Showing posts with label Dr. Ashish Jha. Show all posts
Showing posts with label Dr. Ashish Jha. Show all posts

Thursday, July 9, 2020

Controlling This (Likely Airborne) U.S. Covid -19 Disaster May Have To Await Getting Rid Of Trump


"What we're seeing now is worse than 9/11 and the Great Recession combined."  Sarah Nelson, United Flight Attendant, last night on 'All In'.

"Remember when we were locked down and we all said we need to use the time to suppress the virus and put infrastructure in place?   Testing, tracing, ppe and all sorts of stuff to keep it  from coming back.  We did none of those things and then the CDC issued guidelines on how to open safely. But Trump pushed states to ignore those guidelines, which many did and they reopened too early.  And now, what do we have? We have a curve that looks like this. (See graphic).  Unlike anywhere else in the world the virus is on a huge upward spike in this country, setting records with the number of cases nearly every day. ..Cases are increasing in 38 states and we've now seen more deaths than anywhere else in the world.

All the while this president has been focused on one thing, his re-election. He believes that depends on economic growth and getting back to normal. So now Trump, his administration and the Republicans are out pushing the message so hard that 'things are good and we're moving in the right direction'.  But it is so preposterous that even Trump TV is not buying it.


I mean, there's 130,000 people dead, it's a burning garbage fire. A bit hard to sell that message.  Yet, instead of dealing with the virus this president pushed everyone to reopen to get the economy restarted. So jobs could come back and he could get his growth and get re-elected.  And so he is doing the same thing with schools right now.


There are a long list of problems that need to be solved before schools can reopen, but the president is incapable of solving them.  He just wants them to reopen so people can go back to work. So things can be normal and he can get re-elected.  And he actually threatened to cut off funding if they do not reopen. Also today he said he disagreed with the CDC guidelines for opening the schools. So he's now pushing the CDC to override their own guidelines.

So if I've got that right, we don't want the guidance of the nation's top health agency on how to stay safe in a pandemic to be the reason why we don't send our kids to school,  while we're suffering from the worst outbreak in the world.  So the president will tell them to change the guidance.  And it's not the first time he's done that.  He did it back in April and May when he didn't like the CDC reopening guidance for business.  He even pressured governors to ignore that guidance, just like he pushed the CDC to change their guidance for reopening churches. And now he's not happy with the CDC guidance on schools.

So what do you think is going to happen? Look, the last person in the world you can trust right now with the safety of your kids is Donald Trump. Not only because he's willing to change or ignore scientific guidelines to keep Americans safe, or because he's threatening to cut off funds for schools - when what they need is a massive amount of money- for all the changes needed in order to safely bring back students.  

But also because the best laid plans are not going to survive first contact with an outbreak.  This is the fundamental problem for everything right now, from elementary school to the NBA.  Other countries suppressed the virus and kept it suppressed. We NEVER did that!  And now we're trying to figure out how to live in a burning building, as opposed to putting the fire out. It's not going to work."


-  Chris Hayes intro on 'All In' last night


All you need to know about the metastasizing pandemic nightmare we find ourselves in can be gleaned from Chris Hayes' superb summary - from his introductory remarks on All In- in tandem wit the WSJ graphic above. Look at it, interpret it, read Hayes' words... and weep.  This is the gutter stage of hopelessness and incompetent response we're been brought to by Trump the  White Trash Traitor.   An infernal maggot, who as Chris Hayes has observed, is solely occupied with his re-election not the lives he was supposed to protect on taking his oath of his office. Putting all the unsavory aspects together it now appears we may not be able to get control of this virus until we get rid of the human virus - Trump.

It now appears the virus wreaking havoc is airborne and, if so, it means even more stringent procedures will be needed if the U.S. is to return to any kind of normality.  It also means we will have to get rid of Trump - the new virus ally - as soon as feasible.  Chris Hayes summary of Trump's  total feckless response and aggression in the cause of making more virus cases- makes that abundantly clear.  Put simply, we cannot expect the ship of state (the U.S.)to be steered through this Covid storm if the captain is drunk, demented and devoid of any moral character.

Some of the recent headlines that indicates Trump is part of the problem, not the solution:

WSJ, July 8, p. A3: 'White House Wants Classes To Open In Fall'

WSJ, July 8, p. A1, 'Trump To Pull U.S. Out Of WHO'

Washington Post:

Retail workers are being pulled into the latest culture war: Getting customers to wear masks

Mixed messaging and politicization have turned a public health safeguard into a lightning-rod issue. As a result, workers have been berated, even assaulted, by aggressive anti-maskers.

Trump Criticizes CDC Guidelines for Reopening Schools - WSJ



The preceding is a sampling of how the "great" leader is working at cross purposes to the welfare of the American people amidst this once -in -a -century pandemic. Faced with a severe test of rationality and intellect, Trump has failed miserably, even telling the atrocious lie that "ninety-nine percent of cases are harmless".  As if dealing with him alone is bad enough, we must now also deal with his verminous, brain-fucked followers as the WaPo piece about aggression by anti-maskers reveals. And Trump set these loons and baboons to such actions, i.e. beating up workers -even some health, frontline workers - because Trump shunned masks as "unmanly' and these mindless minions do as well.   

This is why Dr. Joseph Varon at Houston's United Memorial Medical Center decided to allow direct filming of scenes inside an ICU - as televised on Maddow last night. In an interview later he explained he hoped by actually seeing these scenes of what front line medical staff are doing, people will drop the infernal (and idiotic) belief that it's all a "hoax" or "Plandemic".  Yes, the scenes were intense and they will surely be able to achieve that end, but only for those with IQs over 100.  Meanwhile, masked patrons - on seeing the unmasked scofflaws running amuck at assorted businesses - may simply decide to stop patronizing them.  So you can pretty well chalk up many more Chapter 11 filings, and more economic devastation.  After all, in the end any economy prospers only at the whim of public confidence.

  Clearly then, with his mixed messaging (or none at all) we cannot afford to have a maggot of the malignant dimensions of Trump steering us out of the morass we're in - and all because of him.  As Chris Hayes said last night: "This is not a test you can get anyone else to sit for you."

Indeed, and especially given this test - which has now seen national failure on all fronts - as hospitals from Houston to Miami are overrun (WSJ, 'Coronavirus Cases Are Surging Amid Strains On Hospitals', June 30), and supplies again have to be rationed as medical workers burn out.  Where is Trump? Making every dimension worse!  This is particularly unsettling given we now have evidence that this virus is of an airborne variety which means rates of transmission are likely to go ever higher if we don't get our act together, and that includes testing and contact tracing. In regard to the former, we are currently doing 700,000 tests a day and it should be 3-4 million a day according to Dr. Ashish Jha of Harvard's School of Global Health.  Worse, some people are having to wait in line up to 8 hours to get a test, and then up to 7 days or more to get the result. This makes the test all but useless because in the interim said person can be reinfected.

What about the airborne aspect?  According to demonstrations using sophisticated videos tracking a sneeze, cough or loud talk,  the airborne droplets could spread as far as 9 feet in a closed space and last  an average of 1.5 minutes and up to 12 minutes.   See e.g.

https://www.youtube.com/watch?v=cDE5J7og_xM

And:

https://www.nytimes.com/interactive/2020/04/14/science/coronavirus-transmission-cough-6-feet-ar-ul.html

The preceding  videos and demonstrations may help to explain the exponential increase in cases since Memorial Day and now the 4th (and again, I remind readers it's the cases with sick patients needing special care that will overrun hospital ICUs, not deaths) .  Indeed, any large gathering for any reason will be subject to the virus particles in droplets shot out by super spreaders, talking loud, laughing, or coughing - who are not visibly ill themselves.

The separation between what is referred to as ‘airborne spread’ and ‘droplet spread’ is really a spectrum,” especially when talking about relatively small distances, says Joshua Santarpia, an associate professor of pathology and microbiology at the University of Nebraska Medical Center.  Airborne spread has also been hypothesized for other deadly coronaviruses, including the ones that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). A handful of studies suggest the new coronavirus, SARS-CoV-2, can exist as an aerosol in health care settings.  But all the incoming evidence now indicates this is real and the latest aspect we need to treat seriously.


To put it bluntly, the coronavirus is finding new victims worldwide, in bars and restaurants, offices, markets and casinos, giving rise to frightening clusters of infection that increasingly confirm what many scientists have been saying for months: The virus lingers in the air indoors, infecting those nearby.

If airborne transmission is a significant factor in the pandemic, especially in crowded spaces with poor ventilation, the consequences for containment will be significant. Masks may be needed indoors, even in socially-distant settings. Health care workers may need N95 masks that filter out even the smallest respiratory droplets as they care for coronavirus patients.

Ventilation systems in schools, nursing homes, residences and businesses will need to minimize recirculating air and add powerful new  (HEPA) filters. Ultraviolet lights may be needed to kill viral particles floating in tiny droplets indoors.  All this will cost money and Trump and his Repuke enablers have no intention of providing any.

In an open letter last week to the W.H.O., 239 scientists in 32 countries have outlined the evidence showing that smaller particles can infect people, and are calling for the agency to revise its recommendations. The researchers plan to publish their letter in a scientific journal, and by then perhaps the WHO will accept the proof.

What's the WHO's problem? Mainly too little funding coupled with too large a portfolio and a tendency to operate in glaciation mode when new evidence emerges (Which can be counterproductive in a pandemic).  The infection prevention and control committee in particular, is bound by a rigid and overly medicalized view of scientific evidence, is slow and risk-averse in updating its guidance and allows a few conservative voices to shout down dissent.  

What all this means also is that Trump in his ignorance and yen to put re-election above all else, is actively trying to kill tens of thousands more of our countrymen with his reckless directives, pressures and autocratic B.S.  Like ordering the CDC to revise its rules for reopening schools, as well as pushing public schools to reopen without proper systems in place.  Is there a way to rationally get through this waking nightmare without killing ourselves and the economy too? Yes, and the basis was given in a superb WSJ piece yesterday, e.g.

https://www.wsj.com/articles/how-japan-beat-coronavirus-without-lockdowns-11594163172

Noting how this was achieved by focus on contact tracing (specifically retrospective tracing) and 'cluster busting'.. However, to implement this plan requires leaders of intelligence, courage and skill which alas, the current crop in power (starting at the top with Trump) lack. Hence, I do not see any light at the end of the tunnel until we first dispense with Donald Trump.

See Also:

And:

Surge in hospitalizations strains hospitals in several states


And:

And:





Excerpt:



Donald Trump thinks his voters are morons. This universal truth was once again demonstrated this week by a Facebook ad working Trump's new statue-oriented campaign strategy. The ad declared, "WE WILL PROTECT THIS" and featured a photo of ... no, not some racist-loser Confederate general astride a horse but "Cristo Redentor," the famous statue of Jesus Christ that sits atop Mount Corcovado in Rio de Janeiro, which, for those keeping track, is not in the United States but in Brazil, a sovereign nation in a different continent.

It's small story in the grand scheme of things, but one that illustrates yet again that Trump doesn't really see Republican voters or politicians as fellow travelers, allies or even really as a "base" to whom he owes fealty. Trump sees Republicans primarily as marks, to be fleeced for all they're worth and then abandoned the second he sees no value in them. Trump's burning hatred for any American who didn't vote for him is well documented, but just as true and just as disturbing is his utter disregard for the lives or well-being of people who did support him, and continue to do so.

Tuesday, April 28, 2020

"Quarantine Fatigue" - The Latest Meme Hatched By FOX's Coronavirus Truthers? You Bet!


Numskulls & Shutdown "fatigued" wimps crowding Huntington Beach Sunday, even as the virus lurks among them - ready to roar into more overrun ERs. 
Even bigger crowd of numskulls and quarantine wimps at Newport Beach, CA, eager to prove Darwinian theory's culling of the dumbest and most reckless.
"The whole point of the shutdown was to buy ourselves time so we could do it right the second time after we muffed the first response. It's not only important to avoid opening up too aggressively but  if you don't have a good amount of testing, tracing and isolation, you won't be able to keep infected people away from susceptible people. The basic biology then is the infection is just going to take off again.  So unless the biology has changed we're going to end up in the same place and that is what we're all worried about."  - Dr. Ashish Jha,  Professor of Global Health, Harvard University, on 'All In' Monday night

"Despite Donald "Why Not Shoot Up Lysol?" Trump's unsubtle yearning to "reopen" the economy (which won't work) and let the novel coronavirus run rampant, a new poll from the Washington Post and the University of Maryland shows that strong majorities of Americans think that's a really stupid idea. Eight out of ten Americans took one look at the yahoos protesting the lockdowns in various state capitals and said, nah, living is more important than being able to order that 400-calorie vanilla-hazelnut frappuccino inside the Starbucks,:  -  Amanda Marcotte, smirkingchimp.com blog


Have  the last remaining sane and intelligent citizens finally been converted into morons by the raging Trumpie protesters?  That is what we initially considered upon watching the scenes of crowded beaches on the nightly (NBC) news yesterday.  An hour or so later, we were gratified -when Rachel Maddow announced on her MSNBC show: "The vast majority of Americans remain committed to shelter in place guidelines".   New polling appears to support this vote for common sense,, but one wonders how long it will last.   

Seeing the crawlers on the earlier newscast ("Quarantine Fatigue strikes Americans") was definitely not encouraging. to future confidence that citizens will remain in shutdown mode.   But then on further inspection it appears the term evidently originated within the rat warrens of the "Coronavirus Truthers" hunkered down at FOX News.  (See e.g.''Rightwing Media Spreading Epidemic of Misinformation' in one of the links at end of this post)
 Despite the FOX trolls, we ought to all, at least the higher IQ subset of the population, be able to agree on some general propositions:
1) The SARS- Cov-2 virus has spread as an unseen stealth agent among us, causing illness and death- the various forms of which (e.g. strokes in the young) are still not widely understood.
2) Despite the yen to reopen to business, at least 31 states   according to Harvard researchers--have still not met even minimal standards of testing.  These states will have to significantly step up testing to even mildly loosen 'stay at home' orders.  As Harvard Prof. Ashish Jha noted on All In last night, barely 2% testing is being done per day - which needs to be 10-20 times higher.
3) Given we have a vast "naive" population (with no immunity) and no vaccine, or treatment that works, it is pie-eyed foolish in the extreme to rush to reopen unless vastly more tests are run - up to 500,000 per day. Minus that testing, shutdowns are the only protection for a vulnerable populace (elderly, those with severe health issues).
None of this ought to be rocket science, so one is left to wonder why there is this "quarantine fatigue".  Are Americans such pathetic and entitled wimps an whiners that can't at least be content to remain locked down until June? For the sake of our hospitals, heroic health workers- many at the end of their tether?  Or must we again be reminded of Trauma nurse Amy Pacholk's words:
"All I keep hearing is that the curve is flattening, the curve is flattening. So that may be true but all the ICUs are still full. The sickest are still there. People are waiting to be intubated.  We're full we can't handle anything more. We can't open this country. If you want to live you stay home. My God,  don't open up this country. It needs to be closed until at least June."
Well, no, since polls show up to 8 in 10 Americans are not prepared to go out and have nails done, or eat out  - even if every burg in every state re-openend. The smart people know it is a fool's errand until the transmission rate is 1.0 or less. So, in the end we must deduce all those clogging beaches in the images are victims of FOX News and its grievance paradigm - or propaganda machine (also replicated in the WSJ's Op-ed pages)

Given we know the virus is a stealth assailant, it is highly plausible that amidst the tens of thousands  of  FOX-swallowers packing Florida and California beaches Sunday there may well have been lesser thousands of infected roaming amidst the unknowing masses. As an epidemiologist friend of ours at the Queen Elizabeth Hospital in Barbados put it:  "If any one of those beaches in the U.S. had 10,000 beach goers, you can be sure at least 1,000 were Covid-infected.  If the R nought is 3.0 that means each one of the infected could have spread the virus to 3 others, and each of those to three others in turn, i.e. 9 - and so on."
As I've written before in other posts, no one fancies an ongoing shutdown. Hell, I'd like nothing better than to get back to reading the papers over a sausage croissanwich, coffee and hash browns at  the nearest BK, but I can't.  Our Gov. Jared Polis has made it clear that even if some businesses can open seniors have to remain in lockdown mode for the time being. So no appearing at any packed venues, or inside dining. So, I am content just to pick up a bagel a few days a week at the nearby bagel place.
As the NBC News showed, tens of thousands of people packed southern California beaches over the weekend, reigniting fears that large crowds in public spaces could reverse progress on containing Covid-19 in the U.S.  Photos of the crowds in Newport Beach, Orange county, during the weekend  rightly sparked intense backlash and comparisons with Florida, where images of beachgoers raised alarms about the state’s coronavirus strategy. In recent days, beach and park reopenings have also prompted debates and public health concerns in Texas, Georgia, Mississippi, South Carolina and other regions looking to re-emerge from lockdowns.
But none of these impatient fools get that the virus is an unseen (stealth) killer and disabler) and it can be infecting the most healthy looking person. That person can spread it to you just by talking at close distance.  This is why California’s governor Gavin Newsom chastised those who crowded the beaches, saying “this virus doesn’t take the weekends off”.  No, and it doesn't pay any attention to human circulated memes like "the Covid can't take the heat!"
As Newsome went on to say:
“This virus doesn’t go home because it’s a beautiful, sunny day along our coast,” 

The governor, who last week urged beach-goers to practice physical distancing, added at his daily news briefing yesterday:

“We can’t see the images like we saw, particularly on Saturday in Newport Beach and elsewhere,”
As usual there is no unified plan.  Local officials in Los Angeles and the surrounding region have been deeply divided on the merits of allowing beach visitors. Many popular beaches have remained fully closed to the public due to Covid-19, though a handful have taken steps to permit visitors in a limited capacity while adopting a range of restrictions, enforcement plans and recommendations.
California’s statewide shelter-in-place order remains in effect, and police at the open Orange county beaches have attempted to enforce distancing rules. But there have been growing concerns over the weekend that the crowds were too dense, and the Newport Beach city council is now considering closing the beaches for the next three weekends or possibly blocking roads to the most popular destinations.
At Newport Beach, where temperatures were close to 90F (32 C), residents compared weekend crowds to the Fourth of July holiday, and lifeguards reminded people to stay apart if they were in groups of six or more. Police officials told the Los Angeles Times the department did not issue any citations for violations of stay-at-home orders.
Neighboring Huntington Beach in Orange county also saw big gatherings, despite the closure of parking lots along the highway. Sitting on a bench by the beach, Robin Ford surveyed the crush of visitors with concern.  Ford told the Orange County Register.:
“Unless all these people are in one household, it does look like they are not social distancing,”  
Meanwhile, Los Angeles city and county beaches, trails and playgrounds were closed, and officers on horseback were patrolling those areas to enforce social distancing rules. The city also opened cooling centers for people who might not be able to survive the heat wave at home, according to LA mayor, Eric Garcetti.
Barbara Ferrer, the head of the LA county health department, urged LA residents not to crowd the neighboring beaches that remain open.
Further north in California, police in Pacific Grove said they had to close the picturesque Lovers Point park and beach at the southern end of Monterey Bay due to lack of social distancing.
The question of beach access is likely to become more contentious as the U.S. heads into summer. Some experts have argued that governments should find ways to allow people to visit beaches while strongly encouraging distancing and other safety measures.

This isn't a remote issue in Barbados which has enforced a 24 hour lockdown now for weeks, with penalties of up to a year in prison and $50,000 fine for scofflaws.   See e.g.

Janice's take as usual is no nonsense on the comparison:  "Bajans have more sense than Americans and more self-discipline. They don't whine and cry and act like brats if they don't get their way.  They sacrifice for the greater good."

But not only Bajans.  75 years ago Americans also self-sacrificed with limited gas, food rationing and other curfew limits during World War II.  But then  our people were tougher, more resilient and not so entitled - i.e. made soft by too many conveniences and a social media environment that weakened brains.  They - like my parents - put on their big boy pants and toughed it out for YEARS, not just months.   Moreover, the sacrifice was uniform and universal across the nation, not just practiced in certain regions, states. Contrast that with the nonsense we behold now, including a moron president who actually believes injecting disinfectant like Lysol can be a treatment. (Or embedding a UV light into the body).  Compare Trump to FDR who was a real leader during the trying times of the Second World War and you have all you need to know about how and why this nation has gone off the path of being a beacon for the rest of the world.  And will likely cease to be the world's foremost superpower within the next ten years.

As of Monday, California has had 43,464 positive cases and 1,755 deaths..  Here in Colorado we have over 13,500 cases and nearly 600 deaths. Look for those numbers to explode as the morons  - such as shown in the images- keep having their tantrums about "quarantine fatigue". and claiming (as the Gridlock nuts are here in Colo., e.g. 'Inside State's Growing Shutdown Movement' Denver Post, p. 1A yesterday) they have a god-given right to "liberate" themselves.   Just take a gander at one of the quotes (ibid.) out of the mouth of a 'Gridlock'  protest leader  (and Coronavirus truther) named Joel Oltman from Castle Pines:

"If I choose the wrong way and it ends up killing me, I'm sorry but I made a choice.  I made an educated choice affecting me while respecting that other people deserve the right to feel safe."
Sounds all fine and noble, but he's totally oblivious to the fact that if  he's a stealth  (asymptomatic) carrier he can spread the virus to possibly hundreds of others.   How much "respect " is that for the rights of others to feel safe?  Of course, it goes without saying the guy is a Repuke.  As I said, all entitlement, no sense of sacrifice for the common good.  

See Also:



by Amanda Marcotte | April 28, 2020 - 7:15am | permalink
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by Bill Berkowitz | April 29, 2020 - 5:39am | permalink

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by Bill Berkowitz | April 26, 2020 - 5:31am | permalink