"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.
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:
- Spreadsheet of U.S. cases, testing, and fatalities (COVID Tracking Project).
- Map of global cases (mobile version) and US state cases (Center for Systems Science and Engineering, Johns Hopkins).
- Johns Hopkins time-series data visualized: @jburnmurdoch (Financial Times), @profwade_ (University of Illinois), and @aatishb (Princeton).
- Global cases with bar charts (European Centre for Disease Prevention and Control).
Treatment and mutual aid:
- COVID-19 Guide for Hospitalists by Pierre Vo, MD, Hospitalist at Sutter Medical Center (F 20 Mar, updated daily).
- COVID-19 Policies tracks trackers relevant to mutual aid efforts (eg. tenant protections and jail policy).
Policy guidance:
- International/US state projected peak hospital use/peak death rate (Institute for Health Metrics and Evaluation, U. of Washington).
- Search for county-level impact planning data, including charts on each county's proportion of seniors, people with disabilities, people without cars, healthcare resources, and proportion of the population with each type of health insurance.
- State (U.S.): National Governor's Association dashboard of state efforts (updated often).
News watchers
- This week's Kentucky COVID-19 news (updated W 15 Apr).
- David Dayen's COVID-19 daily reports on TAP.
- Morning Shift on Politico updates MWF at 10 AM with labor and employment news.
- Naked Capitalism curates a wealth of links at 9 AM and 2 PM daily.
- Moon of Alabama publishes well-sourced analysis every few days.
- Wolf Street analyzes financial news.
- Nathan Tankus analyzes financial and monetary policy.
- Matt Stoller analyzes monopoly power in the causes of the epidemic and the response to it.
Mutual aid resources
- Caring for someone at home (CDC, W 18 Mar).
- Safety practices for food and supply distribution (Mutual Aid Disaster Relief, W 18 March)
- Where There Is No Doctor: Chapter 3, How to examine a sick person, chapter 4 How to take care of a sick person, chapter 5 Healing without medicines. Useful information in other chapters too, like 11 and 12. (Hesperian, 1992).
- Weekly roundup of labor and rent strikes (NC, M 30 Mar) and live updated Map of labor strikes.
- CDC pattern for sewing cloth masks, now recommended for everyone.
- Care packages provided by South Korean government (a model for mutual aid care packages).
- Tips for First Responders on how to assist seniors, and people with a variety of assistive needs.
- Now joining the fight against coronavirus: The world’s armed rebels, drug cartels and gangs (WP, T 14 Apr).
- Volunteer opportunities in each state.
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.
- Switching.software lists apps that are less compromising to security, patient privacy, and democracy than big tech apps (ie. if you're concerned about critical security flaws in Zoom, try Jitsi Meet).
- The $199 Pinebook Pro is an inexpensive non big tech laptop built like a 13" Macbook Air but without planned obsolescence. High-end $1,000+ ethical laptops are manufactured by System 76 in Colorado and Purism in California.
- The EveryoneOn tool finds free or discount (under $20) broadband plans in your zipcode.
- 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.
Care and testing
- COVID-19 technical guidance and training videos (World Health Organization).
- 68-page Handbook of COVID-19 Prevention and Treatment (First Affiliated Hospital, Zhejiang University School of Medicine).
- Interview with Russian pulmonologist Alexander Chuchalin, head of hospital therapy dept, Pirogov national medical research university (Scott Humor, Su 15 Mar):
[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.
- Technical guidance on testing (World Health Organization), COVID-19 testing (Wikipedia).
- 3 Vans, 6 Coolers, a Plane, a Storm and 2 Labs: A Nasal Swab’s Journey (NYT, M 13 Apr).
- Virologist David Ho Speaks About COVID-19 (F 20 Mar, David Ho at CalTech). On testing:
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.
- Has the Emergency Department Ever Been More Boring -- or Terrifying? (Matt Bivens MD, T 24 Mar):
Study populations in China are reporting significant co-infection rates with COVID-19 and influenza. Yes, you can have both….
Church; Library
- My church's online services, Sundays at 10 AM (Episcopal Church of the Good Shepherd, Lexington KY).
- My dad's online services, Sundays (South Newbury Union Church, New Hampshire). Services are via facebook live. Bible studies are via zoom.
- Announcing the National Emergency Library.
Policy, economy, civic virtue
- @Chris_arnade, Sa, 21 Mar: "The initial spread outside of geographical epicenter has been via global travelers & in global conferences & such…the 1st wave of cases & the reaction to it is mostly from well to do perspective."
- The hammer and the dance (Pueyo, R 19 Mar). A detailed primer on how policy interacts with COVID-19. Very useful for predicting future restrictive policy actions (e.g., when things will reopen), and the reasoning behind current restrictive policy. Solid contrary opinion from Dr. John Ioannidis of Stanford University (Youtube, W 25 Mar).
- Recommended Strategies for Sheriffs and Jails to Respond to the COVID-19 Crisis (Michele Deitch, Senior Lecturer, Lyndon B. Johnson School of Public Affairs, University of Texas at Austin, F 20 Mar).
- Covid-19 and community health (Hesperian, R 5 March)
- World Health Organization situation report (updated daily) and A letter to G20 leaders (Berglöf & Farrar, W 25 Mar).
- CARES Act (H.R.748, Coronavirus Aid, Relief, and Economic Security Act):2 Full text of bill (congress.gov, F 27 Mar); brief summary (Ntnl Governors Assoc, R 26 Mar).
- Were we heading to a recession anyway? (Sa 21 Mar):
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.
- Benediction (Tagonist, 2007):
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).
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.
- State forms task force to deal with COVID-19 in nursing homes and other long-term-care facilities, lists those where coronavirus found (Kentucky Health News, F 10 Apr).
- 141 residents and 86 staff tested positive, and 18 died. 37 new cases of residents, 38 new cases of staff, and two new deaths in the previous 24 hours. Three facilities have been hit "very hard:" Treyton Oak Towers in Louisville, Summit Manor in Columbia and River's Bend Retirement Community in Kuttawa. Full list of affected facilities in article.
- Coronavirus hot spots plague Western Kentucky, Southeast Indiana and Northern Tennessee (Louisville Courier Journal, F 10 Apr).
- Worst in rural Ky is Hopkins County with 87 cases (18/10k), traced to a 15 Mar church revival. Also adjacent Christian County (70 cases, 95/10k), impacting Western State Psychiatric Hospital staff and patients and Jennie Stuart Health, Muhlenberg County, impacting the Green River Correctional Complex, and Jackson County, heavily impacting Jackson Manor, a nursing home. In adjacent states, cases are rising fastest in counties where people commute to work in Cincinnati and Nashville.
- Kentucky EMS responders see call volume decline, prepare for surge (89.3 WFPL, F 10 Apr).
- Calls decreased about 20% in March 2020 vs call volume in March 2019. 10 EMS workers tested positive, 41 are quarantined. PPE is short. Seeking executive order to let people with expired licenses work during predicted surge.
- OHRH to serve as regional hub for coronavirus patients in critical care (Owensboro Times, R 9 Apr).
- Owensboro Health Regional Hospital (in Daviess County in western Ky) will be the regional critical care center for COVID-19 patients, serving 15 rural counties.
- UK Healthcare, Baptist Health temporarily furlough workers in response to the coronavirus (Louisville Courier Journal, R 9 Apr).
- Two of Kentucky's largest health care providers are furloughing an undisclosed number of employees due to suspension of elective surgeries and diagnostic tests. Furloughed employees will be eligable for unemployment when their accrued vacation pay runs out.
- Jennie Stuart lays off 248 employees in response to financial impact of coronavirus (Hoptown Chronicle, W 8 Apr).
- Jennie Stuart Health's hospital is in Hopkinsville, Christian County, southwest Ky. Quorum Health Corp., which owns a subsidiary that provides management services at Jennie Stuart, filed for Chapter 11 bankruptcy. Quorum's subsidiary employs the CEO and CFO of Jennie Stuart.
- Kentucky medical students volunteer on the front lines of state coronavirus response (Louisville Wave 3 News, Sa 11 Apr).
- 700+ volunteers are "monitoring patients' vital signs, making sure their oxygen is stable, making sure their temperature is stable."
- First responders thankful for community support, donations (Central Ky News-Journal, F 10 Apr).
- A nurse who has been required to work from home has sewed 600 masks and given them away, improving her "subpar" sewing skills. Taylor County, home to Campbellsville University, Taylor Regional Hospital has only 30 N95 masks, according to Campbellsville Fire-Rescue Chief.