Journaling the coronavirus Thursday April 16: Guns N Poses play Michigan; testing headaches; Way, Jose; o, the Humana-ty

---

The US death toll from COVID in the US is 30,985. Worldwide, two million people are infected. The number of infected and deceased continue to double every thirteen days though in some places new hospitalizations are starting to flatten.

Nursing homes have featured the highest mortality rates. There are at least 46 residents are dead at Richmond VA facility – which is more than a quarter of the home’s residents. I hate to think how scared they all are. The facility’s medical director, Dr. Jim Wright, tried to get tests as soon as the first case appeared, but state delays meant it took almost two weeks for all the facility’s residents to be tested.  In New Jersey, an anonymous caller tipped police to check out the state’s largest licensed nursing facility; they found 17 bodies piled in the nursing home’s morgue, and one in a shed.

The “Opening Our Country Council” that President Trump has been talking about lately was really an email that not everyone got, inviting them to one of four conference calls that not everyone could make.

In a study published Tuesday in the journal Science, researchers from the Harvard T.H. Chan School of Public Health warned of a large resurgence of infection if social distancing measures are lifted all at once. “We note the potentially catastrophic burden on the healthcare system that is predicted if distancing is poorly effective and/or not sustained for long enough”.

photo Joshua A. Bickel

At the same time people in Michigan – a lot of them with beer bellies, guns and flags – are protesting social distancing as a violation of their rights, chanting “lock her up!” at that woman from Michigan (aka Gretchen Whitmer).  They carried flags – including two guys with a Confederate Flag for some reason – and signs reading “Live Free or Die,” “Make Michigan Work Again” and “We Deem Our Governor Non-Essential”. 

Meanwhile in Ohio, apparently not wearing a mask as you cram up against your fellow protesters proves you are pro business. I really wish my fellow midwesterners would protest in a more socially distant fashion, for the safety of all, themselves included. They’ll have plenty of time to learn, though – some researchers are projecting that social distancing may be necessary well into 2022.

Governor Cuomo has announced an executive order requiring face coverings when New Yorkers are out and about. He’s also extended the shelter in place orders to May 15th. Will the president get in a dig about Cuomo today? Is the sky blue?

It’s bizarre to think that the majority of humans on earth are not out and about. It’s like a nightmare I had as a kid, everyone hiding in their houses as a giant monster made great scary sounds in the distance, not yet in sight but soon to appear. That feeling of hiding from the worst, hoping it passes you by, praying you don’t have a foot or ponytail sticking out from your hiding place, lest it stoop to put its great eye to your window and see you.

Everybody’s doing it
In fits and starts, countries around the world have begun the process of lifting social and economic restrictions. German Chancellor Angela Merkel put it well when she warned the road ahead looks less like a return to “normal” than finding a new way to live, a way to live with a pandemic in progress.

So if everyone else is re-starting their economies shouldn’t the US? Not so fast, say experts. Those countries are doing a far better job with testing and contact tracing; meanwhile, the lack of testing capacity has emerged as the New York Times succinctly puts it, as the “signature failure” of the Trump administration’s response to COVID, and is the primary reason talk of re-opening the American economy is premature.  That isn’t stopping the administration from plowing ahead with Grand Re-opening plans though.

“We do have nine states that have less than 1,000 cases and less than 30 new cases per day,” Dr. Birx. With that information it seems we can expect the first states to be ballyhooing about opening the economy to be Alaska, Hawaii, Maine, Montana, Nebraska, North Dakota, Vermont, West Virginia and Wyoming. The transportation planning behind re-opening noncontiguous states seems like it’s going to be a pretty big deal.

Testing
The president frequently cites California’s lower rate of infection and mortality, crediting our social distancing (which we were early with) but ignoring the fact that testing here has been slower, with just 215,000 tests completed in the whole state, compared with about a half a million in New York. Los Angeles Mayor Eric Garcetti has announced that anyone with symptoms will be able to get a test within a day; up until now, testing has been limited to only health care workers, the elderly, and those with severe enough symptoms to require hospitalization.

The cost of testing continues to be a problem in many places. Though everyone remembers the president visiting the CDC and saying “everyone is going to get a test” (and that furthermore the tests were beautiful and perfect  – like the call was perfect), a woman in Florida was charged more than $6000 by AdventHealth DeLand, and also received dunning phone calls to pay up. Based on what the president himself said,  “I thought it was free” she says, not unreasonably.  With reports like these, people are going to be reluctant to be tested. That’s bad news for a virus that is proven to spread asymptomatically.

Testing will ramp up, it’s a matter of when, not if. My step-daughter is in Los Angeles as I type this, coordinating drive through COVID testing for a lab that is rapidly scaling to fifty thousand tests a day. But that breadth of capability is weeks away,  not days. It’s good to hear the Mayor of LA being so cautious.

Gatherings postponed and cancelled

The Olympics are postponed until 2021.  The US Open is postponed until August 31st. The Tour de France has also been postponed until August, what one COVID adviser to the Scottish government called “a recipe for disaster.” In Los Angeles the Mayor has said the city may not authorize concerts, sporting events and possibly movie premieres until 2021, which means the new Bond movie No Time To Die, already delayed, may be the first major Hollywood prestige film to have a virtual opening… and then subsequently break the internet as everyone tries to download it at once.

“We’ve got many, many miles to walk before we’re going to be back in those environments.”

~LA Mayor Eric Garcetti

Dr. Birx has advised “Don’t have that dinner party for 20 just yet,” reminding us that while infection and mortality trends are improving, maintaining that improvement requires social distancing.

Meanwhile, World Wrestling Entertainment has NOT been postponed but instead declared an ‘essential service’ by the governor of Florida. Still, they’re furloughing wrestlers and employees including, ironically, a wrestler called No Way Jose which, to me, sounds like a brand that could really take off given the current environment. He can develop moves like”CARES Act crunch” where his spine is removed and then he is billed for it by a wrestler called Humana Start Something?

Our unpopular president
It’s a time honored tradition of humans to rally around their leadership during times of crisis and this pandemic is no exception – opinion polls show soaring ratings for the Prime Ministers of Italy, Austria and Denmark. Alone among world leaders, only President Trump’s ratings have fallen.

Habits, rabbits
I have been thinking how it is not just our habits that will be changed by this pandemic; our psyches will, too. I was struck by these words from an ER doctor who is journaling the pandemic for the New York Times in the series None of Us Will Ever Be the Same; she is articulating better than I ever could why people are going to be scared to go out for awhile, until there is a vaccine.

We were assured that America had it under control, it would be miraculously gone by now; no one paying close attention believed that assurance, but all of us thought it would be a lot less botched and slow than it has been.  Now we are faced – for some, this is a first time experience – with the immutable fact that a novel coronavirus makes no exceptions for American exceptionalism.  No one is safe, for sure, yet. Until there is a vaccine. It doesn’t mean we cannot venture out, but we’ll be doing so like the wild rabbits in the Marin headlands do, alert and ready to scatter in all directions at a moment’s notice of danger.

“What I think will actually cause moral injury is seeing people die after getting the most advanced care available. People who come in talking, with stories to share. They get care — the best that modern medicine has to offer — with life-prolonging machines and IV drips of all sorts of critical-care drugs. We put our full minds and whole hearts into trying to save them. Then I see their bodies shut down anyway. They are alone.”

~Helen Ouyang

I don’t think things are going to get back to normal so much as, normal is going to be redefined, a new normal is going to arise, one that includes pandemics as an ever-present possibility.

Chill in the air
First Amendment watchdog group PEN America Missouri Governor Mike Parson has banned reporters from his daily briefings and is now requiring journalists to email their questions in advance for staff to screen and select.

Relatedly, the crux of the president’s most recent presser has moved from the WHO to Congress, as he threatened to adjourn both chambers for dereliction of duty.  “It’s a scam, everyone knows it, it’s been that way for a long time,” the president gripes and I wish not for the first time to see a reaction shot from the reporters, when he makes this announcement. “We’re going to do it, we need people for this crisis.”  It takes me awhile to ferret out the nouns in the irritated stream-of-consciousness that ensues, but once I do it becomes clear he’s mad that Congress is not approving his appointees fast enough to suit him, despite the fact that he has appointed/seated more judges (193) than any sitting president in history.  

US Secretary of Agriculture Sonny Perdue took the podium to firmly tell us there are no food shortages. “We have plenty of food for our citizens. Bare shelves is a demand issue not a supply issue,” he says.  I’m not sure if it matters what side the issue is on to people with no paycheck with which to buy food, but if it’s true then that is good news and I’ll take it. On the same day he made these assurances, news came from Sioux Falls South Dakota, that the third largest employer, pork producer Smithfield, has now closed two plants after 518 employees tested positive. Those employees have infected 126 of their contacts (so far), a number that is likely to get bigger fast since there is no stay-at-home order yet in place.  I’m pretty sure Smithfield is on the supply side of the equation, maybe Mr. Perdue didn’t know the virus could effect people working in the kind of crowded plants typical of meat processing. 

Good News: In Suffolk County a pregnant woman diagnosed with COVID was put in a medically induced coma and given an emergency C-section. She spent eleven days recovering on a ventilator while her infant was taken to a nearby children’s hospital, yesterday she was wheeled out of the hospital surrounded by clapping, masked medical staff. Today she was given her baby, immediately placing him over her heart the sight of which brought a deep lump to my throat.  Be awesome to each other.

See past entries in Coronavirus Event