caulfield12

https://www.dallasnews.com/news/public-health/2020/04/17/17-in-a-homeless-shelter-test-positive-for-coronavirus-dallas-county-says/ 38 test positive for Covid in Dallas homeless shelter...as many as 200 staffers and shelter residents have been exposed, the county’s health director said. More than 160 have been taken to hotels.

The amazing thing is how just 4-6 weeks of Covid arriving late (r) totally changed this year’s election. Biden if the race was interrupted indefinitely after Nevada never gets his momentum going. The entire race then hinges on health care and economic inequality (just imagining Sanders’ reaction to the aforementioned anecdote about private lab testing not being profitable enough.) Now, the Biden/Trump race hinges on Democratic governors, Trump “mistakes,” a “return to decency/empathy” and restoring normalized diplomatic relations with the rest of the world. Even the economic/unemployment numbers can be blamed on “coastal elites” shutting down the country and trying to take away our unique rights/freedoms, conspiring to prolong the shutdown in order to deny reelection. Those Dem governors and Crazy Joe Biden simply don’t want America to succeed, they instead want to turn America into a socialist nanny state like the EU. The big question here (blaming governors or taking credit for only successes, like the stock market now “only” being down 18% instead of mid 30’s) is whether 30-40% of the country in the middle of the spectrum politically actually buy what is being sold. Normally, it’s impossible during a presidential election year to narrow the blame to just governors or Congress when the economic success or (relative degrees of) failure begins and ends at the top of the ticket.

This risk is particularly acute in places of detention, such as prisons, jails, and immigration detention centers, as well as residential institutions for people with disabilities and nursing facilities for older people, where the virus can spread rapidly, especially if access to health care is already poor. States have an obligation to ensure medical care for those in their custody at least equivalent to that available to the general population, and must not deny detainees, including asylum seekers or undocumented migrants, equal access to preventive, curative or palliative health care. Asylum seekers, refugees living in camps, and people experiencing homelessness may also be at increased risk because of their lack of access to adequate water and hygiene facilities. https://www.hrw.org/news/2020/03/19/human-rights-dimensions-covid-19-response So you have these rural issues...whereas SF, LA, Seattle...are worrisome for their own set of reasons, especially homeless populations. Vietnam veterans. Nursing homes are obvious. Prisons in Illinois have already been discussed. Heck, just the 30+ million group of those without any health insurance or a preexisting relationship with a local physician. Those without regular checking or savings accounts for direct deposit. When this is all over, investigating statistics in Europe among refugee/displaced groups, human trafficking victims...it’s going to exhibit quite emphatically how particularly vulnerable these poor populations really are in a health crisis. And how dramatically those groups can impact entire communities. But one can guarantee that’s the exact topic that will never be discussed or even raised in a coronavirus briefing “We’ll have to get back to you.”

Right. These are the kind of calculations the insurance industry typically makes. If you’re a school administrator, it’s certainly much easier to take the conservative approach of keeping the school closed (of course, you have economic impacts in states like Iowa where education sector is the leading employer)...and then doing as much proactive outreach as possible with meal delivery services, food banks, churches, charity groups, etc. This in one huge area for a win-win...if you can contract with local restaurants to keep them with enough revenue opportunities to keep them open, while not paying prohibitively high prices that garner negative headlines. There are also numbers of high quality food warehousers/distributors who no longer are able to sell to higher end restaurants, at least not at the previous rates. Most of these are in urban areas, but it’s another area worth looking into if both sides are willing to compromise on pricing.

South Dakota is mostly accounted for by that Smithfield plant...and related infections. That said, each of one those governors being pointed out as now having “solved this thing” (like Asa Hutchinson in Arkansas), are going to end up killing increasing numbers of their state residents out of sheer stubbornness. Maybe they believe their electoral prospects are so secure (or not in an election year), they can get away with almost anything, but that’s certainly not the case with Kim Reynolds in Iowa. Georgia, Texas and Florida will be three of the leading indicators, and, as noted, that won’t start to show up in the statistical noise until the second week of May in all likelihood.

Another obvious element to consider is the need to reopen schools in order to reopen the country...or day care centers, at the very least. Trump seemed to project a belief that some states would be bringing students back in May, and that just doesn't make a lot of sense...when most districts would be theoretically closing in late May or early June. Are they going to push all those kids into mandatory summer school to catch up? It makes sense from a nutritional standpoint, perhaps, in poorer or rural districts. But who do you bring back first? Middle schoolers? High schoolers have the ability to stay at home (theoretically!), but sending KG and primary/elementary carries that risk because of the high level of transmission in that age group...passing it quickly to others and then families/relatives. Some are considering staggered...where you have JR/SR and then FR/SO on alternate days. What are the social distancing rules? How easy to maintain six feet? What about PE and recess? Cafeteria? There are so many considerations here...pushing kids back into school for just 2-3 weeks of “benefit” (their parents both being able to go back to work) doesn’t seem worthwhile. Granted, a lot of white collar jobs are flexible and allow for the majority of workers to function reasonably well through teleconferencing and stay ay home or only the most essential workers (let’s say 30%) returning to work, and you can even stagger or rotate that until you’re relatively confident in the efficaciousness of such a strategy.

https://www.yahoo.com/lifestyle/trump-administration-writing-death-sentence-220200223.html Unless you love particularly chain restaurants, and consider Ruth’s Chris a small business despite their deep pockets, or typically dine on foie gras with fellow 1%ers...most of our beloved local favorite eating options are going to eventually be wiped out.

https://www.yahoo.com/gma/antibody-research-indicates-coronavirus-may-far-more-widespread-155200568.html Santa Clara (CA) antibody test results suggest real rate of infection is 50-80X higher than officially published numbers. Fwiw...

Just curious. Have there been any protests yet in Indiana, Massachusetts and Ohio? Those are three states (so far) with GOP governors aligning with the “out to destroy America because they hate success/liberal cabal Dem governors” on the two coasts and now Heartland/Rust Belt. What about protests against governors in Texas, Georgia and Florida for being too aggressive in reopening? There’s definitely shaping up to be a battle in SD with Kristi Noem, who ironically came to power over a “fake estate/death tax” backstory that was wholly inaccurate (her father made a simple mistake in financial planning that would have wiped out any tax liability for the family farm.)

And they would have quickly saved thousands and thousands of HIV (and Ebola) patients around the world with generic-pricing of drugs at the beginning of those international crises. Ooops. Apparently the threat of Bernie Sanders taking over the world, of encroaching socialism...forced Sen. Kelly Loeffler to make all of her insider stock trades, mimicking a bad Ayn Rand novel subplot. You would think that Joe Biden was a member of SDS out of the 1960’s throwing Molotov cocktails and organizing violent protests when actually he’s about the most conservative Democrat nominated in recent memory. "This was a political attack designed to take away from the issue at hand. And to use this outbreak to play politics. We have addressed this and taken extraordinary measures to make sure that we can't be attacked for our success. This gets at the very heart of why I came to Washington, to defend free enterprise, to defend capitalism. This is a socialist attack. We have taken extraordinary measures, and I am focused solely on working for Georgians. I have been doing that seven days a week, around the clock. And it's my honor to be here and serve, and that's why I stepped out of the private sector.” https://www.cnn.com/2020/04/17/politics/kelly-loeffler-stock-coronavirus/index.html

Who pays the price when they turn out to be wrong? Definitely not the President, Trump children or Fox News headliners like Carlson, Hannity and Ingraham. I don’t want an authoritative response like here in China, but they at least have the technological means through cell phone app tracking and contract tracing to be able to pinpoint who was/is responsible for putting themselves, their families and others at risk. Even if all the GOP governors were to issue back to work orders, roughly 60-65% would be unwilling to go back voluntarily. Good luck firing them or taking away their unemployment benefits. Let’s not forget a situation was created to reward a significant percentage of employees more money for staying at home to prevent exactly these types of my health and that of my family vs. economic survival decisions. This policy was agreed to by both the Senate and the President. https://www.biospace.com/article/gilead-shutters-covid-19-trial-in-china-stocks-drop-3-percent-/ Abrahams interprets all this to suggest limited efficacy of the drug, writing, “We continue to believe that while remdesivir showed a promising signal of activity in the recent open label compassionate use published data, the fact that no data has been revealed from the truncated severe study in China—the only randomized study thus far—despite today’s update also indicated it had enrolled a reasonably robust number of patients (n=237), suggests any benefits observed were likely inconclusive and maintains our view that the likelihood of remdesivir demonstrating substantial activity remains at best 50/50.” The limited data on the 53 patients receiving the drug on compassionate use basis had no controls and, as a result, made it difficult to draw any definitive conclusions. The study of the 53 patients in the U.S., Europe and Canada who required respiratory support showed that about two-thirds benefited from the drug.

https://www.globaltimes.cn/content/1185711.shtml Here’s another important story. A Chinese intl. student returning from university in Miami was hospitalized, released, quarantined in Beijing for two weeks, then had to go back to the hospital 19 days after the original quarantine had started and was ultimately diagnosed with Covid (also managed to get his entire family sick.) They’re starting to rethink adjusting the normal 14 day timeframe to 21 days. Beijing is still pretty much more locked down than Wuhan, even. They haven’t allowed a single flight or high speed train to go between the two cities, either.

Literally every disaster movie ever made starts with the government ignoring a scientist. A critical difference between the parties is this, Corlette says: Democrats believe that “the healthy should subsidize the sick—the young, the old—because we all get older and sicker at some point in our lives. “On the flip side,” she continued, “if you look at what’s underpinning many of the more conservative health-reform ideas … [it’s that] what people pay toward their insurance or their care should reflect their level of risk.” ..... The biggest paradox in the health-care fight was that the Republican efforts to unravel risk-sharing hurt the material interests of their electoral coalition. The reason is that all their plans raised costs on older people with greater health needs at the same time as their base was becoming older and whiter. Their plans lowered prices for younger people, who now lean reliably toward the Democrats. https://www.theatlantic.com/politics/archive/2020/03/what-covid-19-debate-has-common-aca-fight/608797/

Wuhan Update Pretty much no changes here. My wife has been working for almost three full weeks, and she was just required to do a nose swab (very painful) and blood test this past WED. The government has recently announced they are not going to pay for foreigners’ Covid-19 treatment, so we are looking at getting supplemental insurance that would cost about $500-600. Without it, the full cost for treatment here might be something like $25-40,000. Planes, subway and buses are now running, but still at only about 30-40% capacity of normal levels. Are waiting on official announcement about school reopening and social distancing guidelines, as most classrooms are pretty cramped to accommodate 30-35 students. Mock exams scheduled the week of May 11-15. Just found out Grade 10/11 might not be back until May 18. Rumors we might go 1-2 weeks longer until end of June, we normally have only IB, AP, A Levels exams from May through early June (exam supervision), but 11th graders will now go until end of June since their official exams were all cancelled (AP has online version and shortened format.) Some schools are going into July or only paying 50% of normal salaries so we’re pretty fortunate so far. Still plenty of questions about asymptomatic transmission and those who were originally recovered getting sick again (S. Korea). Chinese applications to US schools could fall 15-25% next year, so there is growing concern on the part of teachers unable to return to China that their positions could be cut in order to save money, especially after students return in May and online classes are suspended. SAT will be offered online in US, probably not Asia. Students thinking about Boston area are already freaking out about Boston U. making contingency plans for Jan 2021 start, fall classes online.

https://www.cnn.com/2020/04/16/world/coronavirus-response-lessons-learned-intl/index.html How Taiwan, Germany, South Korea and Iceland got it right A total of 141 people who had apparently recovered from Covid-19 have tested positive again, South Korea's Centers for Disease Control and Prevention (KCDC) said on Thursday. KCDC deputy director Kwon Joon-wook said the agency did not know what caused the people to retest positive and was investigating. Most experts think it's unlikely that somebody will be re-infected for the coronavirus soon after recovering. It's possible that issues with testing – or varying amounts of viral RNA in the body, which the tests look for – could explain why people tested positive after testing negative. Kwon also said that the government is studying cultivated samples from the patients to determine whether the cases could be contagious. Kwon said the study will take about two weeks from today. “Our KCDC workers are working day and night to collect samples and conduct studies,” Kwon said. cnn.com

Sen. John Kennedy (R-LA) authoritatively declared on Wednesday night that the American people understand that the economy needs to be reopened very soon and that when that happens, the deadly coronavirus is “gonna spread faster.” Appearing on Fox News’ Tucker Carlson Tonight, Kennedy—whose home state has been one of the hardest hit during the COVID-19 pandemic—insisted that social distancing restrictions need to be quickly reversed because “very soon, the can (car) is going to run out of road.” After asserting that the world economy would soon collapse if the United States isn’t opened up in the near future, the Louisiana lawmaker went on to claim that nationwide shutdowns “did not stop the spread of virus.” “I wish it had,” he added. “But it’s too late for that. The shutdown slowed the spread of the virus at enormous cost, but it still spread.” https://www.yahoo.com/news/gop-senator-gotta-reopen-country-020943247.html As U.S. discouraged mask use for public, White House team raced to secure face coverings from Taiwan for senior staff The Washington Post By Carol D. Leonnig, Elizabeth Dwoskin and John Hudson In mid-March, a National Security Council team rushed to address what they saw as a threat to the U.S. government’s ability to function amid the advancing pandemic: a lack of masks to protect enough staff on the White House complex. Alarmed by the small cache and the growing signs of an acute shortage of protective gear in the United States, a senior NSC official turned to a foreign government for help, according to people familiar with the situation. The effort resulted in a donation of hundreds of thousands of surgical masks from Taiwan, which had plentiful domestic production and had sharply curtailed the spread of the coronavirus on the island. The bulk of Taiwan’s goodwill shipment went to the Strategic National Stockpile, but 3,600 masks were set aside for White House staff and officials, administration officials said. https://www.cnn.com/2020/04/16/politics/donald-trump-economy-coronavirus-pain/index.html CNN reported Wednesday that governors and state health officials feel misled by the White House about a rapid, toaster-size testing device made by Abbott Laboratories and unveiled as a "whole new ballgame" by the President. The federal government distributed the machines nationwide last week -- but accompanied them with only enough test kits to test around 115 people in each state. Medical experts are warning that hospitals still lack sufficient tests to diagnose the sick, let alone to cover the rest of the population. "We have made quite a bit of progress in the last few weeks. We are still not anywhere close to testing everyone who needs to be tested," said Dr. Jennifer Lee, an emergency room physician, on CNN's "The Situation Room." "Let's stop pretending that three million tests is enough. We need the capacity to do millions of tests if not per day, per week," Lee said, adding that sometimes a hospital might have sufficient tests kits but lack swabs, or labs might lack supplies to process the tests so that doctors can make a diagnosis

Sure, there were supposedly 6000 in the poll, but only 1600+ have been processed. There were 25 additional results classified as “borderline.” And there was no second test done after two additional weeks. These antibody tests have already been proven to be inaccurate (especially the Chinese ones), so while 1,000 is enough for a political poll about candidate preference as a snapshot in time, would still like to see more. Median income in Telluride is $63,000. Show me the results in Pueblo or Grand Junction, not a ski resort town with presumably better health care resources and far fewer workers in blue collar or public facing/service positions. Show me an area of Colorado with a high density or concentration of people, where the average salary is closer to $35-40,000. http://zipatlas.com/us/co/zip-code-comparison/median-household-income.htm Telluride would be roughly 50 out of 481 in terms of average salaries/community. Placerville is #35, the closest I could find. The test that Mei Mei Hu and Reese donated to the Telluride community is an antibody test developed by COVAXX, a newly formed subsidiary of their New York-based United Biomedical. It’s one of more than 30 commercially available tests without Food and Drug Administration approval under flexible rules adopted to address the COVID-19 pandemic. So far only one antibody test has received official FDA approval — a test made by Cellex, which uses just a pinprick of blood and produces results in about 15 minutes. .... It’s absolutely my goal to make this standard for how we get the country back to a new normal,” Reese had said before the test was suspended. “If we tested everyone in the whole country and were prepared to do it twice, you would know exactly when you would be back at functioning — everybody back at work.” Reese isn’t alone in his excitement. Hedge fund billionaire Bill Ackman invested an undisclosed amount of capital into COVAXX through his Pershing Square Foundation, and bestselling author and XPrize founder Dr. Peter Diamandis is listed as part of the COVAXX leadership team on the company’s website. Diamandis presents a fawning interview with Hu and Reese in a widely shared YouTube video, which does not disclose his relationship with the company. Neither responded to requests for comment. https://khn.org/news/a-colorado-ski-community-planned-to-test-everyone-for-covid-19-heres-what-happened/

https://www.businessinsider.com/coronavirus-antibody-tests-colorado-stalled-new-york-lab-2020-4 But they’re still missing at least 75% of the test results...due to, you guessed it, coronavirus infections in lab workers all the way across the country in NY, where the results are actually being analyzed. Hard to extrapolate from numbers of 1000-2000, unless you randomly tested another 50-100 communities across Colorado. Not to mention there seem to be significant error ranges with these antibody tests (back to Ed Yong/The Atlantic article.)

The problem is waiting 2-3 MORE weeks limits the range of options pretty dramatically. We might end up simply reacting again, instead of trying to get ahead of the curve. We have totally different health care systems, underlying conditions/co-morbidities, ratios of beds/doctors/respirators/nurses...population demographics. How many major cities do you have outside of Stockholm? And Sweden is at 12000 cases and 1200 deaths...so you’re waiting x number of days, and how much longer to be able to scientifically assess the data? What about the different medications they’re using? Taiwan right now is the best case study...and they at least have three major metropolitan areas on a densely populated island. Sweden might relate more to the South, Heartland and near west/Rockies in terms of pop density, but the two coasts, Illinois, Texas, LA, Michigan, Ohio, are different animals. https://www.thelocal.se/20200310/timeline-how-the-coronavirus-has-developed-in-sweden Well, here’s the latest accessible info on Swedish numbers.

So the theory is that if there are less tests, fewer people will know they’re sick...or what they have exactly, causing them to be more likely to stay at home and heal themselves (thus avoiding hospitals being overwhelmed)? That potentially works on keeping deaths and case numbers down (many will also delay going to hospital when their cases become too acute, quickly die, and not be counted), but definitely has the opposite effect on reopening. No symptoms, no test? Of course, the other problem is having to go to the doctor FIRST in order to get tested. Secondly, lots of studies are showing indisputable evidence of patients being the most contagious at least 3-5 days before exhibiting any physical symptoms...which is why we had that 5.7 figure of new infections caused by asymptomatic super spreaders. So there are obviously immense flaws in this not testing. Trump doesn’t want to run a Wal Mart parking lot test center, fine. But that doesn’t change issues of availability, accuracy and lack of testing reagents due to worldwide demands. Remember, a couple of weeks ago, the government was promising to pay for testing and many insurance companies were waiving co-pays for hospitalizations...what happened to that?

Michigan Militia! Soros! Protest funded by DeVos to embarrass Whitmer and prevent her from getting VP nod! Now president threatening to unilaterally adjourn Congress if they don’t approve his nominees. Pretty much exactly what Obama did when McConnell sat on Merrick Garland for months and months, right? 92 nominations potentially held up, but over 150 (shocking!) not even presented for consideration. Mostly judges. Many of those positions are in the public health sector...months and months too late. “We have the right to do whatever we want.” Okay...and also threatening actions against states (certainly with Dem governors.) Does anyone besides the base care at all about Voice of America broadcasts right now? https://fivethirtyeight.com/features/most-americans-like-how-their-governor-is-handling-the-coronavirus-outbreak/

https://www.cnn.com/2020/04/15/politics/kellyanne-conway-covid-19-coronavirus/index.html Amazing that some would actually be naive enough to believe WHO had 18 previous Covid opportunities to get this right, but it’s primarily aimed at a FOX audience, so....

https://www.cnn.com/2020/04/14/health/coronavirus-antibody-tests-scientists/index.html Shocking news. There are now widespread problems with the antibody tests (and one of the factors is that in rushing everything past normal processes and regulations meant to protect us, there’s going to be lots of FAKE results, especially from Chinese tests.) You couldn’t create a dystopian novel/movie with such a series of missteps if Michael Crichton tried his hardest. https://www.scmp.com/news/china/science/article/3079879/chinas-initial-coronavirus-outbreak-wuhan-spread-twice-fast-we China’s initial coronavirus outbreak in Wuhan spread twice as fast as we thought, new study suggests Each carrier was infecting 5.7 people on average, according to US researchers, who say previous estimate had used incomplete data Latest data based on cases whose origin could be traced more clearly, in provinces that had test kits and ample health care capacity https://www.cnn.com/2020/04/15/politics/trump-coronavirus-crisis/index.html Public health experts say a prerequisite for a resumption of regular life will be a mass testing program to diagnose the sick and identify those who carry antibodies that make them immune from the disease. But the nation's top infectious disease expert, Dr. Anthony Fauci, said Tuesday such a structure was nowhere near. In a fresh sign of discord with the President, Fauci told the Associated Press that "we have to have something in place that is efficient and that we can rely on, and we're not there yet." Trump reacted angrily when told of the remarks. "I don't know what he said. Nobody does," Trump said, before warning that the federal government -- responsible for the nation's health and well-being -- has nothing to do with building the testing infrastructure that will be needed. "The governors are supposed to do testing. It's up to them," Trump said.

I was simply just giving an estimate of what would happen under a partial reopening (some states but not others)...let’s say, theoretically the states with GOP governors with exceptions like MA, MD and OH. We’re all just guessing now. Could be in the hundreds of thousands, since we don’t know how many actually have it. The Ed Yong Atlantic article accurately points out how immense the ranges are of a fairly accurate test when you start talking about the differentials between just 1% and 5% already having it (or recovered asymptomatically and developed antibodies along the way.) Below are perhaps two of the most significant paragraphs for an array of health experts to stew over the ramifications. There’s not yet a precise opportunity cost or cost/benefit formula that equates an additional 20,000 lives lost vs. 1/10th of a point off yearly GDP, or whatever relevant metric we choose to apply. Trump’s idea is that the stock market coming back up is the best measuring stick, but most Americans aren’t going to see it that way. In fact, one can reasonably conclude that higher unemployment will actually lead to further automation and leaner corporations that have hollowed out the middle layers, leaving primarily corporate execs and lowly-paid gig workers/Amazon logistics. And a renewal of the national arguments that Wang started over UBI and the future of the US workforce. If it turns out that, say, 20 percent of the U.S. has been infected, that would mean the coronavirus is more transmissible but less deadly than scientists think. It would also mean that a reasonable proportion of the country has some immunity. If that proportion could be slowly and safely raised to the level necessary for herd immunity—60 to 80 percent, depending on the virus’s transmissibility—the U.S. might not need to wait for a vaccine. However, if just 1 to 5 percent of the population has been infected—the range that many researchers think is likelier—that would mean “this is a truly devastating virus, and we have built up no real population immunity,” said Michael Mina, an epidemiologist and immunologist at Harvard. “Then we’re in dire straits in terms of how to move forward.” .... Third, serological tests for the new coronavirus could be deeply misleading for individuals. Consider the test produced by Cellex—the only one thus far with emergency use authorization from the FDA. The test has a 93.8 percent chance of correctly identifying people with antibodies against the new coronavirus, and a 95.6 percent chance of correctly identifying people who lack those antibodies. Those numbers sound great, but if only a minority of Americans have been infected, the test would return far more false positives than true ones. Put it this way: If you have a positive result, the odds that you actually have any relevant antibodies are roughly one in two if 5 percent of the U.S. has been infected, and just one in six if only 1 percent has been infected. Scientists can correct for these errors if they use serological tests to assess immunity in a population, but it’s much harder on a person-by-person basis.

Ed Yong’s one of the most well-informed writers out there on this. Has written a series of excellent articles. . An Indiana congressman said Tuesday that letting more Americans die from the novel coronavirus is the "lesser of two evils" compared with the economy cratering due to social distancing measures. Speaking with radio station WIBC in Indiana, Republican Rep. Trey Hollingsworth asserted that, while he appreciated the science behind the virus' spread, "it is always the American government's position to say, in the choice between the loss of our way of life as Americans and the loss of life, of American lives, we have to always choose the latter." "The social scientists are telling us about the economic disaster that is going on. Our (Gross Domestic Product) is supposed to be down 20% alone this quarter," Hollingsworth said. "It is policymakers' decision to put on our big boy and big girl pants and say it is the lesser of these two evils. It is not zero evil, but it is the lesser of these two evils and we intend to move forward that direction. That is our responsibility and to abdicate that is to insult the Americans that voted us into office." https://www.cnn.com/2020/04/14/politics/trey-hollingsworth-coronavirus/index.html At least he actually said what a lot of politicians on the conservative side are actually thinking...the economy is more important than saving an additional 40-80,000 American lives. That’s the choice. Sacrificing those people willingly, or fighting to save every individual that we can. Surely he will be putting his own family members on the front lines, right?