Friday, March 27, 2020

We're number one

Today the U.S. overtook China as the country with the most confirmed corona virus cases in the world.  Italy is still the world leader in deaths, but that will almost certainly change before too long because we have six times as many people and we have not yet battened down the hatches.  I can just see president Trump getting on TV and crowing about the fact that once again the U.S. is leading the world.  Never mind that it is leading the world into an unprecedented catastrophe.

The U.S. has had it so good for so long that it is easy to fall into the trap of believing that we really are chosen by God or something like that, that we are somehow cosmically entitled to be the richest, most powerful nation on earth, and so all we have to do is carry on as usual and everything will turn out all right.  Unfortunately, everything is not going to be all right this time.

It has now been over three months since the Covid-19 epidemic began, and the U.S. still doesn't have widespread testing in place.  Lockdowns are still sporadic and widely ignored.  Hospitals are already starting to be overwhelmed.  The President is talking about getting everything back to normal by Easter.

It ain't gonna happen.  We have only to look at Italy to see what our future looks like.  Italy has been on lockdown since March 9 -- more than two weeks ago -- and their numbers, both confirmed cases and deaths, are still going up every day.  Wuhan was on lockdown for two months before the situation began to improve.

So even in a best case scenario, where we lock down the entire country tomorrow, we're looking at the beginning of June before we have a realistic prospect of getting back to normal.  But of course that is not going to happen.  It's not going to happen because Donald Trump and his Republican enablers have their heads buried in the sand.  They still believe that American exceptionalism knows no bounds, that we are the chosen of God and are therefore exempt from the laws of physics and biology and economics.

I have bad news for them, and for you: we are not exempt.  But because we are proceeding on the assumption that we are, a lot of people are going to go bankrupt, and a lot of people are going to die.

Texas Lieutenant Governor Dan Patrick has (in)famously suggested that all these deaths are perfectly fine.  Here's the quote:
No one reached out to me and said, ‘As a senior citizen, are you willing to take a chance on your survival in exchange for keeping the America that all America loves for your children and grandchildren?’ ... If that is the exchange, I’m all in.  That doesn’t make me noble or brave or anything like that. I just think there are lots of grandparents out there in this country, like me, I have six grandchildren, that what we all care about and what we love more than anything are those children. And I want to live smart and see through this, but I don’t want the whole country to be sacrificed…I’ve talked to hundreds of people, Tucker, and just in the last week, making calls all the time, and everyone says pretty much the same thing. That we can’t lose our whole country, we’re having an economic collapse. I’m also a small businessman, I understand it. And I talk with business people all the time, Tucker. My heart is lifted tonight by what I heard the president say because we can do more than one thing at a time, we can do two things. So my message is let’s get back to work, let’s get back to living. Let’s be smart about it and those of us who are 70-plus, we’ll take care of ourselves. But don’t sacrifice the country, don’t do that, don’t ruin this great America.
I have to admire the man's skill at taking what would normally be an unspeakable suggestion, that we intentionally condemn hundreds of thousands, possibly millions of people to die slow and painful deaths suffocating on their own bodily fluids, in order to preserve the lifestyles of the rich and famous, and making it sound not-entirely-unreasonable, even noble (notwithstanding his humblebraggy insistence to the contrary).  But this is the way of demagoguery.  It never sounds overtly unreasonable.  You have to actually think in order to see it for what it is, and apparently there are vast numbers of Americans who are no longer capable of this.

(At the risk of stating the obvious, it's not just people who step up to the plate and volunteer who are going to die.  The virus does not discriminate on the basis of patriotism.)

Funny how no Republican ever suggested that the victims of 9-11 should be written off in the name of preserving freedom and economic prosperity.  The conservative devotion to the sanctity of human life has some very peculiar Ts&Cs.

I can't help but wonder just how deep this conservative capacity for denying obvious truths runs, but we're about to find out.  You think things are bad now?  You ain't seen nuthin' yet.  In the next few days, the death toll from the virus in the U.S. is going to exceed that of 9/11 (2977).  A few weeks after that it will exceed the direct U.S. military casualties of the Iraq war (4,491).  Very likely, unless we radically change direction in the next week or two (and I don't see that happening) we will very likely exceed the total number of civilian casualties in the Iraq war (hundreds of thousands, but no one ever actually counted them all).  A final tally in the millions is not out of the question.

I wonder if there will ever come a point where Donald Trump's supporters will realize that much of the pain to come could have been avoided if the pandemic had been taken seriously early on rather than being dismissed as a Democratic hoax.  We spent a trillion dollars attacking Iraq because we thought they might have WMDs.  Now that we are actually under attack by the operational equivalent of a biological weapon, Donald Trump is still dithering about what to do about it, indeed, whether anything needs to be done at all.

Remember this in the coming weeks and months.  Things are about to get worse than you have ever imagined they could.  People you care about will probably die.  You could die.  This is not all Donald Trump's fault; he didn't start the pandemic.  But he actively fanned its flames long after it was apparent that it was burning badly out of control, and long after people sounded the alarm.

I'm writing this not because I think it can have much of an impact on what is to come, but in the hope that once this blows over and the conservatives cry, "But we couldn't have known" (which I am sure they will) I will be able to point to this post and say: no.  We were warned.  We were warned about the pandemic, and we were warned about Trump long before the pandemic started.  It's too late to avoid catastrophe this time.  But maybe, just maybe, next time we will listen.

Friday, March 20, 2020

If you only read one thing about the Corona Virus, make it this

If you only ever read one article about the new corona virus, make it this article by Tomas Pueyo.  Read it all the way to the end.  It points the way to effective and hopeful policy more than anything else I have read.  Then contact your elected representatives and tell them to read it.  Then contact everyone you know and tell them to do the same.  If the information in this article can spread faster than the virus (and it can) we might be able to beat this thing.  But time is very, very short.  Do it now.

Wednesday, March 18, 2020

Don't count on corona virus being seasonal

A lot of people are pinning their hopes on the corona virus being seasonal and magically going away during the summer like the flu.  Don't bet on it.  Brazil, where has hot and humid summer-like conditions year-round, saw its first case of corona virus on February 25.  Since then they have been on the same exponential growth curve as the rest of the world.

Our only realistic hope for keeping this from spreading to everyone in the country (and a concomitant death toll in the millions) is to dramatically ramp up our testing capacity.  You can't fight an enemy that you can't see.  We are badly behind the curve on this thanks to the Trump administration being asleep at the switch (to say nothing of active denial) about this for so long.  Make no mistake, this virus is nasty.  It's not the flu.  Yes, it's still true that there are fewer cases of COVID-19 than there are annual deaths from the flu, but that probably won't be true for much longer.  Summer might bring a miracle, but the numbers from Brazil do not look promising.  This is probably going to get a lot worse before it gets better.  It will eventually get better, but it will take months or years, not weeks.  We need a better plan than shelter-in-place.

Atlantic Monthly: The Gaslighting Vaccine

I know November seems far away, but the time to start preparing for the coming onslaught of Republican misinformation and gaslighting is now.  Towards that end, I would like to recommend an excellent series of articles in The Atlantic starting with this one entitled "We were warned."
We were warned in 2012, when the Rand Corporation surveyed the international threats arrayed against the United States and concluded that only pandemics posed an existential danger, in that they were “capable of destroying America’s way of life.”
We were warned in 2015, when Ezra Klein of Vox, after speaking with Bill Gates about his algorithmic model for how a new strain of flu could spread rapidly in today’s globalized world, wrote that “a pandemic disease is the most predictable catastrophe in the history of the human race, if only because it has happened to the human race so many, many times before.” If there was anything humanity could be certain that it needed to prepare for to prevent the deaths of a lot of people in little time, it was this.
We were warned in 2017, a week before inauguration day, when Lisa Monaco, Barack Obama’s outgoing homeland-security adviser, gathered with Donald Trump’s incoming national-security officials and conducted an exercise modeled on the administration’s experiences with outbreaks of swine flu, Ebola, and Zika. The simulation explored how the U.S. government should respond to a flu pandemic that halts international travel, upends global supply chains, tanks the stock market, and burdens health-care systems—all with a vaccine many months from materializing. “The nightmare scenario for us, and frankly to any public-health expert that you would talk to, has always been a new strain of flu or a respiratory illness because of how much easier it is to spread” relative to other pandemic diseases that aren’t airborne, Monaco told me.
Never forget that in the face of all these warnings, Donald Trump closed the White House pandemic office.  He fired Tim Ziemer, the head of global health security on the White House’s National Security Council, and did not replace him. He tried to cut funding for the CDC (happily that bit of insanity was thwarted by Congress). He called the corona virus a Democratic hoax.  And, despite failing piled upon failing, he steadfastly insists that he's doing a terrific job and takes no responsibility for anything.

James Fallows has been writing a long series in The Atlantic documenting all of Trumps disastrous decisions in real time since 2016.  There are so many it can make tedious reading, but we're all going to have more free time on our hands in the coming months.  One of the ways you can use that time is to inform yourself about how we got into this mess so that we can start to make better decisions going forward.  You can start with the first four installments of Fallows' series dedicated specifically to the corona virus, because even the most die-hard Trumpeteer is going to have a hard time avoiding the reality of the situation.  It is true that Donald Trump is not singlehandedly responsible for the disaster that is currently unfolding.  But there can be no doubt in any sane person's mind that he has made the situation much, much worse by failing to provide leadership at a crucial time, in other words, by utterly failing to do his job.

Pay attention.  This matters.  A lot.  Our last chance to rid ourselves of this pariah comes this November.  Success depends on convincing people who have been very effectively vaccinated against facts, so this is not going to be easy.  But in this case here are, quite literally, lives at stake.  We can't afford to blow this again.

Monday, March 16, 2020

Fedex: when it absolute positively has to get lost twice in a row

Last August I sent a package from California to Colorado via Fedex.  It never arrived and we never got it back despite jumping through all kinds of hoops to open an account so they would send it back.

I vowed I would never voluntarily do business with Fedex again, but last week, to my regret, I broke that promise.  We finally got our generator transfer switch installed so it was time to get a generator.  I decided to get an Onan p4500i and happily there is a dealer down in Santa Cruz which is about 50 miles south of us.  Unfortunately, when we got there we realized that the generator was just a little too big to fit in our car.  We probably could have squeezed it into the back seat, but there just happened to be a Fedex truck right there, and the cost to ship it turned out to be fairly reasonable so I decided to go for it.  It was only 50 miles.  The tracking estimator said it would arrive the next day.  What could go wrong?

Because I didn't trust Fedex, I took a photo of the shipping label attached to the box just in case.  Here it is:

Notice that the destination address is in Emerald Hills, CA, the zip code is 94062, and the ship date is Wednesday, March 11.

Day 1

On Thursday, I checked the shipping status.  Here is what I saw:

OK, still on track to be delivered today, but why did they send it to Tracy?  That is out in the central valley, almost 100 miles out of the way.  (See if you can spot the answer.)

Look at where it says the package is being sent to now: Pleasant Grove, Utah.  That's outside Salt Lake City, about 800 miles away.  It turns out that the zip code for Pleasant Grove is 84062.  Someone had apparently entered the destination zip code manually, and gotten it wrong by one critical digit.

This begs the question: why is anyone entering the destination zip code manually at all?  Don't they just scan the bar code?  And why was there no alert that told whoever entered the wrong zip code, "Um, this is not what it says on the shipping label.  Are you sure you got this right?"  (Of course I harbor no illusions of ever learning the answer to those questions.  I'm just stuck at home trying to avoid the corona virus (again) and so I have nothing better to do than to ponder the unanswerable questions of the universe, like why Fedex can't deliver a package to a destination 50 miles from where it was shipped.)

On Friday I got a call from Fedex.  The CSR said that the package had been located, the destination corrected, and it would soon be on its way back.  And indeed at the moment their system says it's due to be delivered today:

Of course, it also says that it's still in Utah so I'll give long odds against it actually making it on time.  Notice that it has been in Vineland, Utah, just outside Salt Lake City, since 6AM on Friday.  As I write this it is almost 3PM on Monday and the package hasn't moved.  I called Fedex again and they told me it would arrive somewhere in California on Wednesday, but frankly I would not be a bit surprised if it is never seen by human eyes again.

[UPDATE] The generator was finally delivered today, March 21, ten days after it was shipped.  During that time we had yet another Fedex screwup: a box of light bulbs that I ordered showed up as having been delivered when in fact they had not been.  Fortunately, I noticed this right away and called Fedex and they were apparently able to contact the driver and have him go back to wherever he had mis-delivered it to and bring them to us later the same day.  Still, Fedex is now 1 for 4 (we had one successful delivery the day before) on our last four shipments.  That is not a good track record.

To give credit where it's due though, I have to say that their front-line CSRs are quite good.  They were always friendly and helpful, and except for one occasion yesterday (Friday) evening when I gave up after waiting for 40 minutes, I never had to wait on hold to talk to one.  Still, if I ever need to ship stuff, I'm probably going with UPS.

Saturday, March 14, 2020

Don't let conservatives gaslight you: the chaos to come is Trump's fault

In the weeks and months to come you are going to hear a lot of conservative apologists praise Trump's early and pro-active response to the corona virus outbreak, like this from a comment on this blog:
President Trump has declared a national emergency very early in this pandemic. Recall we first learned about COVID-19 on December 31.
Don't believe a word of it.   The Trump administration has been actively and affirmatively dismantling the mechanisms we have (or had) to deal with outbreaks like this.  They have been doing this since the beginning of the administration and people have been sounding the alarm about it since it started happening.  Here, for example, is a story from the Washington Post from April of 2017, less than four months after Trump was inaugurated.  At the risk of violating copyright law, I am going to quote it here in its entirety because this is really important.  Trump and his supporters are going to try to gaslight the country in the next few months.  If history is any guide, they could very well succeed.  It is crucially important that we not let them.  Never forget: this mess is absolutely Donald Trump's fault, notwithstanding his pathological refusal to accept any responsibility for it.

The Trump administration is ill-prepared for a global pandemic

April 8, 2017 at 3:11 p.m. PDT

The Trump administration has failed to fill crucial public health positions across the government, leaving the nation ill-prepared to face one of its greatest potential threats: a pandemic outbreak of a deadly infectious disease, according to experts in health and national security.

No one knows where or when the next outbreak will occur, but health security experts say it is inevitable. Every president since Ronald Reagan has faced threats from infectious diseases, and the number of outbreaks is on the rise.

Over the past three years, the Centers for Disease Control and Prevention has monitored more than 300 outbreaks in 160 countries, tracking 37 dangerous pathogens in 2016 alone. Infectious diseases cause about 15 percent of all deaths worldwide.

But after 11 weeks in office, the Trump administration has filled few of the senior positions critical to responding to an outbreak. There is no permanent director at the CDC or at the U.S. Agency for International Development. At the Department of Health and Human Services, no one has been named to fill sub-Cabinet posts for health, global affairs, or preparedness and response. It's also unclear whether the National Security Council will assume the same leadership on the issue as it did under President Barack Obama, according to public health experts.

“We need people in position to help steer the ship,” said Steve Davis, the chief executive of PATH, a Seattle-based international health technology nonprofit working with countries to improve their ability to detect disease. “We are actually very concerned.”

In addition to leaving key posts vacant, the Trump administration has displayed little interest in the issue, health and security experts say. The White House has made few public statements about the importance of preparing for outbreaks, and it has yet to build the international relationships that are crucial for responding to global health crises. Trump also has proposed sharp cuts to government agencies working to stop deadly outbreaks at their source.

The slow progress on senior-level appointments — even those, such as the CDC director, that do not require Senate confirmation — is hobbling Cabinet secretaries at agencies across the government. Temporary "beachhead" teams the White House installed are hitting the end of their appointments. The remaining civil servants have little authority to make major decisions or mobilize resources.

An HHS spokeswoman declined to comment on personnel decisions. An NSC official, who was not authorized to speak publicly, said the administration recognizes that global health security is a national security issue and that America’s health depends on the world’s ability to detect threats wherever they occur.

Trump's NSC does not have a point person for global health security as Obama's did, but global health security is part of the overall portfolio of Tom Bossert, Trump's homeland security adviser, another NSC official said.Global health experts warn that a pandemic threat could be as deadly as a nuclear attack — and is much more probable.

A global health crisis “will go from being on no one’s to-do list to being the only thing on their list,” said Bill Steiger, who headed the HHS office of global health affairs during the George W. Bush administration. He spoke at a panel on pandemic preparedness in early January. He is now part of Trump’s beachhead team at the State Department.

Next month, the G-20 governments, which traditionally focus on finance and economics, will convene their health ministers for the first time, in part to test coordination and preparedness for a pandemic, according to German officials, who are hosting the summit in Berlin. It’s not clear who will represent the United States.

In a speech to a security conference in Munich earlier this year, billionaire Bill Gates said a pandemic threat needs to be taken as seriously as other national security issues.

“Imagine if I told you that somewhere in this world, there’s a weapon that exists — or that could emerge — capable of killing tens of thousands, or millions of people, bringing economies to a standstill and throwing nations into chaos,” said Gates, who has spent billions to improve health worldwide.

“Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year.”

The projected annual cost of a pandemic could reach as high as $570 billion.

Last month, Trump met with Gates at the White House. After the meeting, press secretary Sean Spicer said the two had “a shared commitment to finding and stopping disease outbreaks around the world.”

Americans are at greater risk than ever from new infectious diseases, drug-resistant infections and potential bioterrorism organisms, despite advances in medicine and technology, experts say. Not only has the total number of outbreaks increased in the past three decades, but the scale, impact and methods of transmission also have expanded because of climate change, urbanization and globalization.
The outbreak of Ebola that erupted in West Africa eventually infected more than 28,000 people and killed more than 11,000. MERS has killed nearly 2,000 people in 27 countries. Health officials around the world are monitoring a strain of deadly bird flu, H7N9, that is causing China's largest outbreak on record, killing 40 percent of people with confirmed infections.
Of all emerging infectious disease threats, a global influenza outbreak is everyone's worst fear because it could be highly lethal and highly contagious. A particularly virulent influenza pandemic that started in 1918 killed an estimated 50 million people. Today's H7N9 strain poses the greatest risk of a pandemic if it evolves to spread easily from human to human, according to U.S. officials.

Last month, several Democratic lawmakers wrote HHS Secretary Tom Price to raise concerns about the nation’s ability to respond to infectious disease threats. They also asked about the vacancies and the impact of proposed budget cuts in the event of a flu pandemic. They received no response.

“Our whole community is kind of ear to the ground trying to figure out any clues we can discern,” said Rebecca Katz, co-director of the Center for Global Health Science and Security at Georgetown University’s Medical Center.Global health security "is clearly an issue that needs to be taken up by the heads of state," said one European official who declined to be identified because her government does not want to appear critical of the United States. Diseases travel fast and don't recognize borders. In today's connected world, a disease can be transported from a rural village to any major city within 36 hours."It's not just from travel of people, but birds, too," she said. Referring to Trump's proposal to build a wall along the border with Mexico, she added: "You can't build walls to stop birds."

Global health security was a top priority for the Obama administration, which launched a partnership in early 2014 to prevent deadly outbreaks from spreading. Experts say the collaboration, known as the Global Health Security Agenda, has raised the political profile of infectious disease threats and strengthened basic public health systems in the countries least equipped to fight epidemics.

In Cameroon, the government developed a new emergency operations center able to respond within 24 hours to an outbreak of a highly lethal bird flu last year, removing more than 67,000 birds that had the potential to spread the virus to humans. In 2015, it took the country eight weeks to respond to a cholera outbreak.

In Mali, personnel who received epidemiology training began vaccination campaigns the day after detecting a measles outbreak last year.

In addition, more than 30 countries have taken part in evaluations to assess their ability to detect and prevent outbreaks, and their “report cards” are made public to spur governments to take action. But the gains made so far are “still fragile and require continued funding until they are strong,” according to an internal CDC analysis.

The Obama administration committed $1 billion to the program, which is due to end in fiscal 2019. Although it has strong support among global health officials and some Republican lawmakers, the Trump administration has yet to say whether it plans to continue funding the initiative.

President Obama also brought up global health regularly in meetings with foreign leaders. Trump has said little since taking office, except for a reference in his inaugural speech about his desire to rid the earth of disease.

During the Ebola outbreak, Trump tweeted that health workers should be blocked from returning to the United States, despite advice from the CDC and other experts that doing so would not protect U.S. health and would harm efforts to stop the outbreak.

The administration’s proposed budget is also problematic, health experts say.

If approved by Congress, Trump’s request for the current fiscal year would slash the entire $72 million budget for global health security at USAID. And his request for fiscal 2018 calls for a nearly 18 percent cut at HHS, which includes the CDC.

The request does propose a new federal emergency fund intended to allow HHS to respond to emerging public health outbreaks. However, administration officials have provided few details.

Many Republican lawmakers have criticized the requests, saying Congress is unlikely to approve such deep cuts to health agencies.

“You can have the best people in the world, but if you’re slashing the NIH budget by 20 percent, and presumably the same thing to CDC, then I don’t care how good your people are, they’re not going to be nearly as effective as they need to be,” said Rep. Tom Cole, (R- Okla.), who chairs the House Appropriations subcommittee on labor, health and human services, education, and related agencies.

The health agencies are “the front lines of defense for the American people for some pretty awful things,” Cole said. “If the idea of a government is to protect the United States and its people, then these people contribute as much as another wing on an F-35 [fighter jet], and actually do more to save tens of thousands of lives.”

Friday, March 13, 2020

A glimmer of hope

Maybe this is the beginning of a trend.

Trump administration blocks states from using Medicaid to respond to coronavirus crisis

If there was any remaining doubt in your mind that the Trump administration is both unashamedly cruel and fantastically incompetent, this story from the Los Angeles Times should put it to rest:
Despite mounting pleas from California and other states, the Trump administration isn’t allowing states to use Medicaid more freely to respond to the coronavirus crisis by expanding medical services.
Donald Trump apparently does not realize that the corona virus does not discriminate on the basis of income.  It will infect and kill rich white people just as happily as it will poor black ones.  By blocking medicaid funding for coronavirus response the Trump administration is insuring that the virus will spread more widely than it otherwise would, and so the death toll will be higher that it otherwise would.  Some of dead will surely be people who voted for him.  But whether they supported Trump or not, the blood they cough up before they die will be on his tiny, pathologically oblivious and utterly incompetent hands.