"It Didn't Go So"

"It didn't go so," she said under her breath. —Erna Brodber, Myal, p.84.

SARS-CoV-2 links - 22 Mar 2020 17:31

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This page is updated three times a week. I watch the world from below and to the left. I like universal socialism and decisions that strengthen the resources of particular communities and traditions. Links added on W 15 Apr have red date.

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43 days since 100th known US case. News:

  • 2 days since IHME predicted US peak, 6 days til Ky peak.
  • Observed peaks are likely a false result produced by a lack of increase in testing, and not suggestive of true case rates. The future is expected to be "fat tailed" (highly uncertain). Based on observations in Europe, new case discovery may reach a steady state rather than decreasing in the near-term.
  • Starting in mid-March, partial lockdowns were imposed state by state in the US. Starting in mid-April, there is increasing pressure to lift stay-at-home orders.
  • Senators Bernie Sanders (I-VT), Richard Blumenthal (D-CT), Mark Warner (D-VA) and Doug Jones (D-AL) introduced the Paycheck Security Act, a bill similar to one introduced by Josh Hawley (R-MO), and worth lobbying your senator about. If passed, it will:

cover payroll and benefits for all employees up to $90,000 in salary, and “a portion of fixed operating costs” for businesses affected by the crisis, large and small (unless they have very large cash reserves), for the next six months. Recipients of the grants would not be able to cut pay and benefits for workers and would have to offer previously laid-off workers their job back. There would be restrictions on stock buybacks and dividends (remember big companies would be eligible too), caps on CEO compensation, and protection of collective bargaining agreements. Obviously, by keeping people on payroll, it protects employee health care for those who have it.

Economic numbers:

  • The lockdown-induced global jobs crisis is the deepest and most sudden on record. In four weeks, 22 million unemployment claims were processed in the US. Many more were filed but systems couldn't handle the volume. Furloughs continue.
  • In the first two weeks, 3.5 million workers likely lost their employer-provided health insurance. Tens of thousands of news and healthcare industry workers lost jobs. Finance and insurance did not experience significant job loss.
  • US Congress passed the CARES Act, a $2 trillion relief bill, half the size of the federal budget and the largest relief legislation ever passed by Congress. Multiple Federal Reserve actions preceded and followed it.
  • 80% of the bailout that reached individuals went to people earning more than $1 million/yr, due to a tax break bigger than the airline bailout.
  • $6 trillion got to investors via Federal Reserve vehicles quickly, buoying the stock market.
  • Money to the rest of the population passed through slower and less dependable institutions: the Small Business Association (via loans originated by local banks), unemployment insurance, and IRS checks sent to local banks.
  • The Fed will soon own 3/4 of debt in the US.

Virus numbers:

  • The US is the world's only country to exceed 200,000 (W 1 Apr) and 700,000 (F 17 Apr) confirmed cases.
  • 153,000 global COVID-19 deaths (6% of 2.6 million avg annual respiratory infection deaths). 37,000 deaths in US.
  • Half of US cases and 60% of US deaths are in NYC and its metro area.

Send me links or data you want to see posted.

Live data

Cases, fatalities, recovered, tested:

Treatment and mutual aid:

Policy guidance:

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News watchers

Mutual aid resources

Telework, intimacy without proximity, and big tech

  • My thoughts:
    • Older/poorer people1 are silenced when they don't know how to DM in Slack or unmute themselves in Zoom, when they have bad or no internet, a pay-as-you-go hotspot, or internet only through their phone.
    • Consider slowing pace and bandwidth, promoting more autonomous work. What can be done by phone or dial-in conference-call, email (lists), mail or delivery with groceries, or by newsletter? How do you promote meetings so people don't miss them? School buses are dropping off and picking up class assignments and lunches in many places. How can work, education, or organizing be more distributed and democratic, on and beyond the internet?
    • Older ways of communicating require more work/cost/thought from the sender (eg. using carbon paper or tracing paper and screen printing to produce newsletters). Digital communication requires more (sometimes an overwhelming degree more) from the reciever.
    • Learn about mail art. Send some. Make and mail masks. Send letters. Send mix CDs or homemade crafts. Send money. Think something complex all the way through with a buddy by mail, maybe a buddy in prison, an expert in their field, or a buddy in another country. Mail isn't only for recieving packages.
  • Work, school, family, church, and accessing benefits have become largely computer-mediated. For example, over 90,000 schools in 20 countries moved classes to Zoom videoconferencing.
  • Fight Amazon is the beginning of a conversation about how local retail can fight Amazon (with tech/marketing/logistics) and survive.
    • People can buy books from bookshop.org without hurting local bookstores.
    • Restaurants are considering how to deliver without losing up to 25% to predatory startups like DoorDash or Grubhub (restaurant profit margins are already razor-thin, like 3%-5%).
    • The conversation is an important complement to antitrust law (eg. as applied by the EU, FTC, and DOJ) and to the Senate's proposed Paycheck Security Act.

Benefit programs

  • IRS for getting $1200 economic impact payments direct-deposited (warning: US Bank and other banks may take it under certain circumstances).
  • SNAP for your state, to apply for food stamps.
  • Dept of Labor state resources, including unemployment application, labor rights, and help finding a job. Unemployment insurance has been extended to self-employed and gig workers.
  • NCOA resources for seniors, including Meals on Wheels, transportation assistance, Medicare help, and assistance with utility bills and prescription drug costs.
  • NIDA resources for finding online alcohol/drug recovery support meetings, guidance for treatment providers, and changes to court, jail, and prison policy in your state.
  • SBA page to find a lender eligible to issue a loan under the Paycheck Protection Program (PPP). Terms: The PPP provides 2-year loans of up to $10 million for businesses with under 500 employees. The loan will be forgiven if at least 75% goes to payroll and employees are kept on for at least 8 months. (Currently out of money, F 14 Apr).
  • CFPB information on student loans, mortgage relief, etc.
  • USA.gov coronavirus page for a comprehensive list of government agencies' COVID-19 pages.
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Care and testing

[Care in early stages:] Often the virusemic period is…like a slight cold: malaise…, a slight [subfebrile] temperature…. Take good care of the nasal mucosa and oropharyngeal area…. [Rinse the nasal mucosa with saltwater. Use] non-prescription [decongestants]…. Make a good [saltwater rinse of] the oropharyngeal area behind the uvula…, too…. [Don't just squirt it up your nose, gargle it deep down your throat] and rinse it out…. [Repeat] until you…[have free, unobstructed] airways….

I would advise those people who can afford to buy a nebulizer [aerosol, with ultrasound]. When a cough starts, it is desirable to still apply the medications that we prescribe for patients with bronchial asthma…[like] Berodual, or Ventolin, or Salbutamol…. These drugs improve mucociliary clearance, relieve spasm…. [Use expectorant/mucolytics like] ACC and Fluimucil…. What you can't do is use glucocorticosteroids [like] prednisone, methylprednisolone, dexamethasone, betamethasone [these impair immune response].

[Therapy in later stages:] [If] the cough increases and…there is shortness of breath…: stop, this is a qualitatively different patient…. A cold is one thing…a viral-bacterial pneumonia…is a fundamentally different thing…. We…usually prescribe fourth-generation cephalosporins…in combination with vancomycin [for pneumonia]. This combination is broad, because very quickly there is…a change of gram-positive and gram-negative flora. What immunomodulatory drug to prescribe is a question for scientific research…. In this situation…immunoglobulin…substitution therapy [can help]….

If this situation is not controlled and the disease progresses, then…a person cannot breathe on their own…. Cardiogenic pulmonary edema can be treated with certain medications, [but] this pulmonary edema can only be treated with a mechanical ventilation machine or advanced methods such as extracorporeal hemoxygenation.

What are the tests we need to detect coronavirus infection?
…PCR [polymerase chain reaction] testing, look[s] for viral RNA to determine whether a person is infected…. PCR testing…is now ramping up very, very rapidly in state and local labs as well as in academic medical centers and in the commercial sector…production will grow tremendously. Roche has a machine that will run 1,000 samples at a time. If you go to a commercial lab, they take a swab, they package it, they quite often send it to another facility somewhere else. The turnaround time is typically 72 hours. In that period, it's very, very hard to manage patients and their contacts. It's a nightmare for the healthcare worker.

[Antibody tests are a crucial tool to combat this epidemic.] We need point-of-care tests…you use a finger stick, drop the blood on a small device, and have a readout in 15 minutes. These tests measure antibody response to the virus and are extremely useful. Yet we don't have a single [rapid] test licensed in the US. In China, in South Korea, and in Europe, those tests are used. The manufacturer for this rapid test is producing a million a day.

Study populations in China are reporting significant co-infection rates with COVID-19 and influenza. Yes, you can have both….

Church; Library

Policy, economy, civic virtue

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Rich people getting things, asset prices rising, large military spending and corporations getting bailed out…doesn't…cause the fragility of our system…in any direct and straightforward way. Our system is fragile for specific and direct reasons: we don't have the infrastructure to respond to crises.

We don't have an indefinite mandatorily funded Medicare for All system which quickly and proactively responds to crises. We don't have a legally enforceable right to a job. We don't have government bank accounts for all residents of the United States (but hopefully congress will pass Tlaib's bill and change that). We don't have a system for providing grants to every business in the United States. No amount of money going to where we don't think it should have gone reduces our capacity to create this infrastructure….

This is the largest, fastest economic crisis that has ever happened…. We need 3.5 trillion dollars distributed to households at a minimum — let alone the support system we need for businesses.

Human social institutions are phenomenally durable. We are, as a species, fond of genocide, warlords, raiding, subjugation and misery, but also collective education, storytelling, celebratory feasting, and religion, and it's remarkable how the latter group have historically survived the worst depredations of the former. It seems really crazy to think that oil shortages or inflation would render libraries and fire department fish fries irrelevant, or that hiding out protecting your patch of jerusalem artichokes would somehow be a better use of your one lifetime than fixing roads or otherwise maintaining civic engagement…. Don't give up on other people just yet.

Proud of my state

In the chart below, light bars are tests until 18 March. Dark bars are confirmed cases. (As of 17 Apr, there are 129 confirmed case deaths in Kentucky and 142 in Tennessee. The confirmed case rate is much higher in Tenn, but the risk of death from a confirmed case is higher in Ky).

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Kentucky news

This week's news: rural cases are rising most rapidly in institutionalized populations, people who work in institutions, and counties where many people commute to big cities to do work that can't be done from home. Layoffs of healthcare workers continue, reaching Ky's biggest healthcare systems. Volunteer labor is replacing previously paid care and supply chain jobs.

News aggregated by the Kentucky Office of Rural Health, updated Mondays.

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