Journaling the Coronavirus, Monday April 13th: New York is at the end of the beginning; behold the power of Cuomo’s powerpoint slides

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Welcome to another pandemic Monday. After weeks of listening to the president’s chaotic, information-free zone pressers, I took the weekend off. I think it was him wishing everyone a “Happy Good Friday” that did it. If you’re not sure what a happy Good Friday looks like, well, I guess the Life of Brian provides the appropriate example.

An early morning visit to the beach and a productive weekend of keyboard pounding later and I’m feeling less apocalyptic. Writing helps; a friend asked me if I felt differently about writing horror now that we’re living in a Stephen King novel. The answer is no, because we’re not living in a Stephen King novel, not by a long chalk (as one of his characters likes to say). Don’t quote The Stand at me, the mortality rate for Captain Trips (as the weapons-grade flu was known) was 98%. We’re in an emergency to be sure; people are dying and it is not an exaggeration at all to say any one of us could be next if we don’t follow the rules to not get infected – but with Captain Trips you were either born lucky (immune) or not, it was pretty stark. The only thing Stephen King-ish about the current scenario is that Donald Trump is our president.  

The number of deaths has more than doubled in a week’s time; more than 22,000 peopled have now died from COVID-19 in the US – more than any other country in the world. The peak in domestic cases was expected on April 11, according to the Christopher Murray model the White House has been quoting – I wonder if the data show the peak now behind, or still in front of us?

Britain’s Prime Minister Boris Johnson was released from the hospital after spending a week in intensive care, seriously ill with COVID; in his proof of life video on Twitter, he called their National Health System “the beating heart of this country” and credited them with saving his life, no question. I was happy to hear of his recovery, and I hope all Republicans have to answer the question over and over and over, why can’t we have what the other first world kids have? 

It took 22 days, but as of Saturday every state in the union is now under a major disaster declaration for the coronavirus pandemic, with New York being the first and Wyoming being the last. The death toll in the US, more than 22,000, is the highest in the world. New York is now the global epicenter of not just finance and culture but also COVID-19 – they’ve had more than 10,000 deaths in the greater metro area, but the news is not all bad; admissions are increasing but that increase is flattening. The three day rolling average of new hospitalizations, ICU admissions and intubations are all down. Even when delivering the good news, Governor Cuomo keeps it in context, saying “It’s flattening, but at a horrific level of pain and grief and sorrow.”

I am here to tell you that the antidote for Donald Trump is Andrew Cuomo; the governor of New York’s pressers are everything the president’s are not. They are reassuring in the extreme mainly because the reassurance is all derived, not spouted. Also he makes excellent use of power point, so you can not only follow along but have the benefit of a visual underscoring of the most important points.

Where President Trump’s pressers are full of long recitations of data that don’t shed any light on the question “What’s going on?”, Governor Cuomo is all about the facts, ma’am. Where the president mouths strange attempts at emoting (“Death is a horrible horrible word”), Governor Cuomo brings a solemnity to the reporting of the passing of his fellow New Yorkers. “The terrible news is as terrible it gets, the worst news that I’ve ever had to deliver, that 671 people died, left this world yesterday.”

The president has been getting in his subtle and not-to-subtle jabs at Governor Cuomo daily now – he’s jealous of how beloved Cuomo is, and specifically how everyone finds Cuomo a breath of fresh, competent air after the endless gaslighting of Trump at his daily white house presser, where you half expect to hear the reporters gasping for breath for lack of oxygen in the room, as Trump warms to his themes and just keeps up the bragging, brooding, and brandishing of his power at his ‘enemies’ like Cuomo. He can’t figure out why people are hailing Cuomo like hhe is the king of New York, he is starting to suspect that next to Cuomo he, Trump, is a bewigged jester sitting on a gilded throne in a broken down tower. Make no mistake, someone’s going to pay for this image of himself.

Governor Cuomo deftly turns the jabs and engages in the joust with a flair that makes you appreciate how hard the job of being a politician really is. He gets right to it in his power point with a slide entitled Why New York? which doesn’t say, but might as well say, “No, New York does not have more cases than California because of better governorship, wise guy.”

It’s about density, the governor says. “The virus is very good at what it does and dense environments are its feeding grounds.” I’m so relieved to be watching a professional presentation by a speaker who has organized his thoughts ahead of time, it is such balm to my operations soul, that my note taking is peppered with nerdy phrases like Excellent use of ppt, at one point noting OH MY GOD THAT ARE USING THE REVEAL METHOD, AND THE POINTS ARE ADVANCING IN TIME WITH HIS REMARKS!! This of course is s.o.p. for anyone with any experience regularly presenting data/information about an ongoing situation, but it’s so absent in the daily melee that is the White House briefing, you really start appreciating these normalities for the history hard-won truths they represent. 

Without ever mentioning religious services he skewers the idiots who gathered in big groups to celebrate Easter Sunday, like the infamous Ammon Bundy, the guy who got a bunch of his buddies to sit in pick up trucks with their guns and taking weepy selfies of themselves as they took over an Oregon wildlife refuge, the reason for and results of which I’ve never been clear on. Like a prairie dog he has popped up again, this time in Emmett, Idaho, where he helped organize an Easter service with 100+ attendees. Mr. Bundy asked the worshippers to defy martial law by going around shaking hands with each other, which they did, replacing being a young drunk spring breaker as the dumbest demographic cohort spreading the virus this deadly spring of 2020. 

Why New Rochelle? the governor asks of one of the early known hot spots. Well, he says, because a few infected people were in dense gatherings, and it spread like wildfire.  You can easily picture him talking to Bundy, his nose inches from Bundy’s, saying “It’s about the density, pal.” He’d come down hard on the “pal”, nice guy code for “you’re a weasel and I’m a weasel hunter.” 

“It’s not just about dense cities, it’s any person in a dense environment,” the governor says as he mounts an impressive offense that effectively closing up any chinks where Trump can get a handhold of criticism. “We have counties with more cows than people, you can be anywhere, it only takes one infected person in a room of 400 to be a disaster.”

Ammon Bundy is one of The Defiant Ones, as I call them. They are mad as a wet hen at being told what to do, a feeling I can sympathize with more than a little, having grown up with an authoritarian father. When the Defiants live in Idaho the amount of damage they do is limited; in cities, the amount of damage they do is unlimited, as was the case in 1918 in Philadelphia the defiant ones held a parade that spread the disease like wildfire and killing more than on thousand Philadelphians in ten days, and sickening another 200,000. It’s a bit of history every mayor and every governor should be aware of.

Re-opening
The heart of Cuomo’s presentation is a slide with the word Reopen in the center, surrounded by question marks. When are we going to re-ope, he says, is a question he hears a thousand times a day and though no one wants his neverending Groundhog Day of death to end more than him, Governor Cuomo tells us essentially no one knows.

“We’ve never done it before, if someone says they know what to do, you don’t know!”

~Governor Andrew Cuomo

When he says no one knows, he means, no one knows.  It’s the nature of a pandemic. It wasn’t until 2008 that researchers announced they’d discovered what made the 1918 flu so deadly.  Back here in the future, New York will be observing the warning signs from countries that have started to re-open, says the Governor. Wuhan, Italy, South Korea – let’s learn from the lessons. So we’ll listen tot he experts, we’ll follow the data is actually a slide, word for word.

As soon as the topic of re-opening is introduced, the topic of testing is introduced with it, like a bumper sticker. “To reopen, we’ll open the valve in a calibrated way, but we’ll  need more testing, more precautions while we watch the meter of infection and daily hospitalization rates,” the governor then explains the coordination between public health officials, the economic experts, transporation system  and schools that will be involved in the calibration. “These systems are big gears intermeshed with other gears,” he says and my notes have a little thought bubble “appropriate use of metaphor and simile” with a smiley.

The one thing that mainstream media has consistently unreported is a complete picture on testing: the importance, the role, the status, the progress, the prognosis. Governor Cuomo at least provides context to his remarks, again leading the way:

“We test more than any other states, more than the leading states combined and it’s still not enough. We have to do more.”

~Governor Andrew Cuomo

What is clear from the governor’s presser is, there is no going back to normal, not for a long time, not til we’ve all either had it or had a vaccine the timeline for which appears to be 12-18 months, though a rumor of a fall ready date has been floated in the media. It’s not going to be over where we flick a switch and we come out of our houses waving and hugging and the economy starts up, the Governor continues, and I picture the economy like a car that has been parked at a drive-in where we were all sitting each in our cars with our provisions of popcorn and JuJubes and Good N Plenty, watching a scary creature feature where the monster destroys the city and kills indiscriminately except for a band of plucky Gen Zsters. 

To end the presser, there is exactly the kind of final “Next Steps” slide you’d expect from any competent professional.  I find myself with room to be surprised that powerpoint is still the go-to, even after three decades.  That’s probably about to change – sure Keynote is good, but nothing has taken the place of the de facto default that powerpoint is. But somewhere out there, someone paying attention to the White House pressers and Cuomo’s and Newsom’s, are saying who knew presentation software could be such a powerful signal of dependability, competence and control?  I’ll be watching the space with interest. It’s still way way too difficult to embed media in ppt, I”m talking to you Microsoft. 

Governor Cuomo says he’ll be working on coordinating with the other governors today on re-opening plans, and will make an announcement with other governors. Gavin Newsom launched his presser today as a Planning for Re-Opening.  Watching it, I wonder if he’s just left a Zoom call with 50 other governors, similarly attired in suits which have become a kind of weird signal of both normalcy and a reminder of what was wrong with the way things were.

When all of this is over it would be cool to have a Governor’s slow pitch softball game. One of the last things Governor Cuomo says before taking questions is a stinging rebuke to the Trump administration, a citizen call to arms, meaning, the voting booth: 

“We need smart, competent, effective government now. Nothing else matters.”

~Governor Andrew Cuomo

We’re going to get through this, the governor reminds us, ending his presser in an unabashed love letter to his city, which is the real capital of America and has always been: 

We’re New York tough, and that means smart, united, disciplined, and most important loving. The toughest people are strong enough to say love, and that’s New Yorkers.  

Governor Andrew Cuomo

Takeaways from Governor Cuomo’s presser: the worst is over if we continue to be smart. We are at the end of the beginning. The healthcare workers are the heroes, and because of a lot of preventable human error they had to show even more courage than the situation called for, and we owe them as much as we owe any soldier returning from any war. 

San Francisco is being celebrated for flattening the curve and I am proud of our Mayor London Breed who moved early, swiftly and surely. San Francisco was ALSO an early standout in flattening the curve of the 1918 pandemic  –  in part because citizens in San Francisco were fined $5—a significant sum at the time—if they were caught in public without masks and charged with disturbing the peace. Mayor Breed may find herself forced to do the same; she warned us against the urge to flock on the beautiful Easter Sunday weekend, but did we listen? My husband took his daily road bike ride past a public golf course yesterday and the lot wasn’t just full, but overflowing, with well over a hundred people milling about on the course and the putting greens. are everywhere.  I’ve never seen it so crowded, he said in astonishment. 

Some history
Last week, the President said that Europe took the brunt of the 1918 pandemic; this fact underscores the greatness of the challenge he faces as president today. I tend to agree that if the average American was more familiar with the 1918 pandemic and its impact on American life, we’d have been better prepared to take coronavirus seriously as a society. Did you know that more U.S. soldiers died from the 1918 flu than were killed in battle during the war? Forty percent of the U.S. Navy was hit with the flu, while 36 percent of the Army became ill.   As it is, the death toll of COVID will be like ten September 11ths. I wonder, will we spend the same amount of time and resources defeating the system that sheltered and enabled this enemy? One can only hope. 

hydroxychloroquine
Dr. Michael Saag at the University of Alabama blogged his battle with COVID. “I didn’t know if each night I would deteriorate and have to go in the hospital, or whether I would survive the night.” He took  the drug the President is urging everyone to take (“Why not? What can it hurt?”) and reported  that he couldn’t tell if it did a hill of beans difference for me.

“Later, as I looked more into this, I’ve sort of regretted my decision because these drugs, especially when used together — the hydroxychloroquine plus azithromycin — can have electrocardiogram abnormalities, and that puts somebody at risk for sudden death. So in retrospect, I’m a little ashamed of myself that I was so cavalier.”

About the same time, a small study of chloroquine, closely related to hydroxychloroquine was halted in Brazil after coronavirus patients taking a higher dose developed irregular heart rates that increased their risk of a potentially fatal arrhythmia – by the sixth day of treatment, 11 of the 81 patients in the study had died.

Dr. Saag warns against premature re-opening without a robust process for identification, isolation and contact tracing, saying “If we just release folks back into the community and do what we were doing in February, why would it be any different?” Treasury Secretary Steven Mnuchin told CNBC he believes companies could reopen in May as long as Trump “feels comfortable with the medical issues” which is a decidedly looser set of criteria than Dr. Saag is suggesting. 

What happens if we open too soon is a question to important to be answered “No one knows” and shoot from the hip – that’s what models are for. And what the models the government has been relying on show is a rise in demand for ventilators 120 days after lifting stay-at-home restrictions that would be more severe than if we’d never sheltered in place at all. The head modeler is Christopher Murray, and he’s the director of the Institute for Health Metrics and Evaluation at the University of Washington whose forecasts have been relied on by the White House. His warning is clear

“If we were to stop at the national level May 1, we’re seeing a return to almost where we are now sometime in July.”

~Christopher Murray, University of Washington 

There are people ready to ignore the science behind Dr. Murray’s warning, and treat it like an opinion equal to their own. One of those people is Jacob Wintersteen, finance chairman for the Texas Republican Party, who thinks businesses should have the right to operate if they see fit despite the risks. What if every business had to sign an agreement: they will not start operating until masks can be provided to every employee and patron; hand washing must be available to customers before they enter the store and throughout; at the entrance vestibule your temperature is taken, social distancing is maintained, and any and all infections tracked to this place of business will be assessed a $2500 fine, which is the cost of treating an uninsured infected person for COVID-19, according to the Kaiser Foundation. This agreement signed must be laminated and posted in at least three conspicuous places around the store: entrance, cashier, and, say, the toilet paper aisle. Guys like Mr. Wintersteen are big on talk about rights, but light on talk about accountability, a bad balance in a pandemic. It’s not even clear who he represents – a survey of business leaders and market participants this week by S&P Global found that only 12 percent of respondents believed the economy would make a “quick complete recovery” soon.

One thing the 1918 pandemic makes clear: the cities that were most aggressive at mitigating were the most successful at mitigating…and were also the fastest growing cities after the flu. 

Food insecurity
In San Antonio, a mobile foodbank attracted 10,000 people in a single day, and my mind burns iwth the images of milions of pounds of vegetalbes and gallons of milk being destroyed all across the country. If this isn’t an indictment of our system, I don’t know what is. 

Masks
My husband busted out the sewing machine and used some of my collection of colorful napkins to sew custom masks.  I was reading yesterday, some of Trump’s supporters are a tad less supportive in the way he’s handling the pandemic. One father whose son caught COVID on spring break lamented the president’s decision not to wear a mask, himself. A lot of people are like President Trump in the not wanting to wear a mask thing. It’s the same as it ever was; back in 1918 a politician took to the papers to complain against the recommendation, asserting  “Only highwaymen, burglars, and hold-up men wear masks professionally.”  

Dr. Fauci R US
Polls now show that Dr. Fauci – Uncle Tony, as I think of him – is the man Americans trust most, and as soon as I read that I thought, uh oh. President Trump hates when anyone steals the limelight, especially if that person can’t easily be fired without backlash. Dr. Fauci being rated the most trusted man in the same poll where more than half of respondents said they disapprove of the President’s performance, will basically have the same effect as painting a target on Dr. Fauci’s back.  When he said during a CNN interview that more lives could have been saved from the coronavirus if the country had been shut down earlier, you could almost hear the twang as Twitter trolls let their “Time to #Fire Fauci” arrows fly. The president retweeted the hashtag, and if he didn’t hear the theme music from Jaws as he did so, I sure did. The Chinese are calling COVID-19 the US virus, a bit of disinformation judo that will fuel a thousand conspiracies for a thousand years.  In response the president will again insist that he banned China, he closed China, he stopped China, but in fact 40,000 travelers have arrived on American shores from China since the president’s order.So Fauci is right to say that, if we had, right from the very beginning shut everything down, it may have been a little bit different. But there was a lot of pushback about shutting things down.” The emphasis is mine, I am imitating the way President Trump heard it in his head.

The politics of now
Two NASA astronauts will be returning to Earth after spending nine months at the International Space Station. “It is quite surreal for us to see this whole situation unfolding on the planet below,” said Jessica Meir, a member of the first all-female spacewalk in 2019.  I would think that normally coming back to Earth from the solitude of space must be quite odd, but in the midst of a pandemic, they may feel weirdly like they are still trapped in a capsule. 

Life will not snap back to the way it was is the message of Dr. Fauci, Governor Cuomo, Dr. Saag – pretty much anyone relying on the science to chart the course back to normalcy.  It’s pretty obvious that it can’t.  American fedearl leadership is like that scene At this moment, a majority of Americans live in nine states, and are represented by one-fifth the total number of senators. That means four-fifths of senators, i.e. a hand majority, represent just 18% of the population spread over 27 states – that means one-fifth of the nation’s population has a 54-seat majority in the Senate.  We are not a nation divided, we are a nation lopsided, a nation jerrymandered and voter suppresssed and redlined by a minority forcing its rule over the voting majority.

So how might life change after this pandemic? Will people move to ‘good states’, will there be a COVID score for governors? Never has a situation provided more opportunity for Americans to observe governors relative to one another, in terms of actual, real-time performance. The federal government called on Americans to practice social distancing in mid-March, but some governors did not issue stay-at-home orders until early April. Each state has its own rules for stay-at-home orders;  some don’t have any at all. Some states provided exemptions for religious services — particularly during Passover and Easter, as if the virus understands high holy days.

Good News: One species, formerly endangered, is flourishing under the pandemic: in Brazil, 100 hawksbill sea turtles hatched, crossed the empty beach and without incident disappeared into the sea.

See past entries in Coronavirus Event