162 thoughts on “Coronavirus–COVID-19

  1. I recommend reading these two articles from The Atlantic:

    Exclusive: The Strongest Evidence Yet That America Is Botching Coronavirus Testing

    Some excerpts:

    Through interviews with dozens of public-health officials and a survey of local data from across the country, The Atlantic could only verify that 1,895 people have been tested for the coronavirus in the United States, about 10 percent of whom have tested positive. And while the American capacity to test for the coronavirus has ramped up significantly over the past few days, local officials can still test only several thousand people a day, not the tens or hundreds of thousands indicated by the White House’s promises.

    Compare this to other countries:

    In South Korea, more than 66,650 people were tested within a week of its first case of community transmission, and it quickly became able to test 10,000 people a day. The United Kingdom, which has only 115 positive cases, has so far tested 18,083 people for the virus.

    The article gives data about the number of people that can be currently tested based on the states they live in. Hawai’i was mentioned. How many can we test according to a Hawai’i state official? Twenty a day. A spokesperson from the California state government claims they can test “6,000 people every day, and it expects that capacity to expand to 7,400 people a day starting today.”

    Twenty a day seems pretty small, man. I think the other states mentioned were in the 100s or less.

    My takeaway: I would anticipate more people have the virus now than what’s currently being reported–or at least that seems like the more cautious assumption to make.

    Another part of the article reinforces my impression that the Trump and his administration can’t be fully trusted with regard to the data. Part of this may be due to decisions that have hurt the effectiveness of agencies like the CDC (due to cut backs) and another part stems from Trump dealing with this mostly through a political approach–i.e., trying to minimize the danger and severity of the virus to create a favorable impression of himself and his administration.

    The other article–The Official Coronavirus Numbers Are Wrong, and Everyone Knows It is similar, but explains why the numbers we have are likely wrong.

    Again, I recommend reading both.

    Edit

    If you’re like me, I only had a vague sense about the importance of testing. The concrete example that came to mind eventually is that without comprehensive and accurate testing the government and individual citizens and businesses really don’t have a good basis to make important decisions. For example, I believe the belief is that covid-19 had about six weeks to potentially spread in Washington state. Better testing may have alert state officials a lot earlier and they could have acted in ways to reduce the spread. Or take Hawai’i right now. Suppose the a lot more people have the virus then we realize. If we knew these numbers, the state could close schools, cancel events, etc. But without these numbers, the state may not do these things and the virus may spread even more. One could say that the states and federal government should err on the side of caution. But that could have significant economic ramifications–ramifications that one would not want to elicit unless we had reliable data.

  2. Speaking about not trusting Trump with regard to this situation…from WaPo, ‘Maybe I have a natural ability’: Trump plays medical expert on coronavirus by second-guessing the professionals

    “I like this stuff. I really get it,” Trump boasted to reporters during a tour of the Centers for Disease Control and Prevention in Atlanta, where he met with actual doctors and scientists who are feverishly scrambling to contain and combat the deadly illness. Citing a “great, super-genius uncle” who taught at MIT, Trump professed that it must run in the family genes.

    “People are really surprised I understand this stuff,” he said. “Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability.”

    Later,

    DC Director Robert Redfield and Health and Human Services Secretary Alex Azar stressed that the administration had authorized tens of thousands of testing kits to be distributed. But as Azar sought to parry with a reporter by calling on Redfield to back him up, Trump, without looking at Azar, raised his right hand and waved him off.

    Redfield said the agency had sent out 75,000 kits. Then Trump jumped in: “Anybody who wants a test will get a test, that’s the bottom line.” A few moments later, he jokingly compared the situation to his phone call last summer in which he had pressured Ukraine’s president to launch an investigation into Democratic presidential candidate Joe Biden and his son.

    “The tests are all perfect, like the letter was perfect, the transcription was perfect, right?” Trump said. “This was not as perfect as that, but pretty good.”

    Based on the Atlantic’s reporting, it’s almost certainly not true that anyone who wants to be tested can be tested. It’s wrong for the Trump to say this. (And that phone call was the opposite of perfect, but I don’t know why he’s bringing that up.)

    During questioning from reporters, Trump goes on a tangent about the ratings of a Fox News segment on Trump’s (?) town hall:

    “How was the show last night?” Trump asked a Fox reporter in the room, referring to a Fox News-produced, town hall-style event in Scranton, Pa., that he had participated in the night before.

    “Did it get good ratings?” Trump said. The reporter said he didn’t know. “Oh, really?” Trump continued. “I heard it broke all ratings records. But maybe that’s wrong. That’s what they told me.”

  3. Some questions that came to mind: Since the ability for states to test people for the virus, what happens when people with flu-like symptons die? What percentage of them can be tested? How many people with flu-like symptons die? (And if can someone die of Covid-19 even if they don’t show symptons?) If states can’t test all of these people, then that could distort the lethality of the virus.

    Is that a bad thing? On one hand, we really want to know the lethality. If it’s highly lethal that would create a greater push for governments and pharmaceutical companies to come up with a cure and/or vaccine and it would likely make people take more precaution. These are good things. On the other hand, if the virus is more lethal, and the public knows this, it’s going to increase the anxiety, fear, and maybe even panic. Of course, if we could test more people and we discovered the virus wasn’t as lethal, that would be reassuring. In general,, it’s better to get the as much accurate information as possible.

  4. From WaPo Squandered time: How the Trump administration lost control of the coronavirus crisis

    Public health officials and experts also struggled to find an uneasy equilibrium between doing their jobs honestly and transparently while trying to manage a mercurial president, who griped about what he viewed as overheated rhetoric by officials and the media.

    At the White House, Trump and many of his aides were initially skeptical of just how serious the coronavirus threat was, while the president often seemed uninterested as long as the virus was abroad. At first, when he began to engage, he downplayed the threat — “The Coronavirus is very much under control in the USA,” he tweeted in late February — and became a font of misinformation and confusion, further muddling his administration’s response.

    On Friday, visiting the CDC in Atlanta, the president spewed more falsehoods when he claimed, incorrectly: “Anybody that needs a test, gets a test. They’re there. They have the tests. And the tests are beautiful.”

    Later,

    The repeated false claims by the president that the virus was being contained exacerbated the problem. They made it difficult for public health officials to lay out the need to prepare for what happens next, even after most experts had begun to fear the virus was already here and spreading. There was also a ripple effect, with health officials and others not taking the threat as seriously as they should have because Trump kept on making faulty assurances, such as his claim at a Feb. 26 news conference that within the United States, the number of cases was “going to be down to close to zero.”

  5. This WaPo op-ed made the ramifications of the COVID-19 a little clearer and more visceral for me.

    McCardle, the writer, addresses a good question I’m sure others have had: The flu kills more people than COVID-19, so are we unnecessarily panicking about the latter. Here’s part of the explanation that helped me see the dire consequences of the virus:

    The crisis in northern Italy is what happens when a fast doubling rate meets a “threshold effect,” where the character of an event can massively change once its size hits a certain threshold.

    In this case, the threshold is things such as ICU beds. If the epidemic is small enough, doctors can provide respiratory support to the significant fraction of patients who develop complications, and relatively few will die. But once the number of critical patients exceeds the number of ventilators and ICU beds and other critical-care facilities, mortality rates spike.

    And this was the real kicker:

    A British health-care worker shared a message from a doctor in Italy, who alleged that covid-19 patients in their hospital who are over 65, or have complicating conditions, aren’t even being considered for the most intensive forms of supportive treatment.

    If I’m understanding this correctly, those patients are pretty much doomed–or at least on their own; and the primary reason is that the hospitals are overwhelmed with patients.

    The takeaway (and the op-ed makes this point): If we can avoid overwhelming the health care system, we can avoid a horrific situation like this. Her message is that every citizen has to take responsibility in limiting the spread of the virus–e.g., practice good hygiene, limit exposure to crowds, etc.

    1. This Atlantic article covers the ethical principles Italian health care workers will use to decide who will receive care and to what extent–given that they are now in a position where they can’t provide care for all those who need it. You know those hypothetical ethical dilemmas that are discussed in philosophy classes, where there are no good options? That’s what the Italians are faced with now.

      Here’s a line that likely confirms the assumption I had above:

      Those who are too old to have a high likelihood of recovery, or who have too low a number of “life-years” left even if they should survive, will be left to die.

      And there’s something I didn’t realize. When medical resources are scarce, even those without COVID-19 ailment may also be excluded from resources. If they may take up too many resources or if their age makes them less likely to survive after treatment, the care the medical resources they may have normally received may go to someone else (i.e. they may be also left to die).

      Here’s the takeaway, which I tend to agree with:

      But if Italy is in an impossible position, the obligation facing the United States is very clear: To arrest the crisis before the impossible becomes necessary.

      This means that our political leaders, the heads of business and private associations, and every one of us need to work together to accomplish two things: Radically expand the capacity of the country’s intensive-care units. And start engaging in extreme forms of social distancing.

      Cancel everything. Now.

      (emphasis added)

  6. From the Atlantic:Trump’s Dangerously Effective Coronavirus Propaganda

    The article chronicles the claims and accusations by Trump and his surrogates regarding COVID-19–specifically, minimizing the danger and accusing the media and Trump opponents as exaggerating the danger of the disease to hurt the economy and/or hurt Trump politically.

    There are two possible reactions to this claim:

    1. If Trump and his surrogates are correct, then the media and Trump opponents–and especially the scientists and experts–should be harshly condemned–their credibility should take a huge hit.

    2. If Trump and his surrogates are wrong, then they should be harshly condemned–their credibility should take a huge hit.

    I would add that this would be far from the first time Trump has made outrageous, baseless claims and turned out to be wrong–with little or no consequences. He’s been doing it at least going back to Birtherism. To me, it’s astonishing that he and his supporters have experienced little consequences for this.

    On another note, the author, like some others, believes Trump is employing an authoritarian, disinformation campaign.

    The administration’s response to the outbreak has drawn some comparisons to that of the autocratic regimes in China and Iran, where information about the virus was tightly controlled to the detriment of the local populations. But what Trump has actually shown is that he doesn’t need to silence the Centers for Disease Control and Prevention or censor the press to undermine politically inconvenient information about a public-health crisis—he can simply use his presidential bullhorn to drown it out.

    Scholars who study modern disinformation tactics have identified this approach as “censorship through noise.” (Steve Bannon, the former White House strategist, has described the strategy in blunter terms: “Flood the zone with shit.”) As I reported in my recent feature on the Trump campaign, the purpose of this sort of propaganda blizzard is not to inspire conviction in a certain set of facts; it’s to bombard people with so many contradictory claims, conspiracy theories, what-abouts, and distortions that they simply throw up their hands in confusion and exhaustion.

    Countries like Russia have been doing this to exacerbate division in our country and sow distrust in democratic institutions. Trump’s doing the same things, and it’s one of many reasons he’s unfit to be POTUS.

    1. Worthy of resignation or impeachment and removal

      There is nothing really new, in my view, in the tapes of the interview between Woodward and Trump. But the recordings of the presidents words put his lies right in front of our faces. If Congress–read: Republicans–remain silent, this reinforces to Trump that he can act with total impunity. This warrants a call for resignation, and even impeachment. But at the very least there should be harsh, vocal criticism from congressional GOP and Democrats.

      When the WH press secretary lies so blatantly like this, their must be a significant response–i.e., they can’t keep covering her as if she has credibility. Some sign of contempt would be appropriate. If they don’t, it signals the behavior is acceptable.

      Edit

      Aside:

      I tend to agree with this–that just because Trump said these things, doesn’t mean he understood or believed it. But we’re now speculating on what’s happening in Trump’s mind, which might not be worth much. My hypothesis is that Trump bases truth and falsehood on that which makes him feel good and that which doesn’t, respectively. This is it–logic and consistency mean nothing. Essentially, what says is true/false is true/false (to him).

      If this is accurate, what does it mean for such a person to understand something? What is understanding to such a person? It’s kind of an interesting and intriguing subject.

      But what should are reaction be Trump’s admission in the recordings? If my hypothesis is correct, one might say never understood what he was saying about the dangers of the virus–because his understanding of reality is based on whatever makes him feel good or bad, personally. But if this is true, this is a horrible admission–Trump would not be of sound mind.

      Edit

      From David Frum.

      I made this point w @AriMelber tonight am still brooding on it:

      So Trump has confirmed in his own voice that he was not self-deluded about COVID. He knew the danger – and still opted to do nothing and instead belittle the risk in public.

      The question that then follows …
      What on earth did Trump expect to happen next?

      I get the utility of the “lie your way out of it” approach to scandals and crimes.

      But you can’t cover up an epidemic!

      So *why* was he so passive? Action might have saved him, even the appearance of action. Instead, nothing. Why?
      This question I think casts light on Trump’s habitual lying.

      At some deep level of his psyche, he imagines that words can change reality.

      He has no idea eg how to run a business. But if you keep saying your business is “tremendous,” bankers lend you money you need not repay.
      His hotels and resorts are 2nd-tier at best. But keep insisting they are “classy” – and people who don’t know better may be duped to regard the Trump brand as somehow equivalent to Ritz-Carlton or Four Seasons.
      So when a virus materialized, Trump did the only thing he knew how to do: try to talk his way out of it.

      He kept promising Americans the virus “would go away” as he once kept promising creditors that the check was in the mail. Maybe something would happen to save him!
      Talk, talk, talk, never stop talking, refuse to be interrupted, overwhelm your creditors/customers/wives with words … and so long as you kept talking uninterrupted, nothing too very bad could happen. Or so Trump had learned to believe.
      Any true plan of action against the virus would have required Trump to cede control and attention to someone else, someone who possessed the expertise and competence Trump lacked. That course was truly radically intolerable to the narcissistic Trump.
      So instead he chose the only course of action he had the know-how to execute: try to out-talk the virus.

      He talked and talked and talked. He contradicted himself, he lied, he made false promises – but he ballooned himself over the landscape on a great gush of hot air
      He felt safe so long as he floated up there, above the people who got sick on his watch, above the dead and dying, above the shuttered businesses, above the lost jobs, above the interrupted educations … words words words, the only thing he knows how to produce.
      He surely could see the air leaking from his balloon of blather. He could feel the basket slowly losing altitude, anticipate the shock of the crash … and so he kept pumping more words, hoping if he could only stay above the tree-line until voting day, he might yet survive.
      It was never a good plan. But any other plan was either intellectually impossible for Trump (do a good job) or psychically impossible (yield power and attention to someone who could do the good job Trump couldn’t). So … he yammered and trusted something would save him.
      Maybe the virus would fall only on the blue states. Maybe sugar tablets would cure it. Maybe he could push enough people back to work to revive the economy without killing too many of them. Maybe Putin’s vaccine would work. Talk talk talk, never pause.
      And so here we are. The trick that more or less worked through so many bankruptcies and relaunches failed to work. Almost 200,000 Americans are dead. He’s facing electoral defeat – and probably massive civil liability and criminal exposure post-defeat. Still …
      … all things considered, it was a pretty good run, wasn’t it? When it’s all over, what will be hard to explain will not be, “What went wrong?” but “How did such a transparent fraud dupe so many people? And how did the fraud continue even as everything crashed into ruin?”
      Those are questions for the future. For now, the immediate problem is, how do we save from the wreckage a country where two-fifths of the population prefer to suffer death and disaster rather than admit a mistake?

      -END-

      I agree a lot with Frum, but his premise is not quite right. Specifically, this line: “So Trump has confirmed in his own voice that he was not self-deluded about COVID.”

      Frum even undermines this premise when he later says, “At some deep level of his psyche, he imagines that words can change reality.”

      If Trump imagines that his words can change reality, then speaking in his “own voice” would not necessarily mean he’s not self-deluded. Indeed, if one believes one’s words can change reality, one is self-deluded. So all of this, if accurate, answers Frum’s question:

      “What on earth did Trump expect to happen next?

      I get the utility of the “lie your way out of it” approach to scandals and crimes.

      But you can’t cover up an epidemic!”

      I’m not criticizing Frum’s question. Hearing Trump explain the dangers of the virus, assuming he understands the danger is reasonable. In fact, it would unreasonable to assume he doesn’t understand what he’s saying. Even though Trump believing he can change reality with words is plausible, I’m still not comfortable with believing this, on some level, as it feels so irrational. So

      1. Trump claims he wanted to keep the public calm, not cause panic and chaos

        He included that narrative in a tweet today:

        An hour later he tweets the following:

        He claims the virus was deadly at the end of January. But he’s had rallies, without urging people to wear masks–including today in Michigan. He just tweeted the tweet below (not sounding like someone who cares about keeping the public calm, too):

        This seems like a lot of people crowded together, and I don’t think they’re wearing masks.

        President at a press conference today:

        Many things to comment on, but I will point out one thing. Trump mentions not screaming “death, death”–as if the only two options were to lie or scream death death. There’s a way to be truthful, an not blatantly lie, while also not inciting panic. My sense is that he doesn’t understand this–that is thinking is too crude and simplistic to think this. This is just based on other things, like only thinking of alliances in terms of money.

      2. Trump said out loud in February that the virus is airborne and more deadly then the flu, and now he seems OK with a supporters crowded together without masks:

        Edit

        Mocking Biden for social distancing at one of Biden’s events(?).

        He’s has responsibility for the spread of the virus. He can publicly urge people who attend his rallies to wear masks–he has not. Is this not immoral? (It’s unreal to see all these people crowded without masks.)

  7. With the 30-day travel ban to parts of Europe, Trump seems to go against expert advice.

    “Travel restrictions can cause more harm than good by hindering info sharing, medical supply chains and harming economies,” the head of the World Health Organization said shortly before the Trump administration’s earlier decision to ban travel from China.

    The article goes into more details for each.

  8. Ed Yong, from the Atlantic has a good, science-y article on the specific coronavirus that is spreading currently. Yong is really good, accessible science writer. Reading the piece reminded me of when I once wanted to major in biology.

    I had some thoughts on a specific passage:

    The immune system fights back and attacks the virus; this is what causes inflammation and fever. But in extreme cases, the immune system goes berserk, causing more damage than the actual virus. For example, blood vessels might open up to allow defensive cells to reach the site of an infection; that’s great, but if the vessels become too leaky, the lungs fill even more with fluid. These damaging overreactions are called cytokine storms. They were historically responsible for many deaths during the 1918 flu pandemic, H5N1 bird flu outbreaks, and the 2003 SARS outbreak. And they’re probably behind the most severe cases of COVID-19. “These viruses need time to adapt to a human host,” says Akiko Iwasaki of the Yale School of Medicine. “When they’re first trying us out, they don’t know what they’re doing, and they tend to elicit these responses.”

    1. The last quote makes implies that the viruses may not actually want to cause harm, so to speak. In a way, not harming humans may be more advantageous, from a survival standpoint, for the specific virus. One thought I had: Is there a way to speed up the “figuring out process?” Is there a way to support and help promote the more benign forms of the virus in a way that it overtakes the strains that cause more damage?

    Perhaps it too complicated to pinpoint which specific strains do this, as well as identify all the various conditions that contribute to invoking these damaging responses.

    2. I wonder if there is a way to gain better control of the immune response. The passage above mentions that the immune response sometimes overreacts. It’s too bad we can’t find a “switch” or “dial” to prevent the overreaction.

    Edit

    Coronaviruses, much like influenza, tend to be winter viruses. In cold and dry air, the thin layers of liquid that coat our lungs and airways become even thinner, and the beating hairs that rest in those layers struggle to evict viruses and other foreign particles. Dry air also seems to dampen some aspects of the immune response to those trapped viruses. In the heat and humidity of summer, both trends reverse, and respiratory viruses struggle to get a foothold.

    This, along with the possibility that warmer temperature kills or damages the viruses, made me think of the following idea: What if someone developed a kind of neck band that generated heat. According to the article, the virus likely attacks certain cells in the airways. If this primarily means the throat, I wonder if warming the throat from the outside would create a hostile environment for the viruses. Also, I’m thinking if the bands could someone create a “heat aura” around a person’s mouth and nose. This might have similar effects that warm weather has on the body, but I’m wondering if it could kill the viruses before they even get into the body.

    Then again, maybe the temperature would have to be too high to be effective. Or maybe the device would be too expensive.

  9. (Note: I’m moving the following posts from the “Journal (7)” thread.)

    Posted Feb. 24, 2020

    My impression of Trump’s approach–to governing or doing business: do and say whatever to create a favorable impression of himself. The issue could be as serious as preventing or limiting nuclear capability in North Korea or a corvid-19 pandemic.

    The thread below points this out. (Note: I haven’t verified if this person says who he says he is.)

    Posted Feb. 29, 2020

    This WaPo op-ed summarizes some key points about Trump and the way he’s handled the coronavirus.

    Posted March 3, 2020

    Trump’s baffling coronavirus vaccine event by Aaron Blake at WaPo is an example of what I mean by Trump doing or saying anything that makes him look good, or at least not look bad.

    Blake’s read is that Trump can’t understand that any vaccine will take about a year to be ready. Despite repeated explanations of this from various scientists, Trump doesn’t seem to understand this. Hence the “baffling” in the heading.

    Another interpretation–that one that seems the most accurate–is that Trump is desperately finding any possible way he can claim the vaccine or cure will be ready within a few months. The scientists keep shooting him down when he takes the tack, but Trump keeps trying. If this reading is accurate, this is obviously awful. He doesn’t seem to care if an effective and safe vaccine can be produced in a few months–he just wants to be able to claim this. (This is similar to wanting the Ukrainian president to announce an the start of investigation into Biden, while not really caring about corruption.)

    Judge for yourself.

    Posted March 19, 2020

    Sen. Richard Burr (R-N.C.), head of powerful committee, sold large amount of stocks before sharp declines in market

    In relation to Trump’s tweet in the above post, and the fact that Senator Burr sold stock in February, ostensibly believing the virus would likely have a deleterious effect on the stock market, David Frum asked in tweet that we need to see Trump and his children’s activity in the stock market during February.

    Posted March 20, 2020

    ‘There is no greater moral crime’: Tucker Carlson calls for Sen. Richard Burr’s resignation over stock sell-off

    I don’t know if this warrants resignation, but I agree with Rep. Ocasio-Cortez that it is “stomach-churning.”

    I also think Burr’s explanation and dispute with this claim–namely, that his warnings at a luncheon constituted a “public statement.” However, according to NPR,

    The luncheon had been organized by the Tar Heel Circle, a nonpartisan group whose membership consists of businesses and organizations in North Carolina, the state Burr represents. Membership to join the Tar Heel Circle costs between $500 and $10,000 and promises that members “enjoy interaction with top leaders and staff from Congress, the administration, and the private sector,” according to the group’s website.

    This sounds more like a private, rather than public, meeting to me. Additionally, if Sen. Burr gave the similar dire warnings on a bigger public platform (e.g., CNN) he’d have a more compelling argument.

    Posted March 20, 2020

    From WaPo: U.S. intelligence reports from January and February warned about a likely pandemic

    This paints a picture of gross incompetence or gross negligence by the POTUS. He thinks he knows more then experts–including in the U.S. intelligence community.

    There’s this as well:

    Trump’s insistence on the contrary seemed to rest in his relationship with China’s President Xi Jingping, whom Trump believed was providing him with reliable information about how the virus was spreading in China, despite reports from intelligence agencies that Chinese officials were not being candid about the true scale of the crisis.

    Some of Trump’s advisers told him that Beijing was not providing accurate numbers of people who were infected or who had died, according to administration officials. Rather than press China to be more forthcoming, Trump publicly praised its response.

    “China has been working very hard to contain the Coronavirus,” Trump tweeted Jan. 24. “The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”

    Why does he believe foreign leaders over our intelligence agencies? Because he thinks they like him? Is all of this impeachable? I don’t know, but at in well-functioning Congress, there would be a ton of investigations and condemnation by both parties.

    Posted

  10. Fauci gets frank about Trump: ‘I can’t jump in front of the microphone and push him down’ from WaPo.

    Amid the ongoing global coronavirus pandemic, Anthony S. Fauci, head of the National Institute of Allergy and Infectious Diseases, has been charged with a herculean task: trying to keep President Trump’s public statements about the novel virus rooted in fact.

    Now it appears that Fauci’s frustration is showing.

    That’s what this article is about. It’s also hammers home, for the umpteenth time, Trump’s unfitness. Trump can’t speak truthfully and responsibly about the virus. Trump as POTUS continues to be a crazy situation. Speaking truthfully shouldn’t be this hard. Speaking responsibly about the virus and about this situation does require skill–one needs to be adept at language–but that’s a critical component of the job, and if one lacks this skill, one shouldn’t be POTUS.

    Here’s another excerpt:

    Though he and Trump sometimes disagree, Fauci said the president does listen to him “on substantive issues.” But they stray when it comes to Trump’s delivery of the critical messages.

    “It is expressed in a way that I would not express it, because it could lead to some misunderstanding about what the facts are about a given subject,” he said.

    Cohen pressed him on Trump making statements that don’t “comport with facts.”

    “I know, but what do you want me to do?,” Fauci responded. “I mean, seriously Jon, let’s get real, what do you want me to do?”

    Dr. Fauci’s exasperation regarding Trump failing to make statements that comport with the facts–that Trump’s way of expressing himself can lead to misunderstanding–about something so consequential as this virus–this is nuts.

    I also forgot to mention: Fauci is in danger of being fired because he will speak the truth and/or contradict the Trump in a way that offends Trump. Someone can be super competent, great at their job, but if they say something about Trump that Trump doesn’t like, he can be fired. Unfit, man.

    1. Apparently, Trump “pushes” Fauci down–Trump blocks Fauci from answering question about drug Trump is touting from WaPo

      President Trump spent a portion of Sunday’s press briefing yet again promoting an unproven treatment for the novel coronavirus, repeatedly asking, “What do we have to lose?”

      A reporter asked Dr. Fauci about the medical evidence of this, but Trump basically jumped in, and prevented the Fauci from answering. It seems like we’re at a point where we accept the POTUS touting unproven drugs, including utilizing rather foolish reasoning–namely, a “what-do-we-have-to-lose” argument. By the way, here’s a response to this argument:

      Separately, the president of the American Medical Association, Patrice Harris, told CNN anchor Wolf Blitzer on Sunday she would not prescribe hydroxychloroquine if she had a coronavirus patient, cautioning against Trump’s “What do we have to lose?” rationale. The drug’s well-known side effects can cause fatal heart problems in patients who are taking other drugs that affect the heart’s rhythm, such as antidepressants, or who have existing heart issues.

      “You could lose your life,” Harris said. “It’s unproven. And so certainly there are some limited studies, as Dr. Fauci said. But at this point, we just don’t have the data to suggest that we should be using this medication for covid-19.”

      The next bit seems really irresponsible to me:

      Last week, the Food and Drug Administration gave emergency approval to the Trump administration’s plan to distribute millions of doses of antimalarial drugs including hydroxychloroquine to covid-19 patients, despite the fact that no substantial clinical trials have been completed. Using its emergency powers, the agency reasoned that trying the unapproved treatment outweighed the risks.

      Trump on Sunday said “we have no time” to do lengthy studies on the drug, saying he fears people may die without it and, “if it does work, it would be a shame if we didn’t do it early.” He told people they still needed a physician’s approval but that personally, “I’ve seen things that I sort of like.”

      “What do I know? I’m not a doctor. But I have common sense,” he added.

      He has put more stock in hydroxychloroquine than Fauci and other leading medical experts, having previously described the drug as possibly one of “the biggest game-changers in the history of medicine.”

      But those optimistic statements have sharply contrasted with Fauci’s.

      Are there any experts who approve of what the FDA is doing? Based on Dr. Fauci’s comments, I would guess it’s not something he would support. Trump really seems to be taking a huge gamble here, based on his “common sense.” It seems super irresponsible. If something tragic happens as a result of this, he owns this.

      By the way, one should ask why is Trump doing this? Some possible answers:

      1. Creating a positive impression of himself and what he does is all he knows how to do;
      2. This is all about politics, not dealing with the virus and protecting the American people in a substantive way;
      3. If his claims prove untrue or even catastrophic, he’ll attempt to distance himself from these claims, or deny he made them (which already happened with downplaying the virus initially and later claiming he knew it was serious all a long). He’s had no serious political blow-back from using this approach.

      1. Update: FDA pulls emergency approval for antimalarial drugs touted by Trump as covid-19 treatment from WaPo.

        As an early booster of hydroxychloroquine, Trump called it a “game changer” and urged people to try it. He toned down his enthusiasm after the FDA issued a safety warning in April, saying the drugs could cause heart-rhythm problems and warning they should be used only in the hospital setting or in clinical trials. But in May, he said he took it as a preventive measure after two aides became ill from the virus.

        The FDA, in a memo explaining why it rescinded the authorization for the malaria drugs for covid-19, said it received almost 400 reports of adverse events about the drugs, including 109 serious cardiac episodes, of which 25 resulted in death. In most cases, the agency said, the patient also was taking another drug that raised the risks of heart problems.

    2. Jake Tapper, yesterday, has a response that seems apropos:

      Edit

      More context on the hydroxychloroquine and Trump’s promotion of it from theAtlantic.

  11. Denmark’s Idea Could Help the World Avoid a Great Depression from the Atlantic.

    The idea, referred to as “freezing their economy” (for three months) intrigued me. Here’s the basic idea:

    Denmark’s government agreed to cover the cost of employees’ salaries at private companies as long as those companies do not fire people. If a company makes a notice saying that it has to either lay off 30 percent of their workers or fire at least 50 people, the state has agreed to take on 75 percent of workers’ salaries, up to $3,288 per month. (This would preserve the income for all employees earning up to $52,400 per year.)

    The philosophy here is that the government wants companies to preserve their relationship with their workers. It’s going to be harder to have a strong recovery if companies have to spend time hiring back workers that have been fired. The plan will last for three months, after which point they hope things come back to normal.

    (emphasis added)

    The Danish government will also pay fixed costs (e.g., rent, utilities, etc.) for companies to keep them afloat. The government will also extend welfare payments and not waive normal requirements (like looking for certain number of jobs).

    The idea makes sense, but it’s going to be expensive. Then again, if the economy completely tanks, fixing that mess will be really expensive–maybe more expensive as well. The only question I have is, what happens if social distancing needs to go on longer than 3 months?

    1. Yeah, the part about giving loans and then forgiving them companies that take the loan don’t lay off their workers. The idea that businesses, and the economy overall, will struggle to get back on their feet if companies lose a lot of employees seems like a big problem to avoid, if possible. So the idea of finding a way for businesses to retain employees in this time seems compelling.

      Also, in 2008, I remember reading one or two reports about the way many people who become unemployed would never be employed again. It was pretty grim.

    2. Welp, the U.S. doesn’t seem to be going the Denmark route. This Atlantic believes this is a missed opportunity, and explains why. The article also explains what we can do now:

      While it may be too late to reverse the millions of layoffs that have already happened, Congress still has a chance to stem the tide. This can start with building on to the emergency rescue package. The new law provides for more than $300 billion in loans to small- and medium-size companies through the Small Business Administration. These loans are designed to be forgiven if the companies borrowing money don’t fire their workers.

      The government can immediately strengthen this program in two ways—with more marketing and more money. First, the administration should advertise the program, repeatedly, publicly urging companies to use government money to continue to pay their workers. The message should be: You have a patriotic and moral duty to hold on to your workers during this national crisis, and the government has a patriotic and moral duty to pay you to do it.

      Second, Congress should return to session immediately to double the loan guarantees to more than $600 billion. That is approximately equal to 11 weeks of payroll for all companies with fewer than 500 employees in the United States.

    3. Germany, France and the UK seem to have adopted similar plan to Denmark’s. (Article is from WaPo.) This seems like the better way.

      The one big drawback is these subsidies have to go into the next year. This is where something like what I’m proposing in the another thread could come in (if it’s not too expensive and feasible in other ways).

  12. Trump wants ‘the country opened,’ but easing coronavirus restrictions now would be disastrous, experts say from WaPo. (Note: This is a article provides a lot of information, giving a nuance view of the problem we’re facing, and offering possible solutions. Trump’s comments suggests he isn’t approaching this problem with much nuance. The article also suggests to me that the Trump administration isn’t providing the leadership we need now.)

    I strongly disagree with Trump expressing these sentiments, and I think we should make note of them now. I’m quite certain if the policy is to return to our normal lifestyle and really bad things occur, Trump will deny he found the idea appealing.

    You conservative seemingly supporting the notion:

    As Greg Sargent wrote today, Patrick and Trump are setting up a false dichotomy. We don’t have to just choose destroying out economy by dealing with COVID-19 or saving our economy based on the elderly resigning themselves to death. There’s a third option–namely, maintain social distancing that experts recommend while the government steps in to save the economy. Congress is trying to do this, and we see above the Danes attempting this as well. Why Trump doesn’t seem to get this, I’m not sure.

    The idea that the economy will be vibrant if people just go back to their normal lifestyle is questionable as well. I liked this response from Lynn Cheney (R-Wyoming) to Lt. Governor Patrick’s suggestion:

    “There will be no normally functioning economy if our hospitals are overwhelmed and thousands of Americans of all ages, including our doctors and nurses, lay dying because we have failed to do what’s necessary to stop the virus,”

    Finally, kudos to Alexandra Petri for this zinger–I regret that I have but one grandparent to give for my country

    1. Inside Trump’s risky push to reopen the country amid the coronavirus crisis from WaPo.

      Lest anyone think that listening to health care experts and not attempt to “reopen” the country so soon is primarily a Democratic position, consider Senator Graham’s position, reported in the article:

      When Sen. Lindsey O. Graham (R-S.C.) called President Trump last Sunday, he delivered a blunt message: If you reopen the nation’s economy too early against the advice of public-health experts, you will own the deaths from the novel coronavirus that follow.

      Trump’s stalwart ally also warned that the president wouldn’t be the only one held responsible. Graham said the Republican Party itself risks being defined ahead of this fall’s elections as prioritizing commerce and the stock market over the health and safety of the American people, according to three White House officials and a GOP lawmaker who spoke on the condition of anonymity to comment frankly.

      I don’t agree with Sen. Graham on many things these days, but I agree with him on the above.

      Trump said this week that he would like much of the country “opened up and raring to go” by Easter, which is April 12 — in part, he said, because he likes the imagery of church pews full for the holiday.

      I would hope this statement is taken out of context. If not, it reinforces my impression that Trump is simple-minded, that he has a very limited capacity to deal with complexity and nuance. Framing the current dilemma as stark choice between lives and the economy is another example of this.

      More examples of awful leadership:

      As Trump said Tuesday on Fox News Channel, “It’s a two-way street. They have to treat us well, also. They can’t say, ‘Oh, gee, we should get this, we should get that.’ ”

      Based on everything I know about Trump, I take “treat us well” as praising and saying nice things about Trump. If this is accurate, this is another of many bits of evidence that he is a terrible leader. Additionally, if psychologists/psychiatrists eventually diagnose Trump as narcissist, no one can say there was little evidence.

      Even those who are Trump’s political allies are “never quite sure what he’ll do or if they can trust what they hear from Pence,” according to one adviser to a Republican governor who, like others interviewed for this story, spoke on the condition of anonymity to comment frankly.

      Again, this is not just Democrats who are unsure about Trump.

      Trump has long viewed the stock market as a barometer for his own reelection hopes, and he has been distraught at the meltdown in recent weeks. He has been inundated with calls from business leaders, wealthy supporters and conservative allies urging him to get Americans back to work and stave off further calamity, even if doing so carries health risks.

      “There’s a fatalism that no matter what he does, he’s going to get blamed by half of the country,” said a former senior administration official with knowledge of Trump’s thinking. “If there is something he has some measure of control over, which is the economy, why not potentially try to take action? Yes, there will be a death toll, and he’ll get blamed one way or another, but in all likelihood, whether he gets reelected or not will depend on where the economy is and where people’s perceptions of the economy are six months from now. That’s where he is primarily focused.”

      My goodness. Is it me, or is this utterly repulsive? This sounds like who cares about the death toll, as long as the economy is good, and I get reelected. If Trump follows through on this he’s a monster.

      I would add that’s not a very smart monster as well. As the article mentions, Trump doesn’t have the power to simply “reopen” the country. The governors also have a lot of say. Additionally, if the virus spreads, and many health care systems are overwhelmed, I’m skeptical the economy would be doing well. But even if this were not true, the thinking that he will allow people to die so that he can be reelected is sickening.

      Trump’s reliance on his gut instincts and his decision to put his grievances and skepticism of the federal government at the fore of his approach has alarmed many governors, who said they feel isolated as they respond to a global crisis.

      “Sometimes it’s difficult to understand what the White House’s position is,” Wisconsin Gov. Tony Evers (D) said in an interview. “We had the president one time saying it’s a hoax, then a few weeks later, it’s really, really bad, then, let’s shoot for Easter.”

      What Gov. Evers is saying is not mere political spin. If you’re paying attention, you’ve heard Trump give these contradictory messages. I don’t believe Trump likes to nor knows how to govern and manage the federal government. There are previous examples of this, but this the most recent glaring example, with big consequences.

      On another note, the article reinforces my impression that the U.S. response is dramatically different from the one in South Korea. Our testing capacity still seems so limited, and I assume that’s a big reason we’re relying on a shut-it-all-down strategy, instead of spending more time focusing on quickly identifying those who are sick and then isolating them and monitoring those they had contact with. I don’t think these things are mutually exclusive, but I get a bad feeling we’re doing too little of the SK approach.

    2. Coronavirus crisis highlights Trump’s resistance to criticism — and his desire for fervent praise from WaPo

      The article provides evidence. I agree with the David Axelrod’s quote below:

      “Trump demands affirmation and does not tolerate oversight from the media, Congress, even inspectors general who he appointed,” Axelrod said. “He wants to impose his version of events and discredit and disable any arbiters of fact who might disrupt his self-aggrandizing story line. That has been his instinct in business and politics, and we see it on full display in this crisis.”

      Trump seems to think the media shouldn’t report on missteps and errors made by his administration:

      Without naming specific publications, Trump took umbrage with the cascade of stories that have documented his administration’s mishandling of crucial aspects of the coronavirus response.

      “It’s so bad for — for our country, so bad for the world,” Trump concluded. “You ought to put it together for a little while, get this over with, and then go back to your fake news.”

      What would be bad for the country and world is if the press did not report these stories.

      The article gives examples of Trump’s whining over not being openly praised:

      And on Monday, when sparring over the inspector general report, Trump demanded accolades from the White House press corps. “We have a brand-new testing system that we developed very quickly and that is your results and you should say, ‘Congratulations, great job,’ instead of being so horrid in the way you ask a question,” he said.

      Can you imagine a really good leader saying anything like this? Forget about the POTUS for a minute, imagine a CEO, a principal, or a head coach saying these things. It would reflect very poorly on any leader that spoke this way.

      Ruth Ben-Ghiat, a New York University professor who studies authoritarian rulers, said Trump’s daily news conferences have become “propaganda occasions.”

      A leader like Trump, she said, “sees any questioning as a challenge, as a threat to his power.”

      “It’s a very crude mentality of either you’re with me or you’re against me,” she said.

      I wonder how many Americans watch these press briefings or know about other things the POTUS has done to support this claim (e.g., having his staff go around the table praising him; vetting potential staff based on positive or negative comments they’ve made about Trump; firing people for doing something that puts Trump in a bad light, even if they were telling the truth or competent at their jobs). There is a lot of evidence for this claim.

  13. I think this analysis from the Atlantic of Trump’s handling of the coronavirus is spot on–specifically, the analysis involving Trump shifting between his typical schtick to one that resembles the way normal presidents would behave.

  14. Trump says some governors asking for equipment they don’t need from WaPo

    “I think that a lot of things are being said that are more — I don’t think that certain things will materialize and you know a lot of equipment is being asked for that I don’t think they’ll need,” Trump said.

    Also,

    “We’re really helping the governors,” Trump said. “We had a call today with almost every governor, just about, I’d say, all 50. And it was like a love fest and they were so happy with the job we’re doing.”

    But, Trump said later, “some of these governors you know they take, take, take and then they complain, they take and you do a great job, you build them a hospital, you do better and they’re always complaining, so I don’t like that.”

    Trump pushes to open parts of country as governors in hard-hit states warn more needs to be done to combat pandemic also from WaPo.

    Inslee called on Trump to use the Defense Production Act to order private companies to produce items such as masks and ventilators, a step the president has resisted after announcing last week he would invoke the federal law. Inslee, citing the dire situation at Washington state’s nursing homes, called on the Pentagon to press defense companies to produce lifesaving materials.

    Trump responded defensively, two of the people said, and told Inslee that he and the federal government have already done much for Washington and other states in recent days, ticking off several initiatives.

    “The President is using the DPA everyday as quiet leverage to enhance what is already the greatest mobilization of America’s industrial base since World War II,” White House trade adviser Peter Navarro said in a statement Thursday evening. “These private enterprises are eager to assist and have said “yes” to helping the country at every turn, so DPA hasn’t been needed yet.”

    I have heard others say that Trump should use the DPA, and I’m confused why he hasn’t. The argument above isn’t convincing to me. If we discover lives and the health care system would have been in a better shape if Trump used those powers, he’s going to deserve condemnation–unless there’s a good reason right now that I don’t understand.

    By the way, I recently listened to a Fresh Air interview with Max Brooks, author of books like World War Z. To write his novels, he’s studied how the U.S. government handles disasters. Here’s a quote that stood out:

    Brooks says the notion that the U.S. government was blindsided by the pandemic is “an onion of layered lies.”

    “What could have happened when this virus exploded — even when Wuhan was locked down — is we could have put the word out,” he says. “The government could have put the word out to ramp up emergency supplies to get them ready and then have an information strategy in place.”

    Instead, Brooks says, President Trump was slow to acknowledge the virus as a real threat. And thus far, the president has resisted using the Defense Production Act to force private companies to manufacture masks, gloves and other essential supplies in the fight against the coronavirus. Many government task forces that plan for disasters have yet to be activated in this crisis.

    1. Trump says he just wants governors to be ‘appreciative’ of White House efforts

      There are so many things Trump does that can elicit outrage or anger. When one specific incident sets someone off, the reaction might be: why that? I suspect there often isn’t a good answer.

      In any event, the story above elicited a few unsavory interjections. The headline started it, but also this:

      “Mike, don’t call the governor of Washington. You’re wasting your time,” Trump said during the White House media briefing. “Don’t call the woman in Michigan. . . . You know what I say: ‘If they don’t treat you right, I don’t call.’ ”

      Asked what he wanted from the two governors he referenced — Jay Inslee of Washington and Gretchen Whitmer of Michigan — Trump said, “All I want them to do, very simple, I want them to be appreciative. I don’t want them to say things that aren’t true. I want them to be appreciative.”

      Trump, who often measures people by their praise of him, listed the governors who had been complimentary but said, “You know, a couple people aren’t. We have done a hell of a job. The federal government has really stepped up.”

      What the heck?! He is acting like a baby. This is not the way a leader acts, not a good one anyway. When you’re the POTUS, you’re going to face a lot of criticism, some of it unfair. I’m sure you’ll have to endure whining, and won’t always be understood or appreciated. This comes with the territory. There’s the saying, “If you can’t stand the heat, get out of the kitchen.” Trump doesn’t belong in the kitchen.

  15. How South Korea Reined In The Outbreak Without Shutting Everything Down from NPR.

    My understanding of how South Korea was so successful without shutting everything down: testing. In a nutshell, they developed testing early, then they tested people widely and successfully isolated those with the virus.

    In the U.S. we were slow to develop a test, got it wrong, and I don’t think we’ve tested as widely, not in Hawai’i at least. Let’s hope we can still slow the spread of the virus.

    1. Yes I read the same about Korea and all their testing. But I didn’t read that about Japan and they flatten their curve pretty quickly. I want to say the biggest thing is civil obedience. Government says stay at home and be safe, and they listen. I’ve seen in Italy just last week where they were still partying. Add to that is the mask wearing. They are super comfortable with wearing them, so they won’t touch them like other countries would when they are on their faces. And it might not really help the healthy guys if they are wearing the mask, but it definitely helps if the Covid guys are wearing them. And because a good amount of people are wearing them it will help contain it. That’s my theories.

    2. I wouldn’t discount those things you mentioned, but the article says that even though Japan didn’t test their population as widely, they quickly investigated flare ups, identifying the infected individuals, and then monitored their contacts. It sounds similar to what South Korea did, without the broad testing.

      But maybe Japan was effective in this entire process because their populace is so compliant. In other words, the same strategy might not work as well in the U.S.

      Another thing the article mentions is that place like South Korea and Singapore had experiences with outbreaks. In other words, the populace had experience with bad consequences. If a lot of Americans suffer in this experience, I’d bet the next time it happens Americans would be quicker to comply and take seriously the threat.

  16. Is Trump blaming hospitals for selling medical supplies? Watch the clip below:

    It’s hard to tell what he’s saying, but its not unreasonable if someone got that impression. Whatever his meaning, it’s crazy to say anything that creates this impression. If he wants to go public with this statement, the responsible thing would be to investigate the manner himself–and provide evidence. I’d like to think the POTUS would at least discuss this with the New York governor first. (I’m not sure if he did, but I wouldn’t be surprised if he didn’t.) Why leave some doubt about the hospitals and health care workers, especially when they’re going through so much now?

    1. The buck stops anywhere else.

      More from WaPo on Trump’s leadership and handling of this situation.

      Leaders from Maine to Oregon and from Dayton, Ohio, to Austin say their constituents are whipsawed by the contradictory messages emanating each day from the presidential lectern, which exacerbates efforts on the ground to enforce social distancing and mitigate the spread of the virus.

      “People are confused about whether this is really serious. People are confused about how long this may last,” Austin Mayor Steve Adler (D) said in an interview. “We’re trying to get as much containment as we can by limiting the number of physical interactions taking place, but they’re hearing it’s not a big deal, it’s going to be over soon, and getting community buy-in becomes a harder thing to achieve.”

      and later,

      In Dayton, a working-class city of about 140,000, Mayor Nan Whaley (D) described the challenges of keeping folks informed as their lives are uprooted.

      “I have people in my city texting me what the president said, and they go, ‘Well, what you’re saying isn’t true because the president says the opposite,’ ” Whaley said. “Every day is a different message from the federal government and there is no consistency, other than from Dr. Fauci,” she added, referring to Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.

      The quotes come from Democrats, but if you’ve paid attention, you’ve heard Trump make confusing statements–first downplaying the virus, then acknowledging it’s a a serious matter, then suggesting we open up the country by Easter. It’s reasonable that leaders and the public would be confused. And I think this is a function of Trump’s “wing-it” style, which is not a new thing.

      “This is not the first time this president has looked schizophrenic, because there’s a long history of him vacillating between incompatible messaging and policy directives,” said a former senior administration official, who spoke on the condition of anonymity to offer a candid assessment. “This is no outlier. This is a result of a more ad hoc approach to governing.”

      This official is speaking anonymously, but, again, if you followed this administration (and also read about Trump’s management/leadership in his own company, there’s evidence his current handling isn’t an outlier.)

  17. What are serology tests and why are they important? That’s what this WaPo article provides some answers for.

    Basically, serology tests can help indentify people with immunity to the virus. Those will immunity can be return to their normal life, and also help those who are ill. There are some big challenges, though:

    But experts on testing warn that these new serology tests come with logistical and scientific challenges just as big, if not bigger, than the ones that made the scale-up of diagnostic testing for active infections so difficult. The mass deployment of blood-based testing will require many millions of accurate tests, a system to take reliable samples, and a slew of decisions that may have to be made based on incomplete knowledge. Will a certain level of antibodies be necessary to declare someone likely to be immune? How lasting and complete will that immunity be? When is the best time to start doing such tests, given that many who are tested today and have no evidence of exposure to the virus may be infected tomorrow? And how will people declare their immunity status?

  18. What is group testing, and how can it help us return to normal? This WaPo provides answers to those questions.

    How group testing works isn’t entirely clear to me. From what I understand, let’s say samples are taken from 10 people, instead of testing each individual sample, all ten samples are thrown into a pool and tested at one time. If the virus shows up, then all 10 have to self isolate. But if no virus shows up, then the 10 would not need to isolate. I think that’s how it works. This is important because the U.S. testing capacity is still quite limited. This would be a way to increase our ability to test. The method seems like a promising way to return people to normal living and help the economy.

  19. Behind the scenes, Kushner takes charge of coronavirus response from Politico

    If Kushner has a big hand in this effort, I feel the chances are slim that he–and the efforts to fight COVID-19–would do well. But this article gives more of a mixed impression. For example,

    But defenders within the administration say Kushner has stabilized what they acknowledge had been a faltering response. For example, the Kushner team quickly assembled experts from around the nation to develop the health department’s new guidance on ventilators that was issued on Tuesday, which allows desperate hospitals to split ventilators in a bid to protect patients amid shortages.

    Kushner’s team is helping speed crucial supplies like ventilators and masks to the front lines, while working to support the “Project N95” clearinghouse for personal protective equipment and ventilators. The team also set up the “Project Airbridge” supply-flights that are rapidly bringing tens of millions of medical supplies from overseas into the United States, rather than waiting for them to be shipped by sea.

    If true, these seem like successes and that is definitely good for the country. It’s enough to give me pause–maybe I’m wrong about Kushner.
    The article mentions problems and also criticisms having to do with conflicts of interest.

    This is a very challenging situation, and even the most well-run organization, with highly skilled people, will fail and make mistakes. Ultimately, I will want to know if Kushner and his team made sound decisions, given what was known as well the consensus of experts.

    One last thing, perhaps a small point. They mentioned Google helping with the collection of test data or something to that effect. That immediately made me think of adversarial nations and actors that are adept and information and cyber warfare. What if they hacked into that information and manipulated the numbers–making it seem like the nation got the virus under control. This could allow the virus to spread and undermine faith in the federal government. (Ultimately, I think this would be a mistake, if they were discovered, as this is something that could really anger the American public. For example, if Russia did this, it could be tantamount to waking a sleeping giant.)

    Here’s another thing that was said that made me think of information warfare as well:

    In addition, the use of so many private sector work-arounds means much of the government’s response to coronavirus is being conducted on unsecured personal cell phones and emails. Officials involved with Kushner’s team bristled at questions about the appropriateness of using personal emails, saying the scrutiny could scare away high-powered executives, analysts and other fixers trying to help the response.

    1. How Jared Kushner’s Secret Testing Plan “Went Poof Into Thin Air” from Vanity Fair

      Another damning article, which chronicles how Kushner. and the experts that eventually helped, actually created a decent national plan to deal with the virus (at least as a start), but Kushner and Trump ultimately decided not to go with it. In its absence, the article claims that the Rockefeller Foundation has stepped in and is attempting to fill the roll of the federal government. Does that sound kinda crazy–and damning–to you, because it does to me.

      Challenges to creating a national testing program

      The obstacles arrayed against any effective national testing effort included: limited laboratory capacity, supply shortages, huge discrepancies in employers’ abilities to cover testing costs for their employees, an enormous number of uninsured Americans, and a fragmented diagnostic-testing marketplace.

      The Plan

      The plan called for the federal government to coordinate distribution of test kits, so they could be surged to heavily affected areas, and oversee a national contact-tracing infrastructure. It also proposed lifting contract restrictions on where doctors and hospitals send tests, allowing any laboratory with capacity to test any sample. It proposed a massive scale-up of antibody testing to facilitate a return to work. It called for mandating that all COVID-19 test results from any kind of testing, taken anywhere, be reported to a national repository as well as to state and local health departments.

      And it proposed establishing “a national Sentinel Surveillance System” with “real-time intelligence capabilities to understand leading indicators where hot spots are arising and where the risks are high vs. where people can get back to work.”

      Possible Reasons Trump and Kushner Didn’t Implement the Plan

      Trusting his vaunted political instincts, President Trump had been downplaying concerns about the virus and spreading misinformation about it—efforts that were soon amplified by Republican elected officials and right-wing media figures. Worried about the stock market and his reelection prospects, Trump also feared that more testing would only lead to higher case counts and more bad publicity. Meanwhile, Dr. Deborah Birx, the White House’s coronavirus response coordinator, was reportedly sharing models with senior staff that optimistically—and erroneously, it would turn out—predicted the virus would soon fade away.

      Against that background, the prospect of launching a large-scale national plan was losing favor, said one public health expert in frequent contact with the White House’s official coronavirus task force.

      Most troubling of all, perhaps, was a sentiment the expert said a member of Kushner’s team expressed: that because the virus had hit blue states hardest, a national plan was unnecessary and would not make sense politically. “The political folks believed that because it was going to be relegated to Democratic states, that they could blame those governors, and that would be an effective political strategy,” said the expert.

      (emphasis added)

      The section in bold is based on one person, so I’ll take it with a grain of salt. Still, given what I’ve seen from this administration, it is totally believable–and appalling.

      The Approach Trump Chose

      …It bore almost no resemblance to the one that had been forged in late March, and shifted the problem of diagnostic testing almost entirely to individual states.

      Under the plan released that day, the federal government would act as a facilitator to help increase needed supplies and rapidly approve new versions of diagnostic-testing kits. But the bulk of the effort to operate testing sites and find available labs fell to the states.

      Dire Warning

      Experts are now warning that the U.S. testing system is on the brink of collapse. “We are at a very bad moment here,” said Margaret Bourdeaux. “We are about to lose visibility on this monster and it’s going to rampage through our whole country. This is a massive emergency.”

      Rockefeller Foundation Desperately Tries to Do What Federal Government Wouldn’t

      Raj Shah, the president of the foundation, knew this coronavirus was going to be a serious threat, and he watched and waited to see the appropriate federal government response. When it became obvious that that wasn’t going to happen, his organization started developing a national plan, eventually working with states and schools districts–which is a damning bit of information for the Trump administration.

      It may seem impossible for anyone but the federal government to scale up diagnostic testing one hundred-fold through a painstaking and piecemeal approach. But in private conversations, dispirited members of the White House task force urged members of the Rockefeller coalition to persist in their efforts. “Despite what we might be hearing, there is nothing being done in the administration on testing,” one of them was told on a phone call.

      “It was a scary and telling moment,” the participant recounted.

      (emphasis added)

      1. It’s a good article. I haven’t seen mention of it in other places (not that I’ve looked) except on Rachel Maddow the other night. Someone in a position to do so needs to get on this.

      1. It’s not meaningless, but yeah: social media is where I heard about the article to begin with. I was sorta talking about a response or interpretation or analysis by someone credible.

    2. Do you mean an expert or someone with the relevant knowledge and experience to either confirm or push-back on the reporting in the article? Initially, I thought you meant greater promotion of the article, so that more people would read it.

      1. No; the reporting is solid and speaks for itself. I’m talking about people buzzing it into consciousness so that people in positions to actually do something about it will do something about it.

    3. Unfortunately, I seriously doubt the WH is going to make a move at a national plan with regard to testing, contact tracing, and creating a supply chain. I don’t think Trump knows what he’s doing, and because of that he’s going to ignore this and go with his used car salesman schitck and try to con his way out of this.

      Or did you mean getting Congress to do something? Then again, you probably don’t think they’ll do anything, too.

      Man, I gotta say–the whole notion that the Rockefeller Foundation had to step in to fill a gap left by the federal government–and some WH task force members “urged them to persist” because “nothing was being done by the administration on testing” is just crazy and appalling.

      The bit about Kushner thinking a national plan “was not necessary” and not politically beneficial because the virus was mostly affecting the blue states is also appalling (although I’m not allowing myself to fully accept this, on the basis that this is so appalling to even accept, and it’s based on one source). But if it’s true, he out to be tarred and feathered.

  20. Coronavirus Models Aren’t Supposed to be Right from theAtlantic

    The article explains the reasons these models are often wrong–e.g., difficulty with getting accurate data, the fact that outcomes rely on multiple variables, etc. So if these models are not accurate in terms of predictions, what is their value?

    The most important function of epidemiological models is as a simulation, a way to see our potential futures ahead of time, and how that interacts with the choices we make today. With COVID-19 models, we have one simple, urgent goal: to ignore all the optimistic branches and that thick trunk in the middle representing the most likely outcomes. Instead, we need to focus on the branches representing the worst outcomes, and prune them with all our might. Social isolation reduces transmission, and slows the spread of the disease. In doing so, it chops off branches that represent some of the worst futures. Contact tracing catches people before they infect others, pruning more branches that represent unchecked catastrophes.

    (emphasis added)

    In other words, epidemiological models present possible outcomes and the likelihood of each. The article’s advice is to do what we can now to avoid the most horrific outcomes.

    The article also mentions that our actions are also a variable that changes these models. So a model made after several weeks of social distancing may look different. At that point, we should do take the same approach recommended above–identify the ways to avoid the worst outcome, and do that. And then keep repeating the method.

    On a side note, the article mentions two places in Italy, one relying heavily on testing and identifying those who had contact with carriers.

    In Italy, two similar regions, Lombardy and Veneto, took different approaches to the community spread of the epidemic. Both mandated social distancing, but only Veneto undertook massive contact tracing and testing early on. Despite starting from very similar points, Lombardy is now tragically overrun with the disease, having experienced roughly 7,000 deaths and counting, while Veneto has managed to mostly contain the epidemic to a few hundred fatalities. Similarly, South Korea and the United States had their first case diagnosed on the same day, but South Korea undertook massive tracing and testing, and the United States did not. Now South Korea has only 162 deaths, and an outbreak that seems to have leveled off, while the U.S. is approaching 4,000 deaths as the virus’s spread accelerates.

    We seem to be on the Lombardy path. I hope the outcomes are different.

    1. After reading the article above, see Experts and Trump’s advisers doubt White House’s 240,000 coronavirus deaths estimate

      What seems clear from this article is that experts and advisers to Trump WH seem confused at how the Trump WH got the death estimates.

      Jeffrey Shaman, a Columbia University epidemiologist whose models were cited by the White House, said his own work on the pandemic doesn’t go far enough into the future to make predictions akin to the White House fatality forecast.

      “We don’t have a sense of what’s going on in the here and now, and we don’t know what people will do in the future,” he said. “We don’t know if the virus is seasonal, as well.”

      The estimate appeared to be a rushed affair, said Marc Lipsitch, a leading epidemiologist and director of Harvard University’s Center for Communicable Disease Dynamics. “They contacted us, I think, on a Tuesday a week ago, and asked for answers and feedback by Thursday, basically 24 hours,” he said. “My initial response was we can’t do it that fast. But we ended up providing them some numbers responding to very specific scenarios.”

      Other experts noted that the White House didn’t even explain the time period the death estimate supposedly captures — just the coming few months, or the year-plus it will take to deploy a vaccine.

      This is a bad sign. Trust in government, in this case Trump and his administration, is important–for the citizenry and the economy. This kind of thing will undermine the confidence in what the administration says (not that it was necessarily high before), but the stakes may be higher now.

  21. The Decisions are Only Going to Get Harder from the Atlantic.

    Juliette Kayyem worked in the Dept. of Homeland Security. She mentions that shutting everything down was the relatively easy decision for government officials. She chronicles much harder choices that these officials could possibly face. Here’s one that I didn’t think about:

    Quick, decide: If 20 percent of a city’s police department is infected or quarantined because of the coronavirus, how should the remaining officers decide which problems to take on? Already, some police departments are closing buildings to the public. No more walk-ins. Others are focused on providing only essential services, such as investigating violent crimes, and are leaving the investigation of nonviolent or property crimes for another day. Houston Mayor Sylvester Turner, who on Monday begged criminals to “chill,” has been roundly mocked. “Until the coronavirus is resolved,” Turner said, “criminals take a break, okay. Stay home. Stay home and don’t commit any crimes.” But he was only saying out loud what mayors and police chiefs around the country know: that their ability to protect public safety may be substantially diminished. In a society that can no longer satisfy all public-safety demands, where do you place a phone call about a marital argument that could escalate against the possibility that a police officer will be infected? Should a late-night dispatcher be left to determine which calls to ignore, or should someone higher up the chain—someone accountable to the public—establish a basic policy?

  22. Bill Gates op-ed on what he believes the U.S. should do now to deal with COVID-19. Being smart in one area doesn’t make one an expert in another, so I would take recommendations like this with a little more caution. Still, from what I’ve seen Gates is a bright person, and his intelligence and insight seems to go beyond computers and business.

    In any event here’s one thing he recommends that seems sensible:

    First, we need a consistent nationwide approach to shutting down. Despite urging from public health experts, some states and counties haven’t shut down completely. In some states, beaches are still open; in others, restaurants still serve sit-down meals.

    Dr. Fauci seems to agree:

    I’ve asked the same question as Fauci–why doesn’t Trump say this. More broadly, why isn’t he taking a more active leadership role in this fight? Right now, based on what I know, it seems like he should be more active.

  23. From NPR, an article about when we can return to normal. The article doesn’t really give a time frame, but the information below was one of the best bits of news I’ve heard in a while (or at least it seems really hopeful to me):

    A test that measure people’s antibodies, and presumably their immunity, to the virus will be available widely by May, according to U.S. Public Health Service Admiral Brett Giroir.

  24. New Zealand Isn’t Just Flattening the Curve, It’s Squashing It from WaPo

    From what I gather, two factors seem key into their success:

    1. Quickly implement physical distancing policy;
    2. Quickly closing their borders.

    I feel like the last point may be important because New Zealand is an island. Once they cut off people coming into the country, then if they control the virus before rampant community spread, then it would make sense that they could control the spread of the virus.

    This makes me think of Hawai’i. Did we do both things quick enough? If we did, I would think we could get similar results.

    By the way, the article doesn’t really mention testing playing a prominent role in their approach. That doesn’t mean it didn’t play a prominent role, but the article gives the impression that the two policies above were more of the decisive factor.

    A couple of thoughts:

    1. New Zealand relies on tourism; same with Hawai’i. Say both places get covid-19 under control. In theory, if they keep visitors out, the citizens should be able to go back to normal life. But this would really damage their economies.

    Could you allow tourists and other visitors in, mandating a 14-day quarantine? Maybe hotels could give free 14 day room and board (subsidized by the government)? Still, even if this worked, I would think this is still going to lower the numbers of tourists.

    2. The other thought: If we can some make cities/towns/regions like islands–“closing borders” as it were–then the people in those towns could go on living normally. The problem is that town borders can’t be as closed like that of an island.

    1. What about the government subsidizing covid-19 survivors coming to Hawaii? But as I stated, I’m not 100% sure that survivors cannot be carriers of the virus.

    2. If they’re not carriers, it would make sense if it was partial subsidy–of things like room, board, plane fare.

  25. Using Technology for Contact Tracing

    From theAtlantic

    Here’s a basic description of how it would work:

    Our cellphones and smartphones have several means of logging our activity. GPS tracks our location, and Bluetooth exchanges signals with nearby devices. In its most basic form, cellphone tracing might go like this: If someone tests positive for COVID-19, health officials could obtain a record of that person’s cellphone activity and compare it with the data emitted by other phone owners. If officials saw any GPS overlaps (e.g., data showing that I went to a McDonald’s hot spot) or Bluetooth hits (e.g., data showing that I came within several feet of a new patient), they could contact me and urge me to self-isolate, or seek a test.

    This makes me uncomfortable, especially after reading the following. The article goes into the way different countries apply this concept. The description of China and South Korea made me uncomfortable. One possible approach, by the Germans seem less problematic:

    …one possibility is to program phones to broadcast a different ID every 30 minutes. So, for example, if I went to Starbucks in the morning, my phone would broadcast one ID over Bluetooth to all the other phones in the café. An hour later, at lunch with a friend, it would broadcast a different ID to all the other phones at the restaurant. Throughout the day, my phone would also receive and save IDs and log them in an encrypted Rolodex.

    Days later, if I were diagnosed with the coronavirus, my doctor would ask me to upload my app’s data to a central server. That server would go through my encrypted Rolodex and find all of the temporary IDs I had collected. An algorithm would match the temporary IDs to something called a push token—a unique code that connects each phone to the app. It could then send each phone an automated message through the app: PLEASE BE ADVISED: We have determined that in the past few days, you may have interacted with somebody … At no point in this entire process would anybody’s identity be known to either the government or the tech companies operating the central server.

    Here’s one takeaway for me: No matter how much people try to protect the privacy, an individual or government will almost surely find a way to breach it. Moreover, we should expect that this use of the technology will not stop at stopping viruses, but will be used by governments and individuals for other purposes, some will not be so palatable. We may have little choice, but we should, at the very least, go in with our eyes wide open.

  26. Ige, UH Economists Agree: COVID-19 Testing May Be Key To Restoring Tourism from Civilbeat.

    This is an article based on a UH report, How to Control Hawaii’s Coronavirus Epidemic and Bring Back the Economy: the Next Steps. (I haven’t read the report, yet.)

    According to the article, the key to re-starting tourism depends on two conditions:

    (1) Potential tourists perceive Hawaii to be a safe place to visit and (2) Hawaii residents can be assured tourists are free of the coronavirus,” UHERO said in the report.

    And this seems dependent on

    …a system that could test visitors using methods that would have to be scaled up quickly. These include so-called antibody tests that could show whether a person already had the virus and recovered, as well as rapid antigen tests that detect whether the person is carrying the virus.

    (I would assume we would have to have reached a point where the virus is either eliminated or close to it in Hawai’i.)

  27. Trump and his administration had made a lot of mistakes initially, but let’s put that aside for a moment; after all, there’s nothing he can do about that now. What he can do is create a sound plan and execute it. How’s he doing on coming up with a plan? Today’s WaPo article, based on “…the result of interviews with 22 senior administration officials, lawmakers, public health officials and other Republicans in frequent touch with the White House, many of whom spoke on the condition of anonymity to be candid. doesn’t paint a promising picture,” doesn’t pain a good picture.

    The article starts by mentioning several groups the White House has set up to address the virus problem. But these groups, described as a “bureaucratic nesting dolls,” are not being coordinated well. The consequences?

    As a result, an administration that has lagged behind at nearly every step of the pandemic still has no consensus plan for when or how to reopen parts of the economy, even as the president and many advisers push to do so as soon as May 1. There is still no concerted plan for getting vital medical supplies to states, which are left to fight among themselves or seek favors from Trump. There is also no developed plan for what happens if cases or deaths spike as people begin to return to work, or how to respond if the coronavirus surges again in the fall, as many public health experts and administration officials fear.

    (emphasis added)

    Later,

    Jack Chow, a U.S. ambassador for global HIV/AIDS during the George W. Bush administration and former World Health Organization assistant director-general, said the problem is that the administration has yet to decide what the national recovery should look like.

    “The whole response has been lagging the curve of the epidemic, and what ought to be happening is the designation of key strategic goals, key accomplishments that can happen within a specified timeline,” Chow said. “It sounds like they’re groping for that. as to what the strategic goals are in each different line of effort, and what the prospective timeline could be given the assets they have to deploy.”

    (emphasis added)

    Later,

    Shortly before the official task force meeting nearly every day, six doctors hold their own meeting, sometimes reconvening afterward….
    …The group is led by Birx — who asked Pence for permission before forming it several weeks ago — and includes Fauci, Giroir, Surgeon General Jerome Adams, Food and Drug Administration Commissioner Stephen Hahn and CDC Director Robert Redfield.

    Why did this group form?

    It sprang up after some of the doctors grew frustrated with the “voodoo” included in the larger meetings, such as Trump’s hydroxychloroquine push, one senior administration official said. Health officials, including those at the FDA, have been routinely distracted by requests from the White House, even as experts argue that the top priorities should be a vaccine and a drug that is ready by the fall.

    In their working group, the physicians have spent time discussing how to moderate Trump’s public message on the anti-malaria drug. And they also view their smaller meetings as better for the scientifically driven policy debates that are sometimes hard to have in the official task force gatherings.

    The president’s snake-oil schtick is making it harder for the health care experts to come up with a sound plan!

    The FDA hopes to approve a serology test in the coming weeks that could be used widely — but not everyone will be able to be tested right away. So far, officials have tentatively agreed that health-care workers, food workers and front-line responders should be given priority for serological tests because they are most at risk of having been exposed to the virus. As fall approaches, students and teachers will also be a priority, one official said.

    But as of now, nearly three months since the first coronavirus case was reported in the United States, no plan is set.

    (emphasis added)

  28. from the New York Times

    The following evoked a what-the-heck! response from me:

    In a series of all-caps tweets, Mr. Trump declared “LIBERATE MICHIGAN!” and “LIBERATE MINNESOTA!” — two states whose Democratic governors have imposed social distancing restrictions that have shut down businesses and schools and forced people to remain at home. He also tweeted “LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!”

    My understanding is that Trump last night posted instructions for dealing with the virus moving forward, and in it he deferred to the govenors. (I haven’t read the announcement.) And this instructions came after Trump claims he, the POTUS, that he has “total authority” to reopen the economy. See below:

    Earlier yesterday, Trump said:

    “We are not opening all at once, but one careful step at a time,” Mr. Trump said Thursday after telling governors earlier in the day that “you’re going to call your own shots.”

    That’s the context for the tweets above. Others have said that Trump wants to have the power of an authoritarian, but he also doesn’t want any responsibility for his actions. And now, he’s egging on people who protest some state governors’ decisions? What the heck? It’s ridiculous.

    My thought: Trump is the guy watching the a football game, shouting how dumb the coach is, and now someone has made him the coach. He doesn’t know know how to coach–he only knows who to complain and criticize. That’s what he’s good at. The tweets above made me think of that. Trump is an armchair president.

    Sidenote

    I have the impression that Trump wants the economy going primarily for his own self-interest. If he’s now egging on these people defying governors’ orders to maintain social distancing, this strengthens this impression. This could raise questions about the trustworthiness of opening up the economy again. To wit, will some governors open up the economy prematurely because of pressure, not just from Trump, but from the collapsing economy? If so, this is not a good thing. Americans have to trust what the governors and government says in these situations. This is probably stating the obvious.

    1. When, and to what degree what degree, should governors ignore Trump’s criticisms against them? I think my response to this would be pragmatic–what response will help the people of my state (and the country) most? I don’t know if Governor Cuomo has this in mind in the response below. Whatever the case, I do think remaining silent on false and erroneous claims needs to be pointed out. Additionally, Americans should know when Trump is significantly derelict and/or failing in his duty.

      I don’t know if Governor Cuomo’s rebuttal is totally accurate, especially with regard to Trump washing his hands of assisting the states with testing. If it is, that is an egregious and reprehensible stance. But even if you put that aside, if the testing capacity is still too low to be able to return safely to normal life, a lot of that is on Trump and the federal government. They can’t change the mistakes in the past, but they’ve got to succeed at ramping up testing capacity.

    2. Rallies against stay-at-home orders grow as Trump sides with protesters from WaPo

      Protest leaders said the demonstrations evolved organically into a collective call for rolling back emergency measures that they think infringe on personal freedoms and further decimate the economy.

      “I feel terrible about the lives lost, but at some point we have to say ‘Mission accomplished’ and come up with the next phase of this that doesn’t have us continuously locked inside our homes,” said Matthew Seely of the Michigan Conservative Coalition, which organized the protests.

      The economic hardship social distancing has causes should not be minimized. If people are acting out of desperation that is understandable. Still, as painful as it is, the social distancing, at this point seems the more responsible decision, a lesser of two evils.

      It’s in this type of moment where presidential leadership–or the abject failure of it–can be so consequential. Encouraging citizens, expressing empathy, pulling us together, having a solid plan–these are things that we need from the Potus. If he did these things, would we see conservatives protests? Would these groups protest if Trump hadn’t minimized the virus, and floated the idea that trying to return to normal soon? I’m skeptical of this.

      And here’s the thing: experts are saying testing capacity and personal protective equipment are the keys to getting people back to work in a safe way. Trump and the federal agencies he oversees has a big role to play in this, and it seems like he’s failing at this.

      4/18/2020

      Crowds return to Florida beaches, despite state reporting highest daily death toll (WaPo)

      Jacksonville’s beaches reopened with limited hours Friday evening, local TV stations aired footage from a crowded beach where people were not maintaining six feet distance.

      Trump and his conservative allies who have minimized risk of the virus and pushed for opening up the economy are at least partly responsible, if an outbreak occurs and more people die.

      The situation also made me think of this:

      I can relate to Richard Dreyfuss’s character:

    3. Evidence That Protests Against Social Distancing Orders from State Governments Are Organized by Conservative Groups

      Pro-gun activists using Facebook groups to push anti-quarantine protests (WaPo)

      The online coordination offered additional clues about how the protest activity is spreading nationwide, capturing the imagination of the president and of Fox News even though it represents the views of a small minority of Americans. Trump himself tied the protests to gun rights — a primary cause for the Dorr brothers — in telling Virginians that the Second Amendment was “under siege” as he urged them to liberate the state.

      On the ground, pro-Trump figures — including some who act as surrogates for his campaign — as well as groups affiliated with prominent conservative donors have helped organize and promote the demonstrations.

      Later,

      Another private Facebook group focused on Pennsylvania, gaining more than 63,000 members by Sunday. Many questioned the wisdom of wearing masks publicly, contrary to recommendations by state and federal officials, and linked to a similar website catering to Pennsylvania gun owners.

      Thousands of Americans backed by rightwing donors gear up for protests (The Guardian)

      Yet while organisers claim the protests are grassroots- and people-driven, a closer look reveals a movement driven by traditional rightwing groups, including one funded by the family of Trump’s education secretary, Betsy DeVos.

      The rallies have drawn comparisons to the Tea Party movement, which sprang into life in 2009 following the election of Barack Obama and was driven in part by Americans for Prosperity, a group founded by rightwing donors Charles and David Koch.

      Later,

      The two groups behind the “operation gridlock” rally in Michigan on Wednesday have ties to the Republican party and the Trump administration.

  29. Trump’s Two Horrifying Plans for Dealing With the Coronavirus (theAtlantic)

    This is worth reading. In my experience, Frum’s prognostication track record is fairly reliable, and I value his insights.

    Frum believes Trump’s plan A and plan B go like this:

    Plan A:
    Re-open at least parts of the country to goose the economy so the economic trajectory is heading up by November. Trump can then argue that while the economy isn’t great, he’s moving it in the right direction. What if people die, though? Frum believes that, in this scenario, many of those who die will be poor, and this won’t hurt him politically. As awful as the second part is, if this and the first part occur, the plan seems viable to me.But what if the deaths, including deaths of non-poor, actually start to hurt Trump politically? This is where Frum says plan B kicks in.

    Plan B:
    Blame Democratic governors or the states in general, turning this into a culture war. I don’t want to discount this approach–especially since Fox News will likely aid Trump in this–and Trump has the shamelessness to go ahead with it–but it seems less viable. The Democratic governors have been advocating for actions that slow the spread of the virus, and it has proven effective. The bad effects have been to the economy. Blaming Democratic governors for more deaths isn’t a logical fit.

    But this argument in plan B is essentially a red herring, as Frum points out. The real issue is testing and tracing–or to be more accurate the lack of both. Re-opening the economy would be sound if the U.S. testing and tracing capacity was at an adequate level. Currently, it is not. To begin to reopen the economy without this capacity is the big mistake. And it is the failure of Trump and his administration that we do not have this capacity now.

    Whether Trump and his administration deserve most of the blame for this failure, or if the failure was beyond his or anyone’s capacity, that’s another question. But it seems clear that he had a lot of warning, at least by January and February, and he did not take action at that time, and publicly minimized the risk of the virus. Additionally, currently, he does not seem to be taking an aggressive approach, using the federal government to lead the charge in developing more testing and tracing.

  30. Trump to suspend immigration to U.S. for 60 days, citing coronavirus crisis and jobs shortage, but will allow some workers (WaPo)

    Testing. Testing. Testing. The ability to contact those that have been near infected people. That’s what we need. This just feels like a demagogic diversion from the fact that his administration has failed to help states ramp up testing and contact tracing.

    Here’s another thought that came to mind: What if Trump doesn’t know how to lead the federal government to accomplish these things? And, to make matters worse, what if he’s reduced the size of government and gotten rid of people with the expertise that could get it done? In other words, what if the federal government, lead by Trump, can’t create a national plan to deal with the virus–can’t ramp up testing, etc.? In other words, the only viable option, for him, is to attempt to increase polarization by resorting to demagoguery and turn the pandemic into a culture war?

  31. The clip below is of a reporter grilling Trump. At the beginning of this press conference, Trump showed almost a campaign commercial of Trump’s handling of the pandemic. But it excludes the month of February, and that’s what the reporter questions below.

    Here’s Jake Tapper going over things Trump said and did in February:

  32. Trump expresses some ideas about fighting COVID-19 after hearing a report suggesting that light and heat(?) may destroy the virus:

    I’m a bit paralyzed by the number of reactions I have. First, a POTUS talking this way–actually any intelligent, competent person speaking to the press this way–is kind of stunning. I’m could pick ten people I know, and, at the very least, they have the sense not to express this in public.

    Second, this is one of many examples of Trump’s lack of self-awareness–he doesn’t realize when he says things that make him appear foolish and incompetent. In this case, what he says is almost comical, tragically so given that he’s overseeing the crisis.

    Third, this is one of many things that suggests relatively low cognitive capacity. Certainly, this is not something I’d expect a “genius” to say.

    Edit

    I forgot–Trump suggested we study injecting disenfectant, since it’s shown to kill the virus. Besides the fact that this seems like a nutty idea, there might be people who try it because the POTUS said it. Ugh.

    1. Trump claims controversial comment about injecting disinfectants was ‘sarcastic’ (WaPo)

      “I was asking a question sarcastically to reporters like you just to see what would happen,” Trump said.

      Nope, the remarks didn’t seem sarcastic or in jest at all. Sounds like something an 11 year old would say.

      In a statement Friday, White House press secretary Kayleigh McEnany did not say the president had been joking, but rather she defended that Trump had said Americans should consult with their doctors about treatment. U.S. Surgeon General Jerome Adams released a statement reiterating that advice on Friday morning. McEnany accused the media of taking Trump’s words out of context.

      “President Trump has repeatedly said that Americans should consult with medical doctors regarding coronavirus treatment, a point that he emphasized again during yesterday’s briefing,” she said.

      I believe Trump did mention consulting with one’s doctors–he said the same when he extolled hyrdocloroquine. This doesn’t remove blame from Trump. He is responsible for his words. The press does distort what politicians say, both Democrats and Republicans. Everyone knows this–or at least experienced politicians and advisers know. Trump has either chosen to disregard this or can’t speak with care and discipline. In this case, people lives are at stake.

    2. Trump’s remarks about injecting disinfectant into people has serious consequences (WaPo)

      The article mostly discusses the people in the Trump administration scrambling to inform the public that ingesting bleach or other cleaners is very dangerous, but it also mentions calls that poison control centers are getting from some states, asking about whether it’s OK to ingest or get bleach into one’s body to kill the virus. I saw another report from Illinois today about their poison control center seeing an uptick in calls about this.

  33. What we know about the COVID-19 virus now will likely change. We’ll be wrong about some things. We learn things we never knew. Here’s an example:

    Young and middle-aged people, barely sick with covid-19, are dying from strokes

    The study the article is based on isn’t really robust, so keep that in mind. What it suggests is a bit scary though.

    Doctors are treating a growing number of stroke victims in their 30s and 40s who test positive for coronavirus.

    The patients are mostly experiencing the most deadly kind of stroke that can obliterate large parts of the brain responsible for movement, speech and decision-making in one blow because they are in the main blood-supplying arteries.

    Many researchers suspect such strokes in novel coronavirus patients may be a direct consequence of blood problems that are producing clots all over some people’s bodies.

    Important to note:

    Oxley said the most important thing for people to understand is that large strokes are very treatable. Doctors are often able to reopen blocked blood vessels through techniques such as pulling out clots or inserting stents. But it has to be done quickly, ideally within six hours, but no longer than 24 hours: “The message we are trying to get out is if you have symptoms of stroke, you need to call the ambulance urgently. ”

  34. Anybody know if Hawai’i has met guidelines to reopen the economy/society? I did a cursory search, and haven’t found anything so far. What I’m looking for is a chart with the conditions needed to start opening up, and then some indication (e.g., check marks) to show if Hawai’i has met those conditions or not.

    1. This statement is not to contradict anything you are saying or questioning, but the whole country is opening up. In some states, this is the worse the pandemic has been and they are still opening up. At least in Hawaii’s case our numbers are really, really good in terms of new infections and amount of people that we know still has the virus.

    2. The situation could definitely could be worse, I guess.

      But why does seem hard to find out if Hawai’i is meeting conditions to justify the steps the Governor and Mayor are taking? I asked two people at DOH, and they didn’t really know if we’re met the conditions, either.

      I think there might be a point where we need to open up, for economic reasons, but if that’s the case, I’d like our leaders, including the POTUS, to be upfront about this. If they don’t, why should people believe them? Trust is really important, including for getting the economy going.

      OK, I found one article from WaPo, written seven days ago.

      The Trump administration has issued a key criterion for states to meet before reopening their economies: They should see a decline in new daily cases for full two weeks. Few governors are abiding by it.

      (emphasis placed by journalist)

      The good news is Hawai’i is one of those states. However,

      It’s unclear whether even all those states meet the guidance from the Centers for Disease Control and Prevention. The CDC says that a state should see a “sustained reduction” of confirmed infections within a 14-day period before “proceeding to a phased comeback.” Almost none of these states saw a reduction in daily confirmed cases every single day before reopening.

      There is an alternate condition states could reach to open:

      States do have another alternative to a 14-day decline: The CDC recommends they see a reduction in positive tests as a percentage of total daily tests, thus indicating a state is testing enough people to capture most covid-19 cases.

      I have no idea if Hawai’i meets this, though.

      And words from Dr. Fauci,

      Anthony Fauci warned senators at a hearing yesterday that Americans will see “suffering and death that could be avoided” if states reopen too quickly. The nation’s top infectious disease official said that the United States risks new coronavirus outbreaks and possibly a broad nationwide resurgence of the disease, my colleagues report. lFailing to follow the guidelines, Fauci said, “would actually set us back on our quest to return to normal.”

      “If some areas, cities, states or what-have-you, jump over those various checkpoints and prematurely open up without having the capability of being able to respond effectively and efficiently, my concern is that we will start to see little spikes that might turn into outbreaks,” said Fauci, the director of the National Institutes of Allergy and Infectious Diseases.

      (emphasis added)

      What seems crazy to me is that we have experts (Fauci isn’t the only one) saying that opening up prematurely can not only lead to unnecessary deaths, but it can set us back–i.e., make it harder to restart the economy.

      People who are focused on the economy should be focused on expanding testing capability and contact tracing. My understanding is that that is one of the primary ways we can prevent outbreaks. If we can prevent outbreaks, individuals will still get the virus, but not in such high numbers as to overwhelm hospitals. My sense is that people can go out and engage in economic activity and work in this situation. But we can’t really do that without adequate testing and contact tracing.

      1. I don’t really disagree with anything written. However, my little push back would be on the medical advisors or experts. They have no real reason to be anything other than overly pessimistic and or cautious. If they are optimistic and are wrong they will be crushed. I think we have to take what they say with some grain of salt because of this, even though they are the experts.

      2. They have no real reason to be anything other than overly pessimistic and or cautious.

        Actually, I think there are reasons for experts, especially in the Trump administration, not to be pessimistic:

        1. The economy is taking a bit hit.
        2. Because of this, I think scientists are feeling pressure from politicians to provide news that will allow politicians to open up the economy. Think of a sports doctor who has to decide if the injured QB can go back in the game.
        3. Businesses and some on the right are putting political pressure on politicians to open up, which puts more pressure on politicians. President Trump, instead of tamping these people down, and giving cover to scientists, governors, and mayors, has, at times, done the opposite.
        4. Providing science-based information and opinions that go against Trump’s opinions can get a scientist in trouble, including getting fired.

        Because of these things, I’m actually getting a little worried about the reliability of scientists–especially from the federal government. If a company develops a vaccine by the end of the year, and scientists in the administration are saying it’s safe–Trump is saying it’s safe–how confident would you be taking it, and letting your family take it? At this point, I would be very uncertain–again, for the reasons above.

        I think we have to take what they say with some grain of salt because of this, even though they are the experts.

        I’ll explain my position by way of analogy. Suppose your child got sick from a novel strain of an existing virus. Out of 10 experts, 8 of them say if your child goes outdoors, there’s a good chance he will develop serious, even life-threatening, conditions. Therefore, they recommend keeping them indoors. 2 out of the 10 say they believe that advice is too extreme. Staying home would be too disruptive and the risk is not high enough.

        Since the virus is a novel strain, I’m pretty sure the experts’ knowledge is flawed, and they might make mistakes. So, yeah, I would take the consensus opinion with a grain of salt. But no, I’m not going to go against the consensus.

        1. So do you think what the scientist are actually saying could be on the conservative side of what they actually believe might happen? Man I mostly only hear what I assume is worst case scenarios. It would be horrible if what they were saying is conservative in terms of what they really think will happen.

          In terms of the analogy, it’s not the same if you talking about your own kid, kids that you know, or kids in general. Yes we are seeing the mysterious illness affecting kids, but the numbers are meniscal. If this illness was mostly affecting children, there would be a different stance or strategy by everyone. Add to that if it was my kid, I doubt I would be as concerned about how much it cost (economy) or how inconvenient it is to me to follow the experts. However, if we talking about society as a whole, it’s easier to say the quarantine could be doing more harm than good (although I don’t really believe that).

          And I’m not really saying the consensus is wrong. But being that these are hypothesis, that the consensus are extremely conservative. Well that’s what I thought, despite what you wrote about being influenced by the politicians to be less conservative.

    3. So do you think what the scientist are actually saying could be on the conservative side of what they actually believe might happen?

      Wait–when you say, “what the scientists are saying,” are you talking about projected deaths? If so, I was mostly referring to the conditions states have to meet before opening up. Those are two really different things to me. With the necessary conditions, I tend to think they are being conservative, but I disagree that there’s no pressure for them to be less conservative–especially scientists in the Trump administration or working in the federal government. A scientist can give information that is factual and science-based, but if it makes Trump unhappy, they can lose their jobs. Also, you don’t think scientists outside of government are sensitive to the economic damage the sheltering policy has had?

      In terms of the analogy, it’s not the same if you talking about your own kid, kids that you know, or kids in general.

      Right–it’s analogy. The child was analogous to society. Even if you take the experts’ advice with a grain of salt, you’re ultimately going to go with the consensus. Now, if the consensus of economic and business experts is that we have to open up the society now, that would change the equation. We would have to make a tough choice. But as far as I know, this isn’t the consensus of economists. Therefore, taking the consensus of both scientists and economists–even if we should take what they say with a grain of salt–it’s clear to me that we should act on the consensus.

      If you do, and something bad happens, this decision is justifiable to me–you went with consensus of experts. But if you go against the consensus–especially without a compelling, substantive argument–and bad things happen–things that the experts predicted–that’s not defensible.

  35. Conservatives charge liberals with social-distancing hypocrisy from Politico

    This article does a good job of laying out the complexities and ambiguities of protesting, while COVID-19 is still a threat. I find some of criticisms by conservatives valid, but I do not feel a sense of disapproval towards people protesting what happened to George Floyd and police treatment of African-Americans; but I do disapprove of the earlier lockdown protests; and I do think the recent protests will likely spread the virus.

    I do worry that the position of politicians and health experts will fuel white grievance. Specifically, some white Americans may view the grievances of the progressives–and people of color–being treated with more concern and legitimacy than their grievances.

    I also think Nichols’s concern about the politicization of expertise is a legitimate as well.

  36. A study published in the Proceedings of the National Academy of Sciences finds that face masks are “the most effective means to prevent interhuman transmission,” an inexpensive bulwark that, when combined with physical distancing, quarantine and contact tracing, is “the most likely fighting opportunity to stop the COVID-19 pandemic” absent an effective vaccine or drug therapy….Face masks alone “significantly reduced the number of infections . . . by over 78,000 in Italy from April 6 to May 9 and over 66,000 in New York City from April 17 to May 9.” By studying pandemic trends, they concluded that the other measures — distancing, isolation and contact tracing — must be accompanied by face masks to really make a difference.

    Later,

    Public messaging matters. Unfortunately, President Trump has retweeted messages that mock the use of face masks, and he has studiously avoided wearing one in public. This signal is no doubt influencing millions of people to assume that reopening the economy means they can return to crowded bars and massive campaign rallies without face masks. They are wrong. If he does not insist on face masks as a condition for attending his upcoming Oklahoma campaign rally, Mr. Trump is condemning to illness many of his supporters, and uninvolved bystanders as well.

    Trump and Pence giving downplaying the virus–also continuing to not wear masks.

    1. Pence’s response to the question–“How can you say the campaign is not part of the problem?”–is to invoke freedom of speech. I’m not entirely sure what he means here, but it sounds like he’s arguing that Trump, Pence, and the Trump campaign have the right to free speech. This is a crazy response. Of course Trump and Pence have a right to express his opinion, but the opinion he and Pence are expressing and promoting goes against health experts in their administration. Right now, the evidence strongly suggests that wearing masks and physical distancing do a lot to control the spread of the virus. (Business people and those who want to help the economy should be pushing this the hardest and should angry at Trump and Pence.)

      Right now, it looks like the Trump, Pence, and others who have ignored the experts are wrong–wrong in a deadly and possibly horrific way. And it doesn’t seem like Trump and Pence correct themselves, with the mask issue. Crazy.

      Here’s what I would have expected every president, before Trump, to do in the situation we’re in now:

      What’s the reasonable explanation for why Trump can’t do something that is sensible, sane, and would ultimately help the economy, which would help him win the election? One possibility is that his playbook is to increase polarization and division–that’s the formula for him winning. If the nation is united or at least far less polarized he loses. So he’s decided to politicize this–pooh-poohing experts–and exploiting those who are suspicious of experts, desperate for opening the economy, etc. Or maybe he just doesn’t believe in the experts–he believes he can just talk and con his way out of this pandemic?

  37. Trump has been claiming that increased numbers of Americans with COVID-19 is due to more testing. I’ve been hearing this is incorrect, but I lack the understanding to explain why this is wrong. I’m going to try and work this out, thinking out loud, so to speak, in this post–using this op-ed by “Jennifer B. Nuzzo is an epidemiologist with the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security. She is also lead epidemiologist for the university’s COVID-19 Testing Insights Initiative.”

    This is actually kind of a complicated topic, and I welcome any corrections or help from others.

    Let’s start with the way in which Trump’s claim is reasonable. More testing might naturally lead to more positive tests. Suppose twenty people out of a 100 people have the virus. Testing only ten of the 100 may lead to a low number of positive tests, versus testing 30 or more of them. In this scenario, a greater number of positive tests might be due to more testing.

    But understanding is that, in addition to looking at the number of tests, you also have to look at the rate of positive testing. That is, out of the total number of people tested, what percentage tested positive for the virus. If you tested ten people and one tested positive, I believe that positivity rate would be 10%.

    Now, here’s the part that I think is a bit confusing–or doesn’t seem as rock-solid to me. Experts believe that high positivity rate likely means we’re not testing enough. Nuzzo uses the example of New York testing 20,000 people per day with a 50% of them testing positive. The assumption here is that 50% is not representative of the New York’s population as a whole–because it seems unlikely that half the population has the virus. Instead, experts assume the 50% number is due to focusing on high risk individuals (medical workers, people with symptoms). If New York tested more people–including those not at a high risk of getting the virus–than the positivity number should decrease. And that’s what happened when New York reached 50,000 tests per day. (The percentage of those positive tests was 2%, which is a good number.)

    Conclusion:

    Testing a lot should lead to a lower percentage of those testing positive–which is a good thing.

    However, if one increases the testing, and the percentage of positive tests is relatively high (above 5%), then that suggests the virus is spreading.

    The value of high number of tests per day, plus the positivity rate, lies in what both reveal about the prevalence and rate of spread (?) in the society. Lots of tests + low percentage of positive tests suggests low spreading rate.

    The actual number of positive tests–in toto or whether it is going up or down–seems like an incomplete story. The percentage of positive tests is also important.

    More later.

  38. Prescient thread from a guy who oversaw Ebola response in the Obama Administration. This was from February 17, 2017.

    Lot of speculation these days about how #Trump Admin will manage a REAL crisis, given its high level of baseline chaos. Let’s dive in. 1/

    I ran int’l disaster response under Obama, incl the Ebola reponse. Trump is undermining every crisis mgmt tool USG has in its arsenal. 2/

    .@BillGates was on @NPR today talking #pandemic threat. Nerve-wracking to think how current White House would handle such a crisis. 3/

    Not a theoretical threat. Each POTUS has faced outbreak crises: AIDS, SARS, Bird flu, swine flu, Ebola. Just a matter of time. 4/

    #Ebola was complex & tough as hell, even tho not a very transmissible disease. A highly contagious, highly fatal flu would be 100x worse. 5/

    Defeating Ebola req’d solid crisis mgmt: strong NSC process, reliable info flow to POTUS, credible public & global messaging… 6/

    …scientific expertise, strong multilat partnerships, all feeding a coherent strategy. Trump weakening EVERY SINGLE ONE of these tools. 7/

    NSC process is reputedly a wreck. Deputies’ mtgs are the engine of major crisis mgmt – if they’re not working, you’ll fail, period. 8/

    Why? B/c any major crisis is inherent whole-of-govt endeavor. On Ebola: USAID, CDC, DoD, State, USPHS, etc. Need strong NSC traffic cop. 9/

    Need reliable info flow to POTUS. Obama’s info reqs kept us focused, helped interagency alignment, enabled informed real-time decisions. 10/

    In active crisis, accurate real-time info is paramount. Ignoring PDBs, not reading briefing papers – ensures poor decision making. 11/

    Next: public credibility. If outbreak hits, White House uniquely positioned to message to US & world – but only if ppl trust them. 12/

    On past outbreaks, POTUS’ personal involvement could spur global action. US credibility was a given. But would the world believe Trump? 13/

    Respect for science…oy. Need I even say it? Will Admin that flirts w/ anti-vaxxers & climate deniers listen to its own health experts? 14/

    This matters ENORMOUSLY. Outbreak control rests on understanding the disease; misunderstand the science and you’ll use the wrong tools. 15/

    Another big lesson of Ebola – need strong multilat partnerships. US must lead but can’t do everything. Need UN, allies to share burden. 16/

    Partnerships even more crucial in a real global pandemic. But will world follow USG that alienates multilat institutions and allies? 17/

    Finally: coherent strategy. On Ebola, NSC put AID & CDC in strat lead, POTUS outlined clear interagency plan so agencies could slot in. 18/

    Hard to see current chaos on NSC, & b/w WH and agencies yielding any kind of strategic coherence. So, likely to work at cross purposes. 19/

    THIS IS ALL FIXABLE. But wld take empowered NSC, engagement w/agency expertise, thoughtful strategy process. Not evident in past 4 wks. 20/So as an emergency manager, welcome to my nightmare. Politics aside, I sincerely hope next Natl Security Advisor empowered to fix it. /end

  39. The data is in: Fox News may have kept millions from taking the coronavirus threat seriously op-ed from Maggie Sullivan of WaPo

    Those who relied on mainstream sources — the network evening newscasts or national newspapers that President Trump constantly blasts as “fake news” — got an accurate assessment of the pandemic’s risks. Those were the news consumers who were more likely to respond accordingly, protecting themselves and others against the disease that has now killed more than 123,000 in the United States with no end in sight.

    Those who relied on Fox or, say, radio personality Rush Limbaugh, came to believe that vitamin C was a possible remedy, that the Chinese government created the virus in a lab, and that government health agencies were exaggerating the dangers in the hopes of damaging Trump politically, a survey showed.

  40. I don’t know this person, but I thought this was a good satirical twitter thread:

    Welcome to the Freedom Cafe! We trust you to make your own choices if you want to wear a face mask. And, in the same spirit of individual liberty, we allow our staff to make their own choices about the safety procedures they prefer to follow as they prepare and serve your food.

    We encourage employees to wash their hands after using the bathroom, but understand that some people may be allergic to certain soaps or may simply prefer not to wash their hands. It is not our place to tell them what to do.

    We understand that you may be used to chicken that has been cooked to 165 degrees. We do have to respect that some of our cooks may have seen a meme or a YouTube video saying that 100 degrees is sufficient, and we do not want to encroach on their beliefs.

    Some of our cooks may prefer to use the same utensils for multiple ingredients, including ingredients some customers are allergic to. That is a cook’s right to do so.

    Some servers may wish to touch your food as they serve it. There is no reason that a healthy person with clean hands can’t touch your food. We will take their word for it that they are healthy and clean.

    Water temperature and detergent are highly personal choices, and we allow our dishwashing team to decide how they’d prefer to wash the silverware you will put in your mouth.

    Some of you may get sick, but almost everyone survives food poisoning. We think you’ll agree that it’s a small price to pay for the sweet freedom of no one ever being told what to do – and especially not for the silly reason of keeping strangers healthy.

  41. James Fallows evaluates the White House Coronavirus response in a new Altantic article. It’s based on two months of “lengthy conversations with some 30 scientists, health experts, and past and current government officials—all of them people with firsthand knowledge of what our response to the coronavirus pandemic should have been, could have been, and actually was.” Some have or are still serving in relevant organizations and agencies (e.g., military, WH, etc.).

    It’s fairly predictable that the article won’t put Trump in a positive light, but there are interesting details that I learned about. Also, I like Fallows’s use of air traffic safety analogy/metaphor throughout the piece.

    Recommended.

    7/6/2020

    On Trump’s travel ban on China (which Trump likes to tout)

    All (30 of the people Fallows interviewed) agreed that Trump’s limitations on travel from China, in late January, and from parts of Europe, six weeks later, made a bad situation worse. The Chinese “ban” was a further irritant to the Chinese government (despite Trump’s ongoing personal praise of Xi Jinping), and because it wasn’t absolute, some 40,000 U.S. citizens and others flew into American airports from China, with minimal testing, screening, or quarantine provisions. The ban might even have worsened the situation, by impelling Americans (who might have been exposed) to get back while they still could.

  42. According to this WaPo article, this is Trump WH plans to spin their handling of the pandemic in the 2020 campaign:

    The goal is to convince Americans that they can live with the virus — that schools should reopen, professional sports should return, a vaccine is likely to arrive by the end of the year and the economy will continue to improve.

    White House officials also hope Americans will grow numb to the escalating death toll and learn to accept tens of thousands of new cases a day, according to three people familiar with the White House’s thinking, who requested anonymity to reveal internal deliberations. Americans will “live with the virus being a threat,” in the words of one of those people, a senior administration official.

    “They’re of the belief that people will get over it or if we stop highlighting it, the base will move on and the public will learn to accept 50,000 to 100,000 new cases a day,” said a former administration official in touch with the campaign.

    (emphasis added)

    I’m hesitant to believe the reporting here–it’s sounds unreal, like a way a hyperpartisan would characterize the other side. Could this really be the thinking of Trump’s adviser’s? If so, this ghastly and appalling. Apparently the Trump administration acknowledges they have mishandled the virus (and also recognize they don’t know what they’re doing?), so instead of actually trying to control the spread of the virus, they’re approach is to hope Americans get “numb to the escalating death toll.” That is…something. If voters disapprove of Trump’s handling of the virus, this is a stunning–and stunningly awful–approach to change things.

    I should add that the economy is the key to Trump’s reelection; the key to getting the economy going is controlling the spread of the virus; the key to controlling the spread has to do with better testing, contact tracing, physical distancing–and the wearing of masks(!). As James Fallows’s terrific, recent article points out, in detail, there was a plan and playbook in place to deal with this virus. If Trump followed that playbook–and was competent–the U.S. would likely be more like Europe and New Zealand, at least by now.

    Some close to Trump, including a range of Republican senators and House Minority Leader Kevin McCarthy (R-Calif.), have encouraged him to focus on blaming China for the pandemic…

    Really? They’re encouraging an approach that will demonize and scapecoat Asians and Asian-Americans, which is bad enough, but this will only polarize the nation more, not less. The new GOP slogan and principle–polarization for power, whatever it takes.

    1. I’m extremely anti-Trump, but I don’t feel as strongly that if there was another administration in charge that this pandemic would have been handled much differently or more “correctly”, sans all the “dumb” gesturing and talk from the man in charge. Everyone is still trying to balance the “death” versus economy issue. There are multiple states who’s numbers is crazy right now, but none of them want to “reclose”.

    2. …but I don’t feel as strongly that if there was another administration in charge that this pandemic would have been handled much differently or more “correctly”,…

      I’m curious to know why you feel this–especially, if you’ve read James Fallows’s article. The interesting thing is that the article mostly deals with what Trump did before the virus got here, if I recall correctly. Here’s one example (and there are many):

      By the final days of December, and no later than January 1, a warning would have appeared in the President’s Daily Brief—the classified summary of international developments distilled from all intelligence agencies and passed to the president and a handful of advisers. “It was in the briefings by the beginning of January,” a person involved in preparing the president’s briefing book told me. “On that there is no dispute.” This person went on: “But knowing it is in the briefing book is different from knowing whether the president saw it.” He didn’t need to spell out his point, which was: Of course this president did not.

      I’m almost sure any other POTUS would have read the Presidential Daily Brief.

      Everyone is still trying to balance the “death” versus economy issue. There are multiple states who’s numbers is crazy right now, but none of them want to “reclose”.

      But these problems are primarily because the Trump administration totally mishandled the pandemic. If Trump followed the playbook developed by the Obama and Bush administration, my sense is that there’s a good chance we would not be balancing the economy and death. And even in spite of not following their playbooks, if he hadn’t politicized mask-wearing or egged on protestors of lockdowns, I think there’s a decent chance we’d be in a way better position.

      The crazy thing is that, had he not politicized this situation, the economy would have been better and his chances of re-election would have been much greater. Even now, July 7, 2020, his best chance at re-election–and the most responsible thing to do–is to encourage Americans to wear masks and for him to wear mask, too. This one thing could help control the spread, which will can help the economy. If that happens in the fall, he’d be in a good position to win.

      But instead of this, the WH supposedly hopes Americans grow numb to the number of Americans dying. Unreal.

      1. My take is that the White House was going to do anything to not shut down and that’s why they waited so long. I think every administration would have done the same thing. And it’s for the same reason they are many places not willing to do another complete shut down again, including Hawaii. And I doubt all these places (Texas, Florida, parts of California) are not shutting down because the federal government is telling them not to. They are staying open because they just cannot do the shut down thing anymore or again. And to me that’s the attitude of the general public at this point. They cannot do the “stay at home” thing, which is why there are huge clusters of people sort of going “crazy” and acting risky.

        I mentioned that Trump’s moronic gesturing and posturing is ridiculous including politicizing this and not wearing the mask. And there are guys not wearing masks because of the President, but my guess is that’s not the main reason. There are just some people done “being sensible” and cabin fever, especially with the youth, is setting in, especially with no end in sight.

        My take is if another similar pandemic was to hit China six years from now, the White House would not even do a complete shut down like they did this time around. I’m not saying that’s right, but that’s the feeling I’m getting based on how the governments (federal and local) are treating this second wave.

    3. My take is that the White House was going to do anything to not shut down and that’s why they waited so long. I think every administration would have done the same thing.

      Are you saying that “waiting too long to shutdown” was the main problem?

      Also, are you assuming that there was no way to avoid the government from ordering a shut down (and I assume by “shut down” you mean mandating a sheltering)?

      From the Fallows article:

      What did the breakdown in U.S.-Chinese cooperation mean in practice? That the U.S. knew less than it would have otherwise, and knew it later; that its actions brought out the worst (rather than the merely bad) in China’s own approach to the disease, which was essentially to cover it up internally and stall in allowing international access to emerging data; that the Trump administration lost what leverage it might have had over Chinese President Xi Jinping and his officials; and that the chance to keep the disease within the confines of a single country was forever lost.“If Trump had been following the norm of previous presidents, we would have known about this informally, because our people would have been on the ground in China,” Shirk said. “But the Trump administration pulled them out, and the last epidemiologist who worked for the U.S. government left last year.”

      (emphasis added)

      There was a chance to keep the virus contained in China.

      Also, you don’t think if Hillary Clinton or Jeb Bush won, the U.S. would have handled the virus like Europe?

      1. I think it’s sort of reckless for the writer to write a sentence like the one you emphasized, “the chance to keep the disease…”. If I could inject truth serum into the writer and ask what is the chance that the virus could have been isolated in China I wonder what his response would be.

        To me, one of the best places in the world for the virus to start in terms of stopping it, was in Wuhan. The Chinese government can make it citizens do stuff most governments can’t. They banned all cars and public transportation (with the exception of a few cabs) in Wuhan forcing citizens to stay home. Add to that Wuhan has one of the best labs/facility in the world for infectious diseases right in the city. The same lab the last epidemiologist from America was station at. And China could not contain it.

        Add to that, the first believed death in America was in early March, but later found out that there were deaths in California a few weeks previously, which meant that the virus was probably in America a month or so prior to what we originally thought.

        I do not think there was anything anyone could have done to contain the virus and I do not think a different administration would have handled this a whole lot different.

    4. If I could inject truth serum into the writer and ask what is the chance that the virus could have been isolated in China I wonder what his response would be.

      Here’s what I asked him: “I’m wondering what your sources believed the COVID-19 situation would be like in the U.S. had the Trump administration behaved like a normal administration, and if there was any consensus on this.”

      Here’s what he said:

      I think that if a “normal” administration, Republican or Democratic, had been in place, the *global* effects of the pandemic would have been far less. The US would have been working with China from early January onward. It would have been more like SARS or MERS, and less like the 1918 flu.

      More like SARS or MERS, which if I recall did not lead to a huge economic damage–not like how we’re experiencing now. Again, his opinion is based two months of “lengthy conversations” he had with “some 30 scientists, health experts, and past and current government officials—all of them people with firsthand knowledge of what our response to the coronavirus pandemic should have been, could have been, and actually was. The government officials had served or are still serving in the uniformed military, on the White House staff, or in other executive departments, and in various intelligence agencies.” And the article’s criticism is focused entirely on what the Trump administration did or did not do prior to the virus getting to the U.S.–which is interesting, because I think much of the criticism is directed on what the Trump administration did once the virus got here.

      To me, one of the best places in the world for the virus to start in terms of stopping it, was in Wuhan.

      I can’t do justice to the article–in terms of summarizing or explaining it–but the article claims the Trump administration interacted with China poorly, on a variety of levels, which are really complicated to explain. But here’s one paragraph that gives a taste:

      What did the breakdown in U.S.-Chinese cooperation mean in practice? That the U.S. knew less than it would have otherwise, and knew it later; that its actions brought out the worst (rather than the merely bad) in China’s own approach to the disease, which was essentially to cover it up internally and stall in allowing international access to emerging data; that the Trump administration lost what leverage it might have had over Chinese President Xi Jinping and his officials; and that the chance to keep the disease within the confines of a single country was forever lost. “If Trump had been following the norm of previous presidents, we would have known about this informally, because our people would have been on the ground in China,” Shirk said. “But the Trump administration pulled them out, and the last epidemiologist who worked for the U.S. government left last year.”

      There’s more, but, again, it’s too hard to summarize, and I don’t want to quote several paragraphs. I should point out that, the article claims that China and U.S. had established good working relationship, in the Obama and Bush 43 administrations, but the relationship broke down in the Trump administration.

      Add to that, the first believed death in America was in early March, but later found out that there were deaths in California a few weeks previously, which meant that the virus was probably in America a month or so prior to what we originally thought.

      According to the article, the Trump administration should have known by January:

      “The bottom line is that for a place like Wuhan, you really are going to rely on open-source or informal leads.” During the Obama administration, the U.S. had negotiated to have its observers stationed in many cities across China, through a program called Predict. But the Trump administration did not fill those positions, including in Wuhan.This meant that no one was on site to learn about, for instance, the unexplained closure on January 1 of the city’s main downtown Huanan Seafood Wholesale Market, a so-called wet market where wild animals, live or already killed, were on sale along with fish and domesticated animals. It was at this market that the first animal-to-human transfer of the virus is generally thought to have occurred, probably from a bat. But by that time, as Marisa Taylor of Reuters first reported, the Trump administration had removed dozens of CDC representatives in China.

      (emphasis added)

      I’d bet Hillary Clinton or even another Republican president would have filled those positions–which would have provided the information to know about the coming threat. In spite of this failure, the warning was put into the Presidential Daily Brief “no later than January 1”–which I’m pretty sure any other POTUS would have read.

      1. My understanding is SARS and MERS was not as contagious as Covid 19, which is why it could be raticated. But I believe the biggest difference between SARS and MERS and Covid 19 is SARS and MERS were a much more severe disease. I’m not sure there were asymptomatic carriers (or as many) like we see with Covid 19.

        Man, those are extremely serious accusations that this writer is making. I’m completely skeptical that we could have ended the disease right away. I have a feeling this disease spread so fast with so many unknown carriers that by the time China acted or if America acted at the exact same time, it was already too late. There is a very good possibility that by the time China knew about it, it was already in California.

  43. My understanding is SARS and MERS was not as contagious as Covid 19, which is why it could be raticated. But I believe the biggest difference between SARS and MERS and Covid 19 is SARS and MERS were a much more severe disease. I’m not sure there were asymptomatic carriers (or as many) like we see with Covid 19.

    I think what you’re missing here is that China and the U.S. coordinated their efforts in dealing with those other diseases–and the article implies this coordination was key in stopping or limiting the spread of those pathogens. That makes a lot of sense to me. But according to the article (and it’s not hard to believe), the Trump administration didn’t do a good job–in terms of coordination with China, as well as many other things. I’m not 100% sure that a normal, competent POTUS would have made a big difference, but I also can’t say it wouldn’t either. And I’m even more confident that a competent POTUS would have at least be able to replicate the results of European countries.

    Man, those are extremely serious accusations that this writer is making.

    First, it’s important to note that Fallows is drawing on experts–30 of them, and some of them have first hand experience of the way the Trump administration responded.

    I have a feeling this disease spread so fast with so many unknown carriers that by the time China acted or if America acted at the exact same time, it was already too late. There is a very good possibility that by the time China knew about it, it was already in California.

    Do you think by late December it was too late? Fallows, relying on his interviews with experts, doesn’t. And the warning system developed by Obama and Bush to detect the start of pandemics worked, according to the experts he interviewed.

    Did the warning system work this time, providing advance notice of the coronavirus outbreak? According to everyone I spoke with, it certainly did. A fascinating unclassified timeline compiled by the Congressional Research Service offers a day-by-day and then hour-by-hour chronology of who knew what, and when, about developments in central China. By at least late December, signs were beginning to show something seriously amiss—despite foot-dragging, lies, and apparent cover-up on the Chinese side. A different kind of Chinese government might have done a different job, calling for help from the rest of the world and increasing the chances that the coronavirus remained a regional rather than global threat. But other U.S. leaders had dealt with foreign cover-ups, including by China in the early stages of the SARS outbreak in 2002. Washington knew enough, soon enough, in this case to act while there still was time.

    (emphasis added)

    Later, the article mentions that a normal administration would have confronted the Chinese about the situation, increasing the chances that the virus would be dealt with immediately and providing assistance that could also increase the chances of containment. What would be the nature of the assistance?

    The metaphor several people used was of firefighters from Oregon and Idaho traveling to help contain a forest fire in California before it can spread. The U.S. has many times in the past 20 years deployed scientists, doctors, and logistical-support teams to Africa, Asia, and the Middle East during disease outbreaks.

    The U.S. military excels in logistics: mobile hospitals, teams of medics, food and water, masks and gowns. American scientists, at leading universities as well as the Centers for Disease Control and Prevention (despite its well-documented recent hollowing-out and politicization), are still seen as world leaders in many fields.

    But the Trump administration never made these critical calls that would have lead to better and timely cooperation.

    1. There is a big difference between isolating Covid 19 to China and everything short of that in terms of how the American government reacted to the virus. So to say it was possible or there was a chance for it to stop in China it takes away the whole health versus economy decision. So there are parts where the author talks to 30 experts, but the most important part, at least to me, is do those 30 experts agree or have a strong consensus that America’s lack of early response could have stopped this virus in it’s tracks and limit it to China.

      When I look at how the virus spread and continues to spread it is super hard to believe that we could have stopped it. It would have took a while from the time the virus was introduced to humans to the time Covid 19 was discovered. Even knowing that Covid 19 exists, there were cases in California in which people died and there wasn’t a link between their death and Covid (It was only discovered much later.). Just think how long it would have taken to just discover the virus not even knowing it even existed. By that time the virus probably had spread far and wide. If there is a good evidence or way to support the claim that we could have stopped the virus early, that would be more interesting to me. And the evidence of SARS just doesn’t convince me based on what I read and heard in terms of the differences in the viruses. Because SARS seem to be a much more “visible” virus in terms of who has it and how it was being passed.

    2. …do those 30 experts agree or have a strong consensus that America’s lack of early response could have stopped this virus in it’s tracks and limit it to China.

      I don’t know–you saw his response. He gives his opinion, but it’s based on extensive conversations over a two-month period with those 30 experts. It would have been cool if he actually asked them, but I assume enough of them indicated this was a distinct possibility, otherwise he wouldn’t answer in the way that he did. It’s worth noting again that Fallows basically thinks the ball game was over–or that the Trump administration totally blew the deal once the virus got here. This is his position, even though the Trump administration made a lot of errors, some quite egregious, once the virus got here. But he really doesn’t address any of those. Finally, his answer isn’t that the virus would completely contained in China (i.e., never getting to another country)–I believe SARS, MERS, H1N5, and Ebola also “escaped” the country they originated. But those things didn’t explode into a global pandemic that lead to great economic damage.

      It would have took a while from the time the virus was introduced to humans to the time Covid 19 was discovered. Even knowing that Covid 19 exists, there were cases in California in which people died and there wasn’t a link between their death and Covid (It was only discovered much later.).

      It sounds like you’re assuming several things:

      1. That humans needed to get the virus before China and the U.S. could have taken meaningful steps to prevent it’s spread;

      2. Even if China and the U.S. coordinated earlier and more effectively–which would included curtailed Chinese from lying and cover-up the virus–this would not have lead to understanding the lethality and global threat of the virus.

      I wouldn’t make these assumptions based on the article.

      On a related note–and another way Trump administration failed, which could have made a difference:

      In cases of disease outbreak, U.S. leadership and coordination of the international response was as well established and taken for granted as the role of air traffic controllers in directing flights through their sectors. Typically this would mean working with and through the World Health Organization—which, of course, Donald Trump has made a point of not doing. In the previous two decades of international public-health experience, starting with SARS and on through the rest of the acronym-heavy list, a standard procedure had emerged, and it had proved effective again and again. The U.S, with its combination of scientific and military-logistics might, would coordinate and support efforts by other countries. Subsequent stages would depend on the nature of the disease, but the fact that the U.S. would take the primary role was expected. When the new coronavirus threat suddenly materialized, American engagement was the signal all other participants were waiting for. But this time it did not come. It was as if air traffic controllers walked away from their stations and said, “The rest of you just work it out for yourselves.”

      My takeaway: The U.S. government served as the hub to alert and coordinate effort to stop a pandemic. This included providing key aid, expertise, supplies and logistical coordination–all of which could facilitate and enhance a response to a potential pandemic. I can see this making a huge difference in containing the virus or at least dramatically reducing it’s spread. And it plausible that a virus would spread a lot more, if the U.S. simply stopped fulfilling this function.

  44. Senator Schatz re-tweeted this thread, which I thought was helpful.

    Summary

    Contact tracing involves identifying infected people and finding and monitoring all the people they interacted with. But we can look at infected people and ascertain the situation and location of their infection and then look for common properties of these situations. Three seem to have been identified:

    crowded spaces with many people
    closed spaces with poor ventilation
    close-contact settings

    The goal is for people to avoid places/situations with these three attributes. Basically, avoid crowds (like the plague).

    An important caveat–something that is important to consider until we get extensive information about the virus: We’re in a phase where our knowledge of this specific virus is far from exhaustive. Therefore, we should take information we receive, including from experts, with some degree of caution. To be clear, this thinking should not be used to discredit or undermine experts. I think we should still defer to them, especially when making decisions about the overall society.

    But avoiding situations with the three Cs seems very sound and reliable advice (at least at this moment). Indeed, I suspect others might not find this information all that interesting as it may have already been obvious.

  45. July 11, 2020: Trump dons mask in public for the first time, months after public health experts said everyone should (WaPo)

    According to the article, this is three months after public health officials from his own administration recommended “that all Americans cover their face when social distancing was not possible.” Has it been that long? In any event, even if it were a month ago, that would be too long. Ultimately, if this gets Fox News, GOP governors and congress people and pro-Trump pundits to push the wearing of masks, this is the best way to get more people to wear them–and that should help reduce the spread, save lives and help the economy–which is a good thing. (Hopefully, he’ll be strongly urge the public to do this as well.)

    1. From the CDC director, Robert Redfield today:

      The United States could get the spread of the novel coronavirus “under control” within a matter of weeks if everyone wore face coverings, Centers for Disease Control and Prevention Director Robert Redfield said Tuesday.

      There are a couple of things I thought about when I saw this today.

      First, this tweet by David French, a conservative:

      The mask culture war has got to be one of the dumbest and most destructive political/cultural disputes in modern American political history. And we’re continuing to pay the price.

      Second, we’ve heard the claim from Trump that people are wearing masks as a way to protest Trump, and that they’re the ones politicizing mask wearing. Actually, if anti-Trumpers wanted to politicize mask-wearing, they would pooh-pooh wearing a mask, as this might be the biggest way to reduce the spread of the virus, which will help the economy–two things, if they were to happen–would increase Trump’s chances of being re-elected. To me, this is one of the many ironies and crazy aspects of the Trump’s handling of the pandemic. Wearing masks will increase the chances of his re-election. He and his supporters should be the biggest advocates of this!

      Oh, and I just thought of a third–namely, an idea from Jay Rosen, media studies professor at NYU, which may offer a key to understanding Trump’s inexplicable and counter-productive handling of the virus, which I touched on above:

      The plan is to have no plan, to let daily deaths between one and three thousand become a normal thing, and then to create massive confusion about who is responsible— by telling the governors they’re in charge without doing what only the federal government can do, by fighting with the press when it shows up to be briefed, by fixing blame for the virus on China or some other foreign element, and by “flooding the zone with shit,” Steve Bannon’s phrase for overwhelming the system with disinformation, distraction, and denial, which boosts what economists call “search costs” for reliable intelligence.

      Stated another way, the plan is to default on public problem solving, and then prevent the public from understanding the consequences of that default. To succeed this will require one of the biggest propaganda and freedom of information fights in U.S. history, the execution of which will, I think, consume the president’s re-election campaign.

      I really don’t think Trump knows what he’s doing–in terms of running the government to deal with this pandemic, and in terms of governing and running the executive branch in general. What he does know how to do is talk–talking in a way to create the appearance that he knows what he’s doing and that he’s doing well, and talking in a way to create confusion, raising doubts in people’s minds about who and what to believe. This explains why he’s attacking Dr. Fauci’s credibility right now.

      This seems like an unreasonable take on Trump’s approach, as it would be completely irresponsible and beyond the pale. It’s hard to imagine any POTUS would do this. But if Trump really cared about reducing the spread of the virus, why doesn’t he advocate the wearing of masks–and signal to his minions to follow suit? Maybe he doesn’t care about reducing the virus and saving lives, but surely he cares about winning the election? Yes, but the way he has gained and maintained power is through lying, conning, and demagoguery. So that’s what he’s falling back on. That seems plausible to me.

      1. The following made me think of the David French tweet above–“The mask culture war has got to be one of the dumbest and most destructive political/cultural disputes in modern American political history. And we’re continuing to pay the price.”

        Why? I don’t get it. I read the article to see if Gov. Kemp has a solid reason. The two best I could find: he wants to encourage people to wear the mask, and says a mandate would be unenforceable. These are very weak answers to me. By voiding the orders to wear masks from several localities, he’s sending, indirectly at least, the message that it’s OK not to wear the mask. Georgia’s COVID-19 numbers are not good, from what I understand. I don’t get it. This seems like madness.

    2. One more thing, a tweet from reporter Yamiche Alcindor, reporting on Trump’s remarks today:

      President Trump just now at the WH said: “Think of this: If we didn’t do testing — instead of testing over 40 million people, if we did half the testing we’d have half the cases. If we did another — you cut that in half, you’d have yet again half of that.”

      I might have commented about this assertion by Trump before, I can’t remember. In any event, he has repeatedly said expressed this notion. What does he mean? The most charitable reading I can muster, off the top of my head, is that the number of tests make the pandemic seem worse than it is. So if we tested less, the impression about the virus would seem less bad? But this would mean that the he’s only arguing about appearances. That is, the situation could, in actuality, be bad, but he wishes we’d have less tests so that people would think the situation wasn’t so bad. ? This is pretty awful.

      But I guess this is less bad than if he thought testing caused more people to have the virus–e.g., “if we did half the testing we’d have half the cases.” He has to mean–we’d identify less people. But again, that would not change the amount of people who actually have the virus.

      Perhaps he’s so fixated on appearances that actual facts and reality are much less important to him, which would make him grossly unfit if true.

    3. This from WaPo report talks about the Trump administration recommending new way of reporting COVID-19 data that “eliminates” the CDC as a “recipient of that information.” In any other administration, I would pause and wonder if there is a good explanation for this. It’s hard for me to do that with this administration. This really seems fishy.

      The Trump administration is asking governors to consider sending the National Guard to hospitals to help improve data collection about novel coronavirus patients, supplies and capacity, according to a letter, internal emails and officials familiar with the plans.

      The move is part of a new data reporting protocol for hospitals that eliminates the Centers for Disease Control and Prevention as a recipient of that information — a decision that is sparking controversy about whether or not the data is reliable.

      It’s also consistent with Jay Rosen’s theory that Trump is going to try and overcome the pandemic through propaganda. Here, “overcome” means Trump surviving and winning the election. What actually happens to American lives and the economy is an afterthought–or it’s only important in how it can help him stay in power. If he can control the data, he can, at the very least, cause confusion and doubt in many Americans, who may not know who or what to believe as a result. (Smearing Dr. Fauci is part of this, as is Trump, today, supposedly saying Navarro was wrong for writing an op-ed. People in the Trump administration attack Fauci, but then Trump says this was wrong. This can be confusing, unless you’re open to the idea that Trump’s intent is to create confusion and hope he can escape from accountability.)

      1. Further undermining of trust in the Trump administration and now possibly the data they provide. Ugh.

    4. The OP for this sub-thread was about Trump wearing on mask (July 11, 2020).

      Here’s a breakdown of what Trump said today, in response to Biden recommending a 3 month nationwide mask mandate:

      “[Biden] wants the president of the United States, with the mere stroke of a pen, to order over 300 million American citizens to wear a mask. … He thinks it’s good politics, I guess,” Trump said.
      Biden said in his remarks earlier in the day that governors need to mandate the use of masks.

      “I trust the American people and their governors very much. I trust the American people, and the governors want to do the right thing to make the smart decisions,” Trump said during a White House coronavirus briefing. “Joe doesn’t, Joe doesn’t. Joe doesn’t know too much.”

      Trump accused Biden of “playing politics from the sidelines” and called the former vice president’s plan “regressive,” “anti-scientific” and “very defeatist.”

      I know I’m a broken record, but this is so insane. Trump’s description of the recommendation is the opposite of the truth–including the charge of politics. If Biden were putting politics–his victory above everything else, including the nation’s well-being–he wouldn’t be advocating the wearing of masks–he’d be doing what Trump’s doing!

      8/27/2020

      Not all the people in the crowd were tested at this event. It doesn’t seem like Trump and Pence are modeling the wearing of masks as well.

  46. Reports of WH trying to discredit Dr. Fauci

    I didn’t read any articles yet, but I saw a comment that described WH trying to find “oppo” on Fauci. That’s so bad, if true, and the undermining of Fauci is bad on many levels. Off the top of my head,…This is even more pressure on scientists in the administration to suppress information that will make Trump mad and give him information that he will like. This undermines the trust in the scientists working in the administration and for Trump and WH officials. We don’t need more politicization of the pandemic right now. Ugh.

    1. Today, I think Philip Bump of WaPo really nails what’s going on with Trump’s attack of Fauci:

      Notice, though, the form of the attack on Fauci. It’s a fundamentally Trumpian one, aimed not at proving Fauci incapable or of elevating some expert they see as more fit for the moment but, instead, at arguing that Fauci’s word can’t really be trusted. It’s not that Trump and his team think that Fauci’s messing up, really. It’s that they want people to be unsure just how good or bad things are. It’s more useful to Trump if there’s an official whom Americans (and his all-important base) feel uncertain about trusting.

      (emphasis added)

      I don’t know if this is intentional, but I really do think this is an effect. Again, really bad.

      Oh, I forgot to add. Trump re-tweeted the tweet below (which supports Bump’s claim):

      edit

      Another:

      7/14/2020

  47. Thread from Andy Slavitt, “former Acting Administrator of the Centers for Medicare and Medicaid Services, a position he held from March 2015 to January 2017.”

    I would describe this as a thread about leadership with regard to dealing with the pandemic–specific examples of good and bad leadership. Slavitt, himself, speaks in a way I wish a POTUS would.

    COVID UPDATE July 13: There are successful examples of taking on COVID-19.

    And there is one story like no others. New York. 1/
    New York did not get off to a good start. In fact, it was the example of what not to do. California acted 6 days earlier than NY did when they had cases hit.

    The mayor clearly didn’t take it seriously & Cuomo was slower to act. Mostly @CoreyinNYC was ringing loud alarms. 2/
    So some thought it was unfair that Cuomo drew such high praise for his handling of the crisis. He earned it for one reason.

    He talked to people. 3/
    At the time, he was doing what Angela Merkel, Jacinda Ardern, Katrin Jakobsdottir & others around the world were:

    -This situation is going to be difficult
    -I know it will be hard for you
    -Here’s what we need to do and why
    -We will pull through this

    4/
    Something else. He didn’t lie. He didn’t sell. He didn’t pat himself on the back. Or avoid responsibility. We had that already.

    He told the hard truths. He showed data. He asked for help. He demonstrated some empathy & some effort. And the country needed that. 5/

    I have had my issues with Cuomo & don’t like the way he runs NY’s Medicaid program. But I respected what he was doing.

    I have never mentioned this but I saw the data Cuomo was first presented with that he later shared. And I saw the model Trump was presented with. 6/
    For all his flaws, when Trump was hiding under his desk, pointing fingers, searching for credit, ignoring scientists, Cuomo was fully present. 7/
    This isn’t about Cuomo as much as it is about New Yorkers. But I have to make one more comment. There’s a right wing meme about how Cuomo killed people in nursing homes. 8/
    The nursing home meme was generally spread by people whose principal skill is retweeting unread click bait. I ran the agency the Agency that oversaw nursing home safety & have been talking about this on TV, in writing & with governors. You can watch. 9/

    The Trump Administration began in 2017 announcing they would not enforce the sweeping nursing home rules the Obama Admin put in place. Too many regulations. And it got worse from there. Many people have their hands on this mess.10/
    Trump Admin, out of state operators, state inspectors. Yes to all. And sadly while this meme was great as a way to shift the state to blue states, today 40% of Texas cases are coming from nursing homes. Turns out it’s difficult to keep spread out.
    11/
    It turns out that the nursing home deaths were caused by the same reason as in every other state. Staff bringing it in, untested, from the community. 1 in 4 staff got infected. And they lacked sufficient PPE.

    Same thing is now happening in the Sun Belt. 12/
    But this isn’t a defense of Cuomo. The fact is NY became the world’s epicenter of COVID-19 for reasons we are still understanding: a new strain, dense conditions, late reaction, nursing home controls.

    But what happened next was remarkable. 13/
    The only thing as steep as NY’s rising curve was NY’s falling curve. It was spectacular & historic.

    And that is a credit to New Yorkers. To discipline. To community. To respect for the medical workers. 14/
    We have seen the death by infection & by suicide of so many many New York health care workers, one of whom saw 40 ICU visitors in a row die.

    For all of them, yesterday was for them….

    👩🏻‍⚕️👩🏻‍⚕️👩🏽‍⚕️👩🏾‍⚕️👩🏿‍⚕️🧑🏻‍⚕️🧑🏼‍⚕️🧑🏽‍⚕️🧑🏾‍⚕️🧑🏿‍⚕️👨🏼‍⚕️👨🏻‍⚕️👨🏽‍⚕️👨🏾‍⚕️👨🏿‍⚕️👩🏻‍🔬👩🏼‍🔬👩🏽‍🔬👩🏾‍🔬👩🏿‍🔬

    https://twitter.com/aslavitt/status/1282523771191152640

    People died for 120 straight days in NY. It is 64 days after peak.

    508 cases/million at peak. Overall 20,600 cases/million.

    32,075 people gone, 22,795 in NYC alone.

    Yesterday, in every ICU, nursing home, ER & hospital bed, it was quiet. Not a single reported death. 16/
    It’s no longer just foreign countries who have shown this can be done. New Yorkers, who many rallied for, flew to NY, and jumped in to help, showed us THIS IS POSSIBLE. WE CAN DO THIS. 17/
    New York now takes the virus as seriously as the rest of the world & they know how to contain this. Their vigilance is just beginning. And sustaining it will be hard.

    But the backside of that curve brings tears to my eyes. The nurses. The doctors. The paramedics. 18/
    Them way to honor them? Let them be our teachers. Sit there in Phoenix & Houston & Charlotte & Miami and don’t doubt them when they tell you not to mess around with this very scary virus. 19/
    Sadly, some are deciding they must learn for themselves. AZ has now passed NY in peak cases/mm with 528, eclipsing NY’s 508. FL is now at 436.

    Both governors openly flaunted their lack of preparation & lack of seriousness.

    They disrespected the sacrifice of their countrymen.20/
    The way they can make it up is with a rapid steep decline. 5ey should follow Greg Abbott in TX. He also got it late & didn’t learn the lesson of NY. But once he saw it, he acted w seriousness.

    All these states can achieve the same sharp drop as NY if they get serious.21/
    And for other states, the movement to begin closing bars today, to consider starting school online, to close churches, to roll things back is the beginning of the political courage they need to show. 22/
    I have talked to governors & mayors across the country. Follow Abbott. Don’t learn the lesson a third time. We CAN do it.

    “Yes we can” someone I know said. 23/
    The Senate must also honor what they’ve seen. Bar & restaurant owners should be protected. Unemployment ins. Prevent evictions. Help Americans get through this.

    Hire the contact tracers, get us the testing. Understand without a president, you need to work with the governors. 24/
    I spoke to Bernie Sanders about this today. He was worked with Mark Warner & Doug Jones (the full expanse of the Democratic caucus) on a Bill to protect Americans’ paychecks.

    Your move Mitch McConnell. Now that this is in red states apparently he’s taking another look. 25/
    Our country’s leading pandemic epidemiologist and I spoke for a while today. He gave a Ted talk in 2006 on this pandemic. He has advised presidents of both parties. I have been talking to him fairly continuously for the last 4 months. 26/
    He believes bearing this virus is possible. He hasn’t seen anything thrown at us by this virus, as nasty as it is, that we can’t defeat.

    He got evidence today. Thank you to our heroes in New York & in memory of all who we lost. /end

    On another note, Here’s a thread, from the Governor of MIssissippi (R) on the unfeasibility of intentionally letting the virus spread in order to achieve herd immunity. I don’t know there’s an error in his thinking, but it sounds logical to me:

    Let’s talk about herd immunity. I’ve listened to some people argue that the rapid spread of cases is a good thing, and we need to reach herd immunity in Mississippi and elsewhere to survive. I’m not a health care expert by any means, but I am a math guy. And I have thoughts:

    The experts say we need 70-80% of the population to get COVID-19 to achieve herd immunity. Let’s assume they’re wrong (it’s certainly possible, they have been before.) Let’s assume they’re being way overly cautious and we actually only need 40% infection for herd immunity.

    In Mississippi, our population is 3 million. We’ve had 36,680 cases so far.

    We’d need 1.2 MILLION infections to achieve that hypothetical 40% threshold. (Remember, experts say it’s double that.)

    Over the last two weeks, our hospital system has started to become stressed to the point of pain. We are seeing the early signs and effects of it becoming overwhelmed. We had to suspend elective surgeries again.

    On our worst day of new cases, we had just over 1,000. It has typically been between 700-900 during this most aggressive time.

    To get to 40% infections, we’d need 3,187 new cases every day for a full year from today.

    We would need to TRIPLE our worst day—every day—for a year

    I’m not one of these guys that immediately dismisses any idea that challenges the expert status quo talking points. I’m pretty skeptical by nature. That’s healthy. But herd immunity is not anything like a realistic solution in the short or mid-term. I wish it was.

    Unless you’re willing to go without hospitals after a car wreck or heart attack, we need a different approach. Right now, despite mixed messages at the beginning, it seems like masks are the best bet. They’re a hell of a lot better than widespread shut downs. Please wear one!

    (emphasis added)

    Edit

    Another great thread about ledership–specifically leaders modeling the right behavior.

    Regarding Senators and airline safety regulations — let me put this photo of Ted Cruz in context with a story about then-Senator John Kerry

    It was just after 9/11. My first year in DC. All the airport security stuff was new and onerous and weird.
    /1 Image
    I had to fly to Boston for something. The flight was slightly delayed. Waiting at the gate was Senator Kerry — who had a computer bag, a smallish overnight bag, what looked like an empty gym duffel bag, several newspapers. He was in a suit, obviously with a first class ticket /2
    The flight gets ready to board and Kerry is chosen by some TSA agents for the extra, annoying, at-gate security screening where you basically have to disrobe in front of everyone while your underpants and widgets are pawed thru at a folding table by annoyed TSA agents. /3
    The agents clearly have no idea this is a US Senator (despite the lapel pin), or who John Kerry is. They picked him because he was closest to the table when they set it up.

    This presents a dilemma for John Kerry /4
    Kerry clearly ran straight from Senate votes to flight. He is slightly in disarray, just wanting to board, relax. He’s clearly inwardly annoyed at the extra delay in boarding

    BUT it’s just after 9/11 security procedures put in place, and he knows he needs to be a good example /5
    Kerry looks around the gate area, smiles, says, “sure thing, no problem!”

    He sighs deeply, picks up things, walks to table.

    One TSA agent paws thru every item and compartment while the other disrobes and frisks Kerry.

    He has on his best “all of the show” tolerance face /6
    Finally he is allowed to redress and put his things away. There are a million cords and papers and electronics. It takes forever for some very small bags. He keeps fake smiling the whole time.

    Then, the one agent says: “Sir you have too many bags.” /7
    Ordinarily, with no audience, he could just say, “it’s ok, I’m in first class, they don’t care.”

    But not right now.

    She says again: “Sir it’s an important rule now, only two items per person or you can’t fly. You can check one.”

    They are all soft bags, not checkable /8
    By now, first class has boarded. So Kerry calmly looks at his bags, says, “so if I just put that bag in the other bag, it’s ok?”

    The lady seems flustered, but ultimately concedes that combining bags is ok.

    Kerry puts *both* his other bags in the empty gym duffel, zips it /9
    “Good to go?” He smiles to the crowd. The TSA ladies wave him on. He tucks his papers under his arm and strides thru gate. By the time I board, he is ensconced with a fizzy water, reading his papers. /10
    The moral is: grown-ups behaving like grown-ups and providing a good example to others even when it is annoying & uncomfortable used to be standard fare for leaders — especially when the nation was facing a crisis & needed to understand these strange changes were important /11
    The QAnon-winking-don’t-tread-on-me LARPers and their sad political reps are a cancer to the durability of the republic

    If John Kerry can get dismantled in a crowded, sweaty airport, Ted Cruz can wear a mask. /12

    1. I really liked this Atlantic article, “A New Understanding of Herd Immunity” by James Hamblin. (By the way, for what it’s worth, the science and health writes at the Atlantic–Ed Yong and James Hamblin, respectively, are really good. (I wish the culture writers were better, especially the people that write about movies.)

    1. Reid,

      Ignoring all the political side of going back to schools, are you thinking of not sending your kids back to school? I think for my son, we are worried, but not enough not to send him I think. I dunno, still waiting on finalized info from his school.

    2. Don,

      I’m not sure if this is the right attitude, but I’m not as worried because there doesn’t seem to be a lot of the virus in Hawai’i. If those numbers start going up, especially exponentially, then I’ll start getting a little worried. Again, maybe I should be more worried now.

      On a positive note, I’m pretty sure I read a WaPo article that mentioned that right now, the evidence suggests that the virus doesn’t spread as much with elementary aged children. (If you want, I can try and find the article). (Intermediate and high school aged students are a different story.) But since the virus is novel, you really have to take this information with a grain of salt.

      I actually don’t know the details of how my children’s schools will handle the virus. I’ve been too caught up with work–I better start getting the details.

      1. Yes it’s hard for kids to get the virus and even harder for them to feel the effects of the virus. For example, I read something like of 1000 kids that tested positive in China in the beginning of the virus not one died that was under 9 (something like that). The unknown though is how effective they are in spreading the virus. That’s the biggest concern. So once my son returns to school, seeing grandparents will be even more limited then it is now.

    3. Speaking of “we are on our own….” this WaPo has passages that make me curse (The entire article is a worth a read.)

      Though Trump does not automatically distrust the expertise of public health officials, he is averse to any information or assessment that he considers “bad news,” that compromises his economic cheerleading message or that jeopardizes his reelection, according to several administration officials and other people with knowledge of the dynamic.

      (emphasis added)

      This makes him incapable of handling this virus, and this also makes him impossible to trust.

      Trump sought to distance himself from those efforts and insisted he has a good relationship with Fauci, despite the fact that Fauci no longer briefs the president on the pandemic and is rarely if ever in the Oval Office anymore.

      Here’s the kicker for me:

      Trump in recent weeks has been committing less of his time and energy to managing the pandemic, according to advisers, and has only occasionally spoken in detail about the topic in his public appearances. One of these advisers said the president is “not really working this anymore. He doesn’t want to be distracted by it. He’s not calling and asking about data. He’s not worried about cases.

      (emphasis added)

      This is outrageous, if true. He is abdicating his responsibility! If this how he feels he should resign. Let someone who cares and can do the job take his place. What the heck?!

      OK something else:

      Many FDA career scientists and doctors see the White House criticism of Fauci as an effort to bully him — to make it clear that no one should consider crossing the president in the months leading up to the election, according to people familiar with the scientists’ thinking.

      and a little later,…

      Some agency professionals worry the episode is a sign the FDA might come under political pressure to approve a vaccine or treatment for covid-19, the disease caused by the coronavirus, before it has been fully vetted for safety and efficacy.

      This is exactly what worries me. If a vaccine comes out soon, and Trump says it’s great, would you take it? Would you let your loved ones take it?

      1. Yeah. It’s been apparent for a couple of weeks that he’s no longer involved and not even thinking about it. Watching the nightly news as I have been for months, I’m seeing some important things he should be commenting on but clearly isn’t. He wants to talk about the election and that’s about it.

    4. Well, you’re more astute that I am. I believed he didn’t know what he’s doing, in terms of running the federal government and governing in general–but that he’s “not really working this anymore. He doesn’t want to be distracted by it.He’s not calling and asking about data. He’s not worried about cases.? It’s not surprising that he’s not interested in the data, but he’s given up on this, sees it as a “distraction” and that he’s “not worried”–that’s crazy to me. I guess there were signs that he gave up on trying to solve this, but ultimately I guess the impact of seeing this expressed hit me. It’s just appalling.

    5. “…perhaps one of the greatest failures of presidential leadership in generations.”

      Inside Trump’s Failure: The Rush to Abandon Leadership Role on the Virus from the NYT is just as damning as the WaPo article above.

      A comprehensive analysis of the Trump administration’s handling of COVID-19, based on “…interviews with more than two dozen officials inside the administration and in the states, and a review of emails and documents, reveal previously unreported details about how the White House put the nation on its current course during a fateful period this spring.” The analysis focuses on many decisions made in April-June of 2020.

      One of the major points of emphasis is the way the WH planned to shift responsibility from the WH to the states, and in the process escape blame for the handling of the pandemic. The primary group speahearding these efforts were mostly made up of people with either political or economic background. One exception seems to be Dr. Birx, who seemed the group seemed to rely on quite a bit. If there’s anything new about this article, it’s that Dr. Birx does not come out looking good, and in my eyes her credibility has taken a big hit. For example,

      Dr. Fauci, a friend of Dr. Birx’s for 30 years, would describe her as more political than him, a “different species.” More pessimistic by nature, Dr. Fauci privately warned that the virus was going to be difficult to control, often commenting that he was the “skunk at the garden party.” By contrast, Dr. Birx regularly delivered what the new team was hoping for.

      Much of the rest of the article gives specifics about the incompetence and poor judgments of the administration.

    6. One question still dogs Trump: Why not try harder to solve the coronavirus crisis? from WaPo

      This the question that has been on my mind, too, and I think this is one that historians will ask as well. Before I say anything else, this article is something–what’s in this, based on comments from people close to Trump, is utterly appalling.

      What will confound historians are the reasons Trump didn’t take simple steps, especially by May-July, to get control of the virus. This article provides some possible answers that are so appalling, future generations will have a hard time believing them:

      Trump’s shortcomings have perplexed even some of his most loyal allies, who increasingly have wondered why the president has not at least pantomimed a sense of command over the crisis or conveyed compassion for the millions of Americans impacted by it.

      People close to Trump, many speaking anonymously to share candid discussions and impressions, say the president’s inability to wholly address the crisis is due to his almost pathological unwillingness to admit error; a positive feedback loop of overly rosy assessments and data from advisers and Fox News; and a penchant for magical thinking that prevented him from fully engaging with the pandemic.

      (emphasis added)

      This is coming from his “most loyal allies” and people that are “close to him.”

      Some aides and outside advisers have, in fact, tried to stress to Trump and others in his orbit that before he could move on to reopening the economy and getting the country back to work — and life — he needed to grapple with the reality of the virus.

      But until recently, the president was largely unreceptive to that message, they said, not fully grasping the magnitude of the pandemic — and overly preoccupied with his own sense of grievance, beginning many conversations casting himself as the blameless victim of the crisis.

      A quote from Trump that I predict will be hard to understand and believe:

      “This could have been stopped. It could have been stopped quickly and easily. But for some reason, it wasn’t, and we’ll figure out what that reason was,” Trump said Thursday, seemingly to simultaneously acknowledge his predicament while also trying to assign blame elsewhere.

      “But for some reason.” This reminds me of when Trump said he takes “no responsibility” for the situation we’re in. He’s convinced–he’s not open to idea that his actions and failures have made this a really bad situation.

      The article mentioned Trump’s penchant for magical thinking:

      Trump is also predisposed to magical thinking — an unerring belief, at an almost elemental level, that he can will his goals into existence, through sheer force of personality, according to outside advisers and former White House officials….

      …Some close to the president say that when Trump claims, as he did twice last week, that the virus will simply “disappear,” there is a part of him that actually believes that assessment, making him more reluctant to take the practical steps required to combat the pandemic.

      A description of the President of the United States by people close to him.

      One last thing, and I’m pretty sure I’ve said this before, but I can’t get over this point: Doing simple things like urging Americans to wear a mask will not only help the economy and make schools safer, but all these things will help his re-election. And yet it seems like a struggle to do even this simple thing.

      One big irony is that Trump and his supporters politicized the pandemic and solutions to them in a way that not only hurts the nation, but hurts themselves politically. On the other hand, Democrats and Never Trumpers who take the virus seriously and urge mask-wearing are advocating a position that will ultimately help Trump politically.

      1. “…Some close to the president say that when Trump claims, as he did twice last week, that the virus will simply “disappear,” there is a part of him that actually believes that assessment, making him more reluctant to take the practical steps required to combat the pandemic.”

        Someone (I can’t remember) tweeted: “I can’t believe that the POTUS will not make a national plan to deal with the virus.”

    7. The original post was a tweet from the Lincoln Project: “Trump doesn’t care whether your kids live or die.” Here’s what Trump tweeted 20 minutes ago:

      To add weight to the Lincoln Project’s claim, read this op-ed by the head of a small school district in Arizona.

      Also, a letter from Arizona’s school superintendent:

    8. video of Trump saying 31 times the virus will disappear.

      I tried to find the WaPo video clip of this, but I couldn’t. So the link is to comedian Jim Gaffigan’s instagram account, where he’s posted the clip. Here’s his caption:

      Can you imagine if a President bizarrely claimed a highly contagious virus would “just disappear” like 30 times over 6 months and then the virus DIDN’T just disappear? Nobody in their right mind would vote to re-elect that level of incompetence.

  48. If someone hadn’t be following the story of COVID-19 in America, Governor Larry Hogan’s (R) op-ed is a fairly decent recap, and one that should enrage the reader. One example:

    On April 6, he (Trump) declared that testing wasn’t Washington’s responsibility after all. “States can do their own testing,” he said. “We’re the federal government. We’re not supposed to stand on street corners doing testing.”

    It was hopeless, waiting around for him. Governors were being told that we were on our own. It was sink or swim. And if I didn’t do something dramatic, we simply would not come close to having enough tests in Maryland.

    Gov. Hogan eventually made deal to get 1/2 million test kits from South Korea. (Hogan credits his wife, Yumi, who is Korean-American for helping get the deal.)

    Also, Trump made comments that implied testing was no longer an issue. (“I haven’t heard about testing for weeks,”):

    As Trump was making these comments, I was requesting his approval to conduct joint testing at the National Institutes of Health. I even called Francis Collins, the head of NIH, to make this request, but he stopped me before I could. Not to argue but to plead: “Actually, Governor,” he said, “I’m glad you called, because I was going to ask you for help.” At NIH headquarters, he explained, his people had the capacity to perform only 72 tests a day. “I don’t even have enough tests for my immune-compromised patients or for my staff,” he said. He wondered if I might prevail upon Johns Hopkins, whose Suburban Hospital is across the street from NIH, to do some testing for him.

  49. Here’s question that involves math. Is it more important to track the daily counts or the overall counts? Initially, I was tracking the overall total, and watching whether the growth was linear or exponential. But now, news outlets are only giving daily counts, and it’s harder to see if the growth is linear or exponential. How would we determine this?

    Here’s what I would say off the top of my head. We could look at the current overall total (1,757, as of today). In a week, if this doubled, that would give us approximately 3,500 cases. If we divide 1,700 by 7 that would give us 240 per day. So we would be looking for an average of 240 cases per day–as that would signal exponential growth. Right now I think we’re way below that average, so can we assume the growth is linear and therefore we shouldn’t be too worried?

    1. The new stat that is common just recently is positive test versus total test. To me this stat is better than either of the stats you talked about.

      What I don’t hear now that we used to in the beginning is the results of random testing. I don’t know why we are not doing random testing anymore. I believe when Covid first came to Hawaii, we were doing these random test and I think during that time only had one or two positives. I would think it would be much higher now. Why not set up a testing booth unannounced in Ala Moana or just go to a business and ask for volunteers? We now do the “group” testing or whatever it’s called where four guys’ sample is tested at once. We could perform a lot of random testing.

    2. Are you talking about the number of people who tested positive out of the total number of people tested? I don’t think that’s a new stat, but it’s important. Less than or equal to 5% is a good number. Or are you thinking of something else? (The last time I calculated, Hawai’i was at 1%.)

      What I don’t hear now that we used to in the beginning is the results of random testing.

      I don’t recall them reporting on this, and I thought the state wasn’t doing a lot of random tests. In the early phase, wasn’t our testing capacity low? There was a debate about whether we should test more people (mildly symptomatic and asymptomatic, in addition to symptomatic) versus only focusing on symptomatic people, because a) we didn’t have a lot of testing resources; and b) CDC said, at the time, that symptomatic were the most contagious.

      As for random tests, I wonder what are testing capacity is now. Do we have enough to test symptomatic people. people who have either been near people with the virus or in high risk situations, and visitors coming to the islands? Also, if you ramp up testing–casting a wider net to random people–would that slow the time for getting results?

      1. Yeah I think the number of positive versus how many were tested may not be new, but only recently have they be showing it every time on the news, I’m pretty sure. I don’t even recall them showing on the news how many were tested as much as they do now.

        Josh Green said even without group testing the state was able to test like 5000 a day. But I’m pretty sure he means on the back end or in the lab that they can take the test in and process them. He cannot be as confident in knowing how many we can actually test. When you see that they set up those drive up testing sites, I thought they were only testing less than a thousand people. And it’s not like those are set up everyday.

        When Hawaii was announcing the random testing, I think it was only like a 100 a day or maybe even less. But to me even if it’s only a 100 a day they should do it. Over enough days, it can provide a lot of information. It may be even more valuable then testing guys that need to be tested and catching the 1% (which is currently over 5%).

    3. Yeah I think the number of positive versus how many were tested may not be new, but only recently have they be showing it every time on the news, I’m pretty sure.

      I don’t really watch the local TV news, so I’m not sure, but Civilbeat and the daily reports from the Department of Health haven’t been including this statistic, which seems odd to me. Indeed, when I read the DOH report, I have to do the calculation myself. From what I understand, it’s an important statistic, so I’m not sure why it’s not featured more prominently.

      Yeah I think the number of positive versus how many were tested may not be new, but only recently have they be showing it every time on the news, I’m pretty sure.

      I don’t think Civilbeat or DOH shows the number of tests per day–that they could do and actually do–but I could be wrong about this.

      But to me even if it’s only a 100 a day they should do it. Over enough days, it can provide a lot of information. It may be even more valuable then testing guys that need to be tested and catching the 1% (which is currently over 5%).

      Could you expand on why you think random testing is so valuable, even if you’re only testing a relatively small number of people randomly? I guess you’re thinking that this would give you a snap shot of how prevalent the virus is? But if you’re only testing a 100 people per day, that seems pretty low. All of this depends on testing capacity as well. One of my co-workers mentioned that our testing capacity and time for processing the tests have increased. But I have no idea if this is accurate or not.

      1. I’m just going by what Dr. Green said, and he said we have the capacity to test a lot more than we do. Again I think he’s talking about the back end processing of the test and not the people that are actually taking the swabs. That being said the back end seems more important, because increasing the “swabbers” doesn’t seem that monumental a task.

        I think random testing gives you a better picture of what population is spreading the virus without actually thinking they may have the virus. If a person is at Ala Moana or at work, I hope they don’t think they have a chance they have the virus. The people that go through the drive thru testing all still need to have symptoms. I don’t think the urgent cares that are doing testing require symptoms but I wonder how many test they are doing. Basically are most of the people being testing having symptoms? When they announce numbers they like to use the wording “community spread”, which seems to be spreading within the community by people that have a low chance of having the virus. Basically the person tested positive without doing anything “dangerous”. Doing random testing may give you more information about “community spread”.

    4. That being said the back end seems more important, because increasing the “swabbers” doesn’t seem that monumental a task.

      Not if there aren’t enough swabs, which I believe was the case for some states. I think I recall the Michigan governor saying they were missing one thing, and if they just got a lot of that one thing, they’d instantly be able to dramatically increase their testing.

      My sense is that the testing capacity wasn’t stymied just by a lack of technical knowledge and ability or costly equipment. It was also hurt by a failure to provide relatively basic equipment or material.

      I think random testing gives you a better picture of what population is spreading the virus without actually thinking they may have the virus.

      Yeah, but I would think the testing has to be way more than a 100 people. If you could test large numbers of people, say a quarter of the population, I could see the value of that. And if they had the resources I would think they would do something like that.

      Basically are most of the people being testing having symptoms? When they announce numbers they like to use the wording “community spread”, which seems to be spreading within the community by people that have a low chance of having the virus. Basically the person tested positive without doing anything “dangerous”.

      I thought “community spread” would refer to the rate or extent to which the virus is spreading within a given community (e.g., Hawai’i). The daily numbers of people testing positive and the percentage of positive tests would be two indicators of this.

      I don’t think it has to do with the types of people who tested positive.

      As to your first question, I don’t know if most people are having symptoms. I got permission to get a test, without symptoms, but I ended up not getting the test. My co-worker’s fiancee got tested because a patient at her office tested positive–but the fiancee didn’t have symptoms.

      1. If you use the random test to find asymptomatic people, then yes you have to test a whole lot at one time. But if you use the random test to get a feel of where we are as a community or state, then testing 1000 or 10,000 shouldn’t make that much of a difference. So when I say test a hundred, within ten days I will hit a 1000. Again I’m pretty sure when they first announced the random testing, which was very early on, they were only testing less than a hundred people. I thought that info was valuable in that it jwould almost never pull up any positive test, meaning the virus wasn’t that prevalent. But now if we are doing random testing and find 2-3 percent positive, that would say a lot.

        I’m pretty sure at least in Hawaii, when they say, “community spread” they are not necessarily talking about the person, but how the person got the virus. So if I went to Vegas and came back with the virus they wouldn’t say that’s community spread. But if you just go Costco (and not the Costco where the guy got the virus) and Safeway, and stay home, they would say that’s “community spread”, as in they don’t really know how I got it, so I must have just got it at Costco or Safeway or in the community.

    5. If you use the random test to find asymptomatic people, then yes you have to test a whole lot at one time. But if you use the random test to get a feel of where we are as a community or state, then testing 1000 or 10,000 shouldn’t make that much of a difference. So when I say test a hundred, within ten days I will hit a 1000.

      I don’t know, 1,000 seems too little. Maybe if it were truly random, but how would you insure this? For example, if you ask for volunteers, maybe those who are more worried, responsible, and cautious types would volunteers, whereas more of the risk-takers would not.

      Do you know if any other country has done used a random approach, with a relatively low numbers of tests?

      Again I’m pretty sure when they first announced the random testing, which was very early on, they were only testing less than a hundred people.

      I’m still unclear what you’re referring to here. Was this when they did drive-thrus? By “random,” anyone who could get a test could do so?

      I’m pretty sure at least in Hawaii, when they say, “community spread” they are not necessarily talking about the person, but how the person got the virus.

      OK, got it.

      By the way, you said the percentage of positive tests was 5%? Where’d you hear that? I’m wondering if my calculations and numbers are wrong. I’m just dividing the number of positive tests by the total tests (numbers from DOH). That should give me the percentage tested positive, right? If we’re at 5%, I would start to be concerned.

    6. From Civilbeat today:

      87 cases, all on O’ahu, reported today…

      But state Department of Health officials said in a news release on Saturday that test results are now delayed again due to a lag in mainland processing where many of Hawaii’s tests are now being sent. So results are taking five to seven days to come back, they said.

      “This delay may make case numbers appear lower than actual disease activity,” the press release said.

      Man, when I was going to get tested at the end of June, the doctor’s office told me it would take three days. I think my co-worker’s fiancee’s results took about three days or less, too. It must be an average, but I guess the delay has been recent.

      In the past week, 4.1% of people tested for COVID-19 had positive results, according to DOH.

      Ah, so the positive percentage is based on total testing within a week’s time frame. I was calculating my number from the total number of tests and total positives up to this point. I wonder which one is more critical. Whatever the case, 4.1% is worrisome.

  50. This Atlantic article was interesting, suggesting that people should

    In multiple studies, researchers have found that COVID-19’s secondary attack rate, the proportion of susceptible people that one sick person will infect in a circumscribed setting, such as a household or dormitory, can be as low as 10 to 20 percent. In fact, many experts I spoke with remarked that COVID-19 was less contagious than many other pathogens, except when it seemed to occasionally go wild in super-spreader events, infecting large numbers of people at once, across distances much greater than the droplet range of three to six feet. Those who argue that COVID-19 can spread through aerosol routes point to the prevalence and conditions of these super-spreader events as one of the most important pieces of evidence for airborne transmission.

    Saskia Popescu, an infectious-disease epidemiologist, emphasized to me that we should not call these “super-spreaders,” referring only to the people, but “super-spreader events,” because they seem to occur in very particular settings—an important clue. People don’t emit an equal amount of aerosols during every activity: Singing emits more than talking, which emits more than breathing. And some people could be super-emitters of aerosols. But that’s not all. The super-spreader–event triad seems to rely on three V’s: venue, ventilation, and vocalization. Most super-spreader events occur at an indoor venue, especially a poorly ventilated one (meaning air is not being exchanged, diluted, or filtered), where lots of people are talking, chanting, or singing. Some examples of where super-spreader events have taken place are restaurants, bars, clubs, choir practices, weddings, funerals, cruise ships, nursing homes, prisons, and meatpacking plants.

  51. I’ve heard people cite a Henry Ford Foundation study that hydroxychloroquine is effective at treating COVID-19 patients. Dr. Fauci addresses that claim in this video:

    To me, Trump pushing hydroxychloroquine–even supposedly taking it himself (!)–and his supporters who continue to insist that it’s an effective treatment is kinda amazing. Maybe one day we’ll learn that it does help treat COVID-19, but even if this turns out to be true, Trump’s claim still would have little or no value. If I said penicillin helps treat COVID-19, and somehow that turns out to be true, does that mean I should be credited for that? Absolutely not. I’m just making that up–and I think that’s not very far from what Trump’s doing.

  52. On the heels of Vanity Fair piece on Kushner’s efforts to fight the pandemic, this WaPo article from yesterday (8/1/2020) is a good companion/follow-up.

    Another report from the Association of American Medical Colleges offered a similarly blunt message: “If the nation does not change its course — and soon — deaths in the United States could be well into the multiple hundreds of thousands.”

    and

    A national strategy, whether advanced by the federal government or by the states working in tandem, will more effectively control viral spread than the current patchwork of state and local policies, according to a study from researchers at the Massachusetts Institute of Technology published Thursday in the Proceedings of the National Academy of Sciences.

    The coordination is necessary because one state’s policies affect other states. Sometimes, that influence is at a distance, because states that are geographically far apart can have cultural and social ties, as is the case with the “peer states” of New York and Florida, the report found.

    To me, what’s said above seems intuitive and obvious, but I post it here because that’s precisely what the Trump administration has failed to do, as that recent Vanity Fair piece and others have pointed out. There are no excuses–this is another warning–a national plan and strategy should be made and implemented. To not do so would be an epic dereliction of duty.

    But there’s another theme in this article–namely, we haven’t learned. And it seems like we’re not going to learn until more people pay a price for this. The article chronicles the different responses from Democratic and Republican governors of states that are being warned their states could see a big spike soon. The Republicans governors seem to be replaying what Texas and Florida did. This is an epic of failure of leadership by the Trump, as he totally politicized the solutions advocated by experts.)

    Fauci and Birx have pointed to a critical metric: the percentage of positive test results. When that figure starts to tick upward, it is a sign of increasing community spread of the virus.

    (emphasis added)

    I’m just posting this because it provides some important information to a question I asked in a recent post positivity rates. In Hawai’i. the positivity rate in the last seven days is a little above 4%. I don’t know if that’s an increase from previous weeks, but it’s more than the overall total numbers. (I wonder what time frame for the increase is critical–e.g., one week, two weeks, a month?) If the percentage increases in the next week, I feel like that would be a really bad sign. Also, this from Johns Hopkins:

    On May 12, 2020 the World Health Organization (WHO) advised governments that before reopening, rates of positivity in testing (ie, out of all tests conducted, how many came back positive for COVID-19) of should remain at 5% or lower for at least 14 days.

    (emphasis added)

    In one way, Hawai’i might be OK because we’re below 5%. But I think the rate has been increasing, so that can’t be good.

    With regard to this, something Dr. Fauci said is relevant:

    “That is kind of the predictor that if you don’t do something — namely, do something different — if you’re opening up at a certain pace, slow down, maybe even backtrack a little,” Fauci said in an interview Wednesday….

    …“You may not fully realize that when you think things are okay, you actually are seeing a subtle, insidious increase that is usually reflected in the percent of your tests that are positive,” Fauci said.

    1. This was a really persuasive–even passionate–thread about what we should do now to deal with the virus. The thread is by Andy Slavitt who is the former Acting Administrator of the Centers for Medicare and Medicaid Services (March 2015 to January 2017). I don’t know how much of an expert he is, but I’ve also seen him interviewed on cable news shows. I don’t know if this is enough to make him a trustworthy source or an expert one should listen to, but what he says sounds pretty consistent with my understanding of the consensus among experts, and I agree with what he’s saying.

      The basic point: We should make COVID-19 the single most important priority, and we can get control of it in 4-6 time frame. If we make this sacrifice, we can have all the other things we want. Indeed, all these other things–a growing economy, sending out kids to school, going out to bars and restaurants, resuming sports–depend on this.

      COVID Update August 1: I suggested that the US consider the option of throwing every resource at defeating the virus for 4 weeks to get back to normal.

      To do this, we would need to make the decision that crushing Coronavirus is the single most important thing. We aren’t. 1/
      If you haven’t seen it is summed here.

      Why should defeating COVID-19 be the single most important thing?

      Because it is the pathway to everything else: safe schools, hiring, reuniting families, in person voting, travel, bars & restaurants, and sports.2/

      coronavirus.medium.com/we-can-elimina…
      We choose to make each of these things equally important— & therefore really get none of them.

      In fact we also make our supply of beef, restaurant delivery, bars, and well— an obscure extension of our civil liberties— the right to breathe on strangers— equally important.3/

      The other reason this is so important is because the American way we prize makes this crisis harder to solve. 4/

      We are asking Americans to defy how we’ve been trained. We bestow everyone here with the belief that if we look out for ourselves, capitalism & individualism will somehow benefit society.

      While that strategy has created great wealth, it has made for a selfish nation.5/

      So that now when we need people to take actions to benefit others, from wearing a mask to avoiding crowds even if the data they’ve seen leads them to feel confident they aren’t at risk, it’s like asking a country to levitate. Who us? 6/

      We have little national culture of caring about each other and our society as much as we do ourselves. 7/

      So 4 weeks. 4 weeks or so is not only about what it takes to flatten the virus, I think it’s all we can possibly ask of many people. And even then we’d need to sell it hard. 8/

      But you might argue, what is more important than our kids & their education? What about people with mental health conditions? What about people who have invested their whole adult lives & savings in a small business?

      How can we risk them because of the virus? 9/

      It’s because those things are so important that we have to commit those 4 weeks. That will allow us to salvage these things and live at 95% of normal vs. today where we live at 70% of normal. 10/

      Because we need to rescue ourselves from ourselves, if we don’t give 4 weeks, pulling out of the 70% existence makes it less & less likely with each day.11/

      As long as we’re confessing some of our flaws, here’s another one: we have to have things now and we don’t trust cause & effect even though we’ve seen it around the world.

      Short term sacrifice for a few weeks seems unimaginable. 12/
      Since I released that piece, I hear a lot of: but what about our kids? School? Or other important things.

      If I say we could send them safely October 1, walk them there confidently, or gamble with no tests or confidence September 1, what do you say? 13/

      There’s a guy on Twitter @kerpen who all he does now is tweet about schools. Bif school guy. He insults people & calls anyone who disagrees with him anti-child.

      Oh, so he’s an educator? A pediatrician? A a lifelong passion for child development? Or maybe not? 14/

      His political favorites are the people who put kids in cages & won’t do a thing to address school shootings, but there’s a new found importance in starting schools on time and how wonderful our children are.

      I hope it’s sustained. 15/

      Yes, we know in person school is vital. Got it. But the start date matters only if you’re worried about the economy.

      The start date doesn’t matter. The number of kids educated for how long & how well is what matters.

      4 weeks & we can do that. 16/

      Managing a national crisis requires a few things. I did this in 2013 and I learned a lot. I’ve also spent time talking to the people who managed the financial crisis.

      Right now we are following none of the principles to get out of this crisis. Here they are… 17/

      1. Decide the single most important thing. Solve that & do the best you can with everything else.
      2. Communicate on a regular cadence why the priority is what it is & report on progress.
      3. Take accountability for every tough decision. Give out credit for each success.18/

      4. Bring in the best people in the world and empower them.
      5. Coordinate with people on the ground & state & local leadership to provide resources, solve problems & coordinate.

      You can decide on a scale of 0 to 5 how we’re doing. 19/

      One of the hard parts is sticking to the most important thing. Tim Geithner had to make a decision whether to bail out banks or risk total financial collapse. His most important thing was to save the economy & so he did what he and many felt was an unpleasant thing.20/
      This situation here isn’t nearly as tricky. For the simple reason that it’s only 4 weeks of sacrifice.

      The Great Depression was a decade. WWII was 6 years. I would be embarrassed to tell my grandparents we couldn’t hack 4 weeks.21/
      We’ve sent 18 year olds to war & yet some of the parents sending their kids off to college this year are complaining their kids are being “forced into a single without their roommate.” 22/
      I’m just going to say this to the parent on the parent chat page, to the new found champions of public schools, to people with more serious concerns: this is a global pandemic.

      Sorry it’s inconvenient.

      We can’t have everything for once. We have to pick.23/
      Once we pick, it’s not as if we can’t have anything else. But you have to choose?

      Rather have bars open or schools?
      Rather have nurses and doctors working or food delivery?

      And Congress & the rest of us have to financially support those making a sacrifice. 24/
      How about a one-time tax in corporations making excess profit from the pandemic?
      How about a one time surcharge on people who are well off & safe to support everyone who isn’t?

      25/
      I promise this won’t be much longer, but I have something else to say.

      Drop me any time. 26/
      And that is this: consider the alternatives.

      One alternative is not to choose the most important thing, to go on just like this and hope that a vaccine changes everything. That’s a big hope. We may feel like we‘re entitled to that. But science doesn’t always work that way.

      27/
      In 6 months, things could be better but they are likely to be only partially better. And 6 months could mean another 50,000 to 100,000 deaths.

      What is possibly worth that price? Why do we even have the power to make this decision? Some personal liberty?

      28/
      We’re belittling science just as we expect it to rescue us.

      29/
      Another alternative is pick something else as the most important thing.

      The president has chose his re-election. But there are other options.

      The economy.
      Education.
      Mental health.
      Treating others illnesses.

      Ok, explain to me how that would work. What happens… 30/
      Show me the plan.
      Show me the plan to make the economy better without addressing the public health crisis.
      She me the plan to educate our kids without addressing the pandemic.
      Show me the plan to end people’s anxiety without addressing the COVID-19.

      I’ll wait. 31/
      I’ll read below. Go ahead and put the ideas here. Link to an article.

      Link to one that says we can get herd immunity.
      Link to one that shows people under 55 are unlikely to die.
      Link to one that shows the “cure is worse than the disease”

      The tell me how the f*ck it happens. 32/
      Use the following metrics: Lives lost, amount of disease, pick up in GDP, increase in jobs, length of the recession.

      It’s hard. Because these things aren’t plans. They’re contrary sound bites— partial truths. They assume facts that don’t exist around how this spreads. 33/
      All of those storylines are just an excuse to do nothing. To decide we shouldn’t have to pay a cost. That we shouldn’t have to inconvenience ourselves. To sacrifice. FOR PEOPLE WE DON’T KNOW AND ARE MORE AT RISK. 34/
      I don’t blame these people. We’ve been taught selfishness and privilege from an early age. Some of us believe we’ve achieved so much because of the rugged individualism & our amazing talent (not because we stood on the shoulders of other generations & the backs of other races).35
      (I know I need to stop making you read all this very very soon). 36/
      But ask ourselves what is wrong with us?

      It’s not an insult. It’s a question we’re supposed to ask when we fail.
      Not are we bad individuals but are we bad as a collection?
      Can a society that has little value for so many people’s lives afford not to re-examine.
      37/
      Let’s pick the most important thing. That thing is each other. That thing is a chance for people to live and thrive. That thing would make us the country we never were but strive to be.38/
      Never quit on each other. Never quit on this country. Criticize it. But be willing to do the hard work to improve it if you love it and love the people in it you’ve never met.

      Now I’m done.

      /end

      As an aside, I agree we, as Americans and less communally-oriented–but I don’t think we’re as individualistic and selfish as Slavitt claims. With a different president–who wasn’t actively trying to divide us–I think the number of Americans behaving in a selfish manner would be way, way smaller. With a normal president, we’d be in a similar position to European countries, Canada, and New Zealand–because a normal president wouldn’t be a) grossly incompetent and b) trying to divide the nation for political purposes.

      This was a much, much more condensed version of the above. I think you could modify this to include the economy, restaurants/bars, sports leagues, and voting, as well.

  53. In ‘sobering’ warning, Lt. Gov. Green says Hawaii ICUs could be full by the end of the month from KHON

    Not good, man.

    Some thoughts that come to mind, that may be slightly tangential:

    Let’s suppose that for a significant group of people going to bars, restaurants, beaches, gyms–places with large gatherings, including indoors–is almost irresistible. If this is true, my thoughts turn back to the idea of quarantining towns/cities–that is, putting them in a bubble. Within those towns, the people would be able to social as much as they want–although if you don’t live in a town with a beach, you’re out of luck. Additionally, many of your friends may live outside your town–you’d be out of luck, too.

    Actually, the whole quarantining of a city idea seems too impractical. On the surface, the disruption would seem to way to much….I wonder if you could quarantine a significant amount of people and then created an area–with restaurants or bars–where the quarantined people could go. The thing is, those places may not be so attractive and appealing, and ensuring that only quarantined people went there would be hard to enforce.

    These ideas seem untenable. But think of what life will be like for the next several months, at least–gradually open, then the virus spreads, gradually close up, repeat. To make matters worse, the virus may spread to the point of overwhelming hospitals. This path is pretty disruptive itself.

    By the way, the quarantined city idea is in line not only with the bubble approach in sports, but it’s also consistent with the co-hort approach in schools. If one child gets the virus, the cohort quarantines–but the whole school can proceed. Similarily, if one town has an outbreak, then you shutdown the town. Also, contact tracing should be a lot easier.

  54. COVID-19 Has Overwhelmed One Essential Strategy To Control The Virus from Civil Beat

    …the state’s epidemiologist told a state Senate panel Thursday that the department still has only 105 contact tracers actively working.

    And that isn’t enough, said State Epidemiologist Dr. Sarah Park.
    To be effective at keeping cases confined to small clusters, contact tracers generally need to reach all potentially infected people within a day or two. Now, with the state facing a surge of more than 100 new cases a day, it takes three to four days for the workers to track down all of the people those infected with the virus have been in close contact with, Park said.

    But during Thursday’s testimony before the Senate Special Committee on COVID-19, Park downplayed the importance of contact tracing, saying that some states no longer even do it. Park ultimately blamed the public for the surge in cases. She cited beach and house parties and other gatherings that people should have known not to engage in as causes for the surge in cases that quickly overwhelmed the system.

    “What we could not have predicted, quite frankly, is how badly our community would behave,” she said.

    (emphasis added)

    I don’t know if she’s taken out of context, but my first reaction was a degree of outrage. Maybe you couldn’t predict how badly they behaved, but you shouldn’t be too surprised by it, either. More importantly, making contact tracing a lower priority based on your expectation that the public will do a good job of complying with best practices seems very unwise.

    Here’s a more damning part:

    According to those standards, a locale with a population the size of Hawaii would need about 420 contact tracers during a pandemic. Although Park pushed back at the time by saying the department could bring on trained contact tracers quickly if they were needed, advocates like Caldwell warned that if the department waited until there was a surge, it would be too late.

    (emphasis added)

    If she really “pushed back” and claimed DOH could “bring on trained contact tracers quickly,” that seems to really reflect badly on her.

    In a Hawai’i News Now report, Park says the following:

    Although the Health Department says it has access to nearly 450 contact tracers trained through a University of Hawaii program, Park contends bringing them on is not that easy.

    “You cannot just take someone because they have clinical background or epi background,” Park said.

    “They have to be trained on what we do. If you’ve never done what we do, you can’t just start day one, you are gonna cause more problems than help.”

    (emphasis added)

    She seems to have contradicted herself–or there is some breakdown in reporting or communication. I can’t help but be annoyed, though, and it does make question Park’s competence. (In the article, lawmakers talk to the contact tracers. Some of the conversations don’t sound good, too.)

    Here’s some (more) evidence (from the CB article) that there is a breakdown in communication (and I tend to put more of the onus on Park):

    After the meeting, Sen. Donovan Dela Cruz said he was shocked by Park’s apparent backpedaling on contact tracing. He said that months ago, when some people were calling for more aggressive testing, health department officials were pointing to contact tracing as the key.

    “When people were pushing testing, she said it was all about these other things,” Dela Cruz said.

    1. From two days ago, Controversial State Health Official Ousted From Leading Virus Tracing Effort from Civil Beat

      Gov. David Ige said Tomiyasu and a recently hired investigations branch chief, Emily Roberson, now will be in charge of leading the inquiries, including contact tracing, meant to identify and contain the virus.

      “I have directed them to accelerate the increase in contact tracing so that we can meet the demand of those additional cases that we’re seeing,” Ige said.

      Questions:

      1. Are the replacements–Danette Wong Tomiyasu and Emily Roberson–more competent than the people they’re replacing?

      2. In the post above, Dr. Park is quoted as saying, ““You cannot just take someone because they have clinical background or epi background…They have to be trained on what we do. If you’ve never done what we do, you can’t just start day one, you are gonna cause more problems than help.” If that’s true, my concern would be these new people the DOH is bringing on–are they adequately trained or are they being rushed in, unprepared, because of public pressure? As bad as things may be, I worry that bringing in improperly trained contact tracers may make the situation worse. I hope the Governor isn’t just caving to pressure.

  55. Take this thread with a grain of salt, but this gave me some real hope:

    BREAKING: Great news.

    SalivaDirect received approval this morning from the @US_FDA.

    This could be one the first major game changers in fighting the pandemic. Rarely am I this enthusiastic. Here’s why.

    Follow if interested.
    1. One reason? Saliva.

    We already have it. We don’t need to export it from Italy or run out. We don’t need to stick something 4 inches up a kid’s nostril.

    But that’s just the start.
    2. The second reason is profit. Or lack thereof.

    SalivaDirect is a protocol of how to do tests with whatever equipment you have as long as it gets approved by Yale (who developed the protocol).
    They decided not to sell a specialized kit (so they didn’t have anyone run out).

    They are turning testing from a bespoke suit to a low cost commodity. I’ve been writing about this goal for months.
    The cost of the materials are about $4. This test should be very cheap even if you add labor and overhead. Not the $100 for current tests.

    This is important for the next reason— so important…
    3. The most important reason is because the most important testing feature is CADENCE. How frequently can we test people.

    At a $10 test, you can test every day or every couple days. This is even more important than accuracy. But on accuracy…
    4. Official data shows 88-94%. If you assume 90% sensitivity, this is the best accuracy (sensitivity) of any saliva test.

    (It also means if you took it twice, for $20, you would have 99% accuracy).
    5. This is important because of schools. Universities. Office buildings. For wide testing of asymptomatic people.

    They are all getting introduced to the test in the next few weeks.

    You can’t spend $100 multiple times/week on a person’s point in time test.
    6. Turnaround time. SalivaDirect can be pooled for faster turnaround.

    In addition, labs around the country will be authorized to be able to do the test if they show they have the basic equipment.
    7. For all of these reasons Saliva Direct should create millions more in test capacity. Easy to use. High volume. Cheap. Widely available and accurate.

    About SalivaDirect
    Regularly testing large numbers of people will play a huge role in monitoring transmission of SARS-CoV-2. Quickly detecting and isolating active cases – people who can transmit the virus, whether sym…
    https://covidtrackerct.com/about-salivadirect/
    Do I sound like I’m advertising? You couldn’t be blamed for asking who is making money at this. Or who could. Or how could it get screwed up.

    Because the pandemic is nothing but a profit making effort for many.
    The people who created this test— a special alliance of folks who came together. Run by @YaleEMD and the @NBA with leadership by @robbysikka.

    Not only are they not making money, they invested money, time & resources. They are making $0.
    Let me say again $0. And they are committed to always making $0.
    What’s the catch?

    Does that mean others won’t try to make money at this test? No.

    You could imagine somebody getting approved for a test that cost $4 and trying to charge $100.
    How we prevent that is our next challenge?

    Public pressure and awareness is a part of this. This should be a kick off to a lot of new lower cost high quality tests.

    And some testing companies aren’t going to like this.
    Side note: if this were any other country but the US, this wouldn’t be a worry.
    It’s a perfect turn of the road to see if profits or our country are more important.
    If you want access to implement in a lab, here is how.

    Coronavirus (COVID-19) Update: FDA Issues Emergency Use Authorization to Yale School of Public Health for SalivaDirect, Which Uses a New Method of Saliva Sample Processing
    The FDA issued an emergency use authorization to Yale School of Public Health for SalivaDirect, a COVID-19 diagnostic test, using a new method of processing sal
    https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-yale-school-public-health
    When can you get? I expect it to be a short time before labs start coming online. Will keep you posted.
    Congratulations and great thanks to patriots:

    @NathanGrubaugh
    @awyllie13
    @VogelsChantal
    @robbysikka

    Very proud to know you all. /end
    If you want more context, here is our comprehensive national testing strategy and how Saliva Direct fits in.

    Why Testing Improvements Are So Critical | by Andy Slavitt | Aug, 2020 | Medium Coronavirus Blog
    It’s time to talk about testing again. Everyone thinks we are doing it badly and we are. Until we do better we are not going to be close to back to normal. Tests to confirm people with symptoms are…
    https://coronavirus.medium.com/why-testing-improvements-are-so-critical-c2713f925861
    In May, when the White House task force ended, I was calling for very close to what Saliva Direct is doing.

    We need to make tests commodities. See how.

    Here’s How The US Can Start Testing More People for Covid-19 | by Andy Slavitt | Medium Coronavirus Blog
    It’s time to turn Covid-19 testing into a real industry so that every American who wants a test can get one. But instead of taking that on, the White House task force is abandoning ship. This is a…
    https://coronavirus.medium.com/heres-how-the-us-can-start-testing-more-people-for-covid-19-ed3f10bb9952
    Here is a background story on the development of the test.

    FDA allowing saliva-based test funded by NBA
    The U.S. Food and Drug Administration issued an emergency authorization on Saturday allowing public use of a saliva-based test for the coronavirus developed at Yale University and funded by the NBA a…
    https://www.espn.com/nba/story/_/id/29667299/fda-allowing-saliva-ba

  56. Neal Milner excoriates everyone–the Ige, Bruce Anderson and DOH, the Legislature, the media, and even the public in this Civil-Beat op-ed.

    With regard to the media and the public, I think it comes down to this: We should have known the DOH would mishandle this. I admit I had faith they would handle this well, I thought two things would make this different: 1) this was a really serious situation; and 2) I thought the Governor would cautious and careful about all this.

    Right now it does seem like this is wrong. What makes me hesitant is that, on the outside, it’s hard to know what’s going on in the inside–maybe there are challenges and obstacles that we don’t know about. Still, it does seem like the State really messed up.

    What do you guys think?

  57. Thread from Jake Tapper regarding the above:

    So what just happened and why?

    Among those skeptical there’s enough data to justify emergency authorization of plasma for COVID-19: Dr. Francis Collins of National Institutes of Health; Dr. Tony Fauci and H. Clifford Lane of National Institute of Allergy & Infectious Diseases.

    2/ These experts have said they don’t think the biggest study yet of this treatment, from Mayo Clinic, was sufficient. They want more data. Two major studies are currently being conducted. (link)

    3/ There’s disappointment being expressed among health experts by what happened today, especially in @SteveFDA
    , who for the second time (the first being with hydroxychloroquine) has seemed to them to bend to political pressure rather than following scientific protocol.

    4/ here is more from FDA

    Also, this

  58. Controversial change in guidelines about coronavirus testing directed by the White House coronavirus task force from WaPo, yesterday (8/26/2020)

    An abrupt shift this week in government testing guidelines for Americans exposed to the novel coronavirus was directed by the White House’s coronavirus task force, alarming outside public health experts who warn the change could hasten the disease’s spread.

    The new guidance — introduced this week, without any announcement, on the Centers for Disease Control and Prevention website — replaces advice that everyone who has been in close contact with an infected person should get tested to find out whether they had contracted the virus. Instead, the guidance says those without symptoms “do not necessarily need a test.”

    Was Dr. Fauci a part of this? Brett Giroir says he was. Fauci disputes that:

    Fauci contradicted aspects of that, however, in a statement he gave to CNN’s Sanjay Gupta. “I was under general anesthesia in the operating room last Thursday and was not part of any discussion or deliberation regarding these new testing recommendations … I am concerned about the interpretation of these recommendations and worried it will give people the incorrect assumption asymptomatic spread is not of great concern. In fact, it is.”

    I think Fauci is probably the only and last guy I trust in the administration at this point. If he does something that makes it seem like his succumbing to political pressure, I fear I will be mistrustful of anything the federal government says or does. On that note, here’s what happened today:

    FDA has to walk back, now CDC. Ultimately, this is good, but it seems like the what they said initially was politicized–and that ultimately erodes trust. I know it does for me.

  59. I don’t know who this person is, but I saw a lot of people I tend to trust re-tweet this thread. If it’s accurate, there’s an interesting idea here–namely, that we could test wastewater to potentially control outbreaks. In the thread, he explains the way the University of Arizona tested the wastewater of college dorms. It eventually tested negative, and then they tested all the people in the dorm. Two asymptomatic students tested positive. They were immediately isolated.

    If this is accurate, this might be a way to prevent outbreaks in schools or work places. We’d have to have to have the capacity to test the wastewater regularly and be able to test all the people at either location.

    What other places could this be useful (i.e., specific work places)? If they could do this at hotels, this could really help the tourist industry.

    But again: I can’t vouch for this person. As far as I know, he’s an author (and not on a subject related to epidemiology), not a person with relevant expertise.

    1. I haven’t read the article and I might not. But I have to say one thing I’m discouraged about is the way people are suddenly experts on contact tracing, a thing I never heard of until five months ago. Everything I know about contact tracing is from Hawaii’s government officials, but I’m hearing criticism from all over from people whose expertise on the subject I question. Where do all these people suddenly know so much about epidemiology and public health?

    2. I’m wary of claims and recommendations from non-experts, and I generally try to shy away from them. I’m not sure of the specific criticisms you have in mind. If non-experts are criticizing policies and/or recommending their own, especially against the consensus of leading experts–I really don’t care for this sort of thing.

      But if the criticisms are about the failure of DOH to execute the recommendations made by experts, than those criticisms seem valid and appropriate. According to articles, sometime in the spring, Dr. Park said they would have enough contact tracers, that they could ramp the number up in time. That doesn’t seem to be the case, and when the some state legislators went down to DOH and saw the low numbers of contact tracers, Dr. Park, around that time, mentioned that it takes time to properly train the contact tracers, and it would be counterproductive to have them working without proper training. Maybe there is some communication breakdown, but this sounds bad, and it’s understandable that the public would get mad at this.

      Additionally, my sense is that contact tracing is a key component to preventing outbreaks. And it seems like DOH doesn’t/didn’t have the adequate numbers of contact tracers. Had they communicated the lack of adequate contact tracers to the Legislature and the public, I would be less upset. Now, maybe they did communicate it, but I just never hear this. I don’t know.

      Finally, in the article, the person who replaced Dr. Park is now asking for leave because she is confused about the chain of command.

      Bottom line: It sounds like a really bad mishandling of the situation.

      (Note: While I’m discouraged and annoyed, I do have a sympathetic angle on this, and I might write about this later.)

      1. Dr. Park is the expert. Under what credible authority do the state senators and other bureaucrats say she dropped the ball? This is what I’m talking about. I’m not saying she didn’t screw up, but I have no basis for saying whether she did or didn’t, but why do they?

    3. I would recommend this Civil Beat article, written on May 8, 2020.

      The article mentions criticism about the low numbers of contract tracers. DOH listed 30 at the time, but later said they doubled that amount.

      Regardless, even the revised, bigger number is much lower than what most state and public health officials want. According to standards published by the National Association of County and City Health Officials, which the committee is using, a locale with a population the size of Hawaii would need about 420 contact tracers during a pandemic.

      I have no idea if that document is based on experts, but that would be my assumption.

      But is there any dispute now that DOH failed in providing the adequate number of contact tracers?

      I would recommend scrolling up to my August 7, 2020 post above, too, including checking out the two articles I link. Parks’s own words, if reported accurately, make her look really bad.

  60. Can this be correct? Maggie Haberman of the NYT re-tweeted this. (I checked the University of Colorado, Denver website–and this guy is a professor there.)

  61. Failure To Communicate: How The State Lost The Public’s Trust And How It Can Get it Back from HPR

    I just wanted to comment on the part that made my heart sink:

    But Hawaii Pacific Health’s (President, Ray) Vara says the lack of public trust goes beyond the lack of data….

    … He listed what is missing:

    “It’s a culture of leadership. It’s a culture of action orientation. It’s a culture of accountability. It’s a culture of transparency,” Vara said. “Unless we see significant change in that entire culture beyond just individuals providing leadership, I think we’re still going to struggle.”

    My heart sank when I read this. Here’s why: If, over decades mediocrity and a lack of transparency was the norm for DOH (or any government agency)–that is, it was tolerated by policy makers and the public–is it reasonable to except DOH to now perform at an optimal level and communicate transparently and effectively with the policymakers and the public?

    If mediocrity and lack of a transparency are by-products of the current culture, and a massive overhaul of the culture has to change if we want better performance and communication, then it’s hard to be optimistic. Changing the culture of an organization seems like a massive, painstakingly long project.

    My hope is that administrators now have a greater desire and demand for good ideas and employees who can execute them, and because of that they’ll look for these employees and give them support and freedom to function well. I feel like this is something feasible without a massive change to the culture.

    However, does the DOH have enough of these employees? That is a key question. And even if they do, asking the department to function in a significantly different way is asking a lot. I’m hoping they don’t have to function too differently.

    On a related note,

    One critical move that impacted transparency was Gov. David Ige’s decision to suspend the state’s open meetings and open records laws, giving the public and the press fewer ways to check on how state and county agencies were performing during the pandemic.

    One thought that came to mind: What if the Governor is doing this because the truth is horrific–e.g., if he were transparent, the public would see gross incompetence and ineptitude. And let’s suppose the truth is that significant changes and improvements are not likely. What is the right thing for a Governor to do in such a case?

    I really don’t know the answer to this.

    On another note, I feel like this should be a wake-up call for administrators in other departments.

  62. Letter from 98 Stanford “infectious diseases physicians and researchers, microbiologists and immunologists, epidemiologists and health policy leaders.” denouncing former colleague, Scott Atlas, who is now advising Trump White House.

  63. I find this helpful and somewhat reassuring, although I’m still kinda nervous that even someone like Fauci may succumb to political pressure.

  64. Why do some COVID-19 patients infect many others, whereas most don’t spread the virus at all?

    This is an older article (May 2020) that I heard about online. I need to read something more current, but I do think a lot of it is still pertinent. The key takeaway: a small percentage of people are responsible for the vast majority of the spread. That is, a large number of individuals who get COVID-19 end up never spreading it.

    The implication is that if we can identify and prevent superspreader events–i.e., events where the most contagious people are in contact with the most people–then we can contain the virus.

    Actually, shouldn’t we try to understand and then identify the individuals that are more contagious? That’s where my thoughts turned to first. The downside is that these people may be stigmatized and mistreated–which isn’t a small thing.

    But identifying spreading activities should be problematic (right?). Banning these activities might be more challenging. In Hawai’i, the first thought that comes to mind are parties–at people’s homes and a the beaches and parks–particularly birthday parties or graduation parties.

    Notes from the article:

    Most of the discussion around the spread of SARS-CoV-2 has concentrated on the average number of new infections caused by each patient. Without social distancing, this reproduction number (R) is about three. But in real life, some people infect many others and others don’t spread the disease at all. In fact, the latter is the norm, Lloyd-Smith says: “The consistent pattern is that the most common number is zero. Most people do not transmit.”

    That’s why in addition to R, scientists use a value called the dispersion factor (k), which describes how much a disease clusters. The lower k is, the more transmission comes from a small number of people. In a seminal 2005 Nature paper, Lloyd-Smith and co-authors estimated that SARS—in which superspreading played a major role—had a k of 0.16. The estimated k for MERS, which emerged in 2012, is about 0.25. In the flu pandemic of 1918, in contrast, the value was about one, indicating that clusters played less of a role.

    (emphasis added)

    Individual patients’ characteristics play a role as well. Some people shed far more virus, and for a longer period of time, than others, perhaps because of differences in their immune system or the distribution of virus receptors in their body. A 2019 study of healthy people showed some breathe out many more particles than others when they talk. (The volume at which they spoke explained some of the variation.) Singing may release more virus than speaking, which could help explain the choir outbreaks. People’s behavior also plays a role. Having many social contacts or not washing your hands makes you more likely to pass on the virus.

    I feel like the understanding the people

    Some situations may be particularly risky. Meatpacking plants are likely vulnerable because many people work closely together in spaces where low temperature helps the virus survive. But it may also be relevant that they tend to be loud places, Knight says. The report about the choir in Washington made her realize that one thing links numerous clusters: They happened in places where people shout or sing. And although Zumba classes have been connected to outbreaks, Pilates classes, which are not as intense, have not, Knight notes. “Maybe slow, gentle breathing is not a risk factor, but heavy, deep, or rapid breathing and shouting is.”

    (emphasis added)

    If public health workers knew where clusters are likely to happen, they could try to prevent them and avoid shutting down broad swaths of society, Kucharski says. “Shutdowns are an incredibly blunt tool,” he says. “You’re basically saying: We don’t know enough about where transmission is happening to be able to target it, so we’re just going to target all of it.”

    Edit

    This Overlooked Variable Is the Key to the Pandemic from theAtlantic. Really interesting article. Recommended.

    Overdispersion should also inform our contact-tracing efforts. In fact, we may need to turn them upside down. Right now, many states and nations engage in what is called forward or prospective contact tracing. Once an infected person is identified, we try to find out with whom they interacted afterward so that we can warn, test, isolate, and quarantine these potential exposures. But that’s not the only way to trace contacts. And, because of overdispersion, it’s not necessarily where the most bang for the buck lies. Instead, in many cases, we should try to work backwards to see who first infected the subject.

    Because of overdispersion, most people will have been infected by someone who also infected other people, because only a small percentage of people infect many at a time, whereas most infect zero or maybe one person. As Adam Kucharski, an epidemiologist and the author of the book The Rules of Contagion, explained to me, if we can use retrospective contact tracing to find the person who infected our patient, and then trace the forward contacts of the infecting person, we are generally going to find a lot more cases compared with forward-tracing contacts of the infected patient, which will merely identify potential exposures, many of which will not happen anyway, because most transmission chains die out on their own.

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