via:

COVID-19: Protecting Health-Care Workers

Worldwide, as millions of people stay at home to minimise transmission of severe acute respiratory syndrome coronavirus 2, health-care workers prepare to do the exact opposite. They will go to clinics and hospitals, putting themselves at high risk from COVID-2019. Figures from China's National Health Commission show that more than 3300 health-care workers have been infected as of early March and, according to local media, by the end of February at least 22 had died. In Italy, 20% of responding health-care workers were infected, and some have died. Reports from medical staff describe physical and mental exhaustion, the torment of difficult triage decisions, and the pain of losing patients and colleagues, all in addition to the infection risk.

As the pandemic accelerates, access to personal protective equipment (PPE) for health workers is a key concern. Medical staff are prioritised in many countries, but PPE shortages have been described in the most affected facilities. Some medical staff are waiting for equipment while already seeing patients who may be infected or are supplied with equipment that might not meet requirements. Alongside concerns for their personal safety, health-care workers are anxious about passing the infection to their families. Health-care workers who care for elderly parents or young children will be drastically affected by school closures, social distancing policies, and disruption in the availability of food and other essentials.

Health-care systems globally could be operating at more than maximum capacity for many months. But health-care workers, unlike ventilators or wards, cannot be urgently manufactured or run at 100% occupancy for long periods. It is vital that governments see workers not simply as pawns to be deployed, but as human individuals. In the global response, the safety of health-care workers must be ensured. Adequate provision of PPE is just the first step; other practical measures must be considered, including cancelling non-essential events to prioritise resources; provision of food, rest, and family support; and psychological support. Presently, health-care workers are every country's most valuable resource.

by The Lancet |  Read more:

Image: Denis Lovrovic/AFP/Getty Images

[ed. Thank a healthcare worker. They are the heros on the frontlines of this pandemic. I saw tonight that some cities were providing personal transportation for nurses, increased salaries, childcare, food security and other measures that will allow them to focus on what they're doing without becoming agents of infection themselves (imagine having to travel in a bus with hundreds of other people every day just to get to work). See also: A Lockdown Can Only Be a Strategic Pause (The Wire).]

via:

Professors, Don’t Be Scared. Teaching Online Is Great.

When I was invited to teach an online reporting class for New York University’s online master’s in journalism program last fall, I had a few concerns. Though I’d taught in university classrooms before, I had no experience teaching online. This was the cornerstone class for a new, online-only program with 21 students logging in live from all over the world for three hours at a time. How would I connect with them, lead class discussion, and facilitate collaboration? How would I handle office hours without an office?

I’ve been thinking about that experience as a number of universities—the University of Washington, the University of Southern California, Harvard, Ohio State, and many more—have announced that they will be moving to online instruction to avoid the spread of COVID-19. Across the country, instructors who, like me, struggle with turning on the class projector will need to jump in and quickly master the much-needed skill of online teaching.

Twitter is full of critics as classes move online. As one tweeted: “These teachers really think these online classes gonna work? Half the time they not even tech savvy enough to log into their gmails.”

But teaching online wasn’t that different from the classroom experience I was accustomed to. It was often more fun than standing at a lectern working through a well-worn set of PowerPoint slides. The trick was making it as personal as possible and accepting that sometimes, the technology fails and you figure it out. In fact, instructors should look at this as valuable practice: Even without a communicable disease making the rounds, the online college experience is likely to become more common with lower overhead for universities and greater flexibility for students.

My class included students across the U.S. with a few international students including one who dialed in from India, sipping her morning coffee as I drank a diet soda. In the first class, a student from the Bahamas was logging in just days after Hurricane Dorian had ravaged the islands. Once, as part of her weekly pyrrhic quest for decent Wi-Fi, she joined us from the parking lot of a Dunkin Donuts. While students whose lives get in the way often struggle with in-person classes, the online nature allowed for flexibility. Another student lost his work visa on a trip home and continued the class from Canada.

I had worried that teaching online would get in the way of the classroom camaraderie that is so important for projects and discussion. But as the weeks wore on, the students got to know one another, perhaps better than if they simply filed in for class and left. As one student observed, in his regular classes, he was usually just staring at a lot of “backs of heads.”

Despite my initial concerns, I found the experience to be invigorating. Instead of the usual exhaustion after an eight-hour workday and a three-hour class, I was energized. Even the challenges ended up being rewarding. For instance, it was initially tough with introverted students—we didn’t have eye contact or opportunities for them to walk up to talk to me after class. So I looked for ways to connect with all of the students on personal level—and it paid off. One student who was not feeling connection early in class wrote me a note to say she appreciated the one-on-one attention and encouragement she received from me in a breakout room. (More on those in a minute.) From then on, she spoke more in class—maybe even more than she would have in an in-person course.

An odd feature on online communication is the number of exclamation points required to relay a simple message: “Nice work! Can’t wait to see the final version!” All those exclamation points paid off, and after the class, more students stayed in touch with me than usual, and one even sent a charming holiday card—in the mail.

I ran the class from a laptop in a conference room at the Atlantic in D.C., where I worked at the time, and sometimes from my second bedroom, a less attractive option given my dog’s habit of barking insistently during conference calls. (A peanut butter–filled bone and two doors between us helped.) I had students with dogs who would jump into laps and cats that would sashay over keyboards and once, two small children jumping gleefully on a hotel bed behind their mom as she discussed her work. This made for a relaxed experience and a deeper sense of who my students were outside of class.

To run the class, I used a version of Zoom video conferencing software customized for NYU users. Zoom staff were available via chat and email to troubleshoot problems, like having the right version of the software appear when I logged on. (Zoom is about to experience a major influx of users, but the CEO seems to be using this as a dare-to-be-great moment.) I worked with a talented co-instructor who helped lead and teach the class, an administrator and a full-time “educational technologist” who helped craft our online curriculum. We conducted three surveys during the semester to be sure that NYU’s online students were mastering the material as if they were live in a classroom. I’m pleased to report they were.

by Liza Kaufman Hogan, Slate |  Read more:

Image: NESA by Makers/Unsplash

Coronavirus Will Change the World Permanently. Here’s How.

For many Americans right now, the scale of the coronavirus crisis calls to mind 9/11 or the 2008 financial crisis—events that reshaped society in lasting ways, from how we travel and buy homes, to the level of security and surveillance we’re accustomed to, and even to the language we use.

Politico Magazine surveyed more than 30 smart, macro thinkers this week, and they have some news for you: Buckle in. This could be bigger.

A global, novel virus that keeps us contained in our homes—maybe for months—is already reorienting our relationship to government, to the outside world, even to each other. Some changes these experts expect to see in the coming months or years might feel unfamiliar or unsettling: Will nations stay closed? Will touch become taboo? What will become of restaurants?

But crisis moments also present opportunity: more sophisticated and flexible use of technology, less polarization, a revived appreciation for the outdoors and life’s other simple pleasures. No one knows exactly what will come, but here is our best stab at a guide to the unknown ways that society—government, healthcare, the economy, our lifestyles and more—will change.

Coronavirus Will Change the World Permanently. Here’s How. (Politico).

Image: DAQ

Slush Fund

As Senate Democrats went to the floor Sunday night to vote — the first time they’d been there in days — they had one thing on their minds: a secret “slush fund” for Corporate America.

That’s what Democrats are calling a $500 billion “Exchange Stabilization Fund” included in the massive Senate GOP proposal to rescue the U.S. economy from the coronavirus crisis. The fund, which would come under the control of Treasury Secretary Steven Mnuchin, is designed to aid distressed industries. It includes $58 billion for U.S. airline and air cargo companies, a source of significant controversy during the last three days of closed-door talks between senators of both parties and the White House.

But the language drafted by Senate Republicans also allows Mnuchin to withhold the names of the companies that receive federal money and how much they get for up to six months if he so decides. (...)

“We’re gonna give $500 billion in basically a slush fund to help industries controlled by Mnuchin with very little transparency? Is that what we ought to be doing?” asked Sen. Mazie Hirono (D-Hawaii.).

“We're not here to create a slush fund for Donald Trump and his family, or a slush fund for the Treasury Department to be able to hand out to their friends,” railed Sen. Elizabeth Warren (D-Mass.), who made corporate accountability a big part of her White House campaign. “We're here to help workers, we're here to help hospitals. And right now, what the Republicans proposed does neither of those. “ (...)

Senate Democrats had other high-profile issues that also led to their Sunday vote to block the stimulus bill. They sought four months of increased unemployment insurance support, but only got three months; they sought hundreds of billions of dollars in emergency funds for hospitals and other health-care providers to combat the coronavirus, yet Republicans budgeted just $75 billion; and they asked for hundreds of billions for a “State Stabilization Fund” to help state and local governments hurt by the looming economic slowdown, while Republicans offered far less.

But the key to the unanimous set of Democratic ‘no’ votes — and what made it easy for Senate Minority Leader Chuck Schumer (D-N.Y.) to line them up — was the “slush fund” accusation.

by John Bresnahan and Marriane Levine, Politico |  Read more:

Image: Jake Sherman (Politico) via Twitter
[ed. See also: Demands for Workers-First Stimulus Grow as Senate GOP Fails to Ram Through $500 Billion Corporate 'Slush Fund'; and To Counter 'Corporate Handout' Pushed by McConnell, Progressives Intensify Demand for #AJustStimulus; and Sanders Calls for 'Unprecedented Legislative Response' to Coronavirus Crisis—Not Corporate Bailouts (Common Dreams). Finally, we must ask again: Where Is Joe? (Current Affairs).]

Here's what progressives are saying should be priorities:

• Paid sick and family leave for households hit by the virus, regardless of employer size, immigrant status and including independent contractors;
• Emergency cash assistance on an ongoing basis, starting with $2,000 immediately to every adult, monthly for the length of the crisis;
• A Homes Guarantee including zero rent and a moratorium on evictions and foreclosures;
• A ban on essential utility shut-offs like heat, water, and electricity;
• and Student debt forgiveness to save people from financial ruin, as well as refunding students on room and board, tuition, and healthcare for this semester.

America: ‘At Home’ With Absurd Consumer Excess

Every culture has a custom or symbol that encapsulates its entire way of life. For example, a salami hanging from the ceiling of a cramped neighborhood deli is Italy. Japan is a tea ceremony or an orderly subway rush hour. And for us, that condensed cultural symbol is not the Declaration of Independence or the ragtag militia or the all-American con man with a bridge to sell you. It’s a big-box store called At Home.

Founded in 1979 and hitting the stock market in 2016, At Home hails—where else?—from Texas. They are not particularly well-known or widespread, with a little over 200 locations at present; however, they plan to double twice over in the coming years. Most of their stores are located in existing buildings vacated by the likes of K-Mart and JCPenney (and even, in Frederick, Maryland, a vacated Walmart). Consider how large one of these buildings is, and then consider that At Home is dedicated entirely to home goods and decor. Imagine a lovechild of Michael’s and the aforementioned Walmart, then imagine dropping acid in said store, and you may get a small sense of what it is like to browse At Home.

The 70s-vintage floor tiles and drop ceilings have been stripped, leaving only the shell of the K-Mart or other defunct chain, making the average At Home location look more like a Home Depot or Costco. Heck, the shopping cart bay at the entrance is bigger than lots of small stores. As long as you can think of something tangentially related to home organizing or decor, it exists in this gargantuan retail warehouse.

A first-time visitor’s emotions are likely to run from exhilarated to wryly amused to vaguely discomfited, as the funhouse-mirror-like feeling of the place dawns. It is staggering how many aisles there are, how many sheer combinations and permutations of stuff. On top of this, the merchandise has an uncanny-valley feel to it, almost as if it has been generated algorithmically based on a Chinese computer’s idea of what an American with too much time and money would like to buy.

You can choose from 10 or 20 slightly different chairs in different colors; four different aisles of pillows with or without embellishments, in every color, texture, and size imaginable and then some; T-Rex skeleton bookends, T-Rex head decorative plaques, oyster shell bookends, plaques inscribed with shallow therapeutic babble, some of which gives the impression of having been engineered randomly out of a word bank. Others are a bit less random, following more of a “Verb phrase/adjective/noun” pattern; one plaque for a child’s room reads “Stay clever, little fox.” The next one reads “Dream big, little whale,” with cute animal illustrations and faux-driftwood frames. There are artichoke wreaths, artichoke-shaped fake flowers, and perhaps, somewhere in there, a “Welcome to Our Home” plaque framed by sketched artichokes. You can buy a plaster cactus, a plaster creepy cat, and a lot of other three-foot-tall plaster statuettes. Or you can pick from an ungodly variety of plastic plants at “The Greenhouse,” where the cheery dystopian slogan reads, “No sun? No problem.” And we’re just getting started. (...)

One is tempted to think of left-wing slam poet Andrea Gibson’s line about “the sweatshops our children call the North Pole.” Surely there is some cost to all this. Perhaps the environmentalists and the fundamentalists are right that we are racking up some sort of planetary bad karma. I recall a college professor of mine who remarked that in a couple of decades we will marvel at the idea of all-you-can-eat shrimp or 20 choices of peanut butter. Perhaps one day we will marvel at the thought that immeasurable and irreplaceable time, talent, and treasure was wasted on fake artichokes and plastic oyster shell bookends.

by Addison Del Mastro, The American Conservative | Read more:
Image: Addison Del Mastro

via:

The Best-Case Outcome for the Coronavirus, and the Worst

Here’s the grimmest version of life a year from now: More than two million Americans have died from the new coronavirus, almost all mourned without funerals. Countless others have died because hospitals are too overwhelmed to deal adequately with heart attacks, asthma and diabetic crises. The economy has cratered into a depression, for fiscal and monetary policy are ineffective when people fear going out, businesses are closed and tens of millions of people are unemployed. A vaccine still seems far off, immunity among those who have recovered proves fleeting and the coronavirus has joined the seasonal flu as a recurring peril.

Yet here’s an alternative scenario for March 2021: Life largely returned to normal by the late summer of 2020, and the economy has rebounded strongly. The United States used a sharp, short shock in the spring of 2020 to break the cycle of transmission; warm weather then reduced new infections and provided a summer respite for the Northern Hemisphere. By the second wave in the fall, mutations had attenuated the coronavirus, many people were immune and drugs were shown effective in treating it and even in reducing infection. Thousands of Americans died, mostly octogenarians and nonagenarians and some with respiratory conditions, but by February 2021, vaccinations were introduced worldwide and the virus was conquered.

The Best Case

I’ve been speaking to epidemiologists about their best- and worst-case scenarios to gauge what may lie ahead and see how we can tilt the balance. Let me start with the best case, since we could all use a dose of hope — which may even be therapeutic — before presenting a bleaker prognosis.

“The best case is that the virus mutates and actually dies out,” said Dr. Larry Brilliant, an epidemiologist who as a young doctor was part of the fight to eradicate smallpox. Brilliant was a consultant for the movie “Contagion,” in which a virus evolved to become more deadly, but that’s the exception. “Only in movies do viruses seem to become worse,” he explained.

Two other lethal coronaviruses, SARS and MERS, both petered out, and that is possible here. “My hope is that Covid-19 will not survive,” said Dr. Charles G. Prober, a professor at Stanford Medical School.

Several countries have shown that decisive action can turn the tide on Covid-19, at least for a time. China, astonishingly, on Thursday reported not a single new case of domestic transmission. While China is still vulnerable to a second wave, it has apparently shown that the virus can be squelched.

The West isn’t going to copy the coercive tactics of China, but Singapore, Taiwan, South Korea and Hong Kong have also demonstrated that, at least temporarily, the virus can be controlled.

[ed. But...]

by Nicholas Kristof, NY Times | Read more:
Image: Elaine Thompson/Associated Press
[ed. See also: Notes on a Nightmare Part 1 and Part 2 . Also, Where is Joe? (Current Affairs).]

I Miss Sports So, So, So Much

I miss sports. I miss millionaires diving into billionaires to save a $150 basketball. I miss buzzer beaters, chin-high heaters, and even Astros cheaters. I miss one seeds and three putts and five holes. I miss Roger Federer faking his opponent so far the wrong way on a forehand that both guys have to laugh.

I quit full-time sportswriting six years ago partly because I was tired of the same old wheel, season after season, year after year—the Final Four to the NBA Finals to the World Series to the Super Bowl to the Final Four. But now that these events are inexplicably gone, I’d give my left pinky toe just to cuddle up with a cold beer and the Valero Texas Open.

This has never happened in American history. Sports is shut down, put up, and locked away. No March Madness, no NBA, no NHL, no golf, no tennis, no spring training, no NASCAR, no nothing. All I have is these two guys hitting a ball from one high-rise-apartment window to the other. I’ve watched it 11 times now.

I know we’re doing the right thing. Until the coronavirus calms down, Americans have to stay away from one another, and sports are the opposite of that. Fans, athletes, refs, writers, popcorn vendors, and sweat-mop boys have to avoid all contact. So, you know, just pretend you play for the Cleveland Browns.

The other day, I read the saddest paragraph in sports history. It was in a how-to-isolate-yourself directive: “Shooting hoops solo is OK … Also permitted: hitting a tennis ball against a backboard.” (Cue soft whimpering.)

Here’s how bad it’s gotten: The other day I came upon two teenage boys throwing a football in the alley near my home. I stopped. My sports-starved brain took over from there. The lefty has a nice tight spiral, but I don’t like his footwork. I’d like to see the redhead catch more with his hands than his body. Still—Suddenly, I noticed they were looking at me like they were about to dial 911.

What do we do with ourselves? After Pearl Harbor, Franklin D. Roosevelt persuaded baseball’s commissioner, Kenesaw Landis, to keep baseball going to take people’s minds off the war. A week after 9/11, baseball was back on. But even sports can’t get us through this. It’s a planet-wide stoppage until … who knows? And when they do finally come back, Tom Brady won’t even be wearing a New England Patriots uniform. We are through the looking glass, people.

by Rick Reilly, The Atlantic | Read more:
Image: Lucas Uebel/Getty

Ghost Town Seattle

America’s Coronavirus Ground Zero (Politico)
Images: Chona Kasinger

[ed. Coming to a city near you. I've been tremendously impressed with Governor Inslee's leadership.]

And It's Gone

[ed. The Everything Bubble is collapsing. See also: Le Freak (Freak Out).]

Today We Are Switching Our Coverage of Donald Trump to an Emergency Setting

Even this far into his term, it is still a bit of a shock to be reminded that the single most potent force for misinforming the American public is the current president of the United States. For three years this has been a massive — and unsolved — problem for the country and its political leadership.

But now it is life and death. On everything that involves the coronavirus Donald Trump’s public statements have been unreliable. And that is why today we announce that we are shifting our coverage of the President to an emergency setting.

This means we are exiting from the normal system for covering presidents— which Trump himself exited long ago by using the microphone we have handed him to spread thousands of false claims, even as he undermines trust in the presidency and the press. True: he is not obliged to answer our questions. But neither are we obligated to assist him in misinforming the American people about the spread of the virus, and what is actually being done by his government.

We take this action knowing we will be criticized for it by the President’s defenders, by some in journalism, and perhaps by some of you. And while it would be nice to have company as we change course, we anticipate that others in the news media will stick with the traditional approach to covering presidents.

This we cannot in good conscience do.

Switching to emergency mode means our coverage will look different and work in a different way, as we try to prevent the President from misinforming you through us. Here are the major changes:

* We will not cover live any speech, rally, or press conference involving the president. The risk of passing along bad information is too great. Instead, we will attend carefully to what he says. If we can independently verify any important news he announces we will bring that to you— after the verification step.

* We plan to suspend normal relations with the Trump White House. That means we won’t be attending briefings. (We can watch them on TV.) We won’t gather around him as he departs in his helicopter. We won’t join in any off-the-record “background” sessions with Administration officials. We won’t enter into agreements of any kind with the Trump team, which includes those nameless “senior advisers” who mysteriously show up in news stories.

* We have always tried to quote public officials accurately, including President Trump. In emergency mode we add a further check. In addition to, “does this fairly represent what he said?” we will ask: is what he said something we should be amplifying? If it is simply meant to demonize a group of people, rewrite a history that now embarrasses the President, or extend his hate campaign against journalists who are doing their job, we may decide not to amplify it, even though it happened. An old tenet of White House reporting states that what the president says makes news— automatically, as it were. Today we are disabling that autoplay system and replacing it with a manual one.

* In general, we will be shifting the focus of our coverage from what President Trump is saying to what his government is doing. We will be de-emphasizing the entire White House beat and adding people who can penetrate the bureaucracy from the rim, rather than the center of the distortion machine.

* Experience has taught us that there will occassionally be times when the President makes a demonstrably false claim, or floats a poisonous lie, and it is too consequential to ignore. We feel we have to tell you about it, even at the risk of amplifying his deceptions. In those special cases, we will adopt a newswriting formula that has been called the “truth sandwich.” It is a more careful way of reporting newsworthy falsehoods. First you state what is true. Then you report the false statement. Then you repeat what is true. 

Refusing to go with live coverage. Suspending normal relations with his White House. Always asking: is this something we should amplify? A focus on what he’s doing, not on what he’s saying. The truth sandwich when we feel we have to highlight his false claims. This is what you can expect now that our coverage has been switched to an emergency setting.

by Jay Rosen, PressThink |  Read more:

[ed. If only the mainstream media were as conscientious as Prof. Rosen. To see real leadership in action (from a couple posts above): Governor Jay Inslee, Washington. Contrasted with: this (NY Times)]

Coronalinks 3/19/20

A brief flurry of interest last week as the UK seemed to be trying a different strategy from everyone else – isolating their oldest and most vulnerable citizens, but letting everyone else get the virus to build herd immunity. They’ve since backtracked after people did the math and found that an epidemic even among healthy young people only would overwhelm their medical system. Here’s another critique of herd immunity, appropriately enough on UnHerd.com.

But the UK’s original point – that without herd immunity, all we can do is continue the lockdown until something happens – remains sound and worrying. Everyone is hoping for a quick vaccine or antiviral, but this is a field where “quick” sometimes means months or years instead of decades. If we don’t get a deus ex machina, eventually somebody will need to implement some long-term strategy.

Last week I predicted that this might look like titrating quarantine levels – locking everything down, then trying to unlock it just enough to use available medical capacity, then locking things down more again if it looked like the number of cases was starting to get out of hand. This would eventually develop herd immunity without overwhelming the medical system. A paper yesterday out of Imperial College London (discussed here) said the same thing, arguing for alternating periods of higher and lower quarantine levels based on how the medical system was doing:

The orange line is projected ICU cases. The blue line is government-mandated social distancing levels. Relax social distancing levels, then after ICU cases cross some threshold, reinstate them again. That way at least we can have a few weeks of normal economic activity and seeing friends in between each lockdown. Control systems are the solution to everything!

Problem: it would take forever to develop herd immunity under this system, and we might just have to keep turning quarantine on and off for a year or two until a vaccine gets developed. Does anyone have any better ideas?

The closest thing I’ve heard is “what China and South Korea are doing”, which seems to be having so many tests available, and such good health services, that it’s easy to detect cases, track down their contacts, and manage the epidemic even while life goes on mostly as usual. So maybe the end date isn’t “have a vaccine available”, it’s “have millions of test kits available”, which I think looks more like a few months than like years and years.

Flatten the curve

Is flattening the curve just another name for the “have a control system to titrate lockdown levels so that only the right number of people get it at a time” strategy? Maybe everyone just assumes that we’re never going to get the cases down to too low a level, so we should try to get them as low as possible and maybe hit the right amount? And overshooting and reducing it so far that you’re not using the medical capacity you have, and wasting an opportunity to have a normal life and/or build herd immunity, is just really unlikely without China-level resources?

An article called Flattening The Curve Is A Deadly Delusion has been going around this part of the Internet, saying that there’s basically no way to match a curve of any flatness with our current hospital capacity. Nostalgebraist says the math is wrong, mostly because it uses a normal distribution when it should use an exponential one. But I’ve seen some other people making this basic point now, so it could just a be a question of how bad things get, rather than whether they’ll be bad at all. (...)

Don’t use aspirin

Doctors in Germany and France are saying that a suspicious number of young coronavirus patients who end up in the ICU took aspirin or other anti-inflammatory drugs (Advil, Motrin, Aleve, ibuprofen, diclofenac, etc, yes I know several of these are the same drug, I’m trying to inform readers) before getting worse. There’s a plausible biological mechanism; anti-inflammatories dial down the immune system. BMJ agrees: Ibuprofen should not be used for managing symptoms, say doctors and scientists. Tylenol, acetaminophen, or paracetamol (YES, I KNOW) is still okay, so use that for coronavirus-induced fever.

[EDIT: WHO is skeptical, but French and German doctors stick to their guns. It seems like there’s a longstanding debate on this with the French and German medical establishment thinking it’s bad for lots of diseases, and most of the rest of the world not believing them. I have no strong beliefs about whether France/Germany or everyone else is better, but switching from Motrin to Tylenol in this case seems pretty low cost] (...)

Ventilation, part 2

Right now the biggest bottleneck to treating coronavirus is likely shortage of ventilators and oxygen concentrators. Many people are trying to come up with ideas for solving the shortage. EndCoronavirus.Org is trying to get a team together, and is looking for doctors, engineers – and of course lawyers, to jump over the inevitable regulatory hurdles.

Meanwhile, at least according to Breitbart, existing ventilator manufacturers are just…not bothering to ramp up production yet? Does this make sense to anyone else? According to Forbes, ventilator manufacturers could quintuple capacity over the next few months, but…nobody has asked them to?…and they don’t want to take the initiative until somebody asks? Economists are begging the US government to ask, and maybe to ensure that every ventilator they make will get bought no matter what the circumstances are a few months from now – if they can’t, maybe private philanthropists should step in? Kudos to the UK government, which has just sent ventilator blueprints to a bunch of manufacturers and told them to get to work. But even if this comes through, how are we going to get enough skilled labor to ventilate this many people? [EDIT: As per WSJ, ventilator manufacturers are now ramping up production].

Also in medical supply news – when a hospital runs out of a critical $11,000 part and the manufacturer can’t supply more, a local guy with a 3D printer prints one up for $1. Now he’s being threatened with a lawsuit by the manufacturer. [EDIT: possibly not true or exaggerated, see here] This whole epidemic has been a fun adventure in “newspapers finally paying attention to what everything in health care is like all the time.”

Ventilation, part 3

When doctors need to ventilate someone in an emergency and don’t have time to hook them up to a real ventilator, they use manual ventilation, ie “bag and mask ventilation”, a really simple technique using a $30 piece of equipment which is literally just a bag attached to a face mask. Somebody squeezes the bag in a breathing-like rhythm, sending air into the person’s lungs until they’re able to get on a real ventilator. It’s not perfect but it saves lives.

In a New York Times article on the expected upcoming ventilator shortage, they say:

One doctor wondered if they could recruit enough volunteers to manually ventilate patients — which involves squeezing a small inflatable device by hand — indefinitely.

I know nothing about respiratory medicine, and I guess I always assumed that there were issues with bag-mask ventilation which made it unsuitable for longer than the few-minute-period it usually gets used for. If that’s not true, and the limiting factor is just getting enough people to keep squeezing the little bag, then surely our civilization can come up with some sort of automatic squeezing machine, right?

[EDIT: some discussion of why this may not work here and here.]

Come summer

The smart people seem to be going back and forth on whether the coronavirus might die down in summer like a seasonal flu. The good news is that this has sparked more interest in the absolutely fascinating field of disease seasonality:

Except in the equatorial regions, respiratory syncytial virus (RSV) is a winter disease, Martinez wrote, but chickenpox favors the spring. Rotavirus peaks in December or January in the U.S. Southwest, but in April and May in the Northeast. Genital herpes surges all over the country in the spring and summer, whereas tetanus favors midsummer; gonorrhea takes off in the summer and fall, and pertussis has a higher incidence from June through October. Syphilis does well in winter in China, but typhoid fever spikes there in July. Hepatitis C peaks in winter in India but in spring or summer in Egypt, China, and Mexico. Dry seasons are linked to Guinea worm disease and Lassa fever in Nigeria and hepatitis A in Brazil.

Their explanation for why we don’t know more about this:

“It’s an absolute swine of a field,” says Andrew Loudon, a chronobiologist at the University of Manchester. Investigating a hypothesis over several seasons can take 2 or 3 years. “Postdocs can only get one experiment done and it can be a career killer,”

As for the coronavirus itself? Unclear. The latest study says it might be seasonal, but a lot of comments on it point out continuing epidemics in tropical countries like Malaysia (currently 900 official cases). If your hometown isn’t going to get warmer this summer than Kuala Lumpur is right now (95 degrees at time of writing), you may not quite be off the hook.

by Scott Alexander, Slate Star Codex |  Read more:
Image: uncredited

Taylor Swift

[ed. More bad news. I think we all know the deal by now, the only question being just how bad it gets. Enjoy some music. It'll get better.]

Tom Petty & The Heartbreakers

The Robert Glasper Trio

Keith Richards

via:

Why Sending $1,000 Checks to Everyone Won’t Solve the Coronavirus Crisis

... Meanwhile on the question of broader economic stimulus, several Republicans are now outflanking Pelosi to the left. On Monday, Senator Tom Cotton (R-Ark.) rejected the Pelosi bill as insufficient, while Senator Mitt Romney (R-Utah) proposed an immediate payment of $1,000 to every adult. On Tuesday, the White House released a massive $850 billion stimulus plan (which may get even bigger), including “$500 billion in a payroll tax cut, a $50 billion bailout for airlines struggling from plummeting demand, and $250 billion for small business loans,” Reuters reports.

Even though these are big numbers, recall yesterday that Edmund Saez and Gabriel Zucman’s back of the envelope calculation was that the US GDP could suffer a 10% fall in GDP. Even Stephanie Kelton’s guesstimate that $2 trillion in stimulus was needed is light relative to that.

Moreover, more delay and more complexity leads to permanent damage. Even though the Administration claimed they’d get their $1000 checks out in two weeks, there’s no way that will happen between getting the legislation passed and the operational requirements of printing all the envelopes and checks and getting them out. In 2009, under an Obama stimulus program, the Federal government sent out 52 million checks, fewer than one expects here (presumably to ~155 million filers of Federal tax returns,1 since those are the addresses on hand; Social Security recipients are set up for electronic deposit, but they aren’t the group most in need). It took five months to distribute them, from May to October. One assumes there was also a sense of urgency then.

And what does $1,000 per adult do? The average US mortgage payment is over $1,000, so for a couple, in most cases, housing costs will eat up a lot. It doesn’t take a lot of budget estimations to show that for most this money will support critical payments like housing, car expenses, the cell phone, perhaps student debt payments, for a month. It’s a very short term stopgap.

And even more important…that amount of money is chump change compared to paying any coronavirus treatment-related bills, and all we have from the officialdom on that front so far is empty promises. Look at an indicator of the costs even for those with insurance. From The Verge:

Someone with health insurance from their employer could pay $1,300 or more out of pocket for treatment if they’re hospitalized with a severe case of COVID-19, the disease caused by the novel coronavirus, according to one analysis. Health researchers based that prediction off of the costs associated with hospitalization for pneumonia… 

Rae and his co-authors analyzed a database of insurance claims for people enrolled in employer insurance plans. They found that the total cost of treatments for people on those insurance plans who were hospitalized with severe pneumonia with complications was, on average, around $20,000 — though it ranged from around $11,000 to around $24,000. Insurers covered most of that cost, but the out-of-pocket expense for most people usually reached or exceeded $1,300.

And for those who have jobs or a bit more of a cushion, a lot will be saved. It was for the most part in 2008 when the Bush Administration also launched a stimulus package that included sending checks of up to $600 to individuals, $,1200 for couples, and an additional $300 per dependent child. Even thought there was more to spend it on at that time (shops and entertainment venues were open), that was also a juncture when it looked like the economy might collapse into a depression. From The Balance:

The Bush Economic Stimulus Package didn’t have the impact it should have. A 2008 survey found that only 20% of those who received checks spent them. Another 32% put the money into savings. The rest use the checks to pay off debt.

In other words, while saving people from bankruptcy or living on the street is a worthy goal, stimulus this ain’t. It’s a band-aid over the gunshot wound of business closures, job losses and pay cuts.

And loans to small businesses? Are you kidding? What small businessman wants to take on more debt when he isn’t sure of his income or even business survival? A few who are in situations where they have genuine reasons to think the coronavirus impact on them is as blip rather than a body slam might take the plunge, but the rest? Fuggedaboudit. Plus the time and effort involved in getting together a loan application and the uncertainty as to if and when any money might be forthcoming are further stressors when someone is fighting for his commercial survival. A business owner hit by the coronavirus lockdown needs money to pay his bills now, if he still has a prospect of riding out months of the new normal, and that’s just not how these programs work.

by Yves Smith, Naked Capitalism |  Read more:

Image: Getty via

[ed. Yes. $1000 or even $2000/person is a panic, drop in the bucket solution (For each family member, or per family? For millionaires? One time? Monthly?). A better solution, if we have to go with something like this (everyone is apparently a socialist now) might be what China is doing - time sensitive coupons/vouchers that have to be spent within a certain time-frame or risk becoming useless. See: More of China’s local governments, companies resort to coupons to boost flagging consumer spending (South China Morning Post).]