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Live and Let Die: The Data Manipulation Begins

From the beginning of the coronavirus crisis, various entities in the United States were always engaged in the kind of dishonesty we accuse China of to hide the extent of the virus. Trump tried to keep a cruise ship off shore so it wouldn’t count against “his” numbers. States everywhere didn’t reveal the crises in nursing homes by hiding where they were occurring. Other states refused to track known COVID-19 deaths because they didn’t occur in a hospital.

But now that Trump has fully committed to reopening the economy before the shut down has its desired effect, he and allied governors are engaged in more aggressive data manipulation to hide the stupidity of what they’re doing.

Georgia had long manipulated its data, by rigging cut-off numbers to make it look like the only outbreaks were around Atlanta and in the Black Belt outbreak around Albany. But as Brian Kemp moved to reopen Georgia in the stupidest possible way, the state shifted its reporting to show confirmed cases.

That means it can always show a trend of declining cases that would match White House guidelines for reopening, rather than the plateau the state actually has, because the trend reflects known cases that aren’t counted yet.

Interestingly, Georgia may also be hiding the extent to which this virus has moved beyond predominantly African-American areas, thereby hiding that Kemp’s stupid decision is actually killing white people, too.

Meanwhile, Arizona’s Doug Ducey, who already lost the state’s experienced emergency manager, just ordered some  epidemiologists at the state’s public universities to stop work on a COVID model that used the states internal data, because their model showed the only way to avoid exponential growth would be to stay closed until the end of May.

The universities’ model had shown that reopening at the end of May was the only scenario that didn’t dramatically increase cases.

In late April, Tim Lant, a mathematical epidemiologist at ASU, said the model showed five different scenarios for how the disease could progress in Arizona, depending on how social distancing efforts were relaxed.

The slowest curve, based on if the state reopens at the end of May, is “the only one that doesn’t put me immediately back on an exponential growth curve,” Lant said in April. That’s because transmission rates would be lowest at that time, he said.

“I can say, scientifically, no, it’s not safe to reopen unless you’re planning on, you know, shutting down again after a couple of weeks, and we can help figure out what the appropriate amount of time is to stay open before we shut down,” he said.

Bailey wrote that health department leadership asked the team to “pause” all work on projections and modeling. The department would also be ending access to special data sets the modeling team had been using for their efforts, Bailey said.

Finally, yesterday the White House tweeted out the model that is has embraced in lieu of models by epidemiologists.

This release is an effort to rebut WaPo reporting on how this model — by the guy behind the Dow 36,000 book, Kevin Hassett — continues to be pulled out of Hassett’s ass whenever Trump needs to be told something he wants to hear.

The epidemiological models under review in the White House Situation Room in late March were bracing. In a best-case scenario, they showed the novel coronavirus was likely to kill between 100,000 and 240,000 Americans. President Trump was apprehensive about so much carnage on his watch, yet also impatient to reopen the economy — and he wanted data to justify doing so.

So the White House considered its own analysis. A small team led by Kevin Hassett — a former chairman of Trump’s Council of Economic Advisers with no background in infectious diseases — quietly built an econometric model to guide response operations.

Many White House aides interpreted the analysis as predicting that the daily death count would peak in mid-April before dropping off substantially, and that there would be far fewer fatalities than initially foreseen, according to six people briefed on it.

Although Hassett denied that he ever projected the number of dead, other senior administration officials said his presentations characterized the count as lower than commonly forecast — and that it was embraced inside the West Wing by the president’s son-in-law, Jared Kushner, and other powerful aides helping to oversee the government’s pandemic response. It affirmed their own skepticism about the severity of the virus and bolstered their case to shift the focus to the economy, which they firmly believed would determine whether Trump wins a second term.

[snip]

By the end of April — with more Americans dying in the month than in all of the Vietnam War — it became clear that the Hassett model was too good to be true. “A catastrophic miss,” as a former senior administration official briefed on the data described it. The president’s course would not be changed, however. Trump and Kushner began to declare a great victory against the virus, while urging America to start reopening businesses and schools.

The effort to prove the value of the epidemiological models done by people who are considered frauds within their actual profession of economics comes as the CDC’s own model showing an increase to 3,000 deaths a day was leaked. And the Council of Economic Advisors released this line-drawing exercise comes as the US has blown by Hassett’s original estimate of 60,000, one also adopted publicly by Trump.

Understand: This is not just an attempt to lie about the sanity of the decision to reopen the economy even as COVID cases continue to grow. It’s an attempt to lie about the stupidity of the economic decisions Trump made, too.

While other countries have had more cases per population, that has happened with economic relief focused on actual human beings rather than cruise lines and luxury hotels. Here, much of Trump’s economic policies have been just another attempt to loot the economy for his friends and campaign donors. That has made the economic impact of all this in the United States worse than it is in other countries, and it will only continue to get worse.

Some places that reopen prematurely will be forced to shut down again. And as more people are out spreading the virus, more bottle necks in critical infrastructure will be exposed.

Trump has pursued the worst of all policy options. After his initial dawdling let the virus spread in some cities, he endorsed shutting down the economy in an attempt to mitigate the pandemic. That had a predictable catastrophic impact on the economy (and more unemployment numbers will be out today). But because Republicans refused to adopt policies that would actually cushion that crash, the impact was much worse than it might have been.

Now, after taking the full hit of shutting down, Republicans are insisting on reopening — bolstered by their fraudulent charts and graphs — before the shutdown has any lasting epidemiological value. We’ll have the medical impact of a herd immunity approach, with the economic impact of a badly executed mitigation strategy. The worst of both options.

And to pretend that this is not all knowable and known now, Trump has swapped briefings by medical experts for photo ops set to campaign music, to the apt Live and Let Die.

Update: Meanwhile, Florida just removed details of possible positive COVID cases in January and February from a public website.

Mark Meadows and the Potemkin Shut-Downs: Welcome to the April’s Fool White House

I know the White House has been running on Trump’s fumes for so long we’ve forgotten that Chiefs of Staff can exercise real power.

I’d like to suggest two things we’ve seen in the last week may reflect the hand of Mark Meadows.

The first is Monday’s campaign video played in the middle of Trump’s briefing, something Trump said Dan Scavino made inside the White House — a violation of the Hatch Act.

In a mash up of clips and audio that amounted to campaign ad, Trump lashed out at critics and returned to his favorite past time of going after reporters. The video began with a white screen saying “the media minimized the risk from the start.” At one point, it showed news clips of different governors giving kind remarks about the president’s response to the pandemic.

[snip]

When a reporter pressed him about the video resembling a campaign ad, Trump said it was done in the office. “We’re getting fake news and I’d like to have it corrected,” he declared.

The president also claimed that White House Director of Social Media Dan Scavino created the video, prompting reporters to question the fact that he had government employees put together what was essentially a campaign advertisement.

There’s nothing that suggests Meadows determined the content of it, but several of the decisions made in the almost two weeks since Meadows has been in place involve merging the White House and the campaign — most notably, the replacement of Stephanie Grisham with his campaign press secretary Kayleigh McEnany.

But I also suspect Meadows is behind a far more important strategy on shut-downs, in which Trump allies carry out a Potemkin shut-down, only to reopen quickly, probably in the context of graft as payoff. For this one, there’s explicit evidence in the Bloomberg coverage of his first week: Meadows convinced a number of hold-outs to enact stay-at-home orders.

Meadows has also gotten involved in the administration’s coronavirus response, calling Republican governors who have held out against issuing stay-at-home orders in their states to ask them to implement the policies immediately, according to two people familiar with the calls. The president has said such decisions are up to state leaders and has not publicly criticized those who decline, who are all Republicans.

[snip]

Meadows has also tried to persuade a group of holdout Republican governors that they should issue shelter-in-place orders to help curb the coronavirus outbreak. It isn’t clear if the new chief of staff has Trump’s blessing for the calls. The president has publicly said it is up to governors and local leaders to decide whether stay-at-home orders are appropriate and has declined to criticize the holdouts, all of whom are his political allies.

The governor of one of the holdout states, Kristi Noem of South Dakota, tweeted Wednesday that she’d spoken with Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, who is a top medical adviser to the president. “Thankfully, he AGREES that a one-size-fits-all approach isn’t the answer in our state,” Noem wrote.

The tweet, according to one person familiar with the matter, was read by some as a signal to Meadows.

The week that Meadows started, a bunch of Trump flunkies issued stay-at-home orders: Arizona’s Doug Ducey (which was issued before Meadows officially started on April 1 and which extends through April 30), Florida’s Ron DeSantis (issued on April 1 and effective through April 30), Georgia’s Brian Kemp (which he has already extended through April 30), Mississippi’s Tate Reeves (imposed April 1, effective April 3, effective through April 20), Missouri’s Mike Parsons (imposed April 3, effective April 6, effective through April 24), South Carolina’s Governor Henry McMaster (imposed April 6, effective April 7, effective until rescinded). On March 31, Texas’ Governor Gregg Abbott issued an order that has been taken as a stay at home order which stops short of that; it remains in effect through April 30.

At least some of these governors, given the timing and the Bloomberg report, were cajoled by incoming Chief of Staff Mark Meadows to do so.

Last Thursday, days after his stay-at-home order, Ron DeSantis started talking about reopening schools in May (to be clear: this shut-down is having the greatest impact on children, especially those who don’t have WiFi at home and rely on schools for other services, like hot lunches). Yesterday, Gregg Abbott told Hannity most states don’t need to wait until May 1 to reopen (even though his own order goes through May 1). And of course, Mississippi and Missouri’s shutdowns don’t even last that long (indeed, they were never long enough to do any good).

So it seems likely that the same governors whom Meadows convinced to impose stay-at-home orders will shortly rescind them, giving Trump the story that he wants, that some of the nation’s biggest states have come through the COVID crisis. In Texas and Florida, in particular, a governor’s recision of a stay-at-home order might supersede those in badly affected cities (and both states are artificially limiting the number of official positive cases, in Texas by not testing likely cases in Houston, and in Florida by playing games with snowbirds.

I also suspect that one reason Mitch McConnell is refusing to negotiate with Nancy Pelosi over the other things she’d like to include in the next COVID relief package — which would include, among other things, $150 billion for state and local governments. McConnell wants to deal with such aid in a fourth aid bill and simply expand the funds available for the Paycheck Protection Program relief for small businesses, which is predictably already running out of money. The obvious reason to do that would be to withhold something that Trump can use as leverage over states and cities to do what he wants, rather than to give funds to them now without strings attached.

Trump believes, the Constitution notwithstanding, that he has either the authority or power to make states reopen. And given that Meadows was involved in getting a handful of states to impose what will amount to shut-downs that don’t appear to be good faith efforts to achieve the goal of shut-downs (though Kemp may have realized he has a bigger problem on his hands than he originally claimed), my suspicion is that those shut-downs were part of a plan to achieve some kind of leverage over reopening the economy.

Trump’s Promise of Only 100,000 Deaths Assumes We Ignore Him

Court transcribers like Peter Baker and Mike Allen were very impressed with what they deemed a very somber new Donald Trump in yesterday’s COVID rally. At it, Trump warned that we’re going to have a hard two weeks ahead of us (and then, over an hour later, admitted in an offhand comment it might actually be three). He warned there were going to be a lot of deaths — then stepped aside so someone not up for election could explain that means upwards of 100,000 deaths. And so, Trump implored while promising everything would get better in two weeks (or maybe three), we need to follow White House 30 Days to Slow the Spread guidelines to ensure we can limit deaths to 100,000.

There are a couple of major problems with that.

First, those guidelines ask for 30 days, but Trump is just asking for two more weeks (or three, if you manage to watch over an hour of this stuff).

Then, as Dr. Deborah Birx noted repeatedly, that 100,000 best case scenario is based off the IHME projections. But the IMHE projections are based off adopting a more stringent level of social distancing than White House 30 Days to Slow the Spread guidelines — basically, stay at home orders — and they assume those orders will remain in place until the end of May, not April.

To be fair, starting before the time Trump was pushing to reopen the economy, a bunch of governors (most of them Democrats, including people like Jay Inslee, whom Trump has repeatedly attacked) decided to impose more stringent requirements than Trump was recommending. As of yesterday, 29 Governors had stay-at-home measures in place to match the IMHE projections. Republican die-hards Doug Ducey of Arizona and Greg Abbott of Texas even capitulated yesterday and imposed state-wide orders (though on second review Abbott’s is just a non-essential business closure).

But even as this presser was going on, Trump’s closest ally among the governors, Ron DeSantis, was digging in, claiming that the White House task force had never suggested to him that they should impose a stay-at-home.

“I’m in contact with (the White House task force) and I’ve said, are you recommending this?” DeSantis said. “The task force has not recommended that to me. If they do, obviously that would be something that carries a lot of weight with me. If any of those task force folks tell me that we should do X, Y or Z, of course we’re going to consider it. But nobody has said that to me thus far.”

Trump was even asked about this. In a presser where Trump and Birx suggested that New York had been really late in adopting social distancing (that’s not true: Andrew Cuomo imposed an order more stringent than Trump’s current guidelines on March 18, just two days after Trump first called for social distancing, and imposed a full stay-at-home on March 20, effective March 22, which was among the earliest full state shut-downs), Trump and Mike Pence also had nice things to say about DeSantis, with Georgia’s Brian Kemp, the last of the major state governors not have one.

Reporter: I wanted to ask you about individual states issuing stay at home or what do you think, for instance, in Florida, Ron DeSantis has resisted urges to issue one of those, but he said moments ago that if you and the rest of the task force recommended one, that would weigh on him heavily. What sort of circumstances need to be in place for you to make that call and say this is something you should consider?

Trump: Different kind of a state, also great Governor, knows exactly what he’s doing, has a very strong view on it, and we have spoken to Ron. Mike, you want to just to tell him a little bit about that.

Pence: Well, let me echo our appreciation for Governor DeSantis’ leadership in Florida. He’s been taking decisive steps from early on and working closely with our team at the federal level. But let me be very clear on this. The recommendation of our health experts was to take the 15 days to slow the spread, and have the President extend that to 30 days for every American. Now, that being said, we recognize that when you’re dealing with a health crisis in the country, it is locally executed by healthcare workers, but it’s state managed. And so we continue to flow information to state governors. We continue to hear about the data that they’re analyzing and consult with them. But at the President’s direction, the White House Coronavirus Task Force will continue to take the posture that we will defer to state and local health authorities on any measures that they deem appropriate. But for the next 30 days, this is what we believe every American and every state should be doing at a minimum to slow the spread.

Trump: So, unless we see something obviously wrong, we’re going to let these governors good. Now, it’s obviously wrong, I mean, people can make things, they can make a decision that we think is so far out that it’s wrong, we will stop that. But in the case of DeSantis, there’s two thoughts to it, and two very good thoughts to it, and he’s been doing a great job in every respect, so we’ll see what happens. But we only would exercise if we thought somebody was very obviously wrong.

Aside from some rural states and Georgia, just about the only entity in the country not telling DeSantis to shut his state full of especially vulnerable seniors down is the President.

According to the IHME projections (and assuming those aren’t hopelessly optimistic because of a known lag of test results in places like California), we might still make that 100,000 projection if DeSantis imposes a true lockdown within seven days. But he says he’ll only do that if President Trump gives him political cover to do so.

Effectively, then, the allegedly sober President yesterday said we might only have 100,000 deaths if people ignore him and one of his closest political allies, Ron DeSantis.

Update: DeSantis is announcing a stay-at-home order within the hour.

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.