Friday, April 17, 2020
A New Statistic Reveals Why America’s COVID-19 Numbers Are Flat
How many people have the coronavirus in the United States? More than two months into the country’s outbreak, this remains the most important question for its people, schools, hospitals, and businesses. It is also still among the hardest to answer. At least 630,000 people nationwide now have test-confirmed cases of COVID-19, according to The Atlantic’s COVID Tracking Project, a state-by-state tally conducted by more than 100 volunteers and experts. But an overwhelming body of evidence shows that this is an undercount.
Whenever U.S. cities have tested a subset of the general population, such as homeless people or pregnant women, they have found at least some infected people who aren’t showing symptoms. And, as ProPublica first reported, there has been a spike in the number of Americans dying at home across the country. Those people may die of COVID-19 without ever entering the medical system, meaning that they never get tested.
There is clearly some group of Americans who have the coronavirus but who don’t show up in official figures. Now, using a statistic that has just become reliable, we can estimate the size of that group—and peek at the rest of the iceberg.
According to the Tracking Project’s figures, nearly one in five people who get tested for the coronavirus in the United States is found to have it. In other words, the country has what is called a “test-positivity rate” of nearly 20 percent.
That is “very high,” Jason Andrews, an infectious-disease professor at Stanford, told us. Such a high test-positivity rate almost certainly means that the U.S. is not testing everyone who has been infected with the pathogen, because it implies that doctors are testing only people with a very high probability of having the infection. People with milder symptoms, to say nothing of those with none at all, are going undercounted. Countries that test broadly should encounter far more people who are not infected than people who are, so their test-positivity rate should be lower.
The positivity rate is not the same as the proportion of COVID-19 cases in the American population at large, a metric called “prevalence.”* Nobody knows the true number of Americans who have been exposed to or infected with the coronavirus, though attempts to produce much sharper estimates of that figure through blood testing are under way. Prevalence is a crucial number for epidemiologists, in part because it lets them calculate a pathogen’s true infection-fatality rate: the number of people who die after becoming infected.
But the positivity rate is still valuable. “It’s not a normal metric, but it can be a very useful one in some circumstances,” Andrews said. The test-positivity rate is often used to track the spread of rare but deadly diseases, such as malaria, in places where most people aren’t able to get tested, he said. And if the same proportion of a population is being tested over time, the test-positivity rate can even be used to calculate the contagiousness of a disease.
Because the number of Americans tested for COVID-19 has changed over time, the U.S. test-positivity rate can’t yet provide much detailed information about the contagiousness or fatality rate of the disease. But the statistic can still give a rough sense of how bad a particular outbreak is by distinguishing between places undergoing very different sizes of epidemics, Andrews said. A country with a 25 percent positivity rate and one with a 2 percent positivity rate are facing “vastly different epidemics,” he said, and the 2 percent country is better off.
In that light, America’s 20 percent positivity rate is disquieting. The U.S. did almost 25 times as many tests on April 15 as on March 15, yet both the daily positive rate and the overall positive rate went up in that month. If the U.S. were a jar of 330 million jelly beans, then over the course of the outbreak, the health-care system has reached in with a bigger and bigger scoop. But every day, 20 percent of the beans it pulls out are positive for COVID-19. If the outbreak were indeed under control, then we would expect more testing—that is, a larger scoop—to yield a smaller and smaller proportion of positives. So far, that hasn’t happened.
by Robinson Meyer and Alexis C. Madrigal, The Atlantic | Read more:
Image: Adam Maida
[ed. See also: Our Pandemic Summer (The Atlantic).]
Whenever U.S. cities have tested a subset of the general population, such as homeless people or pregnant women, they have found at least some infected people who aren’t showing symptoms. And, as ProPublica first reported, there has been a spike in the number of Americans dying at home across the country. Those people may die of COVID-19 without ever entering the medical system, meaning that they never get tested.
There is clearly some group of Americans who have the coronavirus but who don’t show up in official figures. Now, using a statistic that has just become reliable, we can estimate the size of that group—and peek at the rest of the iceberg.
According to the Tracking Project’s figures, nearly one in five people who get tested for the coronavirus in the United States is found to have it. In other words, the country has what is called a “test-positivity rate” of nearly 20 percent.That is “very high,” Jason Andrews, an infectious-disease professor at Stanford, told us. Such a high test-positivity rate almost certainly means that the U.S. is not testing everyone who has been infected with the pathogen, because it implies that doctors are testing only people with a very high probability of having the infection. People with milder symptoms, to say nothing of those with none at all, are going undercounted. Countries that test broadly should encounter far more people who are not infected than people who are, so their test-positivity rate should be lower.
The positivity rate is not the same as the proportion of COVID-19 cases in the American population at large, a metric called “prevalence.”* Nobody knows the true number of Americans who have been exposed to or infected with the coronavirus, though attempts to produce much sharper estimates of that figure through blood testing are under way. Prevalence is a crucial number for epidemiologists, in part because it lets them calculate a pathogen’s true infection-fatality rate: the number of people who die after becoming infected.
But the positivity rate is still valuable. “It’s not a normal metric, but it can be a very useful one in some circumstances,” Andrews said. The test-positivity rate is often used to track the spread of rare but deadly diseases, such as malaria, in places where most people aren’t able to get tested, he said. And if the same proportion of a population is being tested over time, the test-positivity rate can even be used to calculate the contagiousness of a disease.
Because the number of Americans tested for COVID-19 has changed over time, the U.S. test-positivity rate can’t yet provide much detailed information about the contagiousness or fatality rate of the disease. But the statistic can still give a rough sense of how bad a particular outbreak is by distinguishing between places undergoing very different sizes of epidemics, Andrews said. A country with a 25 percent positivity rate and one with a 2 percent positivity rate are facing “vastly different epidemics,” he said, and the 2 percent country is better off.
In that light, America’s 20 percent positivity rate is disquieting. The U.S. did almost 25 times as many tests on April 15 as on March 15, yet both the daily positive rate and the overall positive rate went up in that month. If the U.S. were a jar of 330 million jelly beans, then over the course of the outbreak, the health-care system has reached in with a bigger and bigger scoop. But every day, 20 percent of the beans it pulls out are positive for COVID-19. If the outbreak were indeed under control, then we would expect more testing—that is, a larger scoop—to yield a smaller and smaller proportion of positives. So far, that hasn’t happened.
by Robinson Meyer and Alexis C. Madrigal, The Atlantic | Read more:
Image: Adam Maida
[ed. See also: Our Pandemic Summer (The Atlantic).]
Coronavirus Vaccine Prospects
Time for another look at the coronavirus vaccine front, since we have several recent news items. Word has come from GSK and Sanofi that they are going to collaborate on vaccine development, which brings together two of the more experienced large organizations in the field. It looks like Sanofi is bringing the spike protein and GSK is bringing the adjuvant (more on what that means below). Their press release says that they plan to go into human patients late this year and to have everything ready for regulatory filing in the second half of 2021. For its part, Pfizer has announced that they’re pushing up their schedule with BioNTech and possibly starting human trials in August, which probably puts them on a similar timeline for eventual filing.
“But that’s next year!” will be the reaction of many who are hoping for a vaccine ASAP, and I can understand why. The thing is, that would be absolutely unprecedented speed, way past the current record set by the Ebola vaccine, which took about five years. More typical development times are ten years or more. But hold that thought while you peruse another news item today from J&J. They have an even more aggressive timeline proposed for their own vaccine work: they have already announced that they have a candidate, and they say that they plan first-in-human trials in September. Data will be available from those in December, and in January 2021 they say that they will have the first batches of vaccine ready for an FDA Emergency Use Authorization. Now that is shooting for the world record on both the scientific and regulatory fronts.
So let’s talk vaccine development, because everything is going to have to work perfectly for any such timetable to be realized. Here’s a good overview of the coronavirus vaccine world in Nature Reviews Drug Discovery. The official WHO list is here, and at BioCentury they have constantly updated open-access summaries of the vaccines and other therapies that are in the clinic and the ones that are still preclinical. They have also just published this excellent overview of the vaccine issues; I recommend reading that one after you’ve picked up some background from this post.
NRDD counts 115 (!) vaccine programs, of which 37 are unconfirmed (no further information available on them) and 78 are definitely real. Of those 78, five of them are in the clinic, although that number will be climbing rapidly. You have Moderna’s mRNA1273, which as the name tells you is an mRNA candidate, and Inovio’s INO4800, which is a DNA plasmid, There are two cellular candidates from Shenzhen Geno-Immune Medical Institute: LV-SMENP-DC, a dendritic cell vaccine that’s been modified with lentivirus vectors to express viral proteins, and an artificial antigen-presenting cell (aAPC) vaccine along the same lines. And finally there’s a more traditional protein-fragment vaccine, Ad5-nCoV from CanSino.
Let’s go into what all those mean. You will note the diversity of approaches in that list, and that’s not even the whole spread. When you go back into the preclinical candidates, you have in addition “virus-like particles”, viral vectors, both replicating and non-replicating, live attenuated viruses, inactivated viruses, and more. From this you may deduce correctly that there are a lot of ways to set off the immune response. What are the differences between them?
Types of Vaccines (...)
Adjuvants (...)
Developing a Covid-19 Vaccine: Efficacy (...)
“But that’s next year!” will be the reaction of many who are hoping for a vaccine ASAP, and I can understand why. The thing is, that would be absolutely unprecedented speed, way past the current record set by the Ebola vaccine, which took about five years. More typical development times are ten years or more. But hold that thought while you peruse another news item today from J&J. They have an even more aggressive timeline proposed for their own vaccine work: they have already announced that they have a candidate, and they say that they plan first-in-human trials in September. Data will be available from those in December, and in January 2021 they say that they will have the first batches of vaccine ready for an FDA Emergency Use Authorization. Now that is shooting for the world record on both the scientific and regulatory fronts.So let’s talk vaccine development, because everything is going to have to work perfectly for any such timetable to be realized. Here’s a good overview of the coronavirus vaccine world in Nature Reviews Drug Discovery. The official WHO list is here, and at BioCentury they have constantly updated open-access summaries of the vaccines and other therapies that are in the clinic and the ones that are still preclinical. They have also just published this excellent overview of the vaccine issues; I recommend reading that one after you’ve picked up some background from this post.
NRDD counts 115 (!) vaccine programs, of which 37 are unconfirmed (no further information available on them) and 78 are definitely real. Of those 78, five of them are in the clinic, although that number will be climbing rapidly. You have Moderna’s mRNA1273, which as the name tells you is an mRNA candidate, and Inovio’s INO4800, which is a DNA plasmid, There are two cellular candidates from Shenzhen Geno-Immune Medical Institute: LV-SMENP-DC, a dendritic cell vaccine that’s been modified with lentivirus vectors to express viral proteins, and an artificial antigen-presenting cell (aAPC) vaccine along the same lines. And finally there’s a more traditional protein-fragment vaccine, Ad5-nCoV from CanSino.
Let’s go into what all those mean. You will note the diversity of approaches in that list, and that’s not even the whole spread. When you go back into the preclinical candidates, you have in addition “virus-like particles”, viral vectors, both replicating and non-replicating, live attenuated viruses, inactivated viruses, and more. From this you may deduce correctly that there are a lot of ways to set off the immune response. What are the differences between them?
Types of Vaccines (...)
Adjuvants (...)
Developing a Covid-19 Vaccine: Efficacy (...)
Developing a Covid-19 Vaccine: Safety (...)
Developing a Covid-19 Vaccine: Logistics
Another big problem is going to be manufacturing and distribution. Many readers will have heard about the difficulties that sometimes occur during the flu-vaccine production process, leading to shortages. Depending on what vaccine technology comes out on top, manufacturing enough doses in a reproducible fashion could be quite challenging – space and finger fatigue don’t permit going into all the details, but they are many and complex. Keep in mind as well that many vaccines need “cold chain” distribution and storage, which is always a layer of complexity. What if an eventual vaccine needs more than one round of administration, as many of the adjuvant-formulated ones do? Keeping track of that and following up on it is yet another issue.
My guess is that scale-up and manufacturing could well be the biggest chance for the timelines mentioned earlier to blow up, so there is going to be a massive effort to front-load the work on these problems – this is why, for example, Bill Gates has already indicated willingness to fund factories for up to seven vaccines up front. The live-virus, attenuated virus, recombinant protein, and nucleic acid vaccines will all involve completely different production methods and formulations, and since we don’t know which way we’ll be going, this would seem the only way to address the issue. Pfizer and others have already said that they’re going to be working on production even before the efficacy data come in, which needless to say is not the usual business practice. I think we’ll get vaccine efficacy, one way or another, although it sure won’t be characterized as thoroughly as it normally would. And I think we’re already agreeing to cut corners on safety, whether anyone says so in as many words or not. But producing the vaccine on scale could be a bigger issue yet, and as the process goes on, that’s where I would keep an eye out for trouble.
Developing a Covid-19 Vaccine: Logistics
Another big problem is going to be manufacturing and distribution. Many readers will have heard about the difficulties that sometimes occur during the flu-vaccine production process, leading to shortages. Depending on what vaccine technology comes out on top, manufacturing enough doses in a reproducible fashion could be quite challenging – space and finger fatigue don’t permit going into all the details, but they are many and complex. Keep in mind as well that many vaccines need “cold chain” distribution and storage, which is always a layer of complexity. What if an eventual vaccine needs more than one round of administration, as many of the adjuvant-formulated ones do? Keeping track of that and following up on it is yet another issue.
My guess is that scale-up and manufacturing could well be the biggest chance for the timelines mentioned earlier to blow up, so there is going to be a massive effort to front-load the work on these problems – this is why, for example, Bill Gates has already indicated willingness to fund factories for up to seven vaccines up front. The live-virus, attenuated virus, recombinant protein, and nucleic acid vaccines will all involve completely different production methods and formulations, and since we don’t know which way we’ll be going, this would seem the only way to address the issue. Pfizer and others have already said that they’re going to be working on production even before the efficacy data come in, which needless to say is not the usual business practice. I think we’ll get vaccine efficacy, one way or another, although it sure won’t be characterized as thoroughly as it normally would. And I think we’re already agreeing to cut corners on safety, whether anyone says so in as many words or not. But producing the vaccine on scale could be a bigger issue yet, and as the process goes on, that’s where I would keep an eye out for trouble.
by Derek Lowe, Science Translational Medicine | Read more:
Image: Thana Prasongsin/Getty Images via:
Thursday, April 16, 2020
Reflections on a Disaster (Update)
Update (4/7/2020): I forgot to add the main issue of conflict once the response/execution process is in full swing (actually, the main issue right from the beginning): 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.
***
Ok folks, here we are a week and a half later (4/16/2020). How are things going? (I'm not doing millions of links, so Google them yourselves): Well, the President is pushing some vague authority to reopen the economy (even though he never shut it down in the first place, and governors are pushing back, forming regional coalitions). The small business stimulus program has already run out of money (some businesses never seeing a dollar). No money for individuals yet. The financial sector is a black hole and could blow up at any time on any number of issues including over-leveraged and inter-connected risk, and things like loan defaults on car and house payments (some kind of cascading failure process, like 2008). Rent and mortgage payment relief proposals are mired in the weeds. No widespread virus/antibody testing yet (still several weeks off at best). No expansive contact tracing. No widespread availablility of masks. No killer vaccine on the horizon, maybe new year at the earliest (and no clear leading candidate). Respiratory intubation procedures should be avoided if at all possible. Secondary infections and virus mutations reported (!), a significant setback for vaccine production if true. More to come. See original post.]
A Failure, But Not of Prediction
Vox asks What Went Wrong With The Media’s Coronavirus Coverage? They conclude that the media needs to be better at “not just saying what we do know, but what we don’t know”. This raises some important questions. Like: how much ink and paper is there in the world? Are we sure it’s enough? But also: how do you become better at saying what you don’t know?
In case you’ve been hiding under a rock recently (honestly, valid) the media not only failed to adequately warn its readers about the epidemic, but actively mocked and condescended to anyone who did sound a warning. Real Clear Politics has a list of highlights. The Vox tweet saying “Is this going to be a deadly pandemic? No.” Washington Post telling us in February “Why we should be wary of an aggressive government reponse to coronavirus (it might “scapegoat marginalized populations”). The Daily Beast complaining that “coronavirus, with zero American fatalities, is dominating headlines, while the flu is the real threat”. The New York Times, weighing in with articles like “The pandemic panic” and “Who says it’s not safe to travel to China”. The constant attempts to attribute “alarmism” over the virus to anti-Chinese racism. Etc, etc, etc.
One way people have summed this up is that the media (and the experts they relied on) did a terrible job predicting what would happen. I think this lets them off too easy. (...)
A few weeks ago, I wrote a blog post on face masks. It reviewed the evidence and found that they probably helped prevent the spread of disease. Then it asked: how did the WHO, CDC, etc get this so wrong?
I went into it thinking they’d lied to us, hoping to prevent hoarders from buying up so many masks that there weren’t enough for health workers. Turns out that’s not true. The CDC has been singing the same tune for the past ten years. Swine flu, don’t wear masks. SARS, don’t wear masks. They’ve been really consistent on this point. But why?
If you really want to understand what happened, don’t read any studies about face masks or pandemics. Read Smith & Pell (2003), Parachute Use To Prevent Death And Major Trauma Related To Gravitational Challenge: Systematic Review Of Randomized Controlled Trials. It’s an article in the British Journal Of Medicine pointing out that there have never been any good studies proving that parachutes are helpful when jumping out of a plane, so they fail to meet the normal standards of evidence-based medicine. (...)
Of course this is a joke. It’s in the all-joke holiday edition of BMJ, and everyone involved knew exactly what they were doing. But the joke is funny because it points at something true. It’s biting social commentary. Doctors will not admit any treatment could possibly be good until it has a lot of randomized controlled trials behind it, common sense be damned. This didn’t come out of nowhere. They’ve been burned lots of times before by thinking they were applying common sense and getting things really wrong. And after your mistakes kill a few thousand people you start getting really paranoid and careful. And there are so many quacks who can spout off some “common sense” explanation for why their vitamin-infused bleach or colloidal silver should work that doctors have just become immune to that kind of bullshit. Multiple good RCTs or it didn’t happen. Given the history I think this is a defensible choice, and if you are tempted to condemn it you may find this story about bone marrow transplants enlightening.
But you can take this too far. After highlighting the lack of parachute RCTs, the paper continues:
Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions and preclude parachute use outside the context of a properly conducted trial. The dependency we have created in our population may make recruitment of the unenlightened masses to such a trial difficult. If so, we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial.
Did you follow that? For a good parachute RCT, half the subjects would have to jump out of a plane wearing a placebo parachute. The authors suggest maybe we enlist doctors who insist too stringently on RCTs over common sense for this dubious honor. (...)
But I would ask this of any journalist who pleads that they were just relaying and providing context for expert opinions: what was the experts’ percent confidence in their position?
I am so serious about this. What fact could possibly be more relevant? What context could it possibly be more important to give? I’m not saying you need to have put a number in your articles, maybe your readers don’t go for that. But were you working off of one? Did this question even occur to you?
Nate Silver said there was a 29% chance Trump would win. Most people interpreted that as “Trump probably won’t win” and got shocked when he did. What was the percent attached to your “coronavirus probably won’t be a disaster” prediction? Was it also 29%? 20%? 10%? Are you sure you want to go lower than 10%? Wuhan was already under total lockdown, they didn’t even have space to bury all the bodies, and you’re saying that there was less than 10% odds that it would be a problem anywhere else? (...)
People were presented with a new idea: a global pandemic might arise and change everything. They waited for proof. The proof didn’t arise, at least at first. I remember hearing people say things like “there’s no reason for panic, there are currently only ten cases in the US”. This should sound like “there’s no reason to panic, the asteroid heading for Earth is still several weeks away”. The only way I can make sense of it is through a mindset where you are not allowed to entertain an idea until you have proof of it. Nobody had incontrovertible evidence that coronavirus was going to be a disaster, so until someone does, you default to the null hypothesis that it won’t be.
by BMJ and Scott Alexander, Slate Star Codex | Read more:
[ed. A parody perhaps but one that highlights the problems of being overly concerned with not inducing a panic (or being tarred as an alarmist). Also, do check out the bone marrow transplant link for more relevance to our current situation (and the complexities of "weasels who rush in".]
In case you’ve been hiding under a rock recently (honestly, valid) the media not only failed to adequately warn its readers about the epidemic, but actively mocked and condescended to anyone who did sound a warning. Real Clear Politics has a list of highlights. The Vox tweet saying “Is this going to be a deadly pandemic? No.” Washington Post telling us in February “Why we should be wary of an aggressive government reponse to coronavirus (it might “scapegoat marginalized populations”). The Daily Beast complaining that “coronavirus, with zero American fatalities, is dominating headlines, while the flu is the real threat”. The New York Times, weighing in with articles like “The pandemic panic” and “Who says it’s not safe to travel to China”. The constant attempts to attribute “alarmism” over the virus to anti-Chinese racism. Etc, etc, etc.
One way people have summed this up is that the media (and the experts they relied on) did a terrible job predicting what would happen. I think this lets them off too easy. (...)
A few weeks ago, I wrote a blog post on face masks. It reviewed the evidence and found that they probably helped prevent the spread of disease. Then it asked: how did the WHO, CDC, etc get this so wrong?
I went into it thinking they’d lied to us, hoping to prevent hoarders from buying up so many masks that there weren’t enough for health workers. Turns out that’s not true. The CDC has been singing the same tune for the past ten years. Swine flu, don’t wear masks. SARS, don’t wear masks. They’ve been really consistent on this point. But why?
If you really want to understand what happened, don’t read any studies about face masks or pandemics. Read Smith & Pell (2003), Parachute Use To Prevent Death And Major Trauma Related To Gravitational Challenge: Systematic Review Of Randomized Controlled Trials. It’s an article in the British Journal Of Medicine pointing out that there have never been any good studies proving that parachutes are helpful when jumping out of a plane, so they fail to meet the normal standards of evidence-based medicine. (...)
Of course this is a joke. It’s in the all-joke holiday edition of BMJ, and everyone involved knew exactly what they were doing. But the joke is funny because it points at something true. It’s biting social commentary. Doctors will not admit any treatment could possibly be good until it has a lot of randomized controlled trials behind it, common sense be damned. This didn’t come out of nowhere. They’ve been burned lots of times before by thinking they were applying common sense and getting things really wrong. And after your mistakes kill a few thousand people you start getting really paranoid and careful. And there are so many quacks who can spout off some “common sense” explanation for why their vitamin-infused bleach or colloidal silver should work that doctors have just become immune to that kind of bullshit. Multiple good RCTs or it didn’t happen. Given the history I think this is a defensible choice, and if you are tempted to condemn it you may find this story about bone marrow transplants enlightening.
But you can take this too far. After highlighting the lack of parachute RCTs, the paper continues:
Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions and preclude parachute use outside the context of a properly conducted trial. The dependency we have created in our population may make recruitment of the unenlightened masses to such a trial difficult. If so, we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial.
Did you follow that? For a good parachute RCT, half the subjects would have to jump out of a plane wearing a placebo parachute. The authors suggest maybe we enlist doctors who insist too stringently on RCTs over common sense for this dubious honor. (...)
But I would ask this of any journalist who pleads that they were just relaying and providing context for expert opinions: what was the experts’ percent confidence in their position?
I am so serious about this. What fact could possibly be more relevant? What context could it possibly be more important to give? I’m not saying you need to have put a number in your articles, maybe your readers don’t go for that. But were you working off of one? Did this question even occur to you?
Nate Silver said there was a 29% chance Trump would win. Most people interpreted that as “Trump probably won’t win” and got shocked when he did. What was the percent attached to your “coronavirus probably won’t be a disaster” prediction? Was it also 29%? 20%? 10%? Are you sure you want to go lower than 10%? Wuhan was already under total lockdown, they didn’t even have space to bury all the bodies, and you’re saying that there was less than 10% odds that it would be a problem anywhere else? (...)
People were presented with a new idea: a global pandemic might arise and change everything. They waited for proof. The proof didn’t arise, at least at first. I remember hearing people say things like “there’s no reason for panic, there are currently only ten cases in the US”. This should sound like “there’s no reason to panic, the asteroid heading for Earth is still several weeks away”. The only way I can make sense of it is through a mindset where you are not allowed to entertain an idea until you have proof of it. Nobody had incontrovertible evidence that coronavirus was going to be a disaster, so until someone does, you default to the null hypothesis that it won’t be.
by BMJ and Scott Alexander, Slate Star Codex | Read more:
[ed. A parody perhaps but one that highlights the problems of being overly concerned with not inducing a panic (or being tarred as an alarmist). Also, do check out the bone marrow transplant link for more relevance to our current situation (and the complexities of "weasels who rush in".]
Covid-19 Updates (4/16/2020) Lego Edition
LEGO Unveils New 20,000-Piece Ventilator Set To Aid Supply Shortage.
See also: Americans Begin Receiving Stimulus Checks:
Treasury Secretary Steve Mnuchin announced that 80 million Americans will receive a direct deposit for up to $1,200 this week as part of the government’s economic relief package, with early reports indicating the funds are being used on food, gas, rent, and other necessities. What do you think?
via: The Onion
[ed. Also, can't forget this classic (from 1/7/2001 - eight months before 9/11): Bush: 'Our Long National Nightmare Of Peace And Prosperity Is Finally Over' (The Onion). No good work is ever left unfinished.]
Wednesday, April 15, 2020
Why Animal Crossing Is the Game for the Coronavirus Moment
Imagine escaping to an island paradise where bags of money fall out of trees and a talking raccoon can approve you for a mortgage.
With the world in the grip of a pandemic, that’s exactly the sort of escape that has captivated so many — not in their fantasies, but in the world of Animal Crossing: New Horizons. It’s the latest in a series that’s been around since 2001, but New Horizons is the first built-from-the-ground-up console release in 19 years. It’s also a conveniently timed piece of whimsy for gamers — and has become a phenomenon.
In Animal Crossing, players take on the role of a lone human on an island filled with pudgy anthropomorphic animals. Players are tasked with building a thriving society, filling it with shops, bridges and other accommodations for its residents. There are no high scores, vampire Nazis or final bosses. The game is played at a relaxed pace, in which the player can do as much or as little as they want on any given day. Upbeat acoustic jams or sultry bossa nova synths play in the background.
Already, early sales figures from Japan and Britain suggest that this is the strongest launch for an Animal Crossing game in history. (U.S. figures are to be released later this month.) And the game has extended its reach beyond its main platform, with users sharing screenshots on social media of their Japanese-inspired homes, custom T-shirt designs and perfectly arranged flower gardens. It became the No. 1 trending game on the platform, with Japan, the U.S., Korea, France and Spain at the top.
“It’s now the No. 1 most talked-about game in the world, dethroning the likes of Fate/Grand Order — which held that title for nearly two years — and Fortnite,” said Rishi Chadha, global head of gaming partnerships at Twitter. “The growth in conversation has been astronomical. Conversation volume since launch has grown over 1,000 percent and the number of people tweeting about the game has grown over 400 percent.”
Indeed, there have been more than 38 million tweets about the game since its release, many celebrating its ability to provide comfort and social connection in a time of isolation and struggle.
by Imad Khan, NY Times | Read more:
Image: Nintendo
With the world in the grip of a pandemic, that’s exactly the sort of escape that has captivated so many — not in their fantasies, but in the world of Animal Crossing: New Horizons. It’s the latest in a series that’s been around since 2001, but New Horizons is the first built-from-the-ground-up console release in 19 years. It’s also a conveniently timed piece of whimsy for gamers — and has become a phenomenon.
In Animal Crossing, players take on the role of a lone human on an island filled with pudgy anthropomorphic animals. Players are tasked with building a thriving society, filling it with shops, bridges and other accommodations for its residents. There are no high scores, vampire Nazis or final bosses. The game is played at a relaxed pace, in which the player can do as much or as little as they want on any given day. Upbeat acoustic jams or sultry bossa nova synths play in the background.Already, early sales figures from Japan and Britain suggest that this is the strongest launch for an Animal Crossing game in history. (U.S. figures are to be released later this month.) And the game has extended its reach beyond its main platform, with users sharing screenshots on social media of their Japanese-inspired homes, custom T-shirt designs and perfectly arranged flower gardens. It became the No. 1 trending game on the platform, with Japan, the U.S., Korea, France and Spain at the top.
“It’s now the No. 1 most talked-about game in the world, dethroning the likes of Fate/Grand Order — which held that title for nearly two years — and Fortnite,” said Rishi Chadha, global head of gaming partnerships at Twitter. “The growth in conversation has been astronomical. Conversation volume since launch has grown over 1,000 percent and the number of people tweeting about the game has grown over 400 percent.”
Indeed, there have been more than 38 million tweets about the game since its release, many celebrating its ability to provide comfort and social connection in a time of isolation and struggle.
by Imad Khan, NY Times | Read more:
Image: Nintendo
Bailouts Won’t Save the Economy. More Coronavirus Tests Will.
No sooner had the ink dried on the last $2 trillion round of economic relief from the devastation wrought by the coronavirus pandemic than President Trump and Congress began contemplating the next bill to address the crisis. There is, after all, crisis to spare. You might think the emergency on Washington’s mind is the rapidly escalating number of U.S. infections and deaths, or perhaps the shortage of lifesaving personal protective gear and medical equipment such as ventilators and the ongoing dearth of reliable and available tests.
But the disaster that the next round of stimulus will address, according to media accounts, is the same as the last one: the financial losses to businesses and workers caused by the social distancing measures put in place to limit the spread of the new coronavirus. The severity of current social distancing restrictions is necessitated in part by the United States’ lack of capacity to identify the infected, trace and test their social contacts, and quarantine the sick. If you can’t be sure that everyone outside isn’t contagious, then you must stay inside.
Congress remains perversely determined to treat the symptoms, rather than the illness. On Wednesday, Newsday reported, “Senate Majority Leader Mitch McConnell this week proposed adding $250 billion for the popular small-business loan programs already in the recently enacted $2.2 trillion CARES Act relief and stimulus package. But House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer demanded Wednesday that that interim bill also include $150 billion for state and local governments ... and $100 billion for hospitals and a 15% increase in the maximum benefit to supplemental nutrition assistance for families.” In other words, Republicans and Democrats both just more of the very same things they got last time. In fact, Pelosi explicitly pointed to the last bill as “a good model” because it managed to draw bipartisan support.
It is true that some of these expenditures, such as aid to hospitals and state and local governments, will partly aid the essential efforts to treat the sick. And putting money in people’s pockets goes hand-in-hand with social distancing policies, by defraying some of the costs of closing non-essential businesses, which in turn threatens the reliable paychecks of thousands of workers. But this approach, while vital, has at best only slowed the virus’ spread. The disease must be halted in its tracks to allow the economy to be reopened. The only answer is to rapidly ramp up widespread public testing for Covid-19 and its antibodies. (...)
“I can’t believe that here we are the second week in April and we’re still talking about testing,” said Ashish Jha, director of the Harvard Global Health Institute. “We still can’t test for a virus that has shut the entire American economy down. I talk to conservative economists, and I say, ‘You know, we’re costing the American economy hundreds of millions of dollars a day because we don’t have testing capacity.’”
As Aaron E. Carroll, a medical school professor at Indiana University, noted in The New York Times on Monday, before the economy can be safely reopened, “Every time an individual tests positive, the public health infrastructure needs to be able to determine whom that person has been in close contact with, find those people, and have them go into isolation or quarantine until it’s established they aren’t infected, too... Building that capacity will take significant time and money, and the country hasn’t even started.” (...)
What would such a federal effort look like? For one thing, it would involve a lot more aid to state and local governments earmarked for the purpose. “It means a massive infusion at the state and local level, because the people who are going to do the testing, do the contact tracing, are all state and local people,” said Gregg Gonsalves, a professor of public health at Yale. “The last bill has $150 billion to state and local governments, but they’re losing sales and income tax revenue, so $150 billion doesn’t even begin to meet the lost revenue gap. Money has to flow to the states to do the shoe leather epidemiology.”
Congress also needs to direct the U.S. Centers for Disease Control and Prevention to give proper guidance and assistance to the state and local governments. “Contact tracing would have to be implemented by states,” said Jha. “But Congress could say, ‘You do it, we’ll fund it and put in some metrics to make sure it’s actually happening.’” The state and local departments of health would then, with federal dollars and oversight, hire staff of testers covered in personal protective gear such as masks and gowns.
We also simply must produce vastly more tests and build the lab capacity to turn them around quickly. Currently, patients can wait up to a week for results because the private labs that perform the tests often have a massive backlog. Jha estimates that, based on the current level of outbreak, roughly 500,000 to 600,000 Americans per day should be getting testing, which is roughly five times as many tests as we’re currently performing. It would also be helpful, since so many people who have been sick recently with flu-like symptoms don’t know if they had Covid-19, and many people who had it were asymptomatic, to develop and widely deploy a serological tests, which measure the disease’s antibodies in the blood. Then we’d have some idea of who can safely go back to work without risk of infection.
But the disaster that the next round of stimulus will address, according to media accounts, is the same as the last one: the financial losses to businesses and workers caused by the social distancing measures put in place to limit the spread of the new coronavirus. The severity of current social distancing restrictions is necessitated in part by the United States’ lack of capacity to identify the infected, trace and test their social contacts, and quarantine the sick. If you can’t be sure that everyone outside isn’t contagious, then you must stay inside.
Congress remains perversely determined to treat the symptoms, rather than the illness. On Wednesday, Newsday reported, “Senate Majority Leader Mitch McConnell this week proposed adding $250 billion for the popular small-business loan programs already in the recently enacted $2.2 trillion CARES Act relief and stimulus package. But House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer demanded Wednesday that that interim bill also include $150 billion for state and local governments ... and $100 billion for hospitals and a 15% increase in the maximum benefit to supplemental nutrition assistance for families.” In other words, Republicans and Democrats both just more of the very same things they got last time. In fact, Pelosi explicitly pointed to the last bill as “a good model” because it managed to draw bipartisan support. It is true that some of these expenditures, such as aid to hospitals and state and local governments, will partly aid the essential efforts to treat the sick. And putting money in people’s pockets goes hand-in-hand with social distancing policies, by defraying some of the costs of closing non-essential businesses, which in turn threatens the reliable paychecks of thousands of workers. But this approach, while vital, has at best only slowed the virus’ spread. The disease must be halted in its tracks to allow the economy to be reopened. The only answer is to rapidly ramp up widespread public testing for Covid-19 and its antibodies. (...)
“I can’t believe that here we are the second week in April and we’re still talking about testing,” said Ashish Jha, director of the Harvard Global Health Institute. “We still can’t test for a virus that has shut the entire American economy down. I talk to conservative economists, and I say, ‘You know, we’re costing the American economy hundreds of millions of dollars a day because we don’t have testing capacity.’”
As Aaron E. Carroll, a medical school professor at Indiana University, noted in The New York Times on Monday, before the economy can be safely reopened, “Every time an individual tests positive, the public health infrastructure needs to be able to determine whom that person has been in close contact with, find those people, and have them go into isolation or quarantine until it’s established they aren’t infected, too... Building that capacity will take significant time and money, and the country hasn’t even started.” (...)
What would such a federal effort look like? For one thing, it would involve a lot more aid to state and local governments earmarked for the purpose. “It means a massive infusion at the state and local level, because the people who are going to do the testing, do the contact tracing, are all state and local people,” said Gregg Gonsalves, a professor of public health at Yale. “The last bill has $150 billion to state and local governments, but they’re losing sales and income tax revenue, so $150 billion doesn’t even begin to meet the lost revenue gap. Money has to flow to the states to do the shoe leather epidemiology.”
Congress also needs to direct the U.S. Centers for Disease Control and Prevention to give proper guidance and assistance to the state and local governments. “Contact tracing would have to be implemented by states,” said Jha. “But Congress could say, ‘You do it, we’ll fund it and put in some metrics to make sure it’s actually happening.’” The state and local departments of health would then, with federal dollars and oversight, hire staff of testers covered in personal protective gear such as masks and gowns.
We also simply must produce vastly more tests and build the lab capacity to turn them around quickly. Currently, patients can wait up to a week for results because the private labs that perform the tests often have a massive backlog. Jha estimates that, based on the current level of outbreak, roughly 500,000 to 600,000 Americans per day should be getting testing, which is roughly five times as many tests as we’re currently performing. It would also be helpful, since so many people who have been sick recently with flu-like symptoms don’t know if they had Covid-19, and many people who had it were asymptomatic, to develop and widely deploy a serological tests, which measure the disease’s antibodies in the blood. Then we’d have some idea of who can safely go back to work without risk of infection.
by Ben Adler, TNR | Read more:
Image: Bloomberg / Getty Images
[ed. This seems so obvious it should go without saying. See also: Testing Falls Woefully Short as Trump Seeks an End to Stay-at-Home Orders (NY Times). And: Congress Has Abandoned the Country (TNR); but don't worry, they'll be back in May (maybe, hopefully).]
Tuesday, April 14, 2020
Pandemic Journal: April 13, 2020
During the early days of quarantine, back when I was still trying to keep straight which Tolstoy princess had the mole and which had the mustache, and was still forcing my family to gather before the hearth every evening, as our forebears had, to hear the patriarch read poems aloud; before, that is, the fear of becoming very ill, or of losing our home, had really kicked in, I opened The New York Review of Books and turned to the classifieds. Twentieth-century artifacts still gamely chugging along, these notices offer all kinds of enticements: a farmhouse in the Dordogne or Tuscany, a kit for constructing a geodesic dome, a massage of uncertain propriety. I read the following ad:
The classifieds in the Review tend to be written to a high standard, but there was something unusual about this one that I couldn’t quite describe—since, in fact, I didn’t yet fully detect it. I’d seen offers for commissioned artistic work over the years; this ad seemed quite consciously to offer not only the product itself, but an irresistible narrative. I wouldn’t have bit if I’d encountered it online, or if the singer hadn’t been French, or aging, or charismatic. Imagining that I would need stories to tell after the pandemic passed, I decided that $200 was a small price to pay for one. The song would be almost extra—it would be received as I suspected it was offered, as a kind of prop.
That morning I wrote to the email address listed in the ad:
By this point, I had begun to suspect that, in orchestrating my stunt, I had also become entangled in one. This wasn’t the story I imagined; it was not even, apparently, mine to tell. On Lodbrog’s website, under the section labeled “The Man,” I found, instead of a short bio, a mirror image of my curiosity, slightly intensified as though I’d arrived there after a years-long quest: “Who the hell is Imre Lodbrog,” it read: “Somebody said, ‘He’s like Serge Gainsbourg on ’shrooms.’” It seemed that the construction “Imre Lodbrog” had been designed, in part, as a ruse. But by whom, and why? A longer version of his classified appears under the section “Hired Gun,” describing him as “a softy and a socialist,” and offering his services on a sliding fee scale—as though $200 weren’t already an insane bargain. Beyond those scant details, nothing—except for a link to a book about Lodbrog that “we wrote.”
Last week the song arrived, a twangy, jangly number, utterly infectious, called “Cyrano”; today, the video appeared in my inbox, filmed in a New York desolated by the pandemic. Images of what looked to me like an intersection in the East Village—empty except for a few masked pedestrians—fade to archival footage of the same spot filled with dancers and revelers. The multiple fades of the video suggest the ghost lives we are now living. Both song and video give off a faint whiff of serioludere, with their intentionally broad gestures toward rock-star preening. And yet both are, to me, indescribably beautiful. Lodbrog’s Agent had written to ask if I was OK with his incorporating the story of Cyrano de Bergerac, because, as she put it, “he’s French.” I happily consented. It was a lark. But when I listened to the lyrics, I realized that Lodbrog had assumed the mantle of professor, teaching his own lesson to a group of captivated strangers, my students:
ENGLISH 120 ENGLISH 357
I AM NOBODY WHO ARE YOU?
NOBODY TOO AH PLEASED TO MEET YOU
DO YOU KNOW CYRANO
WHO SPOKE SOMEBODY’S LOVE THROUGH HIS HEART
OH MAN HOW DREARY TO BE
SOMEBODY
I AM HERE YOU ARE THERE
SO LET ME SING THIS LITTLE TUNE TO YA ALL
AND KEEP IT WARM UNTIL THE LIVELONG JUNE
The song continues in this vein for several more verses, adapting Dickinson’s existentially amiable little poem to this new scenario, where Lodbrog—a “nobody”—greets his fellow nobodies, me and my students. The beautifully open-hearted question, “Do you know Cyrano,” is Lodbrog’s own moment of pedagogy. If you don’t know him, I told my students, you should get to know him.
Lodbrog and his agent—whom I have discovered to be none other than Barbara Browning, the distinguished scholar of Brazilian music, and a dancer and performance artist who teaches at NYU—co-authored their quite wonderful book, Who the Hell Is Imre Lodbrog. I wouldn’t dare spoil their story, since it’s such a good one. As for this story, I have no idea how to tell it: Am I its author or its protagonist? Who the hell is Dan Chiasson?
“Cyrano” ends with a lovely conjuring of our current, frightening hiatus, and of some of the ways human connection might be reconceived in the time of Covid-19. Let’s hope Lodbrog is right about “the sunny livelong June”:
I AM THERE YOU ARE HERE
AND THAT’S THE MAGIC OF THE TRICK
A FEW WORDS AND A LITTLE TUNE
A TINY FLAME TO LIGHT UP THE GLOOM
UNTIL THE SUNNY LIVELONG JUNE
TO KEEP US ALL TOGETHER IN THIS EMPTY
CLASSROOM
by Dan Chiasson, NYRB | Read more:
A CHARISMATIC, AGING FRENCH rock star will compose and record an original song for you, your mom, your lover, or your pet in French, English or Franglais (recommended). US$200. Contact: lodbrogsagent@gmail.com; imrelodbrog.com
The classifieds in the Review tend to be written to a high standard, but there was something unusual about this one that I couldn’t quite describe—since, in fact, I didn’t yet fully detect it. I’d seen offers for commissioned artistic work over the years; this ad seemed quite consciously to offer not only the product itself, but an irresistible narrative. I wouldn’t have bit if I’d encountered it online, or if the singer hadn’t been French, or aging, or charismatic. Imagining that I would need stories to tell after the pandemic passed, I decided that $200 was a small price to pay for one. The song would be almost extra—it would be received as I suspected it was offered, as a kind of prop.That morning I wrote to the email address listed in the ad:
Bonjour Monsieur,
I am a US professor and I wonder if you would record a song for my two classes which have been suspended, English 120 and English 357? Something sentimental, using those names? I just posted your ad to Twitter and hope you get lots of business!!Within an hour or so, the rock star’s agent—who identified herself only as “Lodbrog’s Agent”—wrote back from New York City, where the two of them were holed up. Imre Lodbrog would be delighted to compose a song for my classes, if I would send some additional instructions. So I sent a poem, Emily Dickinson’s “I’m Nobody,” and made just one request: that he use my course numbers in the refrain. I was amused by the idea of asking a charismatic French rock star to sing a heartbroken tune to a most unlikely amant: the catalog numbers of my classes. I proposed that Lodbrog—whose moody, gravelly songs I had, by that point, discovered online—also record a video, for an additional $200. Lodbrog’s Agent accepted my pitch, and we were off to the races.
By this point, I had begun to suspect that, in orchestrating my stunt, I had also become entangled in one. This wasn’t the story I imagined; it was not even, apparently, mine to tell. On Lodbrog’s website, under the section labeled “The Man,” I found, instead of a short bio, a mirror image of my curiosity, slightly intensified as though I’d arrived there after a years-long quest: “Who the hell is Imre Lodbrog,” it read: “Somebody said, ‘He’s like Serge Gainsbourg on ’shrooms.’” It seemed that the construction “Imre Lodbrog” had been designed, in part, as a ruse. But by whom, and why? A longer version of his classified appears under the section “Hired Gun,” describing him as “a softy and a socialist,” and offering his services on a sliding fee scale—as though $200 weren’t already an insane bargain. Beyond those scant details, nothing—except for a link to a book about Lodbrog that “we wrote.”
Last week the song arrived, a twangy, jangly number, utterly infectious, called “Cyrano”; today, the video appeared in my inbox, filmed in a New York desolated by the pandemic. Images of what looked to me like an intersection in the East Village—empty except for a few masked pedestrians—fade to archival footage of the same spot filled with dancers and revelers. The multiple fades of the video suggest the ghost lives we are now living. Both song and video give off a faint whiff of serioludere, with their intentionally broad gestures toward rock-star preening. And yet both are, to me, indescribably beautiful. Lodbrog’s Agent had written to ask if I was OK with his incorporating the story of Cyrano de Bergerac, because, as she put it, “he’s French.” I happily consented. It was a lark. But when I listened to the lyrics, I realized that Lodbrog had assumed the mantle of professor, teaching his own lesson to a group of captivated strangers, my students:
ENGLISH 120 ENGLISH 357
I AM NOBODY WHO ARE YOU?
NOBODY TOO AH PLEASED TO MEET YOU
DO YOU KNOW CYRANO
WHO SPOKE SOMEBODY’S LOVE THROUGH HIS HEART
OH MAN HOW DREARY TO BE
SOMEBODY
I AM HERE YOU ARE THERE
SO LET ME SING THIS LITTLE TUNE TO YA ALL
AND KEEP IT WARM UNTIL THE LIVELONG JUNE
The song continues in this vein for several more verses, adapting Dickinson’s existentially amiable little poem to this new scenario, where Lodbrog—a “nobody”—greets his fellow nobodies, me and my students. The beautifully open-hearted question, “Do you know Cyrano,” is Lodbrog’s own moment of pedagogy. If you don’t know him, I told my students, you should get to know him.
Lodbrog and his agent—whom I have discovered to be none other than Barbara Browning, the distinguished scholar of Brazilian music, and a dancer and performance artist who teaches at NYU—co-authored their quite wonderful book, Who the Hell Is Imre Lodbrog. I wouldn’t dare spoil their story, since it’s such a good one. As for this story, I have no idea how to tell it: Am I its author or its protagonist? Who the hell is Dan Chiasson?
“Cyrano” ends with a lovely conjuring of our current, frightening hiatus, and of some of the ways human connection might be reconceived in the time of Covid-19. Let’s hope Lodbrog is right about “the sunny livelong June”:
I AM THERE YOU ARE HERE
AND THAT’S THE MAGIC OF THE TRICK
A FEW WORDS AND A LITTLE TUNE
A TINY FLAME TO LIGHT UP THE GLOOM
UNTIL THE SUNNY LIVELONG JUNE
TO KEEP US ALL TOGETHER IN THIS EMPTY
CLASSROOM
by Dan Chiasson, NYRB | Read more:
[ed. Delightful.]
What Doctors Wish They’d Known a Month Ago
Just about a month ago, people stricken with the new coronavirus started to arrive in unending ranks at hospitals in the New York metropolitan area, forming the white-hot center of the pandemic in the United States.
Now, doctors in the region have started sharing on medical grapevines what it has been like to re-engineer, on the fly, their health care systems, their practice of medicine, their personal lives.
Doctors, if you could go back in time, what would you tell yourselves in early March?
“What we thought we knew, we don’t know,” said Dr. Nile Cemalovic, an intensive care physician at Lincoln Medical Center in the Bronx.
Medicine routinely remakes itself, generation by generation. For the disease that drives this pandemic, certain ironclad emergency medical practices have dissolved almost overnight.
The biggest change: Instead of quickly sedating people who had shockingly low levels of oxygen and then putting them on mechanical ventilators, many doctors are now keeping patients conscious, having them roll over in bed, recline in chairs and continue to breathe on their own — with additional oxygen — for as long as possible.
The idea is to get them off their backs and thereby make more lung available. A number of doctors are even trying patients on a special massage mattress designed for pregnant women because it has cutouts that ease the load on the belly and chest.
Other doctors are rejiggering CPAP breathing machines, normally used to help people with sleep apnea, or they have hacked together valves and filters. For some critically ill patients, a ventilator may be the only real hope. (...)
Breathing Room
“Never in my life have I had to ask a patient to get off the telephone because it was time to put in a breathing tube,” said Dr. Richard Levitan, who recently spent 10 days at Bellevue Hospital Center in Manhattan.
Why is this so odd? People who need breathing tubes, which connect to mechanical ventilators that assist or take over respiration, are rarely in any shape to be on the phone because the level of oxygen in their blood has declined precipitously.
If conscious, they are often incoherent and are about to be sedated so they do not gag on the tubes. It is a drastic step.
Yet many Covid-19 patients remain alert, even when their oxygen has sharply fallen, for reasons health care workers can only guess. (Another important signal about how sick the patients are from Covid-19 — the presence of inflammatory markers in the blood — is not available to physicians until laboratory work is done.)
Some patients, by taking oxygen and rolling onto their sides or on their bellies, have quickly returned to normal levels. The tactic is called proning. (...)
At Lincoln Hospital in the Bronx, Dr. Nicholas Caputo followed 50 patients who arrived with low oxygen levels between 69 and 85 percent (95 is normal). After five minutes of proning, they had improved to a mean of 94 percent. Over the next 24 hours, nearly three-quarters were able to avoid intubation; 13 needed ventilators. Proning does not seem to work as well in older patients, a number of doctors said.
No one knows yet if this will be a lasting remedy, Dr. Caputo said, but if he could go back to early March, he would advise himself and others: “Don’t jump to intubation.” (...)
“Intubated patients with Covid lung disease are doing very poorly, and while this may be the disease and not the mechanical ventilation, most of us believe that intubation is to be avoided until unequivocally required,” Dr. Strayer said.
This shift has lightened the load on nursing staffs and the rest of the hospital. “You put a tube into somebody,” Dr. Levitan said, “and the amount of work required not to kill that person goes up by a factor of 100,” creating a cascade that slows down laboratory results, X-rays and other care.
Now, doctors in the region have started sharing on medical grapevines what it has been like to re-engineer, on the fly, their health care systems, their practice of medicine, their personal lives.
Doctors, if you could go back in time, what would you tell yourselves in early March?
“What we thought we knew, we don’t know,” said Dr. Nile Cemalovic, an intensive care physician at Lincoln Medical Center in the Bronx.Medicine routinely remakes itself, generation by generation. For the disease that drives this pandemic, certain ironclad emergency medical practices have dissolved almost overnight.
The biggest change: Instead of quickly sedating people who had shockingly low levels of oxygen and then putting them on mechanical ventilators, many doctors are now keeping patients conscious, having them roll over in bed, recline in chairs and continue to breathe on their own — with additional oxygen — for as long as possible.
The idea is to get them off their backs and thereby make more lung available. A number of doctors are even trying patients on a special massage mattress designed for pregnant women because it has cutouts that ease the load on the belly and chest.
Other doctors are rejiggering CPAP breathing machines, normally used to help people with sleep apnea, or they have hacked together valves and filters. For some critically ill patients, a ventilator may be the only real hope. (...)
Breathing Room
“Never in my life have I had to ask a patient to get off the telephone because it was time to put in a breathing tube,” said Dr. Richard Levitan, who recently spent 10 days at Bellevue Hospital Center in Manhattan.
Why is this so odd? People who need breathing tubes, which connect to mechanical ventilators that assist or take over respiration, are rarely in any shape to be on the phone because the level of oxygen in their blood has declined precipitously.
If conscious, they are often incoherent and are about to be sedated so they do not gag on the tubes. It is a drastic step.
Yet many Covid-19 patients remain alert, even when their oxygen has sharply fallen, for reasons health care workers can only guess. (Another important signal about how sick the patients are from Covid-19 — the presence of inflammatory markers in the blood — is not available to physicians until laboratory work is done.)
Some patients, by taking oxygen and rolling onto their sides or on their bellies, have quickly returned to normal levels. The tactic is called proning. (...)
At Lincoln Hospital in the Bronx, Dr. Nicholas Caputo followed 50 patients who arrived with low oxygen levels between 69 and 85 percent (95 is normal). After five minutes of proning, they had improved to a mean of 94 percent. Over the next 24 hours, nearly three-quarters were able to avoid intubation; 13 needed ventilators. Proning does not seem to work as well in older patients, a number of doctors said.
No one knows yet if this will be a lasting remedy, Dr. Caputo said, but if he could go back to early March, he would advise himself and others: “Don’t jump to intubation.” (...)
“Intubated patients with Covid lung disease are doing very poorly, and while this may be the disease and not the mechanical ventilation, most of us believe that intubation is to be avoided until unequivocally required,” Dr. Strayer said.
This shift has lightened the load on nursing staffs and the rest of the hospital. “You put a tube into somebody,” Dr. Levitan said, “and the amount of work required not to kill that person goes up by a factor of 100,” creating a cascade that slows down laboratory results, X-rays and other care.
by Jim Dwyer, NY Times | Read more:
Image: uncredited
Monday, April 13, 2020
Nobody Knows How to Wean Manatees Off Coal Plants
The view from the parking lot at Big Bend Power Station, a 1,500-acre plant built in the 1960s to turn coal into electricity just south of Tampa, includes an unexpected sight. Bordering the parking lot are dozens of solar panels, set against a skyline dominated by three smokestacks whose vapor curls across the blue. The panels are little more than a wink—solar is a small fraction of the energy mix at Big Bend—but they suggest, at least, a hoped-for future when the plant no longer relies on coal.
The temperature the day of my visit was 53F—brisk, but perfect for the unusual sight I was actually there to see. Stanley Kroh, manager of land and stewardship programs for Big Bend’s operator, Tampa Electric Co., greeted me near an empty picnic grove. We headed inside the free exhibit, walking past a line of visitors waiting to pose beside a bronze manatee with a gummy smile. Speakers blared “Welcome to the Manatee Viewing Center, where nature meets technology!” on loop.
“We’ve had people that will say, ‘Isn’t it terrible that they put a power plant right next to this manatee sanctuary?’ ” Kroh said. “They get it completely backwards.” We traversed a cement walkway beneath a mangrove canopy—the plant was built on coastal land dredged of pristine mangrove swamps—until we reached a narrow pier jutting into a canal the width of a football field. Across the waterway were massive piles of coal. Conveyor belts zigged up from them, transporting lumps to the plant’s four generation units, which are also fueled by natural gas and are cooled by water sucked in from Tampa Bay.
Also before us, lurking beneath waters turned turbid by leaf tannins and warmed by the nonstop flow of hot water from the plant, were manatees—a hundred or more, by Kroh’s estimate. They remained shadowy blobs until the moment they emerged for air, their noses flaring lightly before spraying water and emitting an abrupt pfff. Then they’d rotate to reveal their ungainly bodies, looking like hippopotamus-walrus hybrids gorged to bursting with bread.
Manatees are the chubby vegan hippies of the sea. Neither predator nor prey, the world’s three remaining species are all considered vulnerable, including the West Indian manatee (Trichechus manatus), of which the Florida manatee is a subspecies. Manatees seem to have evolved almost immune to Darwinian struggle. They’re small-brained, radically farsighted, almost deaf, and barely able to smell—effectively floating digestion machines propelled by paddle-like tails. They survive mostly on seagrass, 100 to 200 pounds of which is working through a manatee’s intestinal system at a given moment. Their lungs stretch the entire length of their trunk, helping them maintain optimal buoyancy so they can munch like Jersey cows grazing a field of clover. Yet though manatees are sitting targets, even sharks leave them alone, uninterested in an animal that, despite its corpulence, lacks a tasty, insulating layer of blubber. So unflappable are manatees that a wild one will roll over and let its only true predator—us—rub its tender underside.
Although manatees were hunted to near extinction for their meat and hides in the 19th century, a remnant ended up in the Florida Everglades, where they “have survived their persecution best,” as one biologist put it. Conservation efforts have included an 1893 statewide hunting ban and the animal’s addition to the endangered species list in 1967, but their resurgence in Florida may owe more to an unusual habitat network: 10 for-profit power plants. As manatees’ preferred habitat, natural warm-water springs, was being destroyed to create more space for humans, they began wintering in heated coal- and oil-fired plant runoff. Of the 7,500 to 10,300 manatees estimated to live in Florida, roughly half depend on these discharges.
This was what Kroh meant when he said visitors have it backward. The plant wasn’t built near the sanctuary; the manatees came there, traveling more than 100 miles north of their historic range to Tampa Bay, then down the almost mile-long canal to huddle in the steady rush of hot water flowing out of the plant. TECO Energy Inc., the parent of Tampa Electric, is one of two major utilities that have turned this unlikely dependence into a tenuous symbiotic relationship, opening manatee viewing centers and putting a friendly, eco-conscious face on an industry that’s one of the state’s top polluters. The utilities have helped make the manatee a beloved symbol of Florida—its official marine mammal and a major tourist attraction.
In recent years, though, a potentially tragic situation has emerged: As the plants, all of which are at least a half-century old, reach the point of requiring major upgrades, they’re being converted away from coal and toward natural gas and to a lesser extent renewables, fuels that don’t require the same volume of water for cooling as coal and oil. This outcome, highly desirable for cutting plant costs and greenhouse gas emissions, could have the unintended consequence of stranding thousands of manatees. Four of the 10 plants the animals have historically relied on are already closed. Within the next few years, Big Bend will retire one of its four coal-fired units and convert another to a gas-fired combined-cycle operation. The two remaining coal-fired units discharging warm water into the canal are getting old, with one only two years away from the average retirement age of U.S. coal units and the other 11 years away. The last of the 10 plants is likely to close in the next three decades or so. (Michael Bloomberg, the founder and majority owner of Bloomberg LP, the parent company of Bloomberg News, and the founder of Bloomberg Philanthropies, introduced Beyond Carbon, a campaign aimed at moving the U.S. toward a 100% clean energy economy, including closing the remaining coal-powered plants in the U.S.)
Scientists don’t yet know if manatees can be weaned from artificial discharges in time, let alone how much it might cost. Decades of good public relations for the industry haven’t led to a workable plan. During temporary shutdowns some plants have tried artificial heaters, at a cost of millions of dollars, but this isn’t a long-term solution, and it won’t work at Big Bend, whose canal is the largest in the state. “It would be just about impossible to do here because of the volume of water,” Kroh said. “I can’t imagine how many heaters it would take to heat just a portion of this canal at the right temperature.”
And even if the manatees could be diverted from the plants, there might be nowhere left for them to go.
by Mya Frazier, Bloomberg | Read more:
Image: National Geographic
The temperature the day of my visit was 53F—brisk, but perfect for the unusual sight I was actually there to see. Stanley Kroh, manager of land and stewardship programs for Big Bend’s operator, Tampa Electric Co., greeted me near an empty picnic grove. We headed inside the free exhibit, walking past a line of visitors waiting to pose beside a bronze manatee with a gummy smile. Speakers blared “Welcome to the Manatee Viewing Center, where nature meets technology!” on loop.
“We’ve had people that will say, ‘Isn’t it terrible that they put a power plant right next to this manatee sanctuary?’ ” Kroh said. “They get it completely backwards.” We traversed a cement walkway beneath a mangrove canopy—the plant was built on coastal land dredged of pristine mangrove swamps—until we reached a narrow pier jutting into a canal the width of a football field. Across the waterway were massive piles of coal. Conveyor belts zigged up from them, transporting lumps to the plant’s four generation units, which are also fueled by natural gas and are cooled by water sucked in from Tampa Bay.Also before us, lurking beneath waters turned turbid by leaf tannins and warmed by the nonstop flow of hot water from the plant, were manatees—a hundred or more, by Kroh’s estimate. They remained shadowy blobs until the moment they emerged for air, their noses flaring lightly before spraying water and emitting an abrupt pfff. Then they’d rotate to reveal their ungainly bodies, looking like hippopotamus-walrus hybrids gorged to bursting with bread.
Manatees are the chubby vegan hippies of the sea. Neither predator nor prey, the world’s three remaining species are all considered vulnerable, including the West Indian manatee (Trichechus manatus), of which the Florida manatee is a subspecies. Manatees seem to have evolved almost immune to Darwinian struggle. They’re small-brained, radically farsighted, almost deaf, and barely able to smell—effectively floating digestion machines propelled by paddle-like tails. They survive mostly on seagrass, 100 to 200 pounds of which is working through a manatee’s intestinal system at a given moment. Their lungs stretch the entire length of their trunk, helping them maintain optimal buoyancy so they can munch like Jersey cows grazing a field of clover. Yet though manatees are sitting targets, even sharks leave them alone, uninterested in an animal that, despite its corpulence, lacks a tasty, insulating layer of blubber. So unflappable are manatees that a wild one will roll over and let its only true predator—us—rub its tender underside.
Although manatees were hunted to near extinction for their meat and hides in the 19th century, a remnant ended up in the Florida Everglades, where they “have survived their persecution best,” as one biologist put it. Conservation efforts have included an 1893 statewide hunting ban and the animal’s addition to the endangered species list in 1967, but their resurgence in Florida may owe more to an unusual habitat network: 10 for-profit power plants. As manatees’ preferred habitat, natural warm-water springs, was being destroyed to create more space for humans, they began wintering in heated coal- and oil-fired plant runoff. Of the 7,500 to 10,300 manatees estimated to live in Florida, roughly half depend on these discharges.
This was what Kroh meant when he said visitors have it backward. The plant wasn’t built near the sanctuary; the manatees came there, traveling more than 100 miles north of their historic range to Tampa Bay, then down the almost mile-long canal to huddle in the steady rush of hot water flowing out of the plant. TECO Energy Inc., the parent of Tampa Electric, is one of two major utilities that have turned this unlikely dependence into a tenuous symbiotic relationship, opening manatee viewing centers and putting a friendly, eco-conscious face on an industry that’s one of the state’s top polluters. The utilities have helped make the manatee a beloved symbol of Florida—its official marine mammal and a major tourist attraction.
In recent years, though, a potentially tragic situation has emerged: As the plants, all of which are at least a half-century old, reach the point of requiring major upgrades, they’re being converted away from coal and toward natural gas and to a lesser extent renewables, fuels that don’t require the same volume of water for cooling as coal and oil. This outcome, highly desirable for cutting plant costs and greenhouse gas emissions, could have the unintended consequence of stranding thousands of manatees. Four of the 10 plants the animals have historically relied on are already closed. Within the next few years, Big Bend will retire one of its four coal-fired units and convert another to a gas-fired combined-cycle operation. The two remaining coal-fired units discharging warm water into the canal are getting old, with one only two years away from the average retirement age of U.S. coal units and the other 11 years away. The last of the 10 plants is likely to close in the next three decades or so. (Michael Bloomberg, the founder and majority owner of Bloomberg LP, the parent company of Bloomberg News, and the founder of Bloomberg Philanthropies, introduced Beyond Carbon, a campaign aimed at moving the U.S. toward a 100% clean energy economy, including closing the remaining coal-powered plants in the U.S.)
Scientists don’t yet know if manatees can be weaned from artificial discharges in time, let alone how much it might cost. Decades of good public relations for the industry haven’t led to a workable plan. During temporary shutdowns some plants have tried artificial heaters, at a cost of millions of dollars, but this isn’t a long-term solution, and it won’t work at Big Bend, whose canal is the largest in the state. “It would be just about impossible to do here because of the volume of water,” Kroh said. “I can’t imagine how many heaters it would take to heat just a portion of this canal at the right temperature.”
And even if the manatees could be diverted from the plants, there might be nowhere left for them to go.
by Mya Frazier, Bloomberg | Read more:
Image: National Geographic
The S.E.C. Rule That Destroyed The Universe
The Covid-19 crisis has revealed gruesome core dysfunction. Drug companies have to be bribed to make needed medicines, state governments improvise harebrained plans for emergency elections, and industrial capacity has been offshored to the point where making enough masks seems beyond the greatest country in the world.
But the biggest shock involves the economy. How were we this vulnerable to disruption? Why do industries like airlines that just minutes ago were bragging about limitless profitability – American CEO Doug Parker a few years back insisted, “My personal view is that you won’t see losses in the industry at all” – suddenly need billions? Where the hell did the money go?
In Washington, everyone from Donald Trump to Joe Biden to Alexandria Ocasio-Cortez is suddenly pointing the finger at stock buybacks, a term many Americans are hearing for the first time.
This breaks a taboo of nearly forty years, during which politicians in both parties mostly kept silent about a form of legalized embezzlement and stock manipulation, greased by an obscure 1982 rule implemented by Ronald Reagan’s S.E.C., that devoured trillions of national wealth.
The mechanics of buybacks are simple. Companies buy their own stock and retire the shares, increasing the value of shares remaining in circulation. This translates into instant windfalls for shareholders and executives that approve the purchases. That this should be proscribed as market manipulation, and additionally offers a clear path to insider trading – former SEC chief Rob Jackson found corporate insiders were five times as likely to sell stock after a share repurchase was announced – is just one problem.
The worse problem comes when companies not only spend all of their available resources on stock distributions, but borrow to fund even more distributions. This leaves companies with razor-thin margins of error, quickly exposed in a crisis like the current one.
“When companies spend billions on buybacks, they’re not spending it on research and development, on plant expansion, on employee benefits,” says Dennis Kelleher of Better Markets. “Corporations are loaded up with debt they wouldn’t otherwise have. They’re intentionally deciding to live on the very edge of calamity to benefit the richest Americans.”
It’s hard to overstate how much money has vanished. S&P 500 companies overall spent the size of the recent bailout – $2 trillion – on buybacks just in the last three years!
Banks spent $155 billion on buybacks and dividends across a 12-month period in 2019-2020. As former FDIC chief Sheila Bair pointed out last month, “as a rule of thumb $1 of capital supports $16 of lending.” So, $155 billion in buybacks and dividends translates into roughly $2.4 trillion in lending that didn’t happen.
Most all of the sectors receiving aid through the new CARES Act programs moved huge amounts to shareholders in recent years. The big four airlines – Delta, United, American, and Southwest – spent $43.7 billion on buybacks just since 2012. If that sum sounds familiar, it’s because it equals almost exactly the size of the $50 billion bailout airlines are being given as part of the CARES Act relief package.
The two major federal financial rescues, in 2008-2009 and now, have become an important part of a cover story shifting attention from all this looting: the public has been trained to think companies have been crippled by investment losses, when the biggest drain has really come via a relentless program of intentional extractions.
Corporate officers treat their own companies like mob-owned restaurants or strip mines, to be systematically pillaged for value using buybacks as the main extraction tool. During this period corporations laid off masses of workers they could afford to keep, begged for bailouts and federal subsidies they didn’t need, and issued mountains of unnecessary debt, essentially to pay for accelerated shareholder distributions.
All this was done in service of a lunatic religion of “maximizing shareholder value.” “MSV” by now has been proven a moronic canard – even onetime shareholder icon Jack Welch said ten years ago it was “the dumbest idea in the world” – and it’s had the result of promoting a generation of corporate leaders who are skilled at firing people, hustling public subsidies, and borrowing money to fund stock awards for themselves, but apparently know jack about anything else.
But the biggest shock involves the economy. How were we this vulnerable to disruption? Why do industries like airlines that just minutes ago were bragging about limitless profitability – American CEO Doug Parker a few years back insisted, “My personal view is that you won’t see losses in the industry at all” – suddenly need billions? Where the hell did the money go?
In Washington, everyone from Donald Trump to Joe Biden to Alexandria Ocasio-Cortez is suddenly pointing the finger at stock buybacks, a term many Americans are hearing for the first time.
This breaks a taboo of nearly forty years, during which politicians in both parties mostly kept silent about a form of legalized embezzlement and stock manipulation, greased by an obscure 1982 rule implemented by Ronald Reagan’s S.E.C., that devoured trillions of national wealth.The mechanics of buybacks are simple. Companies buy their own stock and retire the shares, increasing the value of shares remaining in circulation. This translates into instant windfalls for shareholders and executives that approve the purchases. That this should be proscribed as market manipulation, and additionally offers a clear path to insider trading – former SEC chief Rob Jackson found corporate insiders were five times as likely to sell stock after a share repurchase was announced – is just one problem.
The worse problem comes when companies not only spend all of their available resources on stock distributions, but borrow to fund even more distributions. This leaves companies with razor-thin margins of error, quickly exposed in a crisis like the current one.
“When companies spend billions on buybacks, they’re not spending it on research and development, on plant expansion, on employee benefits,” says Dennis Kelleher of Better Markets. “Corporations are loaded up with debt they wouldn’t otherwise have. They’re intentionally deciding to live on the very edge of calamity to benefit the richest Americans.”
It’s hard to overstate how much money has vanished. S&P 500 companies overall spent the size of the recent bailout – $2 trillion – on buybacks just in the last three years!
Banks spent $155 billion on buybacks and dividends across a 12-month period in 2019-2020. As former FDIC chief Sheila Bair pointed out last month, “as a rule of thumb $1 of capital supports $16 of lending.” So, $155 billion in buybacks and dividends translates into roughly $2.4 trillion in lending that didn’t happen.
Most all of the sectors receiving aid through the new CARES Act programs moved huge amounts to shareholders in recent years. The big four airlines – Delta, United, American, and Southwest – spent $43.7 billion on buybacks just since 2012. If that sum sounds familiar, it’s because it equals almost exactly the size of the $50 billion bailout airlines are being given as part of the CARES Act relief package.
The two major federal financial rescues, in 2008-2009 and now, have become an important part of a cover story shifting attention from all this looting: the public has been trained to think companies have been crippled by investment losses, when the biggest drain has really come via a relentless program of intentional extractions.
Corporate officers treat their own companies like mob-owned restaurants or strip mines, to be systematically pillaged for value using buybacks as the main extraction tool. During this period corporations laid off masses of workers they could afford to keep, begged for bailouts and federal subsidies they didn’t need, and issued mountains of unnecessary debt, essentially to pay for accelerated shareholder distributions.
All this was done in service of a lunatic religion of “maximizing shareholder value.” “MSV” by now has been proven a moronic canard – even onetime shareholder icon Jack Welch said ten years ago it was “the dumbest idea in the world” – and it’s had the result of promoting a generation of corporate leaders who are skilled at firing people, hustling public subsidies, and borrowing money to fund stock awards for themselves, but apparently know jack about anything else.
by Matt Taibbi, Taibbi Substack | Read more:
Image: uncredited
Brandon O’Neill- Message to Seattle
via: The Stranger
[ed. Theater actor in Seattle. Also, from a friend: until further notice the days of the week are now called: Thisday, Thatday, Otherday, Someday, Yesterday, Today & Nextday.]
A Politician Takes a Sledgehammer to His Own Ego
In the market for Easter Sunday inspiration? Try the parable of the blind man who gave up political glory for Jesus Christ.
He quickly climbed the rungs of power, became the lieutenant governor of the state of Washington at 35 and had reason to believe that he’d be governor someday, maybe even before he turned 40.
His ascent impressed people all the more because of his disability. At the age of 8, he lost his sight: A rare cancer forced the removal of both of his retinas. He spent the next decades proving to the world — and to himself — that he could nonetheless accomplish just about anything that he set his mind to.
He attended Columbia University. He won a Rhodes scholarship. He graduated from Yale Law. “From Braille to Yale” was how he often described his journey. It made for a great political speech.
Then the man, Cyrus Habib, had an awakening.
“I was in talks with a top literary agent in New York about a book deal, and it was all predicated on my biography, my identity,” he told me recently. He could feel himself being sucked into “a celebrity culture” in American politics that had nothing to do with public service. He could feel himself being swallowed by pride.
“How many ways,” he said “can you be called a rising star?”
He decided not to find out. Last month Habib, now 38, announced that instead of being on the ballot in November for a second term as lieutenant governor, he would soon leave office to become a Roman Catholic priest.
A few additional details amplify the surprise of that swerve. He is entering the Jesuit religious order, whose intensive, extensive ordination process typically takes about 10 years and involves vows of poverty and obedience as well as chastity.
And he committed to this course just as political gossips speculated about a heady promotion for him. He was a lock for re-election, as is the state’s governor, Jay Inslee. But in one scenario, a Joe Biden presidency could lead to a high-level administration position for Inslee, who would then have to step down. His lieutenant governor would immediately take his place.
Habib worried that if he moved into the governor’s office, he might be too intoxicated by power to let it go. Stepping down now, he told me, is like “giving your car keys to someone before you start drinking.”
His redirection has nothing to do with the coronavirus pandemic, he said. But it does reflect the sort of moral inventory that many people conduct at a time of great suffering, the type of spiritual epiphany they experience in the face of terrifying uncertainty.
He quickly climbed the rungs of power, became the lieutenant governor of the state of Washington at 35 and had reason to believe that he’d be governor someday, maybe even before he turned 40.
His ascent impressed people all the more because of his disability. At the age of 8, he lost his sight: A rare cancer forced the removal of both of his retinas. He spent the next decades proving to the world — and to himself — that he could nonetheless accomplish just about anything that he set his mind to.
He attended Columbia University. He won a Rhodes scholarship. He graduated from Yale Law. “From Braille to Yale” was how he often described his journey. It made for a great political speech.Then the man, Cyrus Habib, had an awakening.
“I was in talks with a top literary agent in New York about a book deal, and it was all predicated on my biography, my identity,” he told me recently. He could feel himself being sucked into “a celebrity culture” in American politics that had nothing to do with public service. He could feel himself being swallowed by pride.
“How many ways,” he said “can you be called a rising star?”
He decided not to find out. Last month Habib, now 38, announced that instead of being on the ballot in November for a second term as lieutenant governor, he would soon leave office to become a Roman Catholic priest.
A few additional details amplify the surprise of that swerve. He is entering the Jesuit religious order, whose intensive, extensive ordination process typically takes about 10 years and involves vows of poverty and obedience as well as chastity.
And he committed to this course just as political gossips speculated about a heady promotion for him. He was a lock for re-election, as is the state’s governor, Jay Inslee. But in one scenario, a Joe Biden presidency could lead to a high-level administration position for Inslee, who would then have to step down. His lieutenant governor would immediately take his place.
Habib worried that if he moved into the governor’s office, he might be too intoxicated by power to let it go. Stepping down now, he told me, is like “giving your car keys to someone before you start drinking.”
His redirection has nothing to do with the coronavirus pandemic, he said. But it does reflect the sort of moral inventory that many people conduct at a time of great suffering, the type of spiritual epiphany they experience in the face of terrifying uncertainty.
by Frank Bruni, NY Times | Read more:
Image: Ruth Fremson/The New York Times
[ed. I was fortunate to hear Mr. Habib give the commencement speech at our local university a couple years ago (almost an hour long; completely extemporaneous). It was a great speech, and he seemed to me quite unique, a smart and thoughtful politician.]
Saturday, April 11, 2020
Bloomberg's Firm Bidding to Take Over Biden's Campaign
The Bloomberg-owned firm Hawkfish, which ran the presidential campaign of Mike Bloomberg, is in serious talks to serve the presidential campaign of Joe Biden, according to sources with knowledge of the ongoing negotiations. Along with Biden’s campaign, the firm is courting a wide swath of other progressive and Democratic organizations, opening up the possibility of Bloomberg gaining significant control over the party’s technology and data infrastructure.
The digital consulting firm has had little political experience outside of the Bloomberg campaign, a trial by fire in which the former New York City mayor burned through nearly $1 billion in less than four months. Hawkfish, which Bloomberg founded in 2019 to be the operational backbone of his campaign, is not yet able to sell its track record or quality of service, since it has no other major clients and few, if any, minor ones.
But instead it comes with other enticements to clients. Democratic operatives who’ve been pitched by Hawkfish say that the firm is able to offer extraordinarily low prices by operating at a loss subsidized by Bloomberg, whose wealth dangles as an added benefit that could come with signing the firm. A Hawkfish insider, who spoke on the condition of anonymity so as not to jeopardize employment, confirmed that the company is willing to operate at a loss in order to grab control of the party infrastructure, explaining that the firm hopes to offer a fee that would be small enough to entice the Biden campaign while passing muster with federal regulators. (If a firm offers services for less than fair market value, the discount is considered under campaign finance laws to be an in-kind contribution, and thus subject to legal limits depending on the entity collecting the contribution. A presidential campaign can’t accept more than $2,800 from a single individual per election, or any contributions at all from a company.)
“When the objective isn’t money but control, $18 million is incredibly cheap to become the center of gravity for all Democratic political information, which we would be if both Biden and [House Democrats] have to come through us,” the source said, referring to the amount of money the Bloomberg campaign transferred to the Democratic Party last month, in a reversal of his earlier pledge to create a Super PAC in support of the party’s nominee. “And in the current environment, the public sees this as generosity.”
In modern campaigning, control of voter data and technology is everything. Currently, the Democratic National Committee houses the party data in a tense, underfunded, and inefficient alliance with 50 state parties. But all candidates have equal access to the data, including the voter file. The party does not bar challengers to incumbents, or members of Congress who cross leadership, for instance, from accessing that voter file. But in private hands, the most up-to-date data could be withheld as a disciplinary tool against renegade candidates and lawmakers, or offered as a reward to loyalists. Winning the Biden campaign contract would give Hawkfish an opportunity to dramatically grow its data acquisition operation. Without it, Hawkfish is a big firm with no big client. Hawkfish and its leadership did not respond to multiple requests for comment. The Biden campaign declined to comment.
The digital consulting firm has had little political experience outside of the Bloomberg campaign, a trial by fire in which the former New York City mayor burned through nearly $1 billion in less than four months. Hawkfish, which Bloomberg founded in 2019 to be the operational backbone of his campaign, is not yet able to sell its track record or quality of service, since it has no other major clients and few, if any, minor ones. But instead it comes with other enticements to clients. Democratic operatives who’ve been pitched by Hawkfish say that the firm is able to offer extraordinarily low prices by operating at a loss subsidized by Bloomberg, whose wealth dangles as an added benefit that could come with signing the firm. A Hawkfish insider, who spoke on the condition of anonymity so as not to jeopardize employment, confirmed that the company is willing to operate at a loss in order to grab control of the party infrastructure, explaining that the firm hopes to offer a fee that would be small enough to entice the Biden campaign while passing muster with federal regulators. (If a firm offers services for less than fair market value, the discount is considered under campaign finance laws to be an in-kind contribution, and thus subject to legal limits depending on the entity collecting the contribution. A presidential campaign can’t accept more than $2,800 from a single individual per election, or any contributions at all from a company.)
“When the objective isn’t money but control, $18 million is incredibly cheap to become the center of gravity for all Democratic political information, which we would be if both Biden and [House Democrats] have to come through us,” the source said, referring to the amount of money the Bloomberg campaign transferred to the Democratic Party last month, in a reversal of his earlier pledge to create a Super PAC in support of the party’s nominee. “And in the current environment, the public sees this as generosity.”
In modern campaigning, control of voter data and technology is everything. Currently, the Democratic National Committee houses the party data in a tense, underfunded, and inefficient alliance with 50 state parties. But all candidates have equal access to the data, including the voter file. The party does not bar challengers to incumbents, or members of Congress who cross leadership, for instance, from accessing that voter file. But in private hands, the most up-to-date data could be withheld as a disciplinary tool against renegade candidates and lawmakers, or offered as a reward to loyalists. Winning the Biden campaign contract would give Hawkfish an opportunity to dramatically grow its data acquisition operation. Without it, Hawkfish is a big firm with no big client. Hawkfish and its leadership did not respond to multiple requests for comment. The Biden campaign declined to comment.
by Ryan Grim, The Intercept | Read more:
Image: Soohee Cho/The Intercept; Getty Images
[ed. If you can't buy the nomination, buy the nominee.]
Airlines Want U.S. Treasury To Scrap Proposal To Make Some Grant Money Repayable
Major U.S. airlines were urging Treasury officials and the federal government’s outside advisers on Saturday to scrap or revise a proposal that would make part of the $25 billion earmarked by Congress to help keep workers on the payroll repayable in the form of low-cost loans.
Treasury Secretary Steven Mnuchin told the airlines on Friday the government would require them to repay 30% of the grants in low-cost loans over 10 years — with the first five years at 1% interest — before the interest rate would rise. The government is also seeking warrants equal to 10% of the loan amount.
U.S. airlines have idled more than 2,200 airplanes, a third of the fleet, canceled hundreds of thousands of flights and sought to shore up their balance sheets as travel demand has fallen by about 95% because of the coronavirus pandemic.
Airlines, in calls with U.S. Treasury officials and the government’s outside advisers, were making the case that Treasury should not require them to repay a big chunk of grants, in part because the $25 billion is not sufficient to cover the full amount of payroll costs submitted.
Airlines for America, a trade group representing American Airlines Group Inc (AAL.O), United Airlines (UAL.O), Delta Air Lines (DAL.N) Southwest Airlines Co (LUV.N), JetBlue Airways Corp JBLU.N, Alaska Airlines (ALK.N) and others, said Saturday it believes the $25 billion in payroll assistance was “to be only in grants – which is considerably more effective for our employees – and not a combination of grants and loans.”
Under the terms laid out in the statute, companies receiving funds cannot lay off employees before Sept. 30 or change collective bargaining agreements. Mnuchin has authority to demand compensation for the grants but is not required to do so.
Sara Nelson, president of the Association of Flight Attendants union, wrote on Twitter Saturday that if Treasury insists on airlines repaying $7 billion in grants, “job cuts will happen now AND longer term cuts will come in October. This is absolutely stealing from the money Congress allocated directly to workers.”
Congress set aside another $25 billion in loans to passenger airlines, but no action on those is expected until Treasury makes decisions on the grants.
by David Shepardson, Tracy Rucinski, Reuters | Read more:
Image: Carlos Barria
Treasury Secretary Steven Mnuchin told the airlines on Friday the government would require them to repay 30% of the grants in low-cost loans over 10 years — with the first five years at 1% interest — before the interest rate would rise. The government is also seeking warrants equal to 10% of the loan amount.
U.S. airlines have idled more than 2,200 airplanes, a third of the fleet, canceled hundreds of thousands of flights and sought to shore up their balance sheets as travel demand has fallen by about 95% because of the coronavirus pandemic.Airlines, in calls with U.S. Treasury officials and the government’s outside advisers, were making the case that Treasury should not require them to repay a big chunk of grants, in part because the $25 billion is not sufficient to cover the full amount of payroll costs submitted.
Airlines for America, a trade group representing American Airlines Group Inc (AAL.O), United Airlines (UAL.O), Delta Air Lines (DAL.N) Southwest Airlines Co (LUV.N), JetBlue Airways Corp JBLU.N, Alaska Airlines (ALK.N) and others, said Saturday it believes the $25 billion in payroll assistance was “to be only in grants – which is considerably more effective for our employees – and not a combination of grants and loans.”
Under the terms laid out in the statute, companies receiving funds cannot lay off employees before Sept. 30 or change collective bargaining agreements. Mnuchin has authority to demand compensation for the grants but is not required to do so.
Sara Nelson, president of the Association of Flight Attendants union, wrote on Twitter Saturday that if Treasury insists on airlines repaying $7 billion in grants, “job cuts will happen now AND longer term cuts will come in October. This is absolutely stealing from the money Congress allocated directly to workers.”
Congress set aside another $25 billion in loans to passenger airlines, but no action on those is expected until Treasury makes decisions on the grants.
Image: Carlos Barria
[ed. Gratitude. You know what? Fuck the airlines. They've been screwing everyone over since 9/11. When this crisis subsides, fly with whoever is left and fuck the rest. Seriously. Maybe then we'll grow an industry that actually cares about its customers (and taxpayers). See also: An Airline Bailout Should Have More Strings Attached Than a Harp (TNR)]
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