly decreased counts of leucocytes and lymphocytes and identified mildly decreased eosinophil counts in four of the patients. Four days later, follow-up testing revealed that the low eosinophil counts remained abnormal and had dropped even further. “The decrease of eosinophil count may be helpful for the early diagnosis of the disease,” they wrote, calling for further study of the phenomenon. …

(Source: http://www.cidrap.umn.edu/news-perspective/2020/03/study-reveals-sharp-increase-covid-19-kids-shenzhen)

Blood test may work in tandem with CT, certainly faster to get than a CDC test for COVID-19.

Another potentially predictive risk factor for severe-critical cases: smoking, whether current or a past history. Explains why more men than women were severe-critical cases in China as men smoke more than women.

Guoshuai Cai
Version 1 : Received: 3 February 2020 / Approved: 5 February 2020 / Online: 5 February 2020 (02:56:53 CET)

Americans overall may have fewer severe-critical cases because tobacco smoking has dropped considerably over the last three decades. A good thing since severe-critical cases need mechanical ventilators or intubation and we simply don’t have enough equipment in our crappy health care system.

We don’t know yet if vaping is another risk factor; it may depend on substances in vapor, with tobacco being most suspect. I haven’t seen anything about marijuana use yet, whether smoked or vaped.

And disinfect (not just clean) your cell phones. Rather high nosocomial (hospital-acquired) infection rate with this bug in spite of aggressive PPE like full suits with hoods, booties, gloves, face shields means we’re dealing with possible airborne bug OR there’s some other fomite (surface) transmission not being documented.

As of Monday it was estimated there were ~600 asymptomatic cases walking around Seattle. This short-ish piece is a must-read, especially the paragraph which begins, “We know that Wuhan went from an index case”

2 Mar 2020 by Trevor Bedford – Bedford Lab

The Emerald City Comic Con convention begins on March 12 in Seattle, at which ~100K people from around the country and world are expected; the event has not been canceled.

March 5, 2020 at 6:00 am Updated March 5, 2020 at 7:08 pm

Wouldn’t want to cancel this massive social event and cause stock market disruption, oh no. *shaking my head*

I’d expect an explosion of cases across the U.S. in about 9 weeks based on Bedford’s estimate.

I know CT test may be inconclusive for me if I get this crap because an autoimmune disorder did a number on my chest ten years ago. I’m at high risk because of this pre-existing condition, as are family members because of their CVD and diabetes.

Must say there’s nothing like a documented mortality rate of 7-13% for CVD and diabetes to put the fear of god in certain at-risk family members about vigorous frequent handwashing.

Now I have to stop family from going full apocalyptic prepper. Somebody bought this household a half gallon of Lysol concentrate and three times more bleach than I’ve used in a year’s time.

I can hardly wait to hear from my family again first thing in the morning.

~ ~ ~
I do want to make one point perfectly clear, all snark aside.

** The Republican Party is responsible for every COVID-19 fatality in the U.S. **

They could have done the right thing and removed Trump by convicting him for obvious abuse of power and obstruction of Congress instead of being chickenshits afraid of Trump’s mean tweets. He’s a clear and present national security threat — this pandemic proves it.

VP Mike Pence has done a crappy job so far but we can’t tell how much of this disaster is his alone, or a result of also trying to keep his malignant narcissist from melting down while handling a mounting pandemic. As long as Trump’s in office they will both continue to screw this up.

The GOP could have done more to assure the pandemic response team remained in place with funding after Trump’s Senate-approved appointee John Bolton rejiggered the National Security Council in May 2018.

But no, the Republican Party is as incompetent and unequal to the job of protecting the American people as their leader in the White House.

Vote these walking disasters out of office in November; the life you save in doing so may be your own.

UPDATE-1 — 2:10 P.M. ET —

Wouldn’t you know it but as soon as I pressed Publish there was a message in my inbox that Emerald City Comic Con will be rescheduled to later this year, some time this summer.

This is the right thing to do given the number of cryptic COVID-19 cases in Seattle. It’s unfortunate the burden of this decision fell solely on the convention organizers in the absence of public guidelines about social isolation from the federal government.