The 9/11 Era is Over

In 2019, I taught a course at UCLA on presidential rhetoric and American foreign policy. One of the speeches I had my students read was Bush’s address to Congress after 9/11, which still stands out as an exceptional piece of speechwriting. Just a couple of years younger than I was when I found those words so stirring, my students read the text as if it came from a different planet. Had the United States really made its entire national purpose a war against a group of terrorists? I asked them to list what they believed were the most pressing issues facing the country. Climate change topped the list. Economic inequality, student debt, structural racism, and a host of other issues filled it out. Not a single student mentioned terrorism. The generational appeal of Bernie Sanders—so out of step with the Democratic establishment I’d been a part of—was obvious in that room.

Trump likes to talk about ending America’s post-9/11 wars. But his latest defense budget is $112 billion higher than it was the year he took office. This additional spending appears guided by little beyond the president’s desire to declare that he’s investing more in the American military. The use of drones has increased. In Afghanistan and against ISIS, rules of engagement to limit civilian casualties have been relaxed. The number of U.S. troops in Afghanistan was increased. With the notable exception of a bizarre and hasty retreat from our counter-ISIS mission in Syria, the post-9/11 resourcing of America’s military and intelligence infrastructure is more robust than ever. Obama’s efforts to formulate a post-9/11 foreign policy—anchored in the Trans-Pacific Partnership and Paris Agreement—were scrapped. In their place came a constellation of policies under the “America first” banner—a mixture of restrictive immigration practices, scorn for traditional allies and international institutions, and a trade war with China.

Most acutely, Trump has fixated on Iran as a top priority. Since pulling out of the Iran deal, he has placed America on a constant precipice of war with the country. In addition to renewed sanctions, Trump has deployed nearly 20,000 additional U.S. troops to the Middle East, fueling Iranian provocations in response. (From the vantage point of quarantine, it’s hard to fathom that a couple of months ago we almost found ourselves in yet another post-9/11 war based on a presidential decision to kill someone.)

In his attitude and approach, Trump himself remains very much a president of the 9/11 era. He could not have become president without the architecture of right-wing media, chiefly Fox News, that blossomed after the attacks of 9/11. His personal lawyer Rudy Giuliani turned his laudable response to those attacks into a career of profiteering that led him all the way to Ukraine in pursuit of conspiracy theories about Joe Biden. Trump’s lie that Muslims in New Jersey celebrated the fall of the Twin Towers completes the distortion of that day from a moment of American common purpose to an expression of white identity politics against an encroaching “other.”

Trump successfully harnessed anger, grievance, nationalism, and crude racism to win political support. But that approach is useless in responding to an actual crisis. In COVID-19, Trump faces an adversary that doesn’t care what it’s called, recognizes no border, and plays not by the rules of America’s broken politics but rather by the rules of science and objective reality.

Whereas the attacks on 9/11 took place in only three locations, COVID-19 has already affected nearly everyone in the country. Most of the U.S. is under social-distancing orders. Clearly, we are entering a period of severe trauma. Many—if not most—of our fellow citizens will get the disease. An unspeakable number of people may die. Social order and cohesion may be tested in unforeseen ways. The American economy will go through a shock likely to rival the 2008 financial crisis and the Great Depression. As with those events, the geopolitical fallout will be profound and enduring.

The first months of this crisis suggest that the world order that emerges on the other end is likely to be permanently altered. America’s response to 9/11 committed the familiar mistake of hastening a superpower’s decline through overreach; the Trump presidency, and our failure to respond effectively to COVID-19, show us the dangers of a world in which America makes no effort at leadership at all.

Enormous upheaval, however, also offers the opportunity for enormous change. And that is what America needs. This is not simply a matter of winding down the remaining 9/11 wars—we need a transformation of what has been our whole way of looking at the world since 9/11. Yes, we have a continued need to fight terrorist groups, but the greatest threats we face going forward will come not from groups like al-Qaeda or ISIS, but from climate change, pandemics, the risks posed by emerging technologies, and the spread of a blend of nationalist authoritarianism and Chinese-style totalitarianism that could transform the way human beings live in every country, including our own.

To meet those challenges, Americans will have to rethink the current orientation of our own government and society, and move past our post-9/11 mindset. Any serious effort must change our government’s spending priorities. It makes no sense that the Pentagon budget is 13 times larger than the entire international-affairs budget, which funds the State Department, USAID, and global programs at other agencies. The entire pandemic-preparedness budget is a rounding error compared with a trillion-dollar plan to modernize America’s nuclear-weapons infrastructure. Smart investments in research and development, including for agencies such as the National Institutes of Health and the National Science Foundation, used to help make America a global leader in health, science, and technology; now we are behind countries such as Germany and South Korea—countries we helped rebuild or build during the Cold War—in developing and deploying COVID-19 tests.

We need to change the way we think about national security and foreign policy. In the Obama administration, efforts to ramp up climate-change and global-health security didn’t mesh well with America’s sprawling counterterrorism infrastructure, or with the interests of Congress. These defining challenges must become the focus of far more personnel—at the White House, the State Department, and other agencies—and they must galvanize partnerships outside government. Meanwhile, if we are to continue to deploy the rhetoric about democracy that we have used since 9/11 toward our adversaries, we and our allies must live up to it ourselves.

We need to change our attitude about government itself. The multidecade assault on the role of government in American life led to a Trump administration that disregards expertise and disdains career civil servants. The COVID-19 crisis has revealed that government is essential; that public service is valuable; that facts and science should guide decisions; and that competence matters more than Washington’s endless gamesmanship.

Donald Trump is the embodiment of trends that have been advancing for a long time—the crudeness of our culture, the meanness of our politics, the disintegration of our media. All those trends have accelerated since September 11, 2001. As we go through an indeterminate period of time separated from the normal rhythm of our lives, Americans are going to be forced to consider what’s most important to them. The answer, so far, appears to be family, community, and a sense of decency—whether it’s in the heroism of health-care workers or in the video that your friend shared of some random act of kindness. Our politics and government should reflect that decency in the priorities we set at home and the actions we take abroad.

by Ben Rhodes, The Atlantic |  Read more:

Image: Ray Stubblebine/Reuters

Possible Developments in the Treatment of Critical COVID-19 #2

Yesterday I noted an emerging debate within the critical care community of whether at least some critical COVID-19 cases are significantly different from standard Acute Respiratory Distress Syndrome (ARDS) and require a different treatment protocol. Since posting that piece I’ve found more evidence that this is a rapidly emerging discussion among critical care doctors and perhaps even some emerging consensus about how critical COVID-19 cases are different from ARDS.

First here’s an update from TPM Reader WC (not their actual initials), a critical care doctor on the West Coast who our team has been in touch with since early in the crisis …

Saw your post on the “Developments on the treatment of Covid-19.” 

As someone who has managed my fair share of ventilated Covid patients, I can say that the opinions offered by Dr Kyle-Sidell seem to have face validity and represent something of a developing consensus in the EM/Critical Care community. 

The Covid-19 epidemic has been interesting from a medical perspective in that so much about it has been new and the management strategies have been in flux since the beginning. I don’t want to get to into the weeds technically, but the concepts have ranged widely as we have gotten more experience with this fairly new disease. We went from early intubation strategies with a paradigm of using ventilator protocols similar to ARDS (Adult Respiratory Distress Syndrome) to strategies trying to delay intubation as long as possible using modalities such as noninvasive positive pressure ventilation (aka CPAP or BiPAP) or High Flow Nasal Cannula oxygen — both controversial as they may raise the amount of virus aerosolized. And now there is this very wild notion of “permissive hypoxia” which is the concept that if the oxygen level is low but the patient looks OK you just let them run low (previously a low oxygen level – one can quibble about the threshold – was an absolute indication for intubation). Anyway, while Dr Kyle-Sidell’s comments were provocative, it’s just one more day, one more change in the management. Whether it’s a game-changer, I doubt, but rather one more step in the road of figuring out how best to serve the sickest of the sick patients with this disease.

Here’s a note we received from longtime TPM Reader AM …

I am a physician and actively treating a number of COVID patients. Something you may not be fully aware of is that MDs nationwide have formed large (tens of thousands strong), private communities on social media to facilitate exchange of information on PPE best practices and PPE shortages, telehealth best practices, and most importantly information on what works and what doesn’t in COVID patients. We have been fortunate to have input from physicians in Italy in particular who have shared their experiences just as our first wave of patients was hitting the ICUs. I would go so far as to say that these groups have supplanted many traditional sources of information for front-line physicians. There is a broad lack of trust in our national leadership so we are relying on the only ones we can believe in ~ one another. 

In this context, Dr. Kyle-Sidell’s video was widely shared and has garnered intense interest. It is buttressed by some very interesting laboratory data that suggests that COVID interacts with hemoglobin in a way that could explain both the hypoxia and other diffuse clinical manifestations of the disease ~ i.e., there is some plausible biochemistry supporting the clinical observation. We will see whether this line of thought goes anywhere but my impression is that many physicians are starting to think along these lines.

WC sent this note in our on-going exchange of emails last night …

In most cases of respiratory failure (pneumonia, heart failure, ARDS) the small air cells, the alveoli, fill up with fluid or collapse. So we maintain a higher constant pressure (PEEP: Positive End Expiratory Pressure) in the airways to hold them open, and it works well. Um, usually. But COVID seems to be different. More oxygen (normal room air = 21% O2) by which I mean a higher fraction of oxygen delivery up to 100% definitely helps. But the positive pressure ladder which worked well in ARDS seems maybe not to work in covid, and maybe even harms the lungs. We’ve always known that a high level of positive pressure is a double edged sword, but in covid maybe the harms clearly exceed the benefits, which would be truly new. 

This is not to say we should not ever intubate. But it does mean that a) we should avoid intubation as much as possible by increasing the inhaled oxygen and b) if we do have to intubate, then the high positive pressures we have traditionally used maybe are to be avoided, even if it means allowing the blood to have less oxygen in it that we would traditionally accept. 

So why would we intubate if it’s harmful? So traditionally we would intubate for “low oxygen level” – and this (maybe) is out the window. But if a patient is too exhausted to continue to draw air in, or too out of it to protect their airway, these are still obligatory reasons to intubate. We can’t get around those. But it’s seeming clear that anything we can do to increase the number of ventilator-free days is a good thing, and this is a new understanding. 

And having seen the videos, I also have to say the “crazy” hypothesis remains valid. But Dr Kyle-Sidell may be crazy but I don’t think he’s wrong. To be clear, he is also not a “lone voice” in the wilderness. He’s reflecting an evolving consensus among docs who have managed a lot of covid.

Let me emphasize a basic editorial point. TPM is not the place to litigate emerging clinical protocols for novel diseases. And we’re not trying to. See this more as a window into emerging discussions among clinicians around the country wrestling with a novel disease. This isn’t unexpected. It is a truism of modern medical history that wars often see major advances in medicine. Doctors are overwhelmed with large numbers of novel or seldom seen injuries and through a grim process of trial and error they develop new insights into treatment. The origins of modern epidemiology are often traced to the work of John Snow who traced the origins of an 1854 cholera outbreak in London to hand pumped wells that were communicating the contagion. It would be surprising if new methods or certainly more targeted treatments for COVID-19 didn’t emerge from this. Whether this points to one of them is a different matter entirely.

I would recommend people who are interested in this read this article that was published this morning in the must-read StatNews. It looks at these general treatment questions, the different doctors I’ve referenced above in a more global (in both senses of the word) context. Anyone who is reading this for more than news curiosity and general knowledge I highly recommend you focus on the articles I’ve referenced in Medscape and StatNews in this and the earlier post. (Here is the preprint of the Gattinoni article I referenced yesterday.)

Meanwhile TPM Reader NC, an intensivist and pulmonologist at a major academic medical center, sounds a more cautionary note …

Please be cautious with pieces like this. To be horribly blunt, this came off not dissimilar to Trumps uninformed grasping at hydroxychloroquine. While there is a well know (and respected) expert in the distant background (Gattinoni), a grainy YouTube video of a random critical care doc without training in pulmonary disease is … well, the optics are bad. 

For the details. What is being proposed isn’t something terribly new. Our field is full of horrible disappointments, treatments that were based on large, very well run randomized controlled trials and then turned out to be useless, or even harmful. The list is long, activated protein C for sepsis, tight glycemic control, early goal directed therapy for sepsis, pulmonary artery catheters, steroids for x, y and z. However the treatment of ARDS using low tidal volume ventilation is the exception. It not only works, its made a visible change in patient outcomes in ICUs over the past decade.

These are cautions I hope it is clear I take very much to heart.

In a follow up email NC provided this helpful context.

Yes, the observation that this disease is very much hypoxia driven and less about stiff lungs is true, and being discussed a lot, but doesn’t really get into the media as its kind of esoteric. Its the driver behind the deaths, rather than how our usual ARDS patients die. ARDS isn’t a disease, its a fixed set of clinical findings that are used to define a syndrome that we treat with a single common model. COVID patients fit the definition, but behave outside the norm. So they absolutely have ARDS (since its a syndrome, not a disease), but maybe their form of ARDS doesn’t slide neatly into the standard treatment model. 

Re Gattinoni. It’s hard to say. It’s very much inside baseball. Gattinoni is super smart and has made massive contributions to this very field, but we’re still talking about stuff thats pretty theoretical and his articles are not going through the normal peer review process to publication. 

My take would be in a different direction. Gattinoni is noting that there is variability in the disease and that treatment can’t be entirely protocol driven. ARDS is the poster child for protocol driven care. So we badly need physicians on the front line that can make decisions about when to follow protocols and when not to. I think most of us who are Pulmonary Critical Care trained are doing that now. However when you burn through us due due to lack of PPE etc, then the remaining providers will have to use protocols.

This is the most interesting part of the discussion to me as an outside, lay observer. The point of common agreement appears to be that the standards ARDS protocol is not appropriate for all patients; that you need experienced clinicians who can depart from standard protocol based on the nuances of specific patients’ course of disease. The complication is that clinicians with deep experience in respiratory critical care are in short supply at the moment. And an additional hurdle is that the less invasive interventions are actually more dangerous to the clinicians who are often using inadequate personal protective equipment. There is a highly complicated set of trade offs in a context where there is limited knowledge, limited resources (human and technical) and mass mortality.

Josh Marshall, TPM |  Read more:

Image: YouTube

[ed. Do check out the original post. See also: This post about ventilators, and how they could be doing more harm than good (which seems to dovetail with what's being said here) (TPM). Finally there's this: From Fine to Flailing (Reuters).]

Fashion week
via:

Online Education in the Covid-19 Crisis: “It’s Like Coke Dealers Handing Out Free Samples”

Economist Gordon Lafer, author of The One Percent Solution: How Corporations Are Remaking America One State at a Time, has delved deeply into the highly-orchestrated political activities of corporate-backed groups set on changing the American education system in ways that he believes are detrimental to the country’s future. Lafer, who teaches at the University of Oregon Labor Education and Research Center, is a member of the Eugene School District Board and once served as senior policy advisor to the Education and Labor Committee of the U.S. House of Representatives. He sees the Covid-19 crisis as the perfect opportunity for companies far more interested in the bottom line than student learning to seize America’s education system and turn it into a robotic, one-size-fits-all program where teachers eventually disappear from the scene and students, especially the most vulnerable, get left behind. He joined the Institute for New Economic Thinking for a conversation about what’s at state in online learning and how technology, if properly guided, can be good for students, teachers, and parents.

Lynn Parramore: This crisis differs from previous ones in the abrupt movement to online learning that is affecting so many people. Many are cheering tech companies for providing education platforms during school closures. Yet your work issues a cautionary message – warning that Big Business and corporate-backed groups like the American Legislative Exchange Council (ALEC) have coordinated in the past to undermine public education through things like lowering accreditation requirements for teachers, replacing public schools with privately run charters, and – here we come to the Covid-19 moment – to move students to online learning. Is this crisis an opportunity to further their agenda?

Gordon Lafer: I think there’s no question that they view it as a huge opportunity. As you know, I was elected to the board of education in Eugene last year. When the pandemic hit, right away we got a list of all these technology companies that make education software that were offering free access to their products for the duration of the coronavirus crisis. They pitch these offerings as stepping up to help out the country in a moment of crisis. But it’s also like coke dealers handing out free samples.

I can see this in my own school system, where you have pressure from everybody, from students and parents who are saying, okay, seniors need to graduate, and kids need to learn whatever they’re supposed to learn. The easiest thing, the laziest thing to do, is to just get some outside apps and put everybody on that. Well, that’s great for those technology companies and their investors. But it’s terrible for education, partly because so much of education depends on the personal relationship between teachers and students.

LP: Surely that is even more true for the less advantaged students?

GL: That’s right. The kids who are most needy are most in need of an adult point of contact, which is harder to get with online learning. The truth is – and we’ve been talking about this here in Oregon – if we would take the time, and put more work into it, we’re at a point where technology allows much more creative forms of online education than what tech companies are offering.

Parents want somebody who pays attention to their kid. Maybe the kid is shy or has anger problems, whatever it is. The learning platforms the tech companies want aren’t interested in that. They only want to see how fast you do the problem. That’s not going to work for the kids from the most marginalized communities who are not getting education support at home, who come from various kinds of trauma. They, more than anybody, need to be taught by a skilled teacher who knows them as an individual. I think, to some degree, that may be what every parent wants, but teachers will have to take the initiative to create these models.

What makes sense for investors in tech companies, first of all, is uniformity and a product that is scalable. Second of all, they do not want to be dependent on teachers. But online learning doesn’t have to be this way. Technology offers many ways to do it. Unfortunately, the software companies want to do it in this one way that is actually a one-pedagogy-fits-all approach.

In some ways, we may be in a race against the education technology industry, which is just going to try to roll their programs out as fast as they can. In light of that, we really need to work through these better alternatives so we can say, look, this is what we can do instead. We can do something which is much better for everybody’s kids.

LP: What might those creative platforms look like? How might they benefit teachers and students?

GL: There are some interesting ideas that I’ve been talking to people about and that teachers here have been investigating. Suppose you needed to learn seventh-grade English. There might be a teacher who teaches it through poetry. Another teacher might look at it through science fiction or memoir-writing. You could really have more choice for kids, right? Instead of just having your one teacher, you could say, here are three different ways you could learn this material. You can choose because the teachers are online.

Maybe somebody is going to teach elementary school math from the textbook. Another is going to teach it by drawing and allow kids to draw interactively online. Yet another might teach it by saying, I’d like you to go walk around your house and find a shoebox and an egg and a cup, and we can talk about shapes and the relationship of shapes to each other.

We’ve even discussed a possibility where, let’s say a social studies teacher has four classes a day and they’re teaching the same thing four times. Well, they could decide that part of the class – the part that is just repeating a presentation — could be done just once. Everybody could watch that part whenever they want, and that frees up time for the teacher either to have more individual time for phone calls with students or small groups through Zoom chats. You end up with much more personal interaction.

The ironic thing is that we’re at a point where the technology actually enables a lot creative, engaged, teacher-driven education that still maintains, and maybe even strengthens, the personal relationship between teachers and their students.

LP: What is at stake for our kids and the country’s future if we go the one-size-fits all, less engaged route that many tech companies and their investors would prefer?

GL: Well, some kids would do ok with it, but a lot of kids won’t. They won’t be able to learn, and their experience will be one of failure. You can kind of tell how it would happen. While other kids are advancing to the next level, they’re not. And the response to failure provided by the tech company software may not be adequate to that situation. Instead of a teacher helping a student to find a book that makes reading fun while they’re learning phonemes, you might have a program that just offers more drilling. Which is probably not going to help.

You also have to realize that kids, even high school kids, are not going to spend six hours a day sitting in front of a screen doing classes. Some will just stop doing it. In the short-run, I think you’re going to see a lot of problems with that kind of disengagement.

There’s also a huge inequity issue of who has access to Wi-Fi and computers. In the long-run, I think what these companies really want is to say, look, our platforms worked during the crisis, so this is what we should do going forward. We should get rid of teachers. They’ll promote all the reasons why they think it’s better not just for now, but long after the crisis has passed.

LP: Get rid of teachers altogether? How would they get the public to accept that?

GL: One of the things that will help them make that argument is budgets. Assuming we’re in a serious recession for a year or more — that means everybody’s budget is going to get cut. Here in Eugene, the school funding is based on income tax. Whether it’s based on income tax or property tax, you can be sure budgets are going to go down, which means that you’re going to see cuts. Then the tech companies are going to come and say, well, instead of spending $10,000 for a kid to be educated in a classroom, you could spend $7,000 per kid to put them online. The tech companies will be happy, still able to make a 20 percent profit. When you have budget cuts, some people will find this sort of thing becoming more attractive.

by Lynn Parramore, Institute for New Economic Thinking |  Read more:

Image: uncredited

Wisconsin Primary Voters Receive ‘I Voted’ Gravestones

via: The Onion
[ed. See previously: Wisconsin Election Held Amid Virus Fears: Here's What You Need To Know (Duck Soup).

Turin Brakes

New York Fed, FDIC Tout “Opacity in a Banking Crisis” to Keep Corporations, Hedge Funds, PE Firms & Counterparties in the Dark about Weak Banks

US banks are now finding themselves in a situation where homeowners don’t have to make mortgage payments for few months, and renters don’t have to pay rent for a while, which leaves many landlords unable to make their mortgage payments – not to speak of the many Airbnb hosts that have no guests and won’t be able to make their mortgage payments. Commercial real estate is in turmoil because the tenants have closed shop and cannot or won’t make rent payments, and these landlords are going to have long discussions with their bankers about skipping mortgage payments. And subprime auto loans and subprime credit card loans, which were already blowing up before the crisis, are now an unspeakable mess, as tens of millions of people have suddenly lost their jobs.

Amid this toxic environment for the banks, here come the New York Fed and the FDIC and tout the “Value of Opacity in a Banking Crisis,” explaining, supported by empirical data from the Great Depression, that it’s better to stop disclosing balance sheet information about individual banks.

So here we go, as to why it’s important for “authorities” to lie about banks during a crisis. It’s not directed at households, as we’ll see in a moment – but at corporations, hedge funds, PE firms, state and local government entities, and other institutional bank customers whose bank balances by far exceed deposit insurance limits and that would yank their mega-deposits out of that bank at the first sign of trouble.

The authors of the article, a joint production by the FDIC and the New York Fed, cite Great Depression data before the arrival of FDIC deposit insurance to show how lying about balance sheets of individual banks is beneficial in ending runs on weak banks. They’re talking about accounts that were uninsured at the time, and that’s the key for today, as we’ll see in a moment. (...)

Having deposit insurance makes household depositors much less sensitive to bank-level information; once they are insured, depositors no longer have an incentive to monitor banks and so they pay less attention to the publication of balance-sheet statistics. 

As a result, the introduction of deposit insurance makes irrelevant the gains from making the balance sheets of state-charter banks more opaque, placing national‑charter and state-charter back on an equal footing.

But wait… That’s not where this story goes.

It U-turns right at this spot in a conclusion, titled “Why Does This Result Matter Today?”

Even with the FDIC’s deposit insurance program, public disclosure of the portfolio of assets held by banks matters because banks issue significant amounts of debt that is not insured (for example, a significant fraction of bank deposits today are not insured by the FDIC).

These uninsured deposits are in accounts that exceed by a wide margin the FDIC deposit insurance limit of $250,000. They’re held mostly by businesses, institutions, state and local government entities, hedge funds, PE firms, and the like. They may have hundreds of millions or even billions of dollars in their transaction accounts.

Few households have daily liquidity needs that exceed FDIC deposit insurance limits, and savers can spread their bank deposits to different banks and stay within the FDIC limits with each deposit account.

Also, these “call reports” are not easy to dig up and read – though they’re available online. This is something that normal households have neither the time nor the expertise to deal with. So this suppression of information is not directed at savers and households.

But it is directed at businesses, state and local government entities, hedge funds, PE firms, and other institutional bank customers that need big balances in their accounts to fund their operations on a daily basis, engage in transactions, and the like, and that have the staff and expertise to study the call reports and use them as actionable data. And they’d yank their mega-deposits out of that bank at the first sign of trouble appearing in the call reports. (...)

It is interesting that the “value” of suppressing information about bank balance sheets are being touted now as banks are suddenly finding themselves stuck in a financial crisis so vast that the Fed decided to unleash the biggest amount of money printing in history in an attempt to bail out all aspects of Wall Street.

And it is even more interesting that this is so clearly directed at business and institutional bank customers and counterparties that apparently need to be kept in the dark about the health of their banks, lest they yank out their large deposits.

Runs on the bank don’t take place today by people waiting in line at the branch to take out their $500 in savings. They happen when corporations, financial entities, and counterparties lose confidence in the bank and yank their millions and billions out.

by Wolf Richter, Wolf Street |  Read more:

[ed. Kind of raises a red flag, don't you think? See also: ‘It will not go forgotten’: One Seattle business and its tale of two landlords during the coronavirus crisis (Seattle Times).]

This Is Trump’s Fault

"I don’t take responsibility at all,” said President Donald Trump in the Rose Garden on March 13. Those words will probably end up as the epitaph of his presidency, the single sentence that sums it all up.

Trump now fancies himself a “wartime president.” How is his war going? By the end of March, the coronavirus had killed more Americans than the 9/11 attacks. By the first weekend in April, the virus had killed more Americans than any single battle of the Civil War. By Easter, it may have killed more Americans than the Korean War. On the present trajectory, it will kill, by late April, more Americans than Vietnam. Having earlier promised that casualties could be held near zero, Trump now claims he will have done a “very good job” if the toll is held below 200,000 dead.

The United States is on trajectory to suffer more sickness, more dying, and more economic harm from this virus than any other comparably developed country.

That the pandemic occurred is not Trump’s fault. The utter unpreparedness of the United States for a pandemic is Trump’s fault. The loss of stockpiled respirators to breakage because the federal government let maintenance contracts lapse in 2018 is Trump’s fault. The failure to store sufficient protective medical gear in the national arsenal is Trump’s fault. That states are bidding against other states for equipment, paying many multiples of the precrisis price for ventilators, is Trump’s fault. Air travelers summoned home and forced to stand for hours in dense airport crowds alongside infected people? That was Trump’s fault too. Ten weeks of insisting that the coronavirus is a harmless flu that would miraculously go away on its own? Trump’s fault again. The refusal of red-state governors to act promptly, the failure to close Florida and Gulf Coast beaches until late March? That fault is more widely shared, but again, responsibility rests with Trump: He could have stopped it, and he did not.

The lying about the coronavirus by hosts on Fox News and conservative talk radio is Trump’s fault: They did it to protect him. The false hope of instant cures and nonexistent vaccines is Trump’s fault, because he told those lies to cover up his failure to act in time. The severity of the economic crisis is Trump’s fault; things would have been less bad if he had acted faster instead of sending out his chief economic adviser and his son Eric to assure Americans that the first stock-market dips were buying opportunities. The firing of a Navy captain for speaking truthfully about the virus’s threat to his crew? Trump’s fault. The fact that so many key government jobs were either empty or filled by mediocrities? Trump’s fault. The insertion of Trump’s arrogant and incompetent son-in-law as commander in chief of the national medical supply chain? Trump’s fault.

For three years, Trump has blathered and bluffed and bullied his way through an office for which he is utterly inadequate. But sooner or later, every president must face a supreme test, a test that cannot be evaded by blather and bluff and bullying. That test has overwhelmed Trump.

Trump failed. He is failing. He will continue to fail. And Americans are paying for his failures.

by David Frum, The Atlantic |  Read more:

Image: Image: Ray Stubblebine/Reuters

[ed. I try to avoid finger-pointing in the middle of a crisis - there'll be plenty of time for that later - but this article provides an excellent chronology of how the US response to the coronavirus threat unfolded (up to this point - 4/8/2020).]

Joni James

Reflections on a Disaster (Update)

From the Duck Soup post: Reflections on a Disaster. Updated occasionally to see how closely we're following the script.

Update (4/7/2020): I forgot to add the main issue of conflict once the response/execution process is in full swing: More Harm Than Good. At the time of this writing we're closing in on what experts hope will be peak contagion/recorded deaths. Expect to see an escalating struggle between health experts/politicians/others vs. economists/politicians/business leaders/others on the issue of when to ease up on social distancing measures (basically, defining "success"). I'm already seeing calls to isolate the most vulnerable (old, underlying health conditions, etc.) and letting everyone else take their chances (possibly developing 'herd immunity' in the process). In other words, pitting numbers of deaths against numbers of unemployed and the health of the economy - which itself is on life-support at the moment.

And, if there's a second wave?

See also: The Fight Against COVID-19: “Bending the Curve” & Then What? (Wolf Street); and Wishful Thinking on Ending Coronavirus Lockdowns (Naked Capitalism).

Real World Depression Measurement

The largest non-pharma antidepressant trial ever conducted just confirmed what we already knew: scientists love naming things after pandas.

We already had PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus) and PANDA (Proton ANnhilator At DArmstadt). But the latest in this pandemic of panda pandering is the PANDA (Prescribing ANtiDepressants Appropriately) Study. A group of British scientists followed 655 complicated patients who received either placebo or the antidepressant sertraline (Zoloft®).

The PANDA trial was unique in two ways. First, as mentioned, it was the largest ever trial for a single antidepressant not funded by a pharmaceutical company. Second, it was designed to mimic “the real world” as closely as possible. In most antidepressant trials, researchers wait to gather the perfect patients: people who definitely have depression and definitely don’t have anything else. Then they get top psychiatrists to carefully evaluate each patient, monitor the way they take the medication, and exhaustively test every aspect of their progress with complicated questionnaires. PANDA looked for normal people going to their GP’s (US English: PCP’s) office, with all of the mishmash of problems and comorbidities that implies.

Measuring real-world efficacy is especially important for antidepressant research because past studies have failed to match up with common sense. Most studies show antidepressants having “clinically insignificant” effects on depression; that is, although scientists can find a statistical difference between treatment and placebo groups, it seems too small to matter. But in the real world, most doctors find antidepressants very useful, and many patients credit them for impressive recoveries. Maybe a big real-world study would help bridge the gap between study vs. real-world results.

The study used an interesting selection criteria – you were allowed in if you and your doctor reported “uncertainty…about the possible benefit of an antidepressant”. That is, people who definitely didn’t need antidepressants were sent home without an antidepressant, people who definitely did need antidepressants got the antidepressant, and people on the borderline made it into the study. This is very different from the usual pharma company method of using the people who desperately need antidepressants the most in order to inflate success rates. And it’s more relevant to clinical practice – part of what it means for studies to guide our clinical practice is to tell us what to do in cases where we’re otherwise not sure. And unlike most studies, which use strict diagnostic criteria, this study just used a perception of needing help – not even necessarily for depression, some of these patients were anxious or had other issues. Again, more relevant for clinical practice, where the borders between depression, anxiety, etc aren’t always that clear.

They ended up with 655 people, ages 18-74, from Bristol, Liverpool, London, and York. They followed up on how they were doing at 2, 6, and 12 weeks after they started medication. As usual, they scored patients on a bunch of different psychiatric tests.

In the end, PANDA confirmed what we already know: it is really hard to measure antidepressant outcomes, and all the endpoints conflict with each other.

I am going to be much nicer to you than the authors of the original paper were to their readers, and give you a convenient table with all of the results converted to effect sizes. All values are positive, meaning the antidepressant group beat the placebo group. I calculated some of this by hand, so it may be wrong.

PHQ-9 is a common depression test. BDI is another common depression test. GAD-7 is an anxiety test. SF-12 is a vague test of how mentally healthy you’re feeling. Remission indicates percent of patients whose test scores have improved enough that they qualify as “no longer depressed”. General improvement was just asking patients if they felt any better.

I like this study because it examines some of the mystery of why antidepressants do much worse in clinical trials than according to anecdotal doctor and patient intuitions. One possibility has always been that we’re measuring these things wrong. This study goes to exactly the kind of naturalistic setting where people report good results, and measures things a bunch of different ways to see what happens.

The results are broadly consistent with previous studies. Usually people think of effect sizes less than 0.2 as miniscule, less than 0.5 as small, and less than 0.8 as medium. This study showed only small to low-medium effect sizes for everything. (...)

What does this mean in real life? 59% of patients in the antidepressant group, compared to 42% of patients in the placebo group, said they felt better. I’m actually okay with this. It means that for every 58 patients who wouldn’t have gotten better on placebo, 17 of them would get better on an antidepressant – in other words, the antidepressant successfully converted 30% of people from nonresponder to responder. This obviously isn’t as good as 50% or 100%. But it doesn’t strike me as consistent with the claims of “clinically insignificant” and “why would anyone ever use these medications”?

by Scott Alexander, Slate Star Codex |  Read more:

Image: SSC

A Google Plan to Wipe Out Mosquitoes Appears to Be Working

An experimental program led by Google parent Alphabet Inc. to wipe out disease-causing mosquitoes succeeded in nearly eliminating them from three test sites in California’s Central Valley.

Stamping out illness caused by mosquitoes is one of Alphabet unit Verily’s most ambitious public-health projects. The effort appears to be paying off, according to a paper published in the journal Nature Biotechnology on Monday.

Verily is also running coronavirus triage and testing in parts of California. Bradley White, the lead scientist on the Debug initiative, said mosquito-suppression is even more important during the pandemic, so that outbreaks of mosquito-borne diseases such as dengue fever don’t further overwhelm hospitals.

Since 2017, the company has released millions of lab-bred Aedes aegypti male mosquitoes into several Fresno County neighborhoods during mosquito season. The insects are bred in Verily labs to be infected with a common bacterium called Wolbachia. When these male mosquitoes mate with females in the wild, the offspring never hatch.

In results of the trial published on Monday, Verily revealed that throughout the peak of the 2018 mosquito season, from July to October, Wolbachia-infected males successfully suppressed more than 93% of the female mosquito population at field test sites. Only female mosquitoes bite.

Working with the local mosquito abatement district and MosquitoMate, which developed the mosquitoes originally, Verily released as many as 80,000 mosquitoes each day in three neighborhoods from April 2018 through October 2018. In most collections, per night Verily found one or zero female mosquitoes in each trap designed to monitor the population. At other sites without the lab-bred bugs, there were as many as 16 females per trap.

“We had a vision of what this should look like and we managed to do that pretty perfectly,” said Jacob Crawford, a senior scientist on the Debug project.

In the arid climate of the Central Valley, disease is an unlikely result of a mosquito bite. But in the hot, humid regions of the tropics and subtropics, diseases caused by the Aedes aegypti, such as dengue fever, Zika virus and chikungunya, kill tens of thousands of people every year. Releasing masses of Wolbachia-infected mosquitoes into the wild might wipe out entire populations of deadly mosquitoes and the diseases they carry.

Verily is not the only organization pursuing an end to mosquito-borne disease. Microsoft Corp. co-Founder Bill Gates has pledged more than $1 billion to help wipe out malaria, including controversial efforts to genetically modify mosquitoes. Infecting mosquitoes with Wolbachia, which occurs naturally in some mosquito species, is a popular approach rooted in an old insect control strategy called sterile insect technique.

by Kristen V. Brown, Bloomberg |  Read more:

Image: David Paul Morris/Bloomberg

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Concrete Blonde

Never Say Never

An Oral History of Tiger Woods' Magical Fifth Masters' Victory

Where were you when it happened? Tiger Woods, 43 last April and 11 years removed from his last major-championship victory, turned doubters into believers again by winning his fifth Masters green jacket in the most emotional final day at Augusta National Golf Club since a 46-year-old named Jack Nicklaus won his sixth in 1986. We interviewed 34 of the key figures and observers in the hours, days, weeks and months after Woods’ powerfully poignant triumph. Even those gutted by Woods’ latest magic—and there were a lot of them so close to winning that day—professed feelings of wonder, grateful to have witnessed history. Here are their stories on what went on beyond the roars.

Prologue: The Long Way Back After Surgery

CURTIS STRANGE (on Woods’ spinal-fusion surgery in 2017): The consensus after that was that Tiger would never win another major. But you never say never.

ROCCO MEDIATE (who also has a history of back problems): If he had come back with the same golf swing he had before the injuries, you never would have heard of him again. But I was watching his tournament in the Bahamas, and I watched one swing, and I went, Oh, somebody figured it out. The club isn’t behind him. He’s not up and down as much. All of a sudden, now the back will hold.

PETER KOSTIS: His swing now is constructed to take pressure off his back. He used to control the club with his hands and arms; his body followed that swinging motion. Somewhere around the end of Hank Haney [as Woods’ teacher] and the beginning of Sean Foley, Tiger started to “body” his swing. He got more physical. He generated his arm swing through his body motion, rather than the other way around. And that’s when he lost his way. That’s when he hit a lot of foul balls. Since the last surgery, he has gone back to swinging his arms again. He lets his body accommodate itself to his arm swing. In that way, he was swinging in 2019 the way he swung in 1997, albeit with a different body and effort level.

FRANK NOBILO (CBS): Once the surgery took, he didn’t take as many risks. Go back to the [2018] Open Championship at Carnoustie. Oddly enough, none of us really agreed with his strategy—it appeared too conservative. He was more than a decade removed from winning a major championship. The other guys had watched, and they were a decade better, and they’re all playing aggressively. He just kept plugging away. So I think what he got out of Carnoustie was the fact that that type of golf, as proven in the Nicklaus era, would still work in the heat of the moment.

THOMAS BJORN: I thought the first 27 holes he played on the weekend at Carnoustie were the most telling indications that he was back. I remember thinking, Hang on—I know this guy. (...)

Foreshadowing A Big Final-Round Putt

TIGER WOODS: The one smart decision I think we really made was on Tuesday, when it just hosed down rain. All the guys who went out and played said it was useless to go out there because it was gonna be so much faster come Thursday. I just did drill work and worked on technique.

JOE LACAVA: Wednesday, we did nine with Fred [Couples] and JT [Justin Thomas]. You might not have heard the story, but the pin on No. 9 [in the final round] was basically out there on Wednesday, the same location. Tiger dropped one on the back of the green [about 70 feet from the hole] and challenged JT to a little putting contest, closest to the pin. So we basically hit the same putt on Wednesday that we did on Sunday. I mean, you can putt that thing off the green. You could leave it up top, which means you’re going to make a 5 or 6. Wednesday, it’s a pretty easy putt. Not on Sunday. You’ve got to barely carry the ridge to trickle it down there, and he did [to within a foot]. Amazing putt, really.

A Good Start

Woods shoots a first-round 70—matching his opening score in three of his four previous Masters wins—and was T-11, trailing co-leaders Bryson DeChambeau and Brooks Koepka by four strokes. The last Masters winner outside the top 10 after the first round had been Woods, who was T-33 and seven strokes behind Chris DiMarco after the opening 18 in 2005.

● ● ●

JOE LACAVA: It’s nice to get off to a good start by hitting that first fairway. It sounds weird—every hole counts just as much as the others. Make a good drive on 1, which might not be his favorite driving hole, and knock it safely on the green. A no-sweat 20-foot two-putt par is kind of nice, you know what I mean? He just had this demeanor about him, but he was still in a mood where he could talk to people and say hello. He wasn’t ignoring people, just a little more focused than he had been.

A Near-Disaster

Woods shoots a second-round 68 and moves up to T-6, trailing co-leaders Koepka, Jason Day, Francesco Molinari, Louis Oosthuizen and Adam Scott by a stroke, but the day has a scary moment: A security guard attempting to keep spectators back at the 14th hole slips on the wet turf and clips Woods’ ankle.

● ● ●

TIGER WOODS: He was just trying to do his job. Look, it was slippery out there. He tried to put the brakes on, and unfortunately my right knee went around my left. And that’s what hurt. It did hurt. My LCL in my right leg, I definitely felt it. But, I gotta go play, so off I went [and birdied the hole]. … You know, when you play in front of a lot of people, things happen.

JOE LACAVA: Friday is a round that could have been better. He birdies 11 [but misses opportunities at 12, 13, 17 and 18]. You know, you’re just happy to be in contention, but I always look at it as we should be better, if not running away with the tournament. (...)

‘The Perfect Storm’

A rainy forecast necessitates an early start on Sunday. Molinari enters the final 18 leading Woods and Finau by two shots, Koepka by three, and Ian Poulter and Webb Simpson by four. Dustin Johnson, Xander Schauffele, Oosthuizen, Matt Kuchar and Justin Harding are five back.

● ● ●

JOE LACAVA: With the weather moving in, we got a break by going in threesomes on Sunday—otherwise we wouldn’t have been in the last group. The fact that Tiger’s in the last group [with Molinari and Finau], and everyone’s pulling for Tiger, that certainly helped our cause. … People were texting me, going crazy ’cause Tiger said on the air that he had to get up at 3 o’clock to get that tee time. I said, “To be honest with ya, he’s usually awake at 3 or 4 in the morning.” So I’d much prefer to have a tee time at 9 o’clock, because by the time the 3 o’clock in the afternoon tee time comes, which is normally when it is, he’s been up for 12 hours; he’s exhausted almost. Most people sleep till 7 o’clock in the morning. He just doesn’t do that.

NICK FALDO: It was the perfect storm for Tiger. It really was. Jim [Nantz] asked me Sunday morning, “So what’s going to happen?” I said, “I think Tiger’s going to win.” Before we went on the air. I’ve never seen the patrons go from 10 deep to 12, to 15, to 20 deep, and he hadn’t arrived yet.

PADRAIG HARRINGTON: Sitting in the clubhouse, we knew he was coming 15 minutes before he appeared. The security started to get ready. And people lined up just to see him walk past. Then he arrived and made his way through the crowd. Everyone stepped out of his way. He had his head down. He made eye contact with nobody. And he smiled at nobody. He was the old Tiger.

by John Huggan, Dave Shedloski, Henni Zuel, Golf Digest |  Read more:

Image: J.D. Cuban

[ed. See also: This was supposed to be Masters week, and folks in Augusta are feeling the emotional and financial sting; and 'Surreal': Jennifer Kupcho looks back on winning the inaugural Augusta National Women's Amateur (Golf Digest).]

Wisconsin Election Held Amid Virus Fears: Here's What You Need To Know

After intense political back and forth, Wisconsin is set to hold its presidential primaries and elections for many state and local offices on Tuesday.

The controversial election day comes after the Wisconsin Supreme Court overturned an executive order issued by Democratic Gov. Tony Evers to delay in-person voting until June 9, followed by a U.S. Supreme Court order on Monday evening to cut off an extension for absentee voting.

The state had been the subject of criticism across the country throughout March, as more than a dozen other states delayed their elections due to coronavirus fears. Wisconsin officials issued a stay-at-home order for the state two weeks ago.

What is the structure of the election?

Wisconsin has an open primary, meaning that voters can request a ballot for either party's contest. Voters will have the option of casting their ballots in person Tuesday, but it may not be easy for those willing to go. Polling places were consolidated and modified to follow social distancing guidelines, and there's expected to be a shortage of about 7,000 poll workers as many decline to work amid the pandemic.

Voters can submit absentee ballots in person until 8 p.m. CT on Tuesday, the result of the last-minute U.S. Supreme Court ruling, overturning a federal judge's ruling that had extended the deadline until April 13. Absentee ballots submitted by mail will be accepted until 4 p.m. CT on that date, but must be postmarked by Tuesday (April 7).

A lower court ruling said that county clerks have to hold results until April 13, and yesterday's court action did not appear to change that.

What does a Wisconsin win mean for Sanders and Biden?

Former Vice President Biden maintains a significant delegate lead over Vermont Sen. Sanders, after winning a majority of state primaries in March.

According to NPR's delegate tracker, Biden has 1,217 pledged delegates and Sanders has 914 pledged delegates. Sanders would need 64% of the remaining delegates in play to win the nomination, while Biden needs 46% of remaining delegates.

Biden has solidly led polling in Wisconsin since early March.

by Elena Moore, NPR |  Read more:

Image: Scott Trindl/AP

[ed. To be honest, with everything going on, I haven't been giving much attention to politics - especially politics in Wisconsin. However, from what I can tell, Biden has been opposed to delaying the election and somewhat ambiguous about closing in-person voting stations. I can understand wanting to maintain campaign momentum, but that kind of ambiguity in a pandemic doesn't exactly inspire a lot of confidence (in his leadership or the validity of the election). See also: Biden: Voting in Wisconsin Is Safe. Locals: It Could Kill Us (Yahoo News/Daily Beast); Wisconsin voters go to the polls in controversial election; and ‘I know what's at stake’: can Biden win over skeptical Sanders supporters? (The Guardian).]

A Practical Guide to Building a Country on the Internet

Building a country on the internet is one of those ideas that people almost always get interested in when I mention it. For some reason, the idea has a lot of charisma.

But what does a country on the internet mean?

In short, a country on the internet means that a virtual entity provides most of the functions that you today would get from a nation state.

But more deeply, what it really means is that there is the possibility of making a much better life for everyone. To help ensure freedom and equal opportunities for all the fine people on this good earth.

So, how can someone make a country on the internet?

A good place to start is to see what the current criteria are for establishing a new country.

by Sondre Rasch, Medium | Read more:
Image: uncredited

[ed. Crazy? Who knows these days. This isn't a particularly convincing or well thought-out proposal, but an intriguing concept nevertheless.]

What the Caribou Taught Me About Being Together, and Apart

Over the past week, as each thread of our ordinary existence unravels and travel feels like something we used to do, I’ve been holding tight to a single mental image. The deep brown gaze of a caribou calf as it passed inches from my face. The whites of its eyes as it glanced at me in surprise. The animal’s fear of the unknown dwarfed by its clarity of purpose.

On St. Patrick’s Day, 2012, my husband and I had set out on a 4,000-mile, human-powered journey from Bellingham, Wash., in the Pacific Northwest to Kotzebue, Alaska, far above the Arctic Circle. For nearly six months, traveling by rowboat, ski, packraft, foot and canoe, we’d made our way across some of the most remote landscapes on earth.

In the last days of our trip, we were canoeing down the swollen Noatak River in the Brooks Range of northern Alaska. Winter had arrived early that year and we paddled through the damp chill of rain turning to snow. Bundled and shivering, we never imagined we’d find ourselves hunkered down on a riverbank surrounded by caribou, our breath mingling with theirs.

But late one afternoon, as we rounded a bend in the river, I noticed what looked like a branch floating downstream. And then another. By the time we realized we weren’t seeing branches, but antlers, two caribou had landed on the far shore. They pranced and shimmied, water flying in beads off their coats. Waiting at the river’s edge were dozens more animals, poised to cross. We pulled our canoe out at the next eddy and stopped to watch. When the last of the animals had finished their swim, we hiked along the brushy bank to find the trail they’d followed to the river. At our feet was a crisscross of tracks, pressed freshly into the soft mud.

At first, everything was still. Then a wave of sound approached like a squall across the water and we crouched down to hide in the bushes. We felt the wave of energy before we saw the first animals, funneling down the hillside toward us. Suddenly we were embedded in the migration of the Western Arctic Caribou Herd. So close I could have reached out and touched their backs, the animals passed in single file on the path beside us. There were dozens of caribou, then hundreds, and soon we lost count. Breath steamy in the cool air, tendons in their legs clicking audibly, black noses moist and shiny, the urgency of their motion was palpable. They stopped only briefly to gather at the riverbank before crossing.

In magazine spreads and documentary footage, caribou migrations look perfectly choreographed. From the air, tens of thousands of animals move synchronously as they dance across the tundra in sinuous waves. On the ground, backstage with the dancers, I discovered a different scene entirely. Instead of an orderly procession, the migration felt jumbled and jostling, anarchic and frenzied. Picture a schoolyard of kindergartners lining up from recess, limbs flailing, bodies in motion, all jockeying for position.

This was made worse by the fact that the river crossing had formed a bottleneck: Each caribou had to decide whether to leap from a six-foot bank into the swirling gray water below or to continue down the trail to another entry. In the moments of indecision, it was almost always a cow and calf that first took the plunge. The calves held tightly to their mothers’ sides, each pair exchanging quiet grunts as they splashed in the swift current. They were the ones with the most at stake; they were also the ones that couldn’t afford to delay. Still, they hesitated and stumbled, sometimes stepping forward only to jolt back a moment later, letting another caribou pass. I hadn’t ever imagined such disorder among these highly social animals, such chaos in their movements.

But the longer I sat and watched, the more I began to notice the nuances of the herd’s dynamics. Each animal’s actions were driven by something larger than itself. Behind the chaos was the collective need to move. And no matter how frantic the motion felt, no matter how many more animals came down from the hills and joined the bottleneck of the river crossing, I never saw a single shove. No caribou were pushed into the water or trampled against the bushes. It was as though a safety bubble hovered around each animal, with an unspoken, absolutist rule shared among the herd: Do not harm thy neighbor. One large bull even stepped carefully over my husband’s outstretched legs, adjusting his gait to whatever obstacles lie in his way. The caribou’s movements might not have been synchronous but I could see how they were intimately and essentially connected.

by Caroline Van Hemert, NY Times | Read more:
Image: Patrick Farrell

April Pink Moon

We are currently in the middle of a miniseries of supermoons – the full moons of March, April, and May swing closer in their elliptical orbit to Earth (known as perigee), making them appear larger and brighter. But of the three, April's full moon will be the one that comes closest to our home planet, and it will be the closest full moon for the entire year. She will pass by a mere 221,772 miles away; for context, at its farthest point this year, which happened in March, the moon was 252,707 miles away.

Why it is called the Pink Moon

Unfortunately, despite its rosy name, the full Pink Moon will be its normal golden wan self. However, the name does have a poetic origin. Many early Native American tribes kept tabs on time by naming full moons rather than the calendar months as we know them. And since the moons helped keep track of the seasons, their names generally aligned with nature. In the case of April, the pink full moon ushered in the arrival of creeping phlox (Phlox subulate) and its early waves of pink.

Full moon names varied from tribe to tribe, others for April include the Sprouting Grass Moon, the Egg Moon, and the Fish Moon.

It will be lovely from sunset to sunrise

The (not so) blushing beauty will be visible toward the east after sunset on April 7, and will reach peak illumination at 10:35 P.M. EDT. It will be at its highest around midnight, and will then begin slinking back down to set in the west around sunrise on April 8. Because of the “moon illusion,” it will look especially large when it is close to the horizon. (...)

Some may complain that we supermoon superfans like to make a big deal over nothing. At its largest, a supermoon appears 14 percent larger in diameter than the smallest full moon. As for the illumination factor, its brightness can increase up to 30 percent. So it may not be enormous and as bright as the sun, but I think there’s something lovely about knowing that Earth’s only natural satellite is just a bit closer to the mothership. And anytime anyone has a chance to look up in the sky and marvel at its wonders – well I would say that’s cause for celebration.

by Melissa Breyer, TreeHugger |  Read more:

Image: NASA

Lucian Freud, Still Life with Zimmerlinde , c.1950

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