Research Misinfo/Disinfo: It’s a Scam

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[Check the byline, thanks! /~Rayne]

When certain folks all push the same angle — Trump, Giuliani, Solomon, et al — one may think immediately it’s a scam.

Like the Ukraine quid pro quo scam on which the very same players worked together, singing from the same hymnal.

The scam is more obvious because two of the people involved are promoting a pharmaceutical and they’re not medical doctors — they may be practicing medicine without a license by encouraging the use of a medication which isn’t approved for the use they advocate.

The drug is hydroxychloroquine, an antimalarial drug which has also been approved for a small number of autoimmune disorders like lupus.

Something is clearly not right when so many of the same players are pushing a drug using the power of the presidency to do so.

~ ~ ~

Interregnum: I’ve had to put this post up now, out of order. I had originally intended to write two posts about misinfo/disinfo about research related to COVID-19 and the underlying virus, but push has come to shove with Trump pushing hydroxychloroquine again today, admitting the U.S. has not purchased ventilators or personal protection equipment on a timely basis but instead bought and stockpiled 29 million doses of hydroxychloroquine.


Something is really wrong and it must be addressed immediately, before more people get hurt.

My post about the problematic background of research behind hydroxychloroquine will have to come next. Right now we need to talk about the scam in progress.

~ ~ ~

It took me a while to figure out what the angle might be on a drug which is old and cheap but I think this is the way this works.

Of course you all know Trump wants and NEEDS to stay in office or he’s up the creek without a paddle. This scam isn’t about making money but instead about serving his need not to be investigated and prosecuted for all manner of tax, bank, wire fraud and more beginning ten months from now.

So…Team Trump picks a drug which when administered in safe dose, doesn’t do much constructively for anybody except people they don’t give a shit about like patients with lupus and autoimmune disorders.

Weak sauce studies on hydroxychloroquine to date suggest it’s a 50/50 crap shoot that the critically-ill patients qualifying for compassionate use and receiving this drug will recover. Somebody external to the White House, possibly external to the U.S., maybe even the drug company/ies which makes this, may have made have chosen this drug because they did this math. They have just enough iffy research by iffy researchers to encourage its use.

They end up with just enough people who’ll recover and claim it’s a miracle drug that saved their lives, and the other half are dead or disabled so they won’t appear on camera to say otherwise. Handpicked survivors become testimonials to Trump’s ‘Wile E. Coyote super genius‘ and his prospective worth as our two-term conman-in-chief.

Even Dr. Fauci has said there’s no proof this drug cocktail works; he’s been clearly frustrated with Trump’s handling of COVID-19.

Trump cut off attempts to ask Dr. Fauci more questions about this drug today.

But Team Trump counters Fauci’s doubts by launching a character assassination attack in social media, calling Fauci part of the “deep state” out to get Trump.

At the same time there’s a continuous social media swarm pushing the drug.

Team Trump haven’t fired Fauci because they still need him to save Trump from making bigger mistakes and Fauci has much higher credibility ratings than any of the rest of Team Trump appearing before cameras.

But Trump’s current pandemic response failures are already projected to cost at least 100-240,000 American lives which Team Trump are now calling a goal, or success.

That’s part of the scam, too, the framing of what success will look like, long after Trump blew by the true benchmark of zero American deaths.

All this to boost his approval rating so he can use it for his re-election campaign. That’s the scam.

Just like the quid pro quo for which Trump was impeached — manipulate the situation so that false information boosts Trump’s approval with voters, abusing his power for his own personal gain.

~ ~ ~

What gave me pause wasn’t just the crappy research. Or the problematic French research with which this all began.

It was the fact that Rudy Giuliani, John Solomon, Charlie Kirk and a bunch of other right-wing support players were also doing their bit repeatedly to push this drug cocktail as well as a Russian doctor.

This is the Ukraine scam all over again, only this time the players are going to push a crappy drug and assassinate Dr. Fauci’s character, instead of pushing a false meme about Hunter Biden and assassinating Marie Yovanovitch’s character while she was ambassador to Ukraine.

Dr. Fauci has received death threats now because of this nonsense and his security detail has been increased because of it.

Michigan’s Governor Gretchen Whitmer has also been criticized by right-wingers about hydroxychloroquine. The state’s Department of Licensing and Regulatory Affairs throttled off-label prescriptions of the antimalarial drug because doctors and pharmacists were abusing their licenses by writing scripts for themselves and their families, hoarding the drug while depleting inventories.

But Dr. Fauci and Gov. Whitmer aren’t the only ones affected by this. There are so many stories about lupus and other autoimmune disorder patients who haven’t been able to fill their prescriptions because of a run on hydroxychloroquine because of Team Trump’s unlicensed practice of medicine at the podium — or unregistered lobbying for pharmaceutical company or companies.

Not to mention the strong possibility that although the Food and Drug Administration caved under pressure from Team Trump and now allows “compassionate use” of the drug for COVID-19, the drug could easily kill patients who are already under stress from SARS-CoV-2’s attack on their systems.

Hydroxychloroquine requires additional caution when used on females, geriatric patients, patients with diabetes — this describes a considerable number of COVID-19 patients in critical care! — thyroid disease, malnutrition, liver impairment, or those who drink alcohol to excess — for starters. The drug must be used with caution in persons with cardiac arrhythmias, congenital long QT syndrome, heart failure, bradycardia, myocardial infarction, hypertension, coronary artery disease, hypomagnesemia, hypokalemia, hypocalcemia, or in patients receiving medications known to prolong the QT interval or cause electrolyte imbalances.

This is only part a portion of the contraindications and precautions for hydroxychloroquine.

It may also cause permanent eye damage.

Imagine monitoring the patients receiving hydroxychloroquine even more closely when hospitals are overwhelmed and understaffed.

None of the research so far has been performed in vivo in a large, randomized trial. We really do not know what it will do except for what it has done for malaria patients and for autoimmune disorders — hardly the same things as patients in extremis from COVID-19.

Trump’s pushing drugs from the presidential podium must stop because Americans are being hurt for the sake of whatever scam Team Trump is pulling off this time.

We can see part of the potential reasoning Team Trump has used, but who else is benefiting from this? How do pharmaceutical companies fit into this, particularly Novartis which may be the sole source for the stockpile of hydroxychloroquine the federal government acquired. We don’t know the total amount the U.S. holds, how much might have been donated, and how much has been bought.

We don’t know whether this was part of conversations which may have happened at Davos around January 22, when pharmaceutical companies like Novartis were present and when business leaders were already concerned about COVID-19 outbreak in China.

We just don’t have all the facts yet to know every angle of this particular artless deal.

~ ~ ~

Part 3 will address the research behind hydroxychloroquine in relation to COVID-19.

Masked Up, Ready to Go (Nowhere)

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[Check the byline, thanks! /~Rayne]

You’ve probably heard the U.S. Center for Disease Control is expected to reverse its position on the public wearing masks a little over a month after this meltdown on February 29:

The CDC’s reversal on policy is a result of several things, though one of the biggest issues is a push to get everyone ready to go back to their workplaces at the end of April. There’s resistance to going any longer than that, based on U.S. for Care’s Andy Slavitt on Twitter last night, attributing this deadline to governors (but I think we know it’s not the governors who are pressing for an end to Stay Home orders).

I have no idea how parents with kids out of school will handle this; we need some sort of an exemption for parents to continue to work at home if they have children who would have been in school into June but whose schools have now closed for the rest of the school year.

I also think it’s too soon to lift the Stay-Home orders given how goddamned sloppy states like Florida have been in executing them. Spring breakers were still congregating this past week in some southern states which means these stupid fools who were exposed will travel home, get sick in 2-3 weeks, infect others during that time and a mini-wave of successive infections will follow that.

Anyhow…the CDC has acknowledged the larger role respiratory droplets play in infection. Many anecdotes from community acquired infections support this. From CDC:

“COVID-19 is thought to spread mainly through close contact from person-to-person in respiratory droplets from someone who is infected. People who are infected often have symptoms of illness. Some people without symptoms may be able to spread virus.”

There are two studies about viability of the virus causing COVID-19 on surfaces; the researchers also noted the hang time of aerosolized virus and its viability. This study is cited most often:

van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1
March 17, 2020. doi: 10.1056/NEJMc2004973
https://www.nejm.org/doi/full/10.1056/NEJMc2004973

The active virus could hang in the air for as long as 3 hours according to this study, from which we can infer the exhalations of infected persons carrying the virus will also hang about.

This study found the respiratory material from infected patients could cover objects and surfaces all over a room:

Ong SWX, Tan YK, Chia PY, et al. Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient.
JAMA. Published online March 04, 2020. doi:10.1001/jama.2020.3227
https://jamanetwork.com/journals/jama/fullarticle/2762692

While not about the virus underlying COVID-19, this paper discusses the exhaled infectious material and how far it spreads — nice graphics included, a nice read:

Bourouiba L. Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19.
JAMA. Published online March 26, 2020. doi:10.1001/jama.2020.4756
https://jamanetwork.com/journals/jama/fullarticle/2763852

Science writer Ed Yong at The Atlantic tries to summarizes everything in his article, Everyone Thinks They’re Right About Masks: How the coronavirus travels through the air has become one of the most divisive debates in this pandemic.

Yong notes as I have that countries which use masks more regularly — like Japan — have had lower rates of COVID-19. But these countries also were more aggressive about dealing with containment much earlier.

Need more perspectives? Molecular biologist Sui Huang of Institute for Systems Biology in Washington state has an overview in support of mask wearing at Medium; science writer Ferris Jabr has a pro-mask article at WIRED.

This DIY Cloth Face Mask page at Instructables has not only information to sew your own mask but discussion about wearing masks and filters in them. The page is changing fairly often because of feedback — it didn’t have filter information in February.

It’s important to think about masks not just as protection for yourself. It’s possible some of us have already had asymptomatic cases and may even be contagious as I type this. Wearing a mask can protect others.

In Asia wearing a mask is also seen as a sign of respect for others’ well-being. Americans have had a skewed perspective about masks and have until now viewed them negatively when worn outside health care settings as a hallmark of illness. We’re going to have to change that.

Because I’m in the at-risk group due to my autoimmune disorder, I have to wear a mask. Family members with heart disease and diabetes likewise need to wear masks. I’ve sewn my own for myself and family members alike. While the first masks I sewed for us were two-layer cotton, I’m now making another batch with non-woven poly fiber — baby wipes and cleaning wipes are just two examples of this fabric in use around us all the time. The non-woven poly inside a reusable fabric mask can reduce the amount of material shed or inhaled by the wearer beyond what two layers of cotton fabric can limit.

If you choose to wear a mask, leave surgical masks and N95 to health care professionals because shortages of these commercial masks are severe and likely won’t be relieved for more than a month. Make your own instead. There are plenty of How-To and DIY instructions out there for sewn and non-sewn masks.

If you do wear a reusable fabric mask, make sure to shut your eyes and hold your breath when taking a used mask off because it will have collected potentially infectious material. Immediately wash it thoroughly in hand soap and water — the soap is all that’s needed to deactivate any virus. Then wash your face and then hands carefully, again with soap and water. Rinse your mask well with water and hang to dry or put the mask in the wash with your other laundry.

If you see somebody at the grocery store picking up milk while wearing a mask, it might be me. I’ll be going nowhere else even with a mask long after April 30 except for the occasional but necessary venture out to pick up groceries.

Three Things: Shit Got Real with Family and COVID-19

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[Check the byline, thanks. /~Rayne]

I spent last night crying off and on all evening.

Right now some parent or parents are experiencing the nightmare I have hoped and still hope I won’t have to face.

A chemical engineering student at a state university died Sunday. He was only weeks away from graduating — just like my younger adult child at another state university.

This didn’t fucking have to happen. This bright promise didn’t have to be swept away in this human-made disaster. Don’t tell me this was natural, not when that narcissistic wretch in the White House treated the governor of my state like crap this week after her persistent pleading for federal assistance. Not after he failed from the time he was first told of this potential pandemic threat in December.

This death is on that miserable wretch’s head, and on the head of every GOP senator who looked the other way after Trump abused his power and solicited a quid pro quo. He did it again to our governor after the GOP senate gave him a permission slip instead of removing his unethical, greedy ass from office.

The horror isn’t over, either. There’s no telling how many more parents will face this same nightmare because one man just plain failed to do his job in a big and repeated way, because roughly 20 senators are spineless if not equally incompetent and corrupt.

~ 3 ~

You can guess what preoccupied my time last evening when I wasn’t crying. Text messages and phone calls were flying furiously between my house and my two kids’ homes downstate.

A capital city newspaper reported a 65-year-old man was confirmed with COVID-19. Nothing remarkable about this story on the face of it; so far he’s a living statistic.

But to this family this particular story is important. The man lives three miles from from my older adult child. Some of the folks who work with my older child live in the same neighborhood development. While the company for which my child works will implement screening body temperature at the door today, it’s a couple weeks late and pretty useless for asymptomatic cases. It would have been useless on this man up until he became sick, three days before Michigan’s Stay Home order took effect.

The patient developed symptoms on March 21 and has been sick since then. Before he developed symptoms he had been shopping at Sam’s Club, Costco, Meijer — three of the most popular grocery stores in the area. My child and their spouse shop at the latter two stores.

My younger college-student child had planned to go to Costco yesterday.

You might think, “Whoa, big spacious stores, no big deal,” right? But a study from China found two COVID-19 cases in Wenzhou traced shared one common trait — both patients had shopped in the same mall on two different floors. They had a low-intensity indirect transmission without prolonged contact.

COVID-19 appears nearly as bad as measles in terms of transmission. It’s spread mainly by exhalation of asymptomatic/pre-symptomatic people as well as those with symptoms. A recent frequently-cited study showed the virus can hang in the air, active, for three hours. This weekend’s story about a church choir which observed all the social distancing rules — apart from staying home — illustrates how easily this virus spreads in the air in closed spaces.

The 65-year-old patient said he doesn’t know where he was infected. “I don’t go to a lot of parties or hang around with a lot of different people,” he told the reporter, “I probably caught it from a public place.” But he did go to the grocery stores and he visited a rehabilitation facility in Ann Arbor to drop off supplies for a family member. The rehab facility was likely not a source since no known COVID-19 case arising from the facility was mentioned in the article.

Kudos to this gent for wanting to share his situation with the public. He’s been quite sick; he admitted, “I can’t imagine anyone with a compromised immune system, I can’t imagine them going through this…My lack of taking it seriously, versus wearing a mask or gloves or both probably contributed to me getting this. I kind of regret it now.”

So now we wait and wonder whether anyone who works with my older child has a community acquired infection from their neighbor.

And we wonder and wait to see if my older child along with their spouse has been infected, too.

Just stay the fuck at home. Don’t put yourself in this situation where you, too, must wait and wonder. You don’t need any more stress than that wretch in the White House has forced on us.

~ 2 ~

Speaking of that wretch, after comparing notes with Marcy this past week, I have a theory about the White House’s abuses of power denying or obstructing aid to certain states under emergency declarations.

See if you can spot what I think has happened in the context of a table Marcy prepared; I added a few more columns to it.

It’s not just that “the woman in Michigan” was mean to poor baby Trump. Her state has a very tight senate race and no Trump hotel, golf course, or Trump organization business within its borders.

One thing I didn’t add but makes sense to me about the tribal governments’ federal emergency declaration: Marth McSally’s Senate seat. What do you think?

~ 1 ~

This pandemic crisis has pushed our system past its limits, exposing all the cracks in a hyper-capitalist system. I know I’m probably preaching to the choir in saying that, or at least if you’re a regular here you’re unsurprised to see that I’ve written this.

But how quickly people have been pushed to their personal breaking point hasn’t really been plumbed. I’ve written before over the last few years that nearly 50% of Americans haven’t had $400-600 cash for emergencies, that rent across the country was beyond what minimum wage workers were paid, and health care insurance let alone health care was simply out of reach even with the Affordable Care Act.

The emergency is here, and any time now the dam is going to break. One-time checks from the government will come too late for many. Read this thread by Yashar Ali explaining one person’s crisis:

Some of us can’t afford to help; we know this from the data and anecdotes we’ve seen. But those of us who can very much need to right now. Find a local soup kitchen or food pantry and make a donation of cash because people may already be experiencing food insecurity. Hunt down charitable programs delivering meals to children, elderly, and even groceries for hospital workers. As hard as we’re expecting health care folks to work, they may not have time to shop for themselves.

The U.S. didn’t become a great nation based solely on personal greed but by what Alexis de Toqueville called our “self-interest rightly understood.” The diminishment of investment in our country through a combination of taxes and giving to ensure we all do well is why country is falling, why we now find ourselves in this mortal mess. Take immediate corrective action and help others if you can with cash.

~ 0 ~

Keep in mind as we go forward this is both a shared national crisis, and an intensely personal crisis. The odds are stacked against any of us getting through the next 12 months without losing someone we know, like, love, and without someone within our personal spheres suffering hardship.

This is an open thread. Bring it here, back up the truck and dump it in comments.

Dispatch from the War on COVID-19 [UPDATE-1]

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[Check the byline, thanks. Update at the bottom. / ~Rayne]

If you’re a regular here you know I don’t like to share stuff from Fox or affiliates. But local station Fox5NY picked up and republished a video online I haven’t been able to capture elsewhere. It’s extremely important.

She isn’t the only nurse we’ve heard from here in Michigan about the “war zone” in which they now work. I shared a link earlier today in a previous post; I’ll share it as an embed here so you can hear these health care workers back to back.

 

View this post on Instagram

 

Dear Family, Friends and Complete Strangers, Please STAY HOME!! Love, an ER Nurse

A post shared by Mary Macdonald (@marymac019) on

Now, a word to Sen. Lindsey Graham who denigrated nurses because of the possibility they may collect $24 an hour on unemployment.

Senator Graham:

Nurses are degreed professionals who not unlike lawyers must pass a state licensing test and earn continuing education credits on top of their regular job. The ICU nurse has had very specific training as has the ER nurse; both have likely had to add more training to cross over to do the jobs they’ve performed this week.

They are our foot soldiers in the war on COVID-19. We will not have enough of these soldiers because they will get sick from a combination of exposure to high viral loads, especially when they don’t have adequate protection, and from the heightened, sustained stress of this pandemic war.

They do not deserve your disrespect. These professionals will treat every patient as someone worthy of their efforts. They will do their level best to save whomever they can provided they have the resources. The least you can do is treat them with the same respect they’d treat you as a patient. For all you know you will find yourself sick with this virus and you’ll be on the business end of one of these professionals who are in such high demand there won’t be any unemployed nurses in this country for more than a year.

Get over yourself, Graham. And stop taking social cues from that rude, nasty cretin in White House. Your friend McCain would be ashamed of you if he were still alive.

To whoever is bashing Governor Whitmer about her performance, a word:

Just like these health care workers who are pleading for supplies, so has Whitmer pleaded for assistance. Her constituents in the state of Michigan deserve all the services they’ve funded their federal government to provide. They are already getting what the state of Michigan can provide because Whitmer is ensuring this happens.

You cannot hide the fact that the federal reserve for supplies should have been ordering and collecting materials in January after China told WHO that a novel coronavirus posed a pandemic risk. Attacking Whitmer won’t change the fact that it is the federal government, directed ultimately by the president, which was responsible for detecting pandemic risk and responding proactively to it, informing states of the risk as early as possible.

That didn’t happen and now governors like Whitmer are forced to do both the job their states have elected them to do and more, taking responsibilities which belong to federal agencies, while Trump denies states the Honest Services they are entitled to because he has not received some sign of obeisance.

To use an aphorism well-known former Michigander Lee Iacocca enjoyed, “Lead, follow, or get out of the way.” Bashing Governor Whitmer is none of those things. Pick one of the three.

To everyone else: pay heed to what these health care workers are saying. Overall mortality will go up, not just from COVID-19, because first responders will be overwhelmed by both the demands this virus places on our systems, and by illness and death as their own ranks are infected and sickened. Stay home. Keep your distance. Heighten your hygiene practices to reduce risk of infection. Wash your hands. Help your loved ones, friends, community as best you can.

To health care workers and all other first responders: do the best you can. That’s all we can ask of you. If the best you can do is allow someone you cannot save to die in peace, so be it. We should have done more for you before this war began.

And someone should have told us all when that war started instead of lying to us until it was nearly too late.

UPDATE-1 — 7:00 P.M. ET —

I am suitably chastened by this video by a doctor at Emory:

YOU are the frontline, the foot soldiers. What you do during this period of necessary social distancing makes the difference counted in lives. We may have to be patient longer because we didn’t start early enough, but our loved ones, friends, their futures depend on it.

And the lives of health care workers also rely on us. We’ve lost a number of nurses and doctors, people like these women in these videos. We can’t afford to lose more.

Trump’s Death Panel Comes for Detroit [UPDATE-1]

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[Update at bottom of post, thanks. /~Rayne]

Ordinarily I wouldn’t step on Marcy’s posts by putting another one up so soon and one so short, but I am both FURIOUS and scared sick about this.

Since last night, Detroit Free Press confirmed yesterday’s rumors about the number of ventilators at one chain of Detroit hospitals — that area hospitals had run out of ventilators and patients were notified on arrival they may not have access to a ventilator if needed.

Without ventilators, those suffering from acute respiratory distress syndrome in critical need may die.

Trump decided to kill Detroiters by withholding essential equipment. He’s chosen not to act in a timely fashion and interfered with the state’s ability to obtain equipment, while trash talking about Michigan’s governor in the process.

Welcome to Trump’s death panel.

Michigan’s Governor Whitmer couldn’t make it any more plain how urgent the situation was, just as Governor Cuomo has.

Trump’s gross negligence isn’t hurting just black Detroiters, either — yeah, I went there, you know damned well Trump doesn’t care about the woman who is our governor or the black people who are the majority in Detroit.

Trump is hurting rural white Michiganders in areas that voted for him in 2016.

If this is how he’s setting out to win swing states, I hate to see what more harm he’ll cause to solidly blue states.

UPDATE — 1:10 P.M. ET —

You need to watch this video produced by an ER nurse in Oakland County, Michigan. The county straddles four congressional districts, two of which recently flipped blue. This is where white flight settled pre-2000, leaving Detroit behind.

They don’t even have acetaminophen to give patients when they put the ventilator tube down their throats — assuming they still have ventilators right now.

Trump’s death panel won’t just kill you. It will make sure you suffer along the way.

 

The Tick-Tock to COVID-19’s Explosion

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[Check the byline, thanks! /~Rayne]

When epidemiologists, virologists, and public health officials first began talking about flattening the curve — using social distancing to reduce the number of COVID-19 cases needing hospitalization at any one time to prevent collapse of hospitals and massive mortality — I kept a running mental tick-tock, resetting this clock as data emerged and events unfolded. We learned from Washington state how the virus spread rapidly because of cryptic transmission, but tracking the virus’s dispersion hasn’t been clear to observers let alone elected officials and business leaders. Missing a concrete picture of how the virus emerges and spreads over time to affect our health care systems, officials have been easily badgered to issue delayed and weak containment orders to suppress COVID-19’S contagion.

The Biogen management conference offered a discrete example of how COVID-19 contagion spread and the time from exposure to illness to new infection:

26-27 February — Biogen, a biotech company, held a management conference in Boston at the Marriott Long Wharf hotel [Day 1-2]

01 March — Biogen employee of Chinese heritage who attended the conference developed a cough. [Day 5]

02 March — A Biogen employee from Indiana developed symptoms; they traveled to Biogen’s facility in Research Triangle Park, NC.

03 March — Biogen conference attendees were notified of a potential COVID-19 exposure [7 days after conference began]

06 March — Attendees received confirmation that they were exposed to COVID-19. Four cases were identified in Boston; two had symptoms. The Biogen employee from Indiana drove home. [10 days after conference began]

09 March — At least 32 cases of COVID-19 of 41 total in Massachusetts on this date were associated with the Biogen conference. [13 days after conference began]

11 March — Chinese Biogen employee flew from Boston to Los Angeles with spouse and child.

12 March — Chinese Biogen employee flew from LA to Beijing with spouse and child.

12 March — 82 cases in Massachusetts have both been confirmed and associated with the Biogen conference. The Marriott hotel at which the conference was held closed for disinfection.

13 March — Chinese Biogen employee tested positive for COVID-19 on arrival.

14 March — 104 of 138 total COVID-19 cases in Massachusetts were associated with the Biogen conference. Two new cases related to Biogen appeared in the cities of  Worcester and Malden.

16 March — Spouse of Biogen employee tested positive for COVID-19 in Beijing. [20 days after conference began]

The case of Biogen’s Chinese employee is incredibly important. The woman visited a hospital in Boston repeatedly for her symptoms, potentially infecting multiple people including health care workers, was given an ineffective antiviral (technically off label for COVID-19), and ended up flying to China, exposing other passengers and airline employees to COVID-19 en route because she couldn’t get tested for the virus until she arrived in Beijing.  She risked prosecution by Chinese authorities for failing to disclose her health status in order to get tested.

The U.S. literally exported two new cases of COVID-19 to China because Trump has dicked around with testing and lied to us about their availability since he first learned about the virus and risk of pandemic.

~ ~ ~

I’ve made up a calendar — not exactly pretty, mind you, since I didn’t quite know how I wanted to present this when I started. But you’ll see the Biogen-based outbreak, the airport terminal debacle thanks to the Trump EU travel ban, and the last holiday during which people gathered en masse in closed quarters (that’s St. Patrick’s Day).

Four states with the largest populations out of the top 11 most populous states issued shelter-in-place/stay home orders after March 17. You’ll see those effective dates noted on the calendar here as well.

Calender - COVID-19 contagion, Feb-April 2020

Note carefully the weekend of March 14-15 when airports across the U.S. were crammed with people, many of whom were likely exposed to COVID-19. As I said in a previous post, this is a hurricane; the mounting deaths over the last couple of days are only the leading edge of a hurricane-like explosion fomented by Trump’s minions’ ineptitude. Every death is on their heads and hands.

The reason for my mental tick-tock and the calendar is the course of the virus and its contagion: exposed persons are contagious about five days after infection; infected persons may begin to show symptoms from 5 to 14 days after exposure; persons who recover are contagious for at least another seven days.

The total 21 days from exposure to the point where an infected person is  clear of virus is optimistic. The WHO China mission report indicated persons may shed COVID-19 for 4-5 weeks in total.

Which brings me to the ultimate point of this post: In no fucking way is it safe to assume the risk of contagion will have been broken by Easter.

No matter what Trump wants or needs to believe, especially since shelter-in-place/stay home orders have not been given across the entire country and not to a uniform standard since states assumed the responsibility to issue these orders and not the federal government.

Perhaps the contagion will be stemmed by the states which gave shelter-in-place/stay home orders, but COVID-19’s spread could resume as rapidly as a trucker can cross a state line or an airplane land at an airport.

A partial lifting of the shelter-in-place/stay home orders might work if everyone had been screened with an antibody test for exposure, and only those persons with active COVID-19 infections were quarantined for the full 4-5 weeks.

But no — we don’t yet have antibody tests. We still don’t have adequate numbers of tests for COVID-19 infections.

Without testing and uniform shelter-in-place/stay home orders across the country, lifting shelter-in-place/stay home orders by Easter only increases the odds there will be another wave of infections on the heels of the first wave. Hospitals and health care workers would not have a break between these successive waves, further stressing the system.

~ ~ ~

Let’s cut through the bullshit here. If Trump wanted to look like a hero to the American public, he’d listen to virologists, epidemiologists, and public health experts.

He’d make sure the health care system had the resources it needs to protect themselves, to treat those who were ill, and to test everyone so the public, their first responders, and their elected state officials knew the status of the virus and where to direct their attentions most effectively.

He’d make sure every American stayed home and had no reason to leave until the contagion was broken.

But this is exactly what he isn’t doing.

He’s even withholding funds from states which are battling to save Americans’ lives from COVID-19 while containing the virus’s spread.

Why?

Why is Trump not doing what he’s supposed to do to insure domestic Tranquility, provide for the common defense, promote the general Welfare as executive of the United States?

Why has he ignored the hundreds of deaths to date, all of which can be blamed on his ongoing failures?

Why has Trump only been able to maintain kayfabe — the appearance of being a president without actually being one, like professional wrestlers who don’t actually wrestle?

If this was the reality TV show The Apprentice, Trump should have been fired already for dereliction of his duties and escorted off studio property by security personnel for deliberately hurting cast and crew.

~ ~ ~

Finally, two more groups of people need to be asked why they aren’t acting in the best interests of the country, let alone their constituents whether voters, donors, or shareholders.

Republican senators have rejected the math — like that selfish yard-waste-pile Rand Paul who continued to use the Senate pool in spite of his exposure to COVID-19.

Why are they actively refusing to do the right things to save Americans’ lives including their own?

Corporate leaders like Lloyd Blankfein whine about getting American workers back on the job instead of worrying whether there will be an economy left if workers continue to get sick in the workplace and die.

Why can’t a fucking investment banker like Blankfein and other business leaders responsible for P&L figure out the numbers?

Fire them all come November.

A Virus Does Not Care

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There’s a right way to deal with a pandemic, and a wrong way to deal with a pandemic

A virus does not care. A virus simply wants to reproduce, and for that it needs a host. A virus does not care about who that host is. A virus just wants a place to live, eat, and reproduce. A virus does not care if it makes the host sick. A virus does not care if it kills the host. This is the First Rule of Viruses: A virus does not care.

In 1918, as WWI was being fought in Europe, a virus emerged at Camp Funston, in the area of Fort Riley, Kansas. This virus did not care about the war. The virus did not care about Our Boys who were preparing to go fight that war. The virus did not care about the farmers in the Kansas fields, who dropped at their plows in the fields when the virus attacked.

A virus does not care.

The soldiers from Fort Riley went to the front lines in Europe with their guns, their ammo, their packs, and their gear, and they took that virus with them. It attacked their comrades in arms, and it attacked their enemies across the trenches.

A virus does not care.

The virus attacked King Alphonso XIII of Spain. Wherever the virus appeared, people began to speak of “the Spanish Flu,” going back to the widely-reported news of the mighty king it brought low. But the virus didn’t care. The virus attacked soldiers. The virus attacked ordinary villagers. Some lived, and some died.

A virus does not care.

The virus spread across the US, just as the war was beginning to come to an end. Bonds were being sold to pay for the war, and soldiers were starting to come home. The virus did not care about the bonds. The virus did not care about the homecoming celebrations being planned.

A virus does not care.

But people care, and they care about lots of things, and that’s where things got worse. People care about their status. People care about their businesses and their livelihoods. People care about parades the celebrate the end of a long and ugly war. People care about gathering in the corner bar with their friends, and playing sports in the local parks. People care about staying safe when danger threatens. People care about singing and dancing and enjoying life. People care about a million and one things, but a virus does not care about any of those things.

A virus does not care.

By 1918, people knew how to deal with a spreading virus in two broad ways: quit interacting so closely with others and practice good hygiene (both individually and as a community). They knew that beating a virus requires that a community care about itself just as much as the virus does not care at all. Give the virus an inch, and it will continue its deadly spread.

Because a virus does not care.

Some communities enacted a wide variety of what epidemiologists today call “nonpharmaceutical interventions” – prohibiting large public gatherings, closing businesses, shutting down churches, suspending schools, and so on. Other communities enacted some of these measures, but not all of them. Some communities took few measures, or decided “We’ll prohibit large gatherings, but not until after the big parade next week.” On the spectrum from “we need to shut everything down” to “we need business as usual,” St. Louis was on one end of the spectrum, and Philadelphia was in the other.

St. Louis:

By late September, Jefferson Barracks [a US military post in St. Louis] went under quarantine as the first soldiers came down with the flu.

In early October, city health commissioner Dr. Max C. Starkloff ordered the closure of schools, movie theaters, saloons, sporting events and other public gathering spots. Churches were told to suspend Sunday services. At the time, with nearly 800,000 residents, St. Louis was among the top 10 largest American cities. . . .

Theater owners, as some of the largest taxpayers at the time, protested the closures. Musicians and entertainers claimed the quarantine threatened their careers. Others were delighted — anti-alcohol leagues that were forming in the runup to Prohibition went on the lookout for taverns that violated the shutdown, [director of library and collections at the Missouri History Museum Chris] Gordon said.

Within two days of the quarantine, eight soldiers at Jefferson Barracks were dead, another eight residents died at St. Louis City Hospital and the number of area flu cases topped 1,150.

Jacob Meeker, a St. Louis congressman, died Oct. 16, six days after touring Jefferson Barracks. He was 40.

With the flu continuing its rampage, Starkloff imposed a stricter quarantine in November, closing down all businesses with few exceptions including banks, newspapers, embalmers and coffin makers, according to Post-Dispatch archives.

The American Red Cross shifted from making bandages to face masks. Volunteers passed around blankets and vats of broth to flu sufferers. An ambulance waited at Union Station to take any sickly train passengers directly to the hospital upon arrival. Police officers and mail carriers wore masks on their daily routes.

And as these measures took hold, it slowed the virus down.

Philadelphia:

In an effort to boost morale for the war and also to sell bonds, the city of Philadelphia threw a parade that drew 200,000 people, despite warnings that the Spanish flu was spreading among the soldiers who were about to head off to World War I and would be in the parade.

That didn’t turn out to be a good idea.

Days later, hospitals in the area were filled with patients suffering or dying from the Spanish flu.

Weeks later, more than 4,500 people in the Philadelphia area died from the virus.

The graph at the top of the post, from a 2007 article in the Proceedings of the National Academy of Sciences, paints the picture of these two approaches in stark, and by now familiar, terms.

Unlike a virus, people get to choose what they care about and how that care will be expressed. In 1918, to borrow from the Grail Knight, the leaders of Philadephia chose . . . poorly, while the leaders in St. Louis chose wisely.

Today, like many places, I and my neighbors in metro Kansas City (on both sides of the state line) are living under a locally-imposed “stay-at-home” order, with school buildings closed, business activity limited to those deemed essential and curtailing large public gatherings completely, including weddings and funerals.

You see, the leaders here know that a virus does not care. Other leaders, however . . .

From an interview on Fox:

Trump: I saw wouldn’t it be great to have all of the churches full—you know the churches aren’t allowed to have much of a congregation there. And most of them, I watched on Sunday online—and it was terrific, by the way—but online is never going to be like being there. So I think Easter Sunday and you’ll have packed churches all over our country—I think it will be a beautiful time. And it’s just about the timeline that I think is right.

A virus does not care about whether churches are full or empty on Easter. A virus doesn’t care if it is beautiful. A virus doesn’t care about your personal faith or lack thereof. In Omaha in 1918, Rev. Siefke S. de Freese, a seemingly healthy 35 year old pastor, led worship on a Sunday, then quickly died days later. A virus does not care.

From yesterday’s coronavirus task force presser:

Q: Mr President, you just reiterated that you hope to have the country reopened by Easter. You said earlier you would like to see churches packed on that day. My question is, you have two doctors on stage with you. Have either of them told you that’s a realistic timeline?

Trump: I think we’re looking at a timeline, we’re discussing it. We had a very good meeting today. If you add it all up. That’s probably nine days plus another two and a half weeks. It’s a period of time that’s longer than the original two weeks, so we’re going to look at it. We’ll only do it if it’s good and maybe we do sections of the country. We do large sections of the country. That could be too, but we’re very much in touch with Tony and with Deborah whenever they [crosstalk].

Q: Who suggested Easter? Who suggested that day?

Trump: I Just thought it was a beautiful time, a beautiful timeline. It’s a great day. . . . I’d love to see it come even sooner, but I just think it would be a beautiful timeline.

A virus does not care if it is a beautiful time. A virus does not care if it is a great day. A virus does not care what you think. A virus does not care what you love.

A virus Does. Not. Care.

We can choose how we respond to an uncaring virus. We can choose like St. Louis did, or we can choose like Philadelphia. And for far too many people, my friends, that is a choice between life and death. And in 1918, even St. Louis didn’t get it completely right:

The quarantine was temporarily lifted Nov. 18 but reinstated when the flu roared back in December. By Dec. 10 the flu peaked in the city with 60 deaths in one day. After illnesses declined sharply, the quarantine was lifted just after Christmas.

Look at that graph again, and you can see the bump at the end of November when the quarantine was prematurely lifted. The virus came back, because a virus does not care.

I’m a pastor. I’d love to see my church packed to the rafters on Easter. I’d love to hear the trumpets leading a 1000 voices in grand hymns of celebration. But that’s not going to happen, because while a virus does not care, I do.

We’re going to be closed this year. Not because we want to be. Not because we lack faith. Not because we don’t care about worship. Not because we’re giving in to the virus. It’s because we care about ourselves and our community so much that we’ll give up this kind of gathering to defeat the virus. Anything less than a full community commitment to a choice like that, and the virus will not be slowed, because the virus does not care.

I pray that more local leaders, state leaders, and national leaders choose wisely, even as Trump seems determined to choose . . . poorly.

I pray this, because I know the First Rule of Viruses: a virus does not care.

Calling ‘Bullshit’ on Trump’s Hoocoodanode

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[Check the byline — yes, it’s me!/~Rayne]

“But the president said nobody could see this coming!” the Trumpists say.

Trump actually said, “No one knew this was going to happen! No one saw this coming!”

Bull shit. Bull. Shit. Lying, fibbing, prevaricating bullshit.

Community members have already seen this in comments, but it bears repeating because the propaganda machine is trying to grant absolution to Trump for his gross failure to act from January onward.

I saw this on New Year’s Eve in my Twitter feed. It was publicly available and should have given pause to anyone charged with this nation’s security. This is what SARS looked like when it started in late 2002 — but the Chinese government didn’t report it to WHO until February 2003.

This time a commercial media outlet may have reported the outbreak within 4-5 weeks of the index case.

Don’t tell me our intelligence community didn’t already know about this outbreak.

Don’t tell me Trump and White House personnel couldn’t and wouldn’t already have been notified.

It was right there in front of anyone who could read the news, begging for further investigation.

Why was Hong Kong so anxious about this — and why wasn’t the White House especially given the heightened tensions at the time between Hong Kong, China, and the U.S.?

What was so “mysterious” about this virus? Why wasn’t it already recognized?

How were the dozens who were infected being treated?

Was this pneumonia another SARS?

If CDC ‘knew’ three or four days after this article there was a new SARS-like illness, why did nothing come out of CDC for the public?

There are no good answers to this. There are only more questions.

Did the CDC’s director simply not do his job?

Did the National Security Adviser not do his job?

Did Trump not do his job?

Well, we know the answer to the that one: Trump chose not to act. We just don’t know exactly what happened at the top of the CDC and NSC. We know the NSC was also hampered by the loss of the pandemic response team, killed by then- National Security Adviser John Bolton in 2018.

We don’t know if Trump’s decision was ignorance,  arrogance, or a belief that hiding this would prevent any damage to his re-election campaign.

Which suggests stupidity was a key factor since Trump could have come out looking like a hero had he simply made a little effort. He could have pointed to successfully preventing a pandemic and done all the self-applied back patting he wanted.

But no. He did absolutely dick-doodley-squat.

Worse, he claims now, “Hoocoodanode?”

Bull shit. Bull. Shit. Lying, fibbing, prevaricating bullshit.

And now people are literally dying because of Trump’s bullshit, including his obscene attempt to practice medicine without a license claiming an anti-malarial was approved by the FDA for use against COVID-19.

There’s more blood on his hands; there will be yet more. How many more lives will he claim before we figure out how to work around his fatal bullshit?

Let’s not forget that the Republican Party owns this mess. He’s theirs. They tied their wagon to his. They could have removed him but they were afraid of his mean tweets.

And now their base — elderly voters — are most at risk of dying during this pandemic Trump could have headed off. The same elderly voters are also at risk of losing their lifetime savings as the economy crashes because Trump still can’t manage his way out of a wet paper bag. Where will the GOP call for easy donations after Trump kills off their base?

One more thing: Trump and his administration have been told what to expect from best and worst case scenarios, and those in between as recently infected persons become sick and need medical attention, and as contagion spreads.

They’ve also been told what will happen to our health care system, how burdened our for-profit hospitals will be and how short of ICU beds and ventilators and personal protection equipment we’ll be.

In some cases, how short we already are and have been.

Trump has done very little about the PPE, left the states to fend for themselves. A few hundred masks from the federal strategic reserve for any one state won’t go far when a single large hospital can use thousands a day during normal business. Suggesting masks should be reused revealed not only Trump’s gross ignorance and cheapness but a shocking lack of understanding about basic infection control.

In spite of estimates which have surely made it to the CDC and DHS, and estimates from the American Hospital Association we’ve seen here more than two weeks ago, the administration has done little to nothing to meet the anticipated shortfall.

This estimate now appears on the light side and yet almost nothing has been done to help hospitals fulfill patients’ needs as they are today, let alone what they will be as the full depth of the pandemic wave hits.

Naval hospital ships arriving in another 3 to 4 weeks time are an insult not unlike the fatal insult Trump offered to Puerto Rican Americans in 2017.

“Hoocoodanode” won’t fly here. There’s no excuse. Trump and his minions were warned.

They own every American death for their failure to fulfill their duty to this nation.

This is an open thread.

Hurricane COVID-19

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[Check the byline, thanks! /~Rayne]

This is a hurricane. You recognize the threat such a storm poses especially if you live in a coastal region; you know that you must be ready by the time the outer bands begin to lash your home. You must be hunkered down and ready to ride it out.

This, too, is a hurricane. Our nation’s problem is that an overwhelming number of Americans didn’t recognize this impending storm when this first man-made outer band hit the airports the weekend of March 15.

Thanks to the incredible incompetence and/or malignancy of Trump’s minions Jared Kushner and Stephen Miller, this hurricane gathered energy in airport terminals across the country.

All the people who were exposed to those who were contagious in these confined and inadequately vented airport spaces are now into their first week of their own contagious state, with and without symptoms.

All the people in this photograph who are going to experience moderate/severe/critical symptoms are beginning to do so now and over the next week.

All the people in this picture who are asymptomatic or have mild, cold-like symptoms are still functioning as they did before their trips which took them through the airports. They are contagious and have no clue that they are for the most part.

The hurricane has only just begun and you had better be hunkered down, staying in your shelter.

The hurricane has only just begun and states need to lock down these contagious persons.

The White House’s bullshit 15-day period is just that, bullshit. The public has NO idea when those inept and corrupt jackasses began counting their 15 days. More importantly, to break this contagion will require MORE than 15 days because there hasn’t been a uniformly-applied, well-communicated lockdown, and because the federal government continues to yank us around on both testing and personal protection equipment.

I’m begging businesses small and large to understand there is NO economy ahead if this hurricane wipes a broad swath of consumers off the map, if this hurricane sweeps away resources through sustained illness and dealing with the fallout from deaths.

Small and large businesses must also come to the same conclusion as governors and other state leaders: the Trump administration has failed, is failing, and will continue to fail just as it did in 2017 before, during, and after Hurricane Maria.

Thousands of Americans died on a small island because of gross negligence by Donald Trump and his administration. They were in better shape then, had more resources than they do now, because there has been continued gross neglect of the government systems required to respond to emergencies and disasters.

The tests are not coming. The personal protection equipment isn’t coming. Assume you must find alternatives in your own backyard. Build them and protect your own. Work with state and local government to identify shortfalls and fill them. Do what the Trump administration has refused to do — be competent, be pro-active, care for your state and communities.

Do it right the fuck now before the next band of this hurricane comes within the week.

Not everyone will be able to take shelter even as states like Michigan order lockdown — it’s expected at 11:00 a.m. today that Gov. Gretchen Whitmer will announce all non-essential businesses shut down. Those folks who must continue to work need our understanding and our efforts to protect them.

So, too, do the folks who can’t afford to take time off work but will and have been forced to do so. Their bills continue even as their work stops.

Call your representatives and senators and ask them to pass aid packages which help the working people of this country, those in the lower 50% of income, because money given to them in aid is immediately plowed back into the economy.

The Trump tax cuts clearly didn’t put money back into the economy; savings from the cuts were used to buy back stock and boost share prices rather than create jobs or invest in equipment. Corporations received aid with those cuts; they shouldn’t get more after having abused the chance to build more robust business able to withstand this hurricane.

Nor should any business which pays zero taxes or operate in a different country — like cruise ship lines operating under foreign flags to avoid U.S. taxes — receive any consideration.

The Senate is scheduled to reconvene at noon E.T. — contact your representatives and senators NOW, whether by phone, fax, or @Resistbot.

Congressional switchboard: (202) 224-3121

Above all, #StayTheFuckHome.

This is an open thread.

Three Things: The GOP’s Trumpian Death Panels [UPDATE-1]

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[Check the byline, thanks! Update at the bottom of this post. /~Rayne]

Remember all the squealing by conservatives and Republican members of Congress back in 2009-2010 during the debate about health care, crying crocodile tears about “death panels“?

Well here they are, death panels brought to you by the same whiny selfish leeches who claimed socialized medicine would result in Democratic bureaucrats picking off Americans to limit health care.

~ 3 ~

I won’t embed video here. Open these links at your own risk, knowing these may be triggering to those who’ve had bad experiences in hospitals.

1 — Bergamo Italy hospital

2 — Brescia and Rome Italy hospitals

But this I’m going to share.

Those are Italian military trucks carrying away the dead to churches and cremation facilities, some outside of Bergamo because Bergamo’s own facilities are at capacity.

This, in a very much pro-life country which is predominantly Catholic.

This, in a country which has more hospital beds per 1000 persons than the U.S.

Some of those patients who are not in ICU have likely been labeled “codice nero” — death is imminent, do not resuscitate — during triage due to the shortage of ventilators. They are more likely to be over 60 years old because they are prioritizing critical care services and equipment for those more likely to survive.

This is what conservatives and Republicans really wanted: death panels, but conducted by the poor overtaxed health care workers who are themselves at risk because of incompetent governance by conservatives and Republicans.

I hope Americans are ready to see the dead hauled away by the truck load after the GOP’s death panel is through with them.

~ 2 ~

$34,927.43.

That’s the price for multiple tests and trips to the ER over seven days for COVID-19 an uninsured Boston-area patient was charged. You can imagine some people aren’t going to want to deal with that bill — or that swamped hospitals may discourage the uninsured — leading to a lack of treatment and more deaths. Many patients will be too sick to hassle with chasing a lower cost approach as charges can vary widely across many health care providers.

A death panel by health care expense.

Capitalism unto death.

~ 1 ~

Death panels may be composed of single individuals.

John Bolton, with Trump’s imprimatur, chose to kill the National Security Council’s pandemic response team, which has now lead to the deaths of Americans.

Mike Pompeo’s crappy diplomatic work failed to develop and build relationships with China, South Korea, other countries facing the same pandemic threat in order to obtain and share usable information and assistance to reduce American deaths.

Jared Kushner and Stephen Miller pulled a grossly negligent EU travel ban out of their asses, executing it so poorly that the resulting crush of travelers in the airports last week will sure increase American deaths in the weeks ahead many times over.

And the malignant narcissist-in-chief continues to push bad information jeopardizing lives both here and abroad after more than two months of inaction. Trump pushed a non-peer reviewed study on hydrochloroquine and azithromycin by tweet today after pushing this drug combo during a presser. There’s already been a run on the anti-malarial potentially hurting lupus patients for whom this has been prescribed; there’ve also been reports of poisonings in Nigeria after users self-medicated with the anti-malarial.

Trump has also mentioned and then lied about the Defense Production Act. There has been no real effort to order production of personal protection equipment for health care workers under the DPA. He’s choosing to expose first responders to COVID-19.

Mass death panels by Trumpism.

~ 0 ~

Sadly, it’s not just Americans who will face so-called conservatives’ death panels. The UK is already entering a state of crisis as its hospitals’ ICUs exceed capacity. There is no sign of constructive decision making by Boris Johnson to alleviate the capacity problem nor realistically halt the rate of infection.

Instead, Johnson’s government and now Trump’s Department of Justice are seeking powers to detain people instead of doing what is already within their ability and purview to do to stem contagion and aid respective health care systems.

Death panels by Tory conservatives and Trump fascists.

By the way, where’s Sarah Palin now? Still licking her polyester-pink wounds after her recent fiasco appearance on The Masked Singer when the show’s death panel gave her the much-deserved axe?

This is an open thread.

UPDATE-1 — 22-MAR-2020 — 11:00 P.M. ET

This video features Rep. Katie Porter’s sister who’s an emergency room physician. She breaks down what the Trump-GOP death panel will decide by the numbers.

Are you one in 50? Or are you one of the 49 which Trump and the GOP have decided in their pro-life hypocrisy won’t be saved?