Yves here. I trust readers will not devote energy to debating the author’s vigorous criticism of Trump. It is true that Trump has provided just about the worst leadership possible on Covid-19, and if he loses next fall, that will be the biggest reason why. However, public health is a state and local matter. So even though Trump has made himself the biggest owner of the US Covid-19 train wreck by putting himself out in front of it, the reality is that this disaster had many parents.
Living in red state Alabama, I am not convinced that things would have been much different here with President Hillary. A large segment of the population, and it included members of the upper middle class, are anti-vax, skeptical of science and government, and are temperamentally “Don’t tell me what to do” libertarians. Blue state New York closed public schools only because teachers threatened to walk out. Cuomo initially opposed Di Blasio’s plans to shut down all but essential businesses. And those red states that hadn’t seen much in the way of infection could blame the results on the coasts on furriners and public transportation and too many people living in apartments.
In other words, it’s quite plausible that Republican-dominates states would have behaved more or less the same way even with a Democratic administration. The big difference on the health response could have been a much earlier pivot to masks, including browbeating newscasters to wear them.
By Roy Poses, MD, Clinical Associate Professor of Medicine at Brown University, and the President of FIRM – the Foundation for Integrity and Responsibility in Medicine. Originally published at Health Care Renewal
Introduction: Health Care Professionals Vilified After They Caution Against Premature Reopening During the Pandemic
As we discussed in April, 2020, after the curve of the coronavirus pandemic began to flatten in the first heavily affected areas in the northeast US, supposedly popular protests, broke out calling for the end of onerous social distancing measures, ostensibly to let the economy recover. President Trump then jumped in, calling for the “liberation” of multiple states from these measures.
Trump wrote: ‘LIBERATE MINNESOTA’ and then, ‘LIBERATE MICHIGAN’ and then, ‘LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!’
As these protests multiplied, health care professionals responded by staging counter-protests to warn people about the danger of premature “reopening.” For their pains, they were often vilified. In particular, we noted that one brave ICU nurse silently stood at the capitol of Arizona.
‘She would spend the next few hours standing silent, her facial expressions partly hidden behind her medical mask. Her body standing rigid in surgical scrubs.’
For that, she was insulted, scorned and generally screamed at by flag-waving protesters, some of whom carried signs about an overblown crisis and a ‘pretend-demic’.
The state Republican chairwoman even accused her of one of the “actors playing parts.”
In that and a later post we noted how these “reopening” protests were egged on by right-wing politicians, including President Trump himself; infiltrated by extreme right-wing groups, including armed militias; accompanied by threats of death and violence to counter-protesters and anyone preaching restraint; and organized and funded by right-wing political organizations, often allied with Trump, and often funded by plutocrats. It was unclear whether more than a small minority of the protesters were truly concerned about the economic costs of delaying reopening. Rather, they seemed mainly about pushing a political agenda which had little to do with public health or health care.
Was this any way to make health care and public health policy? Nonetheless, these protests, which were orders of magnitude smaller than those which later broke out after the death of George Floyd, and pressure from Trump et al seemed to induce Republican state leaders to reopen early and quickly.
Now the health care professionals’ warning are shown to be valid. Consider the case of Arizona.
Health Care Professionals Inundated as Coronavirus Surges
As documented by the Washington Post on June 25, 2020:
Arizona has emerged as an epicenter of the early summer coronavirus crisis as the outbreak has expanded, flaring across new parts of the country and, notably, infecting more young people.
Maricopa County, which includes Phoenix, is recording as many as 2,000 cases a day, ‘eclipsing the New York City boroughs even on their worst days,’ warned a Wednesday brief by disease trackers at Children’s Hospital of Philadelphia, which observed, ‘Arizona has lost control of the epidemic.’
This came after Arizona became the poster child for early and quick reopening. “The state’s cases began rising dramatically about May 25, 10 days after Ducey allowed the state’s stay-at-home order to expire….” said a local public health expert.
The Republican Governor seemed to be reacting directly to Trump’s push to “liberate” states:
Trump, who was urging governors to jump-start their economies, was coming to Arizona to tour a Honeywell plant and to convene a discussion about issues facing Native Americans.
The day before the president’s visit, Ducey announced plans to accelerate the reopening of his state’s economy, lifting restrictions on salons and barbershops and allowing restaurants to resume dine-in service. A chart displaying the number of new cases, which did not show the 14-day decline recommended by White House guidelines, ‘really doesn’t tell you much,’ Ducey said at his May 4 news conference.
In the Washington Post’s summary:
At critical junctures, blunders by top officials undermined faith in the data purportedly driving decision-making, according to experts monitoring Arizona’s response. And when forbearance was most required, as the state began to reopen despite continued community transmission, an abrupt and uniform approach — without transparent benchmarks or latitude for stricken areas to hold back — led large parts of the public to believe the pandemic was over.
Stories coming out of Arizona are starting to resemble those that came out of New York at its peak of pandemic induced misery. On June 24, 2020, the Arizona Republic published a vivid anecdote of yet another person who scoffed at the virus, and then became ill.
Jimmy Flores, 30, met up with his close friends at the bars in Scottsdale on a Saturday night in June.
‘This bar was super packed. I was kind of concerned because I was like, man, everyone’s tight, they have limited cups. Some people were sharing drinks, it was weird,’ said Flores, who also shared drinks with his friends at a bar in north Scottsdale that night.
He ended up hospitalized for over a week. He “was discharged home Monday, but breathing is still a challenge and he is taking multiple medications.” He started posting about his case on Facebook, but his friends thought he was being “political.” Now he says, “I really care about people not going through this and that they have to take this seriously because it really hurts.”
[Old Town, Scottsdale in happier times]
And the New York Times published an op-ed on June 26, 2020 from an emergency department physician sadly mirroring the tales of despair coming out of New York only a few months ago.
Patients are evaluated, stabilized and admitted to an inpatient medical team. But many admitted patients remain in the emergency department, ‘boarding’ while awaiting transfer to the hospital wards because there are no more intensive-care beds available in the hospital or there is insufficient staff to care for them in the beds that are available.
Because of that, far fewer emergency department beds are availablefor people with non-Covid-19 health conditions and medical emergencies. So sick people wait for an emergency department bed to become available. The surge in cases night after night shows no sign of slowing and it is terrifying.
The media has reported how few hospital beds are available in the state. But even if we had enough beds, it wouldn’t matter if our staff wasn’t physically and emotionally well enough to attend to the people occupying those beds. Many hospital systems have chosen to furlough staff and tighten belts even as health care teams were beginning to feel the psychological strain of the pandemic. Physicians are a small part of our clinical care teams. We are profoundly limited in what we can do without the support of nurses, paramedics, emergency and intensive-care technicians, respiratory therapists, radiology technicians, environmental services workers, social workers, case managers, unit coordinators, clinical pharmacists and others.
Health care workers are exhausted. Staffing shortages and increasing fatigue are the new normal for emergency departments, intensive-care units and Covid-19 units, and across hospital wards. Staffing levels are being set with an emphasis on ‘productivity’ as determined by financial calculations rather than clinical severity or the complex needs of our patients and the community we serve.
Finally,
Emergency medical and critical-care team members are canaries in the coal mine. When we are understaffed and overworked, when there is no staff to triage patients, when more and more patients are piling up at the emergency department door, the system breaks down, then people break down. You can borrow ventilators (until you can’t) and make more personal protective equipment (we hope). You cannot magically produce more nurses, respiratory therapists, physicians or other professionals.
And things are getting worse every single day. The Arizona Republic reported June 28, 2020:
Arizona cases of COVID-19, the disease caused by the new coronavirus, increased by more than 3,850 cases on Sunday — the highest number of cases in a single day, according to data released by the Arizona Department of Health Services.
Arizona’s total identified cases rose to 73,908 on Sunday with 1,588 known deaths, according to the most recent state figures. That’s an increase of 3,857 confirmed cases, or 5.5%, since Saturday.
Inpatients with suspected or confirmed COVID-19 and ventilator and ICU bed use again hit record highs Saturday, while emergency department visits dropped from Thursday’s record of 1,249, according to the daily report from the Arizona Department of Health Services.
As of Saturday, 85% of current inpatient beds and 87% of ICU beds were in use for COVID-19 and other patients.
But it did not have to happen. Had Arizona’s political leadership paid attention to the message of one brave ICU nurse back in April, or numerous messages from other health care and public health professionals, had they resisted President Trump’s constant exhortations that the economy comes first, and that coronavirus is not a big problem, the pandemic would likely have been better controlled in Arizona, and elsewhere, than is actually the case.
So do cry for those in Arizona.
Summary
Traditionally, political leaders have trusted health policy experts, and health care and public health professionals to help them make health policy. In the past, political leaders listened to such experts and professionals when planning for epidemics and pandemics, and addressing new health and public health emergencies.
However, in our new (ab)normal, many political leaders follow the lead of the current president, Donald Trump, and his party. They seem unworried that the president has a record of peddling lies and disinformation (look here), and has a record of conflicts of interest and corruption goes far beyond any conceivable precedent (look here). They accept Trump’s multiple assurances that the coronavirus pandemic is either a hoax, or “fake news,” or inconsequential, or fading away (look here). They shrug when Trump scoffs at public health measures meant to slow viral spread, such as face masks (look here). They put extreme politics, ideology, and sectarianism (look here) ahead of science, logic, and the warnings of experts.
So, health care professionals trying to uphold their mission to put patients’ and the public’s health first have stumbled into a political conflict far beyond anything we have seen in our lifetimes. Upholding the mission is proving to be difficult, unpleasant, and now dangerous. The danger is not just from the virus, but from our fellow humans putting their politics and ideology ahead of all else. That does not make the mission any less important. Innocent lives are still hanging in the balance.
We could retreat in fear from the powerful opposition we have stirred up. That would allow complete politicization of the management of the coronavirus pandemic, doubtless leading to even more disease and death (and ironically, even worse economic disruption). Retreating would betray our patients and make a mockery of our mission. Or we could persist. What will it be?
“And if not now, when?”
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Welp, the democrats in congress could provide some sort of leadership. Tired of hearing how they have no power. Pelosi? Schumer? where the hell are they.
They don’t have power. The administration sets this agenda and they screwed up when they didn’t put out strict mitigation protocols….well a surge of lockdowns began.
Controlling ½ of Congress is power as well as a great pulpit. Pelosi, with Schumer’s assistance in the Senate, could make all kinds of noise, attempt to work with Republicans besides McConnell, propose legislation, even send something to the Senate. It probably wouldn’t work, but it might. It’s called politicking and campaigning with optics sometimes more important than the immediate votes lined up.
All they can do is make noise. Nothing gets to be law unless the Senate votes for it too. In dangerous times, I would prefer the party of sanity attempt to wisely trying to coop the other side than use it for political stunts.
You mean like taking a knee wearing kente cloth masks?
Sorry unless it means serving the same masters as most of the Republicans serve (see massive bailout for the wealthy with a few crumbs for the peons in the CARES Act) all we have gotten from Pelosi and Schumer is political stunts most particularly the impeachment.
In other words, the Trumpers now claim the Democrats are at fault for not trying hard enough to overcome the GOP’s and Trump’s stupidity. That is what is known as “right-wing logic.”
Democrats control the House of Representatives, in which parliamentary control is absolute. This gives House Democrats unilateral power of the purse, since all spending bills must originate there.
So if they aren’t *using* that power as leverage to pass other things for the people, that really should tell you something: they don’t *want* to and they don’t give a rat about the people. All that hogwash about procedure is just to fool the chumps.
The House majority has (mostly) absolute (parliamentary) control of House procedures, yes. But even spending Bills need to be voted on in the Senate and signed by the President to become law. Remember any government shut-downs? They are usually caused by Congressional delay or lack of Presidential signature.
Also, the party of small government and breaking government probably will be amused to be “held hostage” by the power of the purse. The problem here is that Trump doesn’t have a policy agenda, except maybe more tax cuts. Democratic enforced spending cuts just play into his hands and he can blame the Democrats for them.
> They don’t have power
That’s what they always say. In fact, the House Democrats:
1) Originate revenue bills
2) Can hold hearings; they have subpoena power
3) Could, with a modicum of intellectual and party discipline, have staked out a position on a “plan,” a baseline (“narrative”) against which Trump’s performance could be measured, and
4) Used their assets in the press and allies in the intelligence community to make that plan a baseline. All this could have been done by March. Instead, what we have is Biden about to make a speech, four months late, about how Orange Man bad.
The contrast between the energy and focus — even now! — devoted by liberal Democrats to RussiaGate, as opposed to #COVID-19, is just stunning. With RussiaGate, there’s a clear (if deranged) narrative, constantly reinforced in the press. There’s no equivalent with the virus. It’s amazing.
So, the Democrats have plenty of power. They simply choose not to exercise it. Instead, we get Cuomogasms, Faucigasms, etc., despite the performance of the one being miserable, and the lying of the other (on masks) deplorable.
Got it. It’s all the Democrats’ fault for not trying hard enough to overcome GOP’s and Trump’s ignorance.
So it’s not really the Republicans’ fault. They can’t be blamed for being what they are.
I love the logic.
McConnell is focused on transforming the federal judiciary instead, with the Senate confirming over 150 of Trump’s nominees to the federal bench. And he has refused to bring Democratic bills to the Senate floor in part to protect vulnerable Republican senators from having to take tough votes that could divide the GOP ahead of the 2020 election.
https://www.vox.com/2019/11/29/20977735/how-many-bills-passed-house-democrats-trump
Thank you. Watching this thread unfold was starting to irritate me. Now I will shut up again.
My sister is finishing her doctorate in physical therapy in AZ, and is now in the middle of clinicals. She’s had at least one confirmed covid exposure at work, and neither the clinic nor the school (Franklin Pierce) seemed particularly concerned about it and pressured her to return to work, even though they didn’t help her find testing. My father had to wire her money from Germany (he’s an american expat) to pay out of pocket for a test, and still then she had to wait in her car for hours. It’s likely that she’ll have to repeat that course of action over and over again. She can’t take a leave of absence from the program without paying through the nose in extra tuition, which would only compile the debt she’s already in. On top of this, she is also helping care for her fiance’s three children, as their mother is another essential healthcare worker.
I don’t know how she’s going to get out of the next few months without getting Covid.
My sister is in her mid 30s and is otherwise healthy. She loves helping people and was looking forward to devoting her life to exactly that. Not only are the institutions tasked with training her exploiting her financially, they’re not even pretending to protect her.
serfin’ USA
Good one and so effing true.
Welcome to the corporatization of America. Neoliberalism at its finest – ie. the monetization of everything. Its whats defines America now.
MCB, things should be better for your sister. She is doing great work and I hope she stays well.
I have been following the progress of the virus in your part of the country because my son and his wife are presently residing in the state next door and just recently New Mexico began to get more cases. They both were working in New York City and, when things became bad there, they decided to travel to NM in the middle of March where they felt they could work safely from home. She comes from NM.
I, too, worry about them every day because of what is happening in the US.
> She can’t take a leave of absence from the program without paying through the nose in extra tuition, which would only compile the debt she’s already in.
So you’re saying the system works?
Dr. Poses decries the politicization of the disease by attacking politicians. Yawn.
As Lambert has noted the health authorities bear some responsibility for public skepticism. Here’s just a partial list of errors and untruths:
– no need to limit air travel from China (WHO)
– too early to call it a pandemic (WHO, for weeks after it clearly was)
– no evidence that COVID spreads asympotomatically (WHO and various US health depts)
– you can protect yourself by washing your hands (local health authorities)
– masks are useless and may be harmful (WHO, US health authorities, including St Fauci himself)
– Chloroquinine is dangerous even though used for many years to treat other illnesses (based on data that proved to be fraudulent and sourced from a mysterious group with ties to the pharmaceutical industry)
I’m sure there are many more examples. In many cases these were probably honest errors due to lack of complete information but still were pronounced Ex cathedra with complete certainty. In some (especially the mask debacle) they were “noble lies”, a particularly poor strategy if you want to preserve your credibility.
Maybe an even bigger factor is the environment of media misinformation and narrative control that surrounds us every day. WMD in Iraq, Russiagate, now this Russian bounty story – it’s not at all surprising that people don’t know what to believe and therefore choose to be believe no one and nothing unless confirmed by their own experience. It’s not just COVID. I often ran into similar skepticism when canvassing for Sanders before the primary.
So are you wearing a mask when in public? Avoiding congregating indoors or out ? Have a spray bottle of 70% ethyl alcohol? Taking the demonstrably ineffective HCQ? Then there is advancement toward a solution to the pandemic.
I think there is a bigger issue than initial misinformation. Nobody – NOBODY – knows the future and much of the early information was based on drawing parallels to other diseases and what were thought to be common-sense estimates.
However, as the disease has progressed more was learned about it. Some countries reacted to the facts, did the necessary things and between government policy and citizen cooperation have saved the lives of many of their citizens.
Other countries (yes, we all know who) acted as if they really believed bullshit and bravado could limit a human disease. People there believed that their whims were worth other peoples’ lives. You can look at the graphs and see how that is working.
There is no country on Earth where people care less about their fellow citizens than the US of A.
That’s probably a big factor. Neoliberalism is all about markets, invisible hands and the supposedly positive impact of selfishness. Now suddenly the elites have gone all Bernie Sanders “not me, us”, expecting communal solidarity and self-sacrifice to appear. in response to the pandemic. Instead they are reaping the whirlwind.
Except they lied about the masks, and who knows what else. Lies are not very Us-oriented. Or rather there’s one Us for some people and another Us for everyone else.
> Except they lied about the masks, and who knows what else
Asymptomatic transmission, I think (I need to check more).
I think that there is a big element of “science advances” in all of this; people who are not comfortable with ambiguity may have issues with that. There are also elements of institutional incentives: WHO, Big Pharma, the administration, scientists themselves all are at one time or another tempted to engage in motivated reasoning. One would hope that normally the scientific process would winnow this out, but we also have preprints, due to the pressing nature of the pandemic. (I think social media is the least of it.)
So I can accept some messiness. But I can’t see Fauci on masks as being anything other than a direct lie, which is not acceptable to me in a scientists. And it was a fabulously destructive lie, since (a) it looks like universal masking is our only way out, since the contract tracing horse has long since left the barn, and (b) it undercuts making a vaccine mandatory when, and if, a vaccine is discovered.
They didn’t “lie” about the masks. Early recommendations were based on knowledge of prior coronaviruses.
As research progressed, recommendations changed based on new knowledge. Data on transmission led to recommendations of face coverings.
The original recommendation of reserving medical grade PPE for medical professionals is STILL valid.
Recommending PPE for medical professionals is completely at odds with saying masks dont work. Early recommendations were to prevent a run on PPE by the public.. which I can sort of understand, but there should be a way to do this without outright lying to the public and creating distrust in the CDC. I still see people on facebook posting this quote as a way to back up their refusal to wear a mask
I’m not sure what world you’re living in where masks didn’t work on previous coronaviruses. The whole reason people in Asia masked up quickly was because of their previous experience with SARS, which, I might add, was a coronavirus.
It was a lie. The only question is whether it can be called a “noble” lie.
All of it true, yes. Definitely the largest problem has been the lack of information, attempting to fly in the dark when the facts aren’t established. The mask lie, however “noble,” was awful. Isn’t a lie that causes harm, even with “noble intent,” still a lie that causes harm?
However, when public skepticism is taken to such extremes that people are being shot for asking their customers to wear masks, when significant chunks of the country see are throwing tantrums so loud while marching around with their assault rifles about wearing masks saying they are free to spread the virus as far as they wish, when Trump keeps repeating the virus is finished, when the Texan Lieutenant Governor Dan Patrick, an upstanding member of the Conservative Movement, says old people should start thinking about sacrificing themselves for the good of the economy, then maybe you are glossing over a very important part of the story which doesn’t have anything to do with the incompetent overstating of the facts by the WHO, or the missteps of the CDC.
Just maybe, the skeptics need take responsibility for the horrible consequences or their skepticism themselves.
All of this is to say, yes, the “liberal coastal elite” willfully live in a bubble that has disastrous consequences. But the trouble is, people often seem to forget they aren’t the only ones who do.
> thinking about sacrificing themselves for the good of the economy
If the CARES act isn’t re-upped, thereby forcing people back to work, the entire political class will be sending the same message, albeit less crudely than Texas politicians (who I am given to understand are capable of considerable crudity). Wage work, by definition, means that you sell your labor power to survive. And here we are!
Re: the alternative universe with Hillary in the White House, one need only consider that when Obamacare offered a federally-funded expansion of Medicaid, many states refused to sign on.
The bottom line is that it doesn’t matter which side is in power because Americans are so entrenched in the R-vs-D culture war, even though most of it is a farce to distract from how they are working together to rob us blind.
Why was Medicaid expansion even made an option in ACA? It was defective legislation from the get-go. Also note that the federal 90% payment for Medicaid expansion was time limited, 10 years, IIRC.
And Medicaid is really substandard provision of care, speaking from family experience.
Lastly, M4A would have solved these current problems, but it was never on Barry O’s radar because it didn’t provide massive subsides to his health insurance buddies.
> Why was Medicaid expansion even made an option in ACA?
Medicaid expansion was made optional by the Roberts Court:
That said, it was ObamaCare’s rickety, multipayer system architecture that made the Roberts decision possible. Roberts drove a wedge into a huge crack that was already there.
Systemic failure here very much worsened by the Clown in Charge who looks able to sink the US into its worst disaster excluding wars. Arizonians have witnessed from the distance what Covid-19 did to Italy, Spain, France, UK the Northwest of the US and still “collectively” decided that this was not an issue and no precautions were needed. I put the word collectively in brackets because it is, IMO, the result of short sigthed individualism and propaganda, not of a concerted evaluation of the situation and risks.
Libertarians might be happy but this could result in outcomes they didn’t really want.
Unfortunately it was a minority that managed to create this uncontrolled community transmission. The majority here in AZ took precautions and are still taking them and paid attention to what was happening elsewhere. Having said that it is clear that the Majority of the ordinary rank and file members of the public were ahead of the national, state and local governments as well as our employers in our responses. The problem is that because the authorities are SO ineffectual, a minority of (libertarian minded) individuals can have a serious outsize effect.
With respect the US as a whole is not very much like Spain, France, the UK or that area that is still most infectious, the US Northeast. We overwhelmingly travel around in cars with public transportation barely a thing in towns like mine. I do object to all the hindsight that suggests there’s no learning curve here or that the health authorities always knew how to deal with this unprecedented (in modern times) crisis if only the politicians would have listened.
Letting people carelessly die is very bad politics, even for Red State governors. Maybe Cuomo will eventually find that out despite batting for the supposedly right team.
Letting people carelessly die is (eventually) very bad politics…
Most of what passes for American leadership has the foresight of a fruit-fly. They also think that they can keep using nonsense and lies to cover up their mistakes.
>Arizonians have witnessed from the distance what Covid-19 did
Again, not criticizing but you would be shocked how unaware of the rest of the world America is. Most of us didn’t witness anything. The southwest is especially known for having no interest in anything two states over, let alone Europe.
> The southwest is especially known for having no interest in anything two states over, let alone Europe.
See my comment above on what Democrats could do. A Democrat plan that incorporated foreign experience as a baseline would have been useful — educational — if distributed. Yes, FOX would be hammering on it, but I would rather have them saying “Hong Kong sucks” than not; and people can do their own research given an initial clue.
Ding ding ding! It’s been a complete failure from top to bottom, every institution, government leader and agency, and a gigantic crowd of willfully, aggressively, proudly ignorant people. USians are now banned from travel to Europe when they reopen July 1, and rightfully so. We’re reaping the rewards of extreme capitalism.
> We’re reaping the rewards of extreme capitalism
“As 45 million Americans lost their jobs, U.S. billionaires made $584 billion.” We?
In Oregon and California the early demonstrations in favor of Reopening were small and associated with conservative groups. But — hey presto! — Democratic governors in both states began announced upcoming Reopening shortly thereafter. The national level of coordination between ostensible political enemies tastes funny to me.
Even more interesting are the repeated statements of the Oregon State epidemiologist in the last week, quoted in the Oregonian, that it was always known that Reopening would increase the spread of the disease. So they know what they are doing. One can envision a range of decision-maker postures behind the policy, from denial, on through let-the-weak-die, to burn-’em-a-little-until-they-beg-to-lock-down-again. This is administered national suicide.
” it was always known that Reopening would increase the spread of the disease”
Was, and is. It is true and acknowledged by all epidemiologists.
But ‘reopening’ is not a binary event. There can be partial reopenings, limited reopenings, reopenings for certain age groups… lots of ways to manage.
But when a President holds a public rally or a governor essentially says “OK, folks, hit the bars!” they have given a signal that caution can be ignored. As a result, people will die. That’s just a fact.
Here in Oregon reopening has become reclosing within a couple weeks.
for Arizona; I trusted legal source has informed me that upon accompanying someone to hospital for treatment for what appeared to be Covid 19, the patient asked the doctor if they could be tested for Covid 19. THE DOCTOR REPLIED THAT IT WAS ILLEGAL FOR THEM TO TEST ANYONE.
that tells you much about Arizona, the place where hundreds of thousands of persons with respiratory problems immigrated to during the 1900’s due to the dry air.
It’s a nice conspiracy story but you are giving these idiots way too much credit.
It is possible to construe the policy as simple political damage control. Maintaining a state policy of stricter control is risky — economic activity is constricted, STATES have few fiscal resources to support incomes, yet they are the proximal recipients of political heat. It is easier for state governments to reopen and let the virus spread; despite the grim consequences, they can blame the virus.
It is possible to construe Reopening as simple political damage control, not a conspiracy.
Lockdown was politically risky –governors had clear responsibility before the public because they ordered it, economic constriction resulted, and state governments have limited fiscal resources to support worker incomes. It is less risky for them to reopen and let the virus take the blame.
My first reply appeared to have disappeared; thus, the redundant replies.
A few points:
1) I feel like we will be debating how much blame Trump gets for the COVID response for many years to come. The implications of the debate are massive. If we place too much blame on Trump, then we miss crucial reforms of our public health infrastructure.
2) I genuinely worry about people’s willingness to take a vaccine once it’s released. I have heard friends and colleagues tell me that they would refuse to take a vaccine if one was developed. The battle over masks is likely only a start.
3) I worry about the entire scientific community being involved in COVID research. When there are 20k+ articles/month being published on the disease and the top two medical journals in the world have already had to pull articles, how are scientists to sift through the research to separate quality, path-breaking research, from pseudoscience and poor studies? At a certain point, I feel that “prestige” will become a proxy if it hasn’t already.
You absolutely nailed it. Democrats, if they come to power (looking more likely by the day) will use Trump as the whipping post, just like they did with GWB and in general with republicans.
Democrats, upon gaining power, mostly whine.
As of today AZ deaths per 100k, 22. New York state, 161. New Jersey is even worse at 170. Active cases AZ–68,404. Supposedly recovering NY state, 296,803.
The assumption of the above seems to be that AZ will eventually become another NY/NJ and here’s suggesting that this will never happen. The big Covid story is still the Northeast despite all the media look over there. While Phoenix does have an extensive bus/light rail system and plenty of homeless people and other highly prone groups it’s a city where transportation is overwhelmingly by car and those bars have now been closed again with masks are required in stores etc.
https://www.worldometers.info/coronavirus/country/us/
Arizona is running out of ICU beds. That means there is a problem:
https://www.abc15.com/news/state/fewer-than-200-icu-beds-available-in-arizona-as-state-reports-more-than-60-000-coronavirus-cases
https://www.12news.com/article/news/health/coronavirus/code-red-arizona-hospitals-could-run-out-of-beds-by-july-public-health-expert-says/75-36593ee3-33db-4b81-965b-d0c616c711ce
I live in Tucson and posted an exasperated comment here several weeks ago complaining that people were acting in an absurdly irresponsible fashion as mask wearing inside stores was dropping like a rock; it was clear then that the refusal to wear a mask had become a ‘political statement’ and/or macho posturing.
Several of the scofflaws, however, were elderly women so probably we can attribute this to too much Fox ‘News’ rather than too many John Wayne movies.
Tucson now has an ordinance “compelling” mask wearing (as of June 20th) but there’s no penalty if you don’t! Most shoppers at stores such as Sprouts and Trader Joe’s are taking mask wearing seriously again. CostCo, to their credit, has been requiring them to enter their stores.
On Sunday, while in Chandler, AZ (a suburb of Phoenix), I saw numerous shoppers entering and existing Target and Petsmart wearing masks. At the LA Fitness, in contrast, it appeared that the majority of people were not wearing masks. And when I stopped at a Love’s Gas Station south of Phoenix, only about 25% of the people inside were wearing a mask. One cashier wore one; the other did not.
My riskiest behavior, I presume, is trying to use a gym a couple of times a week. Planet Fitness is a 24-hour gym and quite expansive so I try to sneak in after 11 PM when it is largely empty. I wear a mask and try to stay about 20-feet from other patrons as best I can. Mask wearing is about 30% and the staff wear them.
Unfortunately, I notice a lot of the younger patrons (20s and 30s) congregating literally face to face, chatting and laughing, without masks. I try to avoid these happy-go-lucky clusters like the plague.
My main fear of catching the disease is not dying, but incapacitation — as I am trying to run a small business, pay my bills, and take care of my dogs with no backup from family or friends.
Anyway, the combination of a corrupt idiocracy, religious nuts, and Mad Max style social Darwinists has put Arizona at the top of the new’s food chain when it comes to disease and death.
Have a nice day, Arizona.
I cry for all Americans for they do not know who they vote for. I can’t wait for trump to thrash Biden. That should knock some sense into Biden supporters
A Trump victory would perhaps shake-up the democrat party enough so perhaps might offer us a somewhat principled and honest candidate for office in 2024… Nah, won’t ever happen– too busy shaking-down taxpayers and hustling for campaign contributions.
Biden would be the same more-of-the-same that got us Trump, if he doesn’t cross the line with Russia and get us vaporized.
I hope that Trump gets re-elected, and that he steps down after 2024 to enjoy his spoils. And then maybe a few years after that, he’s forced to flee USA for fear of prosecution from a citizenry that has finally regained its senses– joining our previous three presidents in the dock or in exile.
don’t get yer knickers in a twist. there will be no HOT hot war. the thieves who have stolen everything will not allow their loot to be destroyed. in the words of the immortal FZ:
“There will never be a nuclear war; there’s too much real estate involved.”
you read it here first.
I do not think a vax is going to be much of a help. Setting aside development and assuming it is ready tomorrow, how many people would be willing to be the first to get the vax? Polls have been out that less than half would take it. I suspect, people willing to get vax’d would want to wait a couple of years to see what, if any, side affects developed from this vax, as well as whether or not the vax is even effective. I think about the flu vax, which is generally a shot in the dark. If COVID is similar in mutating itself, a vax maybe be just as useless.
I would consider getting a vaccine if it originates from Europe or Asia.
If it originates in the utterly corrupt US and is sponsored by either a Trump or Biden administration, I prefer to let somebody else be the sacrificial guinea pig.
An endorsement by a known liar like Fauci would make zero difference, since he is probably just doing whatever he thinks is best for himself and the other health care PMCs, not what is best for the recipients of the vaccine.
Remember, govt has no duty to protect an individual, only society, so it would be his job to encourage a few sacrificial lambs to step forward.
https://en.wikipedia.org/wiki/DeShaney_v._Winnebago_County
https://en.wikipedia.org/wiki/Town_of_Castle_Rock_v._Gonzales etc, etc
As for Europe and Asia, I wouldn’t trust it either. The US does not hold a monopoly on corruption and incompetence.
This slender Arizona went to the credit union this morning. Okay, big deal. Slim had some bankin’ to do.
Actually, it was a big deal.
In order to be admitted into the credit union, I had to make an appointment. And I had to be wearing a face mask. No big deal. I called and made an appointment yesterday, and I donned my mask before entering the building.
When I came home, I made sure that I washed my hands as soon as I got inside. Then I wiped down the various surfaces I had touched. Finally, it was time for a shower and change of clothes.
Now I’m back at my computer. Finding blog posts like this one, which isn’t the happiest. OTOH, here’s something from a longtime friend and mentor:
https://powersforthepeople.net/2020/06/29/where-are-the-covid19-wizards-to-help-us-re-imagine-ourselves-our-future-video/
Slim, I think it was you who mentioned, last year, a “seed lending library” operating in one of the local public libraries.
Did that survive the lockdown?
I’m also curious if you have seen evidence of more gardening locally.
My imagined future contains a lot more local food production.
The Seed Library still exists! Go library.pima.gov and see what strikes your fancy.
As for more people gardening, I noticed that the community garden is just about full. It’s in a park near the Arizona Slim Ranch and it usually empties out in the summertime.
I live next door to Arizona in California, Oceanside to be exact. It is tourist season here and a lot of people come here of course, but the majority come from Arizona to cool off from the summer heat. My daughter was downtown the other day and noticed the majority of the tourists were not wearing masks while the locals were. Our infection numbers are going up anyway due to the opening of the economy and having these people coming here(especially from states with rising infection rates) is just going to exacerbate the problem.
It’s going to be an interesting summer.
I’m of mixed emotions. I happen to believe in science and distancing, masks, and all the rest of the pain in a necessary thing in my view. I vote Republican and the president is making it harder for me to support him. Fortunate for him, the Democrats have chosen to run a retread has-been of shaky morals. Not only is the guy creepy abround women and girls (sniffing their hair and touching them) but is in my opinion a racist against blacks. We’ll see which is the worst guy come November but Trump’s not making it any easier with his foolish positions regarding the science. Yes, I know he’s in a tizzy over the economy (and I feel for him) but this pandemic trumps every other consideration. It is what it is and people know it’s not his fault – but – he needs to lead us better than he has thus far, in my opinion.
Meanwhile, when I’m out because I have no choice, e.g. grocery store pharmacy, when I see someone not wearing a mask I observe to myself, ‘That guy is a fool”, and sadly, I can assure you he is looking at me wearing my mask and thinking, “That guy is a fool.” about me! We’ve devolved into political camps over this. Yikes!
In becoming a political issue, the fact is I’m fine with people not wearing a mask.
But, without a mask you’re not allowed to go to a grocery store, or pharmacy. Basically, if you want to be mask-less, fine, then get someone else to do your grocery shopping because you cannot enter a grocery store without one. Ditto pharmacy, offices, and any other shopping. Yup, your libertarian-ass can go without a mask all it wants, but not around other citizens, because your right to self-harm stops at the end of my nose (if I may mix my metaphors). In short, I view you choosing to not wearing a mask around me as the functional equivalent of punching me in the nose. I expect the cops to arrest you for violence against my person. Honestly, it’s the same thing!
Anti-vaxxers . . . I don’t care if you want to put yourself in danger but your beliefs don’t trump the good of society, e.g. everybody else vaccinating. Don’t vaccinate yourself you can’t go into public and expose others. And you give up your kids (just as if you were beating them with a stick until they were black and blue). In short, not vaccinating your kids is the same as physical abuse and means they’re removed from you. Don’t like it? Leave the United States if you can find some other country to take you. This anti-vax nonsense has to stop. Now.
Bottom line? Just as you don’t have the right to murder me, you don’t have the right to expose me to pathogens for which we have vaccines. And once we get one 9if) for CVOVID-19, everybody will have to get it. Don’
t want it? See the above about not going in public and leaving the USA.
This article fails to note the financial pressures likely involved in moving to reopen (too) early. Subsidizing unemployment benefits plus depleted tax revenues plus ballooning public services costs associated with the crisis surely played a part.
You can give workers money to stay home. You cannot conjure doctors and nurses to administer to a rapidly spreading pandemic. It’s not a choice between reopening and lockdown. The fear of contagion puts people out of work all by itself. (I’m sure the folks in Arizona are now spooked to their core.)
Agreed, but the article seems to spend much of its time addressing the motivations for reopening. My point here being that financial concerns might be a more powerful motivation than some tweets.
There will be even more deaths from suboptimal care being delivered by health care professionals insecure about inadequate PPE. They need to provide full body suits, designated wards/floors and shifts limited to 8 hours to remove the fear element. Ethical conflicts are widespread because of this very rational fear. For example I was looking after an 88 year old very confused COVID-19 patient last week. He clearly needed a feeding tube as he had received no nutrition for 5 days . The nurses were reluctant to place one as they felt he was likely to pull it out because of impaired mental status. This is a high risk procedure as patients cough and sneeze during the tube’s introduction with massive aerosolization. 2 people will be needed to place the tube in a patient who will resist, and then 2 X-ray techs will be exposed to confirm position of the tube with an X-ray. As a physician I have to decide is it worth risking 4 exposures in one shift(or more depending on how often he pulls out his feeding tube) in a patient who has a poor prognosis. These ethical conflicts do not arise in non COVID-19 patients. And so care is less than desirable….
So we did place a tube after applying soft restraints that we would have otherwise not done. In the ordinary course of events we would have had a sitter present bedside to prevent the patient from pulling the tube. Can we really leave a sitter in a COVID-19 room for 12 hours at a time and shift after shift to prevent this from happening?
I feel that if you know that you have saved one life worth saving, that you have done your part in the greater scheme of things.
That doesn’t make things much easier when you don’t have a crystal ball at hand while facing immediate, real-world situations, when you feel that you must take action on a limited and given amount of information.
But you found an imperfect work-around– soft-restraints– and gave at least four people other than yourself a better chance of coming through this somewhat unscathed, and to be themselves in a position to help others rather than requiring help themselves.
You may be the harshest judge of yourself, and if you are then I hope that you are at least a fair one. As an outsider, I feel that you made the right call. While I hope that you pitch a no-hitter, the statistics aren’t working in your favor.
I hope that you stay well during all of this craziness, and that when all of this is done you can say that you’ve done your best to support the good in this world.
I salute you.
Automatic Earth cited a cell phone study that indicated “While overall consumer traffic fell by 60 percentage points, legal restrictions explain only 7 of that. Individual choices were far more important and seem tied to fears of infection. Traffic started dropping before the legal orders were in place; was highly tied to the number of COVID deaths in the county; and showed a clear shift by consumers away from larger/busier stores toward smaller/less busy ones in the same industry”.
In reality, this shows that everybody is on their own. The US Federal government collapsed. Any additional protection individuals have from getting infected by coronavirus is provided by local and state governments. But the response has been politicized and is haphazard at best and dangerous at worse. There is no universal testing, contact tracing and isolation of the infected in the whole of the USA. CDC estimated that 20 million Americans were infected with coronavirus. Avoiding the illness is becoming impossible. In hot-spots, ICUs are being overwhelmed.
Draconian measures are needed to address the dangers of the new Cold War with Russia and China, the pandemic, climate change, and the greater depression to avoid another Succession of States. Except, Republicans are crazy radicals, once again. Democrats are hiding in the basement except to come out and blame anything bad on Russia and Racism.
Since the Iraq Invasion, it is clear that the federal government uses lies and public relations to hide the truth that the death of Americans is of no concern. The rich are free to exploit humans and the environment at will for greater profits and bonuses. Healthcare workers are overworked, under protected and have no paid way out. Nursing homes are elder death traps. Media moguls hype the number of deaths to get ratings but omit that the only way out of these catastrophes is the restoration of government by and for the people.
I watched the whole pandemic unfold via BBC World News. The showed the new conference of the leader of The WHO every day. It didn’t take many days to realize something very serious was taking place. Each day his news conference became more bleak and frightening. In my mind I concluded that the world was in big trouble.Everything I suspected and even more occurred. I also decided the when things were loosened up, I wasn’t going to return to my former behavior. I was going to still be careful and play a wait and see game. It doesn’t take a scientist to realize how contagious and dangerous this virus is. Only when a viable vaccine is developed will I return to my former behavior.