Double Standard: Essential But Unwanted

The coronavirus sure has got our number.

Maybe nowhere has the onset of the pandemic spotlighted the hypocritical realities of modern American life more clearly than in the farm fields of Washington.

Farmworkers, many of them undocumented and for decades relegated to live in the shadows, suddenly have been classified, by the federal Department of Homeland Security, as “essential critical infrastructure workers” in the fight against the disease.

Many migrant workers are now being given letters — papers, if you will — that grant them special license to violate stay-at-home orders so they can freely go to work to pick vegetables and fruit.

“The fact that there is that cognitive recognition that we have to allow these individuals to travel to and from work because they are critical — that’s the complete opposite of what they’ve heard for nearly their entire lives,” a Northwest dairy farmer told The New York Times.

So the people we’re building a wall to keep out — it turns out we need them now?

Of course we’ve always needed them — the fruit pickers, the asparagus cutters, the roughly 200,000 campesinos who help keep Washington state’s grocery stores stocked with produce and milk. It’s just the pandemic now is forcing our two-faced system to admit it.

“We will continue to work because we understand that in times of crisis we must show solidarity,” said Familias Unidas por la Justicia, a small union of Mexican farmworkers in Skagit and Whatcom counties. “However we ask ourselves, we are working for what exactly? To maintain the status quo? Get sick and no health care plan for us? Getting paid at poverty levels? Hunted down by ICE?” [ed. Emphasis added.]

These are great questions. But they’re great questions whether we’re having a national emergency or not. Can we go back, once this is over, to trying to deport millions of people who the government just acknowledged are a critical national resource?

That’s a question I asked last week: Will we go back? I asked it in respect to how local government suddenly is responding with more alacrity to “crises long in plain view, like homelessness,” as well as “absurd, gouging rules” such as airline fees and airport security.

“The COVID-19 crisis has stripped away the mask,” wrote Guy Hoyle-Dodson, of Lacey, in response to that column, one of hundreds of Seattle Times readers to do so.

“Guaranteed income? Not a problem, if only to save our consumer economy,” he went on. “Housing the underclass? Only makes sense, to protect the overclass.”

Wrote reader Cheryl, no last name: “Define your emergency — when it hits the right people, it’s an emergency,” she said. “Before that it’s a line item we may or may not have the resources for.”

Tacoma’s John Gizzi was blunter.

“Yeah, we’ll go back,” he wrote. “That’s the one thing we can count on: America returning to its comfortable place of ignorance and willful blindness.” (...)

Yes, the great leveler. In its attack, the coronavirus has shown zero interest in our usual divisions of politics, class or culture. I’m not saying everyone is experiencing its harms equally. But it is uniquely a communitywide problem. So once it ebbs, once we’re through to the other side, will we take up our tribal resentments quite so vigorously as before?

I don’t know. But if you’d predicted to me that the Department of Homeland Security would declare the long-maligned farm fieldworkers to be a critical national resource, in the middle of an election year in a country that two minutes ago was inflamed about wall-building and immigration, I would have said: You’re dreaming.

by Danny Westneat, Seattle Times |  Read more:

Image: Rich Pedroncelli/AP

If Only

There has never been a more important time, since perhaps World War II, for the President of the United States to bring the country together. Here is what he should say.

Recently, a reporter at the daily White House coronavirus briefing asked US President Donald Trump what he would say to his fearful fellow citizens.

Here is what America still needs to hear from its leader.

“My fellow citizens, this is a terrible time for our country and for the world. We are in the midst of a brutal war as challenging as any that humankind has fought. But this fight is not between countries. It is between human civilization and a virus that threatens to upend it.

“COVID-19 is deadly. It is not to be taken lightly, even if you are young and healthy. I have heard comments dismissing the danger it poses – this virus should not be underestimated. It is a real threat not just to your life, but also to your loved ones.

“But be assured, we will defeat it. Just as we have faced down lethal health threats before, from polio to SARS, we will come through this dark period and return to a better way of life.

“From this day forward, I am committing every available resource at the US government’s disposal to ensure that everyone in America receives the medical care they need. Everyone is precious. We will not trade one life for another, nor will we leave anyone behind.

“Let me repeat: We will leave no one behind.“ In 1961, President John F. Kennedy used his inaugural address to pledge this country to ‘bear any burden … in order to assure the survival and the success of liberty.’ Sixty years later, it is fitting that we re-commit to the same lofty goal.

“We should have been more prepared for this pandemic. When we get through the immediate crisis, we will make the necessary changes to ensure we are never caught off guard again.

“Here is what your government is doing now. First, we are mobilizing the full might of the private sector. Exercising my authority under the Defense Production Act of 1950, I have ordered our pharmaceutical, manufacturing, and textile companies to produce 300 million COVID-19 tests, one million ventilators, and enough personal protective equipment for 20 million health-care workers.

“Second, I have ordered that all military and Department of Veterans Affairs hospitals be made available for COVID-19 patients.

“Third, the Army Corps of Engineers is building temporary hospitals in the country’s 50 largest cities. We will have about 200,000 new hospital beds ready within a month, and more than one million new beds just a few months after that. We will double our nation’s hospital capacity.

“Fourth, all military medical professionals not engaged in urgent tasks will be assigned to support civilian medical staff.

“Fifth, I have called up specialized military reserve units – including engineer battalions, chemical-biological response units, and other relevant groups – to oversee testing sites in every county that has more than a minimal number of cases. The same mobilization force will also oversee testing in every major city (in partnership with local authorities), as well as in every transportation hub of towns with more than 20,000 people.

“Sixth, I have ordered the US Navy to deploy every available amphibious vessel, aircraft carrier, hospital ship, and support vessel to the harbors of our major coastal cities. Each of these is equipped with state-of-the-art medical facilities.

“To operationalize these plans, the Chairman of the Joint Chiefs will lead the military’s efforts, in partnership with the National Guard.

“We thank our selfless military personnel for their help. We also thank our church and community leaders, non-profits, and ordinary citizens, who together are consoling the bereaved, providing emotional and mental support for those struggling to cope, and pitching in to make meals and deliver food to the elderly, the indigent, and others in need. You are the backbone of this country.

“And we have your back. Beginning now, every American will receive free testing and free treatment for COVID-19. Medicare will be made available to everyone who lacks health insurance.

“But we must do more...

by Alexander Friedman, Charles C. Krulak, Project Syndicate | Read more:

Image: AP via

In Rural Towns and on Remote Farms, the Virus Creeps In

Photos: In Rural Towns and on Remote Farms the Virus Creeps In (NY Times)
[ed. Excellent photo-essay.]

Lawsuits Swell as Owners, From Gun Shops to Golf Courses, Demand to Open

Blueberry Hill Public Golf Course & Lounge became a community institution almost the day it opened in western Pennsylvania in 1961, with one generation of players succeeding the next on the wooded, undulating course bordering the Allegheny National Forest.

It had its share of misfortune — last spring a tornado roared through its 400 acres, leaving $100,000 in damages across its 18 holes. With spring now budding early, Jim Roth, the general manager, anticipated a boom year even as coronavirus fears escalated — people still needed exercise, didn’t they?

“I thought I had a little bright light starting to shine, then somebody turned the light bulb off,” Mr. Roth said.

That somebody, as far as he was concerned, was Gov. Tom Wolf of Pennsylvania. On March 19, Mr. Wolf introduced an initiative to categorize businesses as “life-sustaining” or not, shuttering golf courses among the latter.

So Mr. Roth sued, joining a lawyer, a realtor, a logger, a politician and a laundry owner in demanding that the governor not hold absolute power to open and shut segments of the Pennsylvania economy like a spigot.

“I do not understand why Mr. Wolf is able to deem this business life-sustaining and this one not,” Mr. Roth said. “I think the governor might have overstepped his boundaries.”

It is a growing refrain across the United States as more governors invoke their “police powers” to take extraordinary measures to protect public health. Some Americans, many hoping to protect their livelihoods and others suspicious of such sweeping powers, are turning to the courts.

by Neil MacFarquhar, NY Times | Read more:
Image: Libby March for The New York Times

[ed. Our local course officially closed a couple weeks ago but still let golfers out for free, allowing for exercise and much needed outdoor relief. Everybody learned to respect social distancing (6 ft. or more), no carts were rented, just walking, and all pins were pulled so no one would repeatedly touch anything. Nevertheless, a few days ago a new guidance proclamation (pdf) came out stating that among other activities, "neither the operation nor enjoyment of a golf course qualifies as an essential business or activity." This follows the closing of state parks, trails, and other forms of outdoor recreation (even fishing). People are eventually going to go nuts. I've agreed with just about everything our Governor has done so far, but this seems like a little too much.]

via:
[ed. See also: Celebrity Culture Is Burning (NY Times).]

Giving Her All She's Got

[ed. Now's the time, Scotty.]

The Anatomy of the $2 Trillion COVID-19 Stimulus Bill

The unprecedented response to the COVID-19 pandemic has prioritized keeping people apart to slow the spread of the virus. While measures such as business closures and travel restrictions are effective at fighting a pandemic, they also have a dramatic impact on the economy.

To help right the ship, the Coronavirus Aid, Relief, and Economic Security Act — also known as the CARES Act — was passed by U.S. lawmakers last week with little fanfare. The act became the largest economic stimulus bill in modern history, more than doubling the stimulus act passed in 2009 during the Financial Crisis.

Today’s Sankey diagram is a visual representation of where the $2 trillion will be spent. Broadly speaking, there are five components to the COVID-19 stimulus bill:

Individuals / Families $603.7 billion 30%
Big Business $500.0 billion 25%
Small Business $377.0 billion 19%
State and Local Government $340.0 billion 17%
Public Services $179.5 billion 9%

by Nick Routley, Visual Capitalist |  Read more:

Image: Visual Capitalist

Passing the Smell Test

My father now knows nine people who have been killed by the coronavirus. He’s 83 and entirely sound of mind and body. He rides his bike many miles every morning around Audubon Park in New Orleans and is as fun to talk to as he was when he was 40. His only response to the news that he and my mother would be confined to the house I grew up in was to call the liquor store and order seven cases of wine.

But now he finds himself watching the annihilation of what is left of his generation. Many of his old high school classmates and business associates and tennis partners live in the Lambeth House, the retirement community of choice for the New Orleans gentry. It’s a peculiar group, with its own customs and language, maybe the only American subculture to use “cocktail” as a verb. Up until a month ago, the few hundred New Orleanians living at Lambeth House cocktailed together nightly, without any idea of the risks they were running. On March 10, the first resident tested positive for Covid-19. At least 52 others now have it, and 13 have died, nine of whom my father knew.

Without more tests it’s hard to say how many people are likely to catch the virus — or how many will die. It seems amazingly well-designed to leap from person to person. People can walk around with it for days and even weeks, carrying the infection wherever they go, without knowing they have it. Young people are especially likely to remain oblivious to their infection, but if an 80-year-old man can feel well enough to cocktail and still be ill enough to give the virus to another 80-year-old man, who can’t?

The surprise, if anything, might be that the virus hasn’t spread more rapidly. “Why don’t even more people have it?” asked Richard Danzig, a national security and bioterrorism expert who served as secretary of the Navy under President Bill Clinton. “Early reports stated that only about 10% of family members of people who fall ill are infected. Possibly the numbers are wrong, but we need to focus on why so many people who are exposed don’t get sick.” The Lambeth House in New Orleans is a case in point. Even now there are a couple of hundred ancients still living there, virus free. How did it miss them?

One possibility — Danzig offered this up the other day at a virtual gathering of pandemic experts — is that the virus has a special need to be projected. “Shorter exposure in some contexts like church events seems to have more impact than prolonged exposure to infected family members at home even when no or few precautions were taken pre-symptomatically,” Danzig wrote to his fellow experts. “I am wondering if singing is the important characteristic of church events (the New Rochelle synagogue, et al), making them a major vector of transmission.”

Another possibility is that a lot more people than we know — even 80-year-old people — have had the virus but never got sick enough to get themselves tested. That’s what’s so interesting about the simple, one-page letter written last week by two British doctors. Claire Hopkins and Nirmal Kumar, among the country’s most prominent ear, nose and throat specialists, had both noticed the same odd symptom in their coronavirus patients: a loss of the sense of smell. “Anosmia,” it is called, but I suppose they have to call it something.

The inability to smell was the first symptom many patients noticed; in some cases, it was the only symptom the patients noticed. “In the past it was once in a blue moon that we saw patients who had lost their sense of smell,” Kumar told me. “Now we are seeing it 10 times as often. It’s one of the things that happens with this virus.” The British doctors compared notes with doctors from other countries and gathered what data they could. They concluded that roughly 80% of the people who lost their sense of smell would test positive for the coronavirus, and that somewhere between 30% and 60% of those who had tested positive for the virus had also lost their sense of smell.

Those numbers might turn out to be a bit off — maybe even way off. They are a heroic guess, given how little testing has been done. But it’s precisely the scarcity of tests that makes the observation so intriguing, as it offers the possibility of a crude alternative to a test. Lose your sense of smell and you know to isolate yourself, even if you feel great.

It offers two other things as well: a way to glimpse the virus as it moves through various populations, and a tool for managing the risk. Oddly, hardly anyone who read the doctors’ letter had this thought — or, at any rate, hardly anyone who got in touch with the doctors. “We’ve had more than a thousand responses,” Kumar said. “But almost no one really seeing it as a risk management tool.” The exception was a former Wall Street guy, an Englishman named Peter Hancock.

Hancock had spent much of his career at JPMorgan, where, in the late 1990s, he had served as the bank’s chief risk officer. After the financial crisis he’d been tapped to run the giant risk management mess that was AIG. When he read the letter written by the British doctors, he thought, “Here might be a free way to get a signal, out of all the noise.”

But now he finds himself watching the annihilation of what is left of his generation. Many of his old high school classmates and business associates and tennis partners live in the Lambeth House, the retirement community of choice for the New Orleans gentry. It’s a peculiar group, with its own customs and language, maybe the only American subculture to use “cocktail” as a verb. Up until a month ago, the few hundred New Orleanians living at Lambeth House cocktailed together nightly, without any idea of the risks they were running. On March 10, the first resident tested positive for Covid-19. At least 52 others now have it, and 13 have died, nine of whom my father knew.

Without more tests it’s hard to say how many people are likely to catch the virus — or how many will die. It seems amazingly well-designed to leap from person to person. People can walk around with it for days and even weeks, carrying the infection wherever they go, without knowing they have it. Young people are especially likely to remain oblivious to their infection, but if an 80-year-old man can feel well enough to cocktail and still be ill enough to give the virus to another 80-year-old man, who can’t?

The surprise, if anything, might be that the virus hasn’t spread more rapidly. “Why don’t even more people have it?” asked Richard Danzig, a national security and bioterrorism expert who served as secretary of the Navy under President Bill Clinton. “Early reports stated that only about 10% of family members of people who fall ill are infected. Possibly the numbers are wrong, but we need to focus on why so many people who are exposed don’t get sick.” The Lambeth House in New Orleans is a case in point. Even now there are a couple of hundred ancients still living there, virus free. How did it miss them?

One possibility — Danzig offered this up the other day at a virtual gathering of pandemic experts — is that the virus has a special need to be projected. “Shorter exposure in some contexts like church events seems to have more impact than prolonged exposure to infected family members at home even when no or few precautions were taken pre-symptomatically,” Danzig wrote to his fellow experts. “I am wondering if singing is the important characteristic of church events (the New Rochelle synagogue, et al), making them a major vector of transmission.” [ed. Possibly by forcefully projecting aerosol-borne contaminants?]

Another possibility is that a lot more people than we know — even 80-year-old people — have had the virus but never got sick enough to get themselves tested. That’s what’s so interesting about the simple, one-page letter written last week by two British doctors. Claire Hopkins and Nirmal Kumar, among the country’s most prominent ear, nose and throat specialists, had both noticed the same odd symptom in their coronavirus patients: a loss of the sense of smell. “Anosmia,” it is called, but I suppose they have to call it something.

The inability to smell was the first symptom many patients noticed; in some cases, it was the only symptom the patients noticed. “In the past it was once in a blue moon that we saw patients who had lost their sense of smell,” Kumar told me. “Now we are seeing it 10 times as often. It’s one of the things that happens with this virus.” The British doctors compared notes with doctors from other countries and gathered what data they could. They concluded that roughly 80% of the people who lost their sense of smell would test positive for the coronavirus, and that somewhere between 30% and 60% of those who had tested positive for the virus had also lost their sense of smell.

Those numbers might turn out to be a bit off — maybe even way off. They are a heroic guess, given how little testing has been done. But it’s precisely the scarcity of tests that makes the observation so intriguing, as it offers the possibility of a crude alternative to a test. Lose your sense of smell and you know to isolate yourself, even if you feel great.

by Michael Lewis, Bloomberg |  Read more:

Image: Emily Kask/Bloomberg
[ed. See also: Further discussion in the BBC and NY Times.]

Hillsong United

Impossible Decisions

Tents are now strewn across Manhattan’s Central Park—a field hospitals in the literal sense—that resemble the convalescence wards of the 1918 flu pandemic. They sit a stone’s throw from some of the world’s most expensive real estate. Not to mention some of the world’s most luxurious brick-and-mortar hospitals.

In these tents, on the cots that sit less than six feet apart, it is expected that millionaires will lie beside people without a penny to their names. Care will be allocated based on where it can be the most useful and do the most good.

This is not a type of health care that most Americans are accustomed to. But already, rationing is upon us.

If you are one of the 7.6 million people in New York City, you are advised by city officials to stay home until you become short of breath. Typically, this is a sign of being on the brink of a critical illness. It means a respiratory infection has spread into the lower airways, and it could quickly progress to the point of needing supplemental oxygen or intubation and mechanical ventilation. But, at this point, medical care—prior to the point of becoming short of breath—must be rationed. Clinics and emergency departments cannot currently handle being filled with people who, sick as they may be, do not yet clearly require hospitalization.

New York, like other states, does not yet have enough hospital beds, masks, or diagnostic tests for the coronavirus to accommodate all who might need one. Certain rationing decisions are already being made, including which surgeries can be considered “elective” and canceled, and which cannot.

Perhaps most ominously to the thousands of New Yorkers at home wondering just how short of breath is “short of breath,” we also do not have enough ventilators. By Governor Andrew Cuomo’s estimate, the state will need around 30,000 in coming months. We have about 5,000. Some new ventilators are being made, but this cannot happen quickly enough to meet that sort of demand.

And so, ethics boards at various hospitals are writing guidelines for how to manage allocation of life-saving resources like ventilators. These groups will deliberate and model various hypothetical scenarios, and then issue directives about what sort of decisions should be made. At a certain point, the calculus of American doctors will switch from the default of preferentially caring for the person who appears sickest to caring for the person with the greatest chance of benefiting from care—and with the greatest potential for years of life ahead.

These decision trees are guided by the four basic principles of medical ethics: personal autonomy, beneficence, non-maleficence (“do no harm”), and justice. In a fast-moving pandemic like this, these principles may look different in execution, but are no less important. A patient’s personal autonomy becomes limited based on, say, availability of resources. You may want a ventilator, and a doctor may agree that it’s necessary, and yet it may not be possible. The call to do no harm, likewise, can become a call to do as little harm as possible—or to do maximal good.

The question of who gets a ventilator and who does not, when two people are both in real need, is a question of justice of the sort doctors are not trained to adjudicate. But others are, and this is the moment they’ve been training for. (...)

James Hamblin: There was discussion over the weekend about making sure that there not be discrimination against elderly people, against chronically ill people. There is that tension, which is similar with organ donation, where you have to think about the utility of how many “quality life years” does a person have if they receive an organ.

So it seems like there is discrimination against elderly and chronically ill people built into so many rationing decisions. How do you navigate that in a way that if, say, if it comes to ventilators, is as nondiscriminatory as possible—while making decisions that are, by definition, discriminating who gets what?

Caplan: When I look at policies, including my own institution’s, the first thing you have to commit to is that you won't discriminate. I'm looking for a statement that says everyone will be considered. That includes elderly people, the chronically ill, the disabled, and also would include no discrimination by gender or race or culture. We're trying to lead with the principle, and this is what I would call fairness, that everybody has a shot. Everybody has an opportunity.

That's somewhat true in transplant rationing, and it's somewhat true with emergency medicine rationing. You begin by saying in order to get support for rationing, you have to make people know that the squeaky wheels won't have an advantage, the rich won't shove aside the poor, the disabled just won't be killed. We're not going to have hard and fast age boundaries.

You then move on to justice. And your question, James, is what about biological and physiological differences? The answer to that is, that's the first consideration. Try to maximize the chance of saving a life. I do think that the moral principle that has emerged is that first you try to save the most lives.

That does put people who have underlying chronic illnesses involving their respiratory system—chronic obstructive lung disease damage from vaping, smoking—that could put you down lower than somebody else. I wouldn't start with an age cutoff because we've seen healthy 70 year olds and very, very sick, compromised 20 year olds. But it would be fair to say if you can't sort them out by biology and physiology, then you go to age because age is somewhat of a predictor of who's going to do well.

Young people just do better than older people. It's not like 40 versus 30, it's more like 20 versus 70. I think Americans also want kids first. We haven't seen many kids get infected here, but most of the policies that I've had input to, we try to see children first, too.

Hamblin: We don't want the wealthy and powerful people to have unfair access. At the same time, there are questions of a person's utility in a specific scenario, like if you are the head of emergency medicine or ICU care at a hospital and your health ends up subsequently meaning many more people could be kept healthy. Do people in positions like that get priorities over people who ... who are of less ... I don't even know how to use these words appropriately without being offensive.

Caplan: Significance to trying to save more lives. I know where you're going. So the answer is yes. But I think you apply the physiology test first. So a very, very sick, dying head of an ICU [who] is not probably going to do well on a ventilator and they're gonna get excluded. Where I believe we should take into account health-care worker status is a tiebreaker. So after you get by physiology, after you get by age as a predictor, then you probably are going to say we got to get people back to work if we can, and they will save more lives that way, and we'll be prepared for the next wave of this virus if it bounces back. Which it could.

by James Hamblin, The Atlantic |  Read more:

Image: Aleksandra Michalska/Reuters 

Masking a Problem

For health care workers, the N95 mask is an invaluable line of defense against the novel coronavirus. These highly protective respirators can keep doctors and nurses from getting infected by their patients, but the world is quickly running out of them. While global production is ramping up, the shortage of N95 masks is so great that companies, unions, and even average people are scrambling to fill the need. And now, after a number of fortuitous events, millions of N95 masks are appearing in mysterious or unexpected places.

The latest discovery comes from the Service Employees International Union’s medical workers division (SEIU-UHW). After an extensive search, the union found a distributor with a supply of 39 million respirators that it plans to sell to hospitals nationwide. The situation is more complicated than connecting a buyer and a seller, though. The SEIU has refused to name the distributor, apparently out of concern that the company would be overwhelmed, and one of the hospitals that considered buying the N95 masks through the union seems to have walked away from the deal.

“This is the Wild West,” SEIU-UHW president Dave Regan told the Washington Post. “There are a lot of good actors and a lot of shady actors.”

It’s great news that more N95 masks are being unearthed. Improving access to personal protective equipment (PPE) stands to save the lives of health care workers treating patients with Covid-19, the disease caused by the novel coronavirus. As the Centers for Disease Control and Prevention (CDC) reportedly considers recommending that everyone cover their faces in public, the N95 shortage could become even more severe as more people seek out the precious respirators.

While discoveries of thousands or millions of lifesaving masks are good news in a pandemic, they also draw attention to a supply chain that’s been badly mismanaged. The situation also raises the question of why unions, banks, tech companies, and others have taken it upon themselves to find masks for health care workers. Shouldn’t the federal government be dealing with this?

What makes N95 masks so hard to find

Certified N95 respirators are special. Unlike a conventional surgical mask, N95 masks are built so that 95 percent of very small airborne particles can’t get through. These masks also need to be approved by the CDC’s National Institute for Occupational Safety and Health and, depending on the type, the Food and Drug Administration. In order to fulfill those requirements, N95 masks must be constructed so that they seal tightly around one’s mouth and nose, unlike surgical or cloth masks which are loose-fitting. (...)

Why companies keep discovering N95 masks in stockpiles

Many companies and organizations are purchasing masks for the specific purpose of donating them to fight the Covid-19 pandemic. However, others are offering up N95 masks that were being kept in storage. Reasons vary as to why so many companies have these high-end respirators stashed away in warehouses.

Mark Zuckerberg, for instance, recently said that Facebook was donating 720,000 N95 masks that were purchased following the wildfires in California last year. He added that the company was “also working on sourcing millions more to donate.”

Currently, California emergency regulations require that when air quality worsens by a significant amount, workplaces must take steps to ensure their workers have respiratory protection, like N95 masks, if other adjustments can’t be made. The change in regulation came following the catastrophic 2018 California wildfires. The same regulation suggests that a good number of other California employers also have N95 masks on hand. (...)

Then there are more cases of discovered masks with mysterious origins, much like the SEIU’s huge stockpile. For instance, one major N95 donation has come from Apple. The company’s CEO Tim Cook tweeted that his company had “sourced, procured, and is donating” 10 million masks, though it’s not immediately clear why the company had access to so many masks. Vice President Pence had said earlier last week that Apple would be donating 9 million N95 masks from its “storehouses.” Still, Apple would not comment on why the company had these masks in supply.

by Rebecca Heilweil, Recode | Read more: (Millions of N95 masks keep surfacing. So why is there still a shortage?)

***

You never know what a new day will bring. What started as an early morning call with a friend to help get N95 masks to hospitals in desperate need turned into a roller coaster of contacts in a frenzied, pandemic-driven market. For the next 10 hours, I sat in on calls between brokers selling masks and potential buyers, watching the psychology of market pressures play out in real time as millions of masks changed hands in a matter of hours.

The buyers—from state government purchasing departments and hospital systems representing facilities throughout the Northeast, Midwest and California—expressed desperation for masks to protect their healthcare workers, but in the end not a single deal was completed with any of these groups, and millions of masks were earmarked to leave the country, purchased by foreign buyers.

In the interest of brevity, I’m going to summarize what I learned below and then jump into a bit more detail.

• Millions of N95 masks have been available throughout the U.S., Canada and the UK during the pandemic, according to brokers trying to sell them.
• The high price point per mask, driven by extreme demand, has contributed to an overwhelmed reaction among potential buyers, especially in the U.S.
• Scrutiny surrounding these deals is high because of ongoing scams and claims of price-gouging, both of which are triggering emotionally charged reactions and fear of making deals.
• Millions of masks are being purchased by foreign buyers and are leaving the country, according to the brokers, while the domestic need remains alarmingly high.

My main contact in this frenzy was a medical supplies broker named Remington Schmidt who spends nearly every working hour of the day on phone calls trying to make deals between potential buyers and sellers with personal protective equipment (PPE) available to sell in the U.S. and abroad.

“This is the craziest market I’ve ever seen,” he told me between calls while scanning through a stream of text messages from sellers and other brokers. (...)

When contacting potential buyers, Remington needs two things to secure a deal with a seller: a letter of intent to purchase and proof of funds.

“If you are working with a seller who has masks but you can’t quickly show proof of funds, someone else is going to buy them,” he told me.

And I watched that happen repeatedly throughout the day. Buyers from state procurement departments and hospital systems expressed desperate need for masks, but the deals bogged down when it came to providing proof that they could commit and follow through. In the meantime, another buyer provided proof of funds and the masks were gone, sometimes within the hour.

The masks in play are those we’ve been hearing about in every press conference since the pandemic began: N95 3M™ brand masks, mainly in model types 1860 and 8210, which, according to 3M™, are “NIOSH (National Institute of Occupational Safety and Health) approved for at least 95% filtration efficiency against certain non-oil based particles.” Some buyers are also looking for alcohol-based sanitizer sprays, hospital gowns and a few other items, but mostly the demand is for N95 masks. And the demand is only getting more intense as hospitals rapidly run low on the supplies they have due to increased need for masks to protect staff as numbers of COVID-19 infections, and suspected infections, increase each day.

by David DiSalvo, Forbes | Read more: (I Spent A Day In The Coronavirus-Driven Feeding Frenzy Of N95 Mask Sellers And Buyers And This Is What I Learned)

[ed. See also: Everyone Thinks They’re Right About Masks (The Atlantic).]

Image: Smith Collection/Gado/Getty Images

Yoichi Midorikawa, Seto Inland Sea, 1978.
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There Might Be An App For That (Or Not)

The newly emergent human virus SARS-CoV-2 is resulting in high fatality rates and incapacitated health systems. Preventing further transmission is a priority. We analyzed key parameters of epidemic spread to estimate the contribution of different transmission routes and determine requirements for case isolation and contact-tracing needed to stop the epidemic. We conclude that viral spread is too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient and happened at scale. A contact-tracing App which builds a memory of proximity contacts and immediately notifies contacts of positive cases can achieve epidemic control if used by enough people. By targeting recommendations to only those at risk, epidemics could be contained without need for mass quarantines (‘lock-downs’) that are harmful to society. We discuss the ethical requirements for an intervention of this kind.

In this study, we estimated key parameters of the SARS-CoV-2 epidemic, using an analytically solvable model of the exponential phase of spread and of the impact of interventions. Our estimate of R0 is lower than many previous published estimates, for example (12, 28, 29). These studies assumed SARS-like generation times; however, the emerging evidence for shorter generation times for COVID-19 implies a smaller R0. This means a smaller fraction of transmissions need to be blocked for sustained epidemic suppression (R < 1). However, it does not mean sustained epidemic suppression will be easier to achieve because each individual’s transmissions occur in a shorter window of time after their infection, and a greater fraction of them occurs before the warning sign of symptoms. Specifically, our approaches suggest that between a third and a half of transmissions occur from pre-symptomatic individuals. [ed. Emphasis added] This is in line with estimates of 48% of transmission being presymptomatic in Singapore and 62% in Tianjin, China (30), and 44% in transmission pairs from various countries (31). Our infectiousness model suggests that the total contribution to R0 from pre-symptomatics is 0.9 (0.2 - 1.1), almost enough to sustain an epidemic on its own. For SARS, the corresponding estimate was almost zero (9), immediately telling us that different containment strategies will be needed for COVID-19.

Transmission occurring rapidly and before symptoms, on April 1, 2020 as we have found, implies that the epidemic is highly unlikely to be contained by solely isolating symptomatic individuals. [ed. Emphasis added] Published models (9–11, 32) suggest that in practice manual contact tracing can only improve on this to a limited extent: it is too slow, and cannot be scaled up once the epidemic grows beyond the early phase, due to limited personnel. Using mobile phones to measure infectious disease contact networks has been proposed previously (33–35). Considering our quantification of SARS-CoV-2 transmission, we suggest that this approach, with a mobile phone App implementing instantaneous contact tracing, could reduce transmission enough to achieve R < 1 and sustained epidemic suppression, stopping the virus from spreading further. We have developed a web interface to explore the uncertainty in our modelling assumptions (24). This will also serve as an ongoing resource as new data becomes available and as the epidemic evolves. 

We included environmentally mediated transmission and transmission from asymptomatic individuals in our general mathematical framework. However, the relative importance of these transmission routes remain speculative based on current data. Cleaning and decontamination are being deployed to varying levels in different settings, and improved estimates of their relative importance would help inform this as a priority. Asymptomatic infection has been widely reported for COVID-19, e.g., (14), unlike for SARS where this was very rare (36). We argue that the reports from Singapore imply that even if asymptomatic infections are common, onward transmission from this state is probably uncommon, since forensic reconstruction of the transmission networks has closed down most missing links. There is an important caveat to this: the Singapore outbreak to date is small and has not implicated children. There has been widespread speculation that children could be frequent asymptomatic carriers and potential sources of SARSCoV-2 (37, 38). 

We calibrated our estimate of the overall amount of transmission based on the epidemic growth rate observed in China not long after the epidemic started. Growth in Western European countries so far appears to be faster, implying either shorter intervals between individuals becoming infected and transmitting onwards, or a higher R0. We illustrate the latter effect in figs. S18 and S19. If this is an accurate picture of viral spread in Europe and not an artefact of early growth, epidemic control with only case isolation and quarantining of traced contacts appears implausible in this case, requiring near-universal App usage and near-perfect compliance. The App should be one tool among many general preventative population measures such as physical distancing, enhanced hand and respiratory hygiene, and regular decontamination. 

An App-based intervention could be more powerful than our analysis here suggests, however. The renewal equation mathematical framework we use, while well adapted to account for realistic infectiousness dynamics, is not well adapted to account for benefits of recursion over the transmission network. Once they have been confirmed as cases, individuals identified by tracing can trigger further tracing, as can their contacts and so on. This effect was not modeled in our analysis here. If testing capacity is limited, individuals who are identified by tracing may be presumed confirmed upon onset of symptoms, since the prior probability of them being positive is higher than for the index case, accelerating the algorithm further without compromising specificity. With fast enough testing, even index cases diagnosed late in infection could be traced recursively, to identify recently infected individuals before they develop symptoms, and before they transmit. Improved sensitivity of testing in early infection could also speed up the algorithm and achieve rapid epidemic control. 

The economic and social impact caused by widespread lockdowns is severe. Individuals on low incomes may have limited capacity to remain at home, and support for people in quarantine requires resources. Businesses will lose confidence, causing negative feedback cycles in the economy. Psychological impacts may be lasting. Digital contact tracing could play a critical role in avoiding or leaving lockdown. We have quantified its expected success and laid out a series of requirements for its ethical implementation. The App we propose offers benefits for both society and individuals, reducing the number of cases and also enabling people to continue their lives in an informed, safe, and socially responsible way. It offers the potential to achieve important public benefits while maximising autonomy. Specific issues exist for groups within the population that may not be amenable to such an approach, and these could be rapidly refined in policy. Essential workers, such as health care workers, may need separate arrangements. Further modelling is needed to compare the number of people disrupted under different scenarios consistent with sustained epidemic suppression. But a sustained pandemic is not inevitable, nor is sustained national lockdown. We recommend urgent exploration of means for intelligent physical distancing via digital contact tracing.

Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing (pdf). Science.

Luca Ferretti1 *, Chris Wymant1 *, Michelle Kendall1 , Lele Zhao1 , Anel Nurtay1 , Lucie Abeler-Dörner1 , Michael Parker2 , David Bonsall1,3†, Christophe Fraser1,4†‡ 1

Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK. 2 Wellcome Centre for Ethics and the Humanities and Ethox Centre, University of Oxford, Oxford, UK. 3 Oxford University NHS Trust, University of Oxford, Oxford, UK. 4 Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.
[ed. In other words, total and specific surveillance]

Not Flattening

4/1/2020

[ed. Source: Not Winning This Fight. See also: Infected but Feeling Fine: The Unwitting Coronavirus Spreaders (both NY Times).]

Reflections on a Disaster

[ed. I've only been involved in one major disaster in my life - coordinating and supervising cleanup for the Exxon Valdez oil spill - but the ongoing cornonavirus response has prompted reflection on parallels that might be instructive in our present-day crisis (especially since this time around we're the affected wildlife):

Initially, disbelief followed by widespread horror and panic (in this case, more like a dawning realization of severity). Decisions are ceded to experts (scientists), who themselves are overwhelmed with intense pressure to gather data quickly, disseminate information, coordinate with peers, and interact with the public (media being a constant presence and distracting pressure). Different plans are evaluated and, after many fits and starts, a final approach/strategy is agreed to. Resources (such as they are) are marshalled, checkbooks open, massive dollars are allocated (with flexible terms and wide distribution) and logistics become key. Timelines for securing needed equipment and support facilities become the most important factors driving success of the response going forward. [ed. Where we are now: 4/1/2020.]

At the same time (and throughout the rest of the response), various alternatives and response actions will continue to be proposed, reviewed, tested and modified. Confusion escalates as different players insert themselves into the decision-making process, jockeying for influence. Unsoliticed advice and untested 'solutions' flood in, jamming lines of communication and authority. [ed. Where we are now: 4/6/2020. But expect this process to continue indefinitely.]

As more resources are secured and the response ramps up, focus shifts to execution. But it's execution that's uneven, with different priorities and targets based on different sources of input and pressure. Some areas are hit harder than others. Politicians propose new emergency orders and legislation. Communities and other affected entities become increasingly more vocal and activist. Lobbyists and others (insurers, risk management experts, state and foreign delegations, etc.) descend in droves. Advocacy organizations mobilize supporters.

Then, whatever happens happens, with success (a highly subjective and undefined term) largely dependent upon how closely response efforts adhere to established guidelines (usually, hit or miss); guidelines which themselves are constantly being revised to incorporate new sources of information (leading to more confusion). (ed. Where we are now: 4/16/2020).

This goes on for some time with the system evaluating and re-evaluating various metrics of success while chains-of-command gradually reassert themselves. Prominent players from early in the response (eg. scientists, administrators, technicians) are slowly shuffled back into their established roles so that messaging can be more effectively managed by higher level personnel more attuned to political and PR considerations. The public can only watch and form their own conclusions about decisions that were made, how effective they are, and what it all means, or will mean. Media plays a large role in defining public opinion. (Where we are now, May 2, 2020).

Finally, at some later stage (post-peak, well into the response) as the disaster slowly abates, expect to see growing opportunism, ass-covering, finger-pointing and greed (remember all that money?). This phase was especially grating since nearly everyone involved started with a common focus and unmitigated mutual trust and support. It was particularly instructive to see how the spill destabilized existing power relationships and how those relationships eventually reestablished themselves. Power snaps back.

With this disaster, in an election year, it'll be interesting to see how this all plays out. Especially now that 'disaster capitalism' is a well understood concept (which wasn't the case back then), and also because of the open-ended nature of the problem itself. See also: The Lockdown Is an Opportunity to Redefine What Our Economy Is For (Jacobin). I can only speculate but have a feeling that recovery will be a long and uniquely difficult/different process this time. In many ways, large and small, the world will never be the same again. We'll see what that means.

Note: As the coronavirus response proceeds, I'll link to this post once in a while to see how closely we're following the script. 

See also: What Are The Dying Worth? and Why the Global Recession Could Last a Long Time (NY Times).]

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Food Fight

By now, the sight of ravaged grocery store shelves across the United States has become grimly familiar—and those right-wing memes about food shopping in Venezuela are suddenly as scarce as hen’s teeth—as the country struggles to contain the rapidly spreading coronavirus pandemic. Grocery stores have become ground zero in the battle over social distancing and the site of endless disheartening displays of misguided resource hoarding. Worse, millions of underpaid and overworked grocery store workers are now on the receiving end of the public’s panic over the pandemic—as well as their germs.

Not only does the nature of their work put all grocery store employees—from cashiers to floor workers to those in the warehouse—at high risk of exposure to the virus, they’re also forced to deal with customers’ increasingly nasty attitudes, as supplies run out and shelves sit empty. This added emotional labor is, of course, unpaid, and many hourly workers are braving such conditions without the protection of a union or a living wage, to say nothing of paid sick leave or hazard pay. Through it all, there’s continued pressure coming from above for them to stay smiling as the world around them crumbles. These essential workers are being treated as disposable. As one told me yesterday, “It’s hard to feel like an essential worker when you don’t have health care.”

Even people who work at supposedly more progressive chains like Trader Joe’s and Whole Foods (at least until its Amazon takeover) are anxious, tired, and afraid, and they certainly aren’t being paid enough to deal with these extraordinary circumstances—especially when the hand sanitizer runs out, and emotions at the cash register run high.

“None of us ever expected to be emergency workers; the idea of an ‘essential worker’ is a totally new concept that no grocery store bag boy considers when they drop off an application,” a current Whole Foods worker who prefers to stay anonymous told me. “There’s all of this rhetoric around how we’re just as important as the doctors, and yes, that’s true, but we’re getting paid way less, and medical workers have a little bit more of an idea of the risks that they are setting themselves up for. . . . We’re not used to this shit.” (...)

The lack of safety and support in the workplace is even more of a problem now that the ongoing coronavirus pandemic has thrust Trader Joe’s workers and their fellow grocery store workers onto the front lines of a public health crisis. As a current TJ’s worker based in a Manhattan store put it, “Trader Joes does not give a fuck about human beings; at the end of the day, this is just progressive-themed corporate retail without a soul.”

Trader Joe’s isn’t the only crunchy liberal favorite that has been coming under fire from its frightened and frustrated workforce. Whole Foods—another grocery chain with a notorious allergy to unions—has also failed its workers during this fraught time. The company has taken only incremental measures to protect them, like promising workers up to two weeks of sick leave contingent on a positive COVID-19 test at a time when the vast majority of civilians cannot access them, and offering a $2 hourly wage increase through April. Meanwhile, the chain’s parent company is literally owned by the richest man in the world. (...)

Back in January, Whole Foods cut health care benefits for 1,900 of its part-time workers, a decision that now appears especially cruel. As the Chicago worker told me, “Any kind of argument about money saving or profitability just seems totally absurd when we’re owned by Jeff Bezos. There’s no rationalization for not giving your workers health insurance during a pandemic.”

A group called Whole Worker has since launched a public campaign to hold Whole Foods accountable. They have organized a sickout today in order to bring attention to their demands, which include guaranteed paid sick leave for workers who self-quarantine, hazard pay, proper sanitation procedures, and reinstating the health care benefits that were lost in January. Since Whole Foods has temporarily relaxed its attendance policy, those who participate in the sickout can do so without fear of reprisal, which is a huge advantage when dealing with a company so adamantly opposed to collective organizing.

Matthew Hunt, a former Whole Foods worker who says he was fired in 2017 for trying to start a union, spent several years with the United Food and Commercial Workers International Union (UFCW) before reconnecting with some of his former colleagues and starting Whole Worker. Hunt, who lives in Queens, theorizes that the company is actively trying to cover up the number of employees who have already been exposed. “They’re just protecting their profits. That’s what they do, so I wouldn’t expect anything less from the employing class, especially Jeff fucking Bezos,” he says. “They want people to either quit or to show up to work. They really don’t give a shit about employees.”

by Kim Kelly, The Baffler |  Read more:

Image: Wikimedia Commons

[ed. See also: We Keep You Alive (The Baffler); “Amazon Is a Breeding Ground”; Nationalize Amazon (Jacobin); and We Need Amazon During the Coronavirus. That’s a Problem. (NY Times).]

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Bosses Panic-Buy Spy Software to Keep Tabs on Remote Workers

The email came from the boss.

We’re watching you, it told Axos Financial Inc. employees working from home. We’re capturing your keystrokes. We’re logging the websites you visit. Every 10 minutes or so, we’re taking a screen shot.

So get to work — or face the consequences.

“We have seen individuals taking unfair advantage of flexible work arrangements” by essentially taking vacations, Gregory Garrabrants, the online bank’s chief executive officer, wrote in the March 16 message reviewed by Bloomberg News. If daily tasks aren’t completed, workers “will be subject to disciplinary action, up to and including termination.”

Straight-up Big Brother, perhaps, but it’s perfectly legal for businesses to keep an unblinking eye on employees as long as they disclose they’re doing it. Of course, digital surveillance has been used for years on office desktops, yet it seems a violation of privacy to a lot of workers when they’re required to have software on their computers that tracks their every move in their own homes.

Workers at various companies have complained of excesses, but many of them are new to telecommuting, with its temptations of a midday nap or the demands of children out of school. Employers justify going full Orwell by saying that monitoring curbs security breaches, which can be expensive, and helps keep the wheels of commerce turning.

With so many people working remotely because of the coronavirus, surveillance software is flying off the virtual shelves.

by Polly Mosendz and Anders Melin, Bloomberg | Read more:
Image: Nick Little
[ed. See also: Bigger Brother: The Age of Surveillance Capitalism (NYRB).]

Marinel Sheu, Home alone
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