Welcome to the New (Ab)Normal!
“There is a deepening national sense that the progress made in fighting the pandemic is coming undone and no patch of America is safe.” Sobering truths from @juliebosman @mannyNYT @thomasfullerNYT https://t.co/eW1EMxvSN8
— Patricia Mazzei (@PatriciaMazzei) August 2, 2020
Colleagues and I are out with a new report today with 10 recommendations for how the US should chart a new course. Here’s a thread with a quick rundown of the 10 –https://t.co/Sy42qDtPrS
— Caitlin Rivers, PhD (@cmyeaton) July 29, 2020
Tweets ‘stripped’ for your reading convenience…
1. Encourage and, where appropriate, mandate things like physical distancing, masks, and limit on indoor gatherings. Without these measures in place, it will be difficult to maintain control of an outbreak or turn the corner on an outbreak that is accelerating.
2. Close higher risk activities and settings in places where the epidemic is worsening and reinstitute stay at home orders in jurisdictions where healthcare systems are in crisis. Hope is not a plan. Communities that are not doing well need to act.
3. Bolster PPE supply chains and stockpiles and make information about the PPE manufacturing base and supply chain publicly available, with the ultimate goal of expanding PPE availability as much as possible.
4. Bolster test supply chains, plan for shortages, and collaborate with states and commercial laboratories to improve test turnaround times. We’re doing more tests than ever, but in many places it’s still not enough, and the results are taking too long to be useful.
5. Conduct and make public detailed analyses of epidemiology data collected during case investigations and contact tracing. Where are people getting infected? How is testing performance? How well is contact tracing working? These are things we should know.
6. Curate and fund a rapid research agenda to cope with major challenges that have arisen. How do we make masks better, and how can we encourage people to wear them? How can we easily improve ventilation? What is the role of children in transmission? We should find out.
7. Scale up contact tracing and continue to improve performance. There is no way to contact trace tens of thousands of cases a day. It’s too much. But we can build the infrastructure and improve tracing operations so that it becomes more and more useful as incidence falls.
8. Identify and disseminate best practices for improving the public health response. Thousands of public health professionals have been running at top speed for months. What have they learned, and how we can we share those best practices with everyone?
9. Plan for a vaccine, incl production, allocation, distribution, and community engagement to ensure a successful rollout. Finding a safe and effective vaccine is step 1. We need to have our eyes on steps 2-99 as well. Let’s do that now, so we’re ready to hit the ground running.
10. Develop policies and best practices to better protect group institutions. Nursing homes, prisons and jails, manufacturing have been very hard hit. We should be doing more to shift the burden of paying for and implementing needed mitigation measures away from facilities.
The social distancing to stop COVID-19 has resulted in cutting flu infections by more than half https://t.co/p2UO8hPD6l
— Doomscrolling (@Lee__Drake) August 1, 2020
Reports of influenza and a host of other infectious diseases have plummeted as the COVID-19 pandemic has driven people into lockdowns.
In many places, social distancing measures aimed at curbing the spread of the new coronavirus may be smothering the spread of other infectious diseases at the same time. But, in other places, the pandemic may simply be masking disease spread, as people may avoid seeking care for more routine infections while health care systems stretched thin by the pandemic may struggle to conduct routine, surveillance, testing, and reporting.
Some of the resulting declines are dramatic. Countries across the Southern Hemisphere have reported much lower numbers of influenza than usual. Australia, for instance, began 2020 with a relatively high level of flu—reporting around 7,000 lab-confirmed cases in both January and February. But the outbreak crashed in March, with reports of only 229 cases in April, compared with nearly 19,000 in April 2019, as noted by the New Scientist…
don't miss this one!
— Eric Topol (@EricTopol) July 31, 2020
Pleased to share my contribution to @BostonReview's "Thinking in a Pandemic" series. My focus was applying solution-based thinking to move us towards our goal of living safely. I would love for you to read it, but summarizing the main points here. 1/11https://t.co/vY9gQPerrP
— Natalie E. Dean, PhD (@nataliexdean) July 30, 2020
… At this point, we know the problems. The novel coronavirus, SARS-CoV-2, can spread before infected people develop symptoms—between 4 and 41 percent of people never develop symptoms, in fact—yet we are nowhere near herd immunity. At the same time, the United States continues to lack sufficient capacity for testing and contact tracing. Countries like Germany, Greece, Italy, and Australia conduct on average two hundred tests to find a single confirmed case; in the United States, every twelve tests uncovers a new infection. Widespread lockdowns imposed in March and April dramatically slowed epidemic growth, but they came with enormous costs, not only economic—leaving tens of millions unemployed—but also social and medical. Vital medical services have been disrupted, including infant vaccination, cancer screening, and HIV treatment programs. The impacts are far-reaching and severe. On the other hand, where lockdowns have been lifted too quickly, transmission has resurged, leading some states to reclose businesses.
It is natural to react to seemingly impossible situations by focusing on the problems. Why is this happening? Why were we so unprepared? Who is to blame? Our collective experience during the pandemic has been likened to the stages of grief; hundreds of millions of people have collectively experienced denial, anger, bargaining, and depression. The last, critical stage is acceptance. Given that the virus is here to stay, how do we learn to live with it safely?…
As we continue the work of implementing sorely needed solutions, there are four principles we can use to guide our action.
First, we must constantly work to shift the public discussion from the general to the specific, forcing ourselves into the proverbial weeds. Much of the national conversation surrounding lockdowns, for example, has operated at an unhelpful level of generality. Policies of this magnitude have large and broad-reaching impacts—medical and economic, of course, but also legal and social. They also are not implemented uniformly: they impact different geographic regions and different employment sectors in different ways. The reality is far more complex than a simple dualism: “lockdown good!” or “lockdown bad!”…
Depressing how quickly we went from panic to complacence, with no directed societal effort to stop this thing.
So COVID’s endemic now? Is that what I’m hearing?
You are a rock star, AL. I don’t know how you find all this good information and still have a life and get any sleep. You deserve the Balloon Juice equivalent of a Pulitzer Prize for your day in and day out coverage of the coronavirus. All praise and thanks from me.
So here is where I tell you a colleague and myself, have had lingering shortness of breath and fatigue since symptoms begin – him, March 5, me. April 13. There are still days when normal activity can leave me winded, tired and unable to complete tasks.
There is so much unknown…
West of the Rockies
You are not alone. My S.O. caught it in late February and still has days that shred her. She is getting better, but maddeningly slowly.
Also, too, one “upside” to this… The longer the pandemic continues and the worse it gets, the more likely Trump and company lose BIGLY.
@TaMara (HFG): That is awful. It’s a cruel virus, and I’m sorry that it affected you.
But… there was nothing in that list about goosing the stock market. Or.. reducing the number of reported cases by slowing down testing. Or… alien sperm. Useless.
Thank you, AL??
That’s a good 10 point list. I’d add another – the NIAID/CDC/DARPA/etc. should develop/fund development of a full-featured prototype app using Google and Apple’s Bluetooth LE close-contact APIs and get it out there along with the source code. It’s astounding that there still isn’t any app out there for people in the US to use to know if they were close to someone that was found to be infected.
And only 4 states have committed to participating.
Drove by a grad party down the street here in southern MN where we have a mandatory mask rule. Out of 50 people, only 3 were wearing a mask with no distancing.
Another bad day for Mass. 353 new cases, more than double the daily rate for early in July. Heard a rumor, from the greenskeeper of my local golf course, that Gov. Baker will reinstitute a total lockdown on Thursday.
@Mary G: Ditto to this. Thanks so much, AL.
They need to start imposing penalties for non-compliance with public health orders like masking and public gatherings that exceed limits. The only thing Americans seem to care about is their money, so lets start collecting some from the asshole performance artists and use it to help defray some of the costs of contact tracing and enforcement. And make them penalties that hurt, like $500 for a first offense.
Thank you, Anne Laurie, for all your research and posting to keep us informed.
For those of you who remember that my middle son (who had stents put in two years ago) was exposed in his work place, there is good news. He is finished with quarantine and back home to the delight of his wife, two small daughters and his mom. The bad news is that he still has to go to work but only on every other day. I guess that is progress. Luckily his job (appellate attorney for the county) involves research and writing, so he doesn’t have to deal with people very often. If it wasn’t for my writing and the two precious little girls, I think the isolation we are experiencing would make me crazy. This is difficult, even for an introvert like me. I am so looking forward to expressing my anger on November 3.
I am so sorry you are still dealing with this. I hope things improve for you soon. Are you still able to keep up with your writing?
The Pale Scot
UK TV correspondent Jonathan Pie,
Put a F**king Mask On!
Love this guy
@satby: Yup, it seems that without punitive measures, compliance is a joke. The gym near me is still open, even with the Gov Gav’s orders to shut down gyms.
@TaMara (HFG): I hope that while recovery is slow, it continues steadily.
You remind me that I should see our local “blockbuster” art exhibition soonest, in the event Virginia shuts down public spaces again too. VMFA. Treasures of Ancient Egypt: Sunken Cities.
@TaMara (HFG): Joining in to wish you a return to full health and no more bad surprises.
I’m so sorry, TaMara. Sending you healing.
@satby: But how do you collect if every sheriff is a constitutional scholar these days and expounds that any mask mandates are unconstitutional in their weighty opinion? There is nothing that breeds contempt for rules and the law than rules and laws that are not enforced. I think this is why Newsome opened up CA, not because he wanted to but because he could not make the restrictions stick
The Pale Scot
@satby: Add a surcharge to their health insurance policy. 200 bucks for every instance of non-compliance. If they cancel their policy and a waver releasing ERs from taking them in, surcharges rescinded
Edit, 200 per month
@TaMara (HFG): Echoing what everyone else has said. With all that’s gone on with your dad and everything, take it easy and take care of you. Hopefully you’ll get back to your old self soon.
The Pale Scot
@TKH: The Sheriffs that have joined the madness? cancel any state or Federal support they get. Reclaim any military gear they received
My BiL’s widow was working in an office where two people have the virus. She’s a walking set of comorbidities. I hope she didn’t get it. Not really looking forward to taking care of a teenage boy if she doesn’t survive it.
@TKH: Yep, that’s a real issue, because I’ve developed nothing but contempt for the local health department here, who has the ability to shut down food vendors violating our mask regs, but doesn’t.
If I was in charge I’d make it clear to sheriffs who don’t want to enforce that they wouldn’t be continuing in a job they don’t care to do. And then I’d fire the ones who continued to refuse to enforce the law. Obviously, that’s a problem in those places where sheriffs are elected, but there must be some mechanism to enforce their compliance too.
@The Pale Scot: Oh, that’s a good idea!
I decided Winston Churchill was wrong.
Organ damage is something that does not easily or quickly repair; I had mass liver damage from stains (blood tests didn’t give any warning) – I spent tens years recovering and will never be fully healed. Apparently, corona can do the same for a number of organs. This is the worse unknown – why it does that to some, but not others and why one organ vs. another for someone else.
@satby: Thought that one would be it. Trouble is, there’s a seemingly endless store of bullshit things to try before running out.
Well, here in Melbourne, as you’ve probably read, we’ve just gone into a Stage 4 lockdown. The main points are:
TBH, I don’t think I’ve been out after 8pm since February so the curfew won’t affect us much here. The exercise will as I was walking Juno 2-3 times a day, as much a mental break as a physical one, so I’m going to feel that.
Having said that, I think this is the way the pandemic should be dealt with. I tweeted in June (yes, it was only June) that I thought we were coming out of the first lockdown a few weeks too early. We were almost on the point of eradication. However, most Melburnians accpet this and will do what is necessary to get out of this with as few illnesses and deaths as possible. The Murdoch press is going full tilt at the Labour State Premier Daniel Andrews of course. First it was that the lockdown was too severe and too long, then criticising him for opening up too early when the cases started to grow.
We’re in this for the next six weeks, but even if it works, we’ll probably only be back to Stage 3 restrictions then so it looks like this will last till Christmas.
We’re lucky here. We’re out in the ‘burbs with a big back yard and plenty of space. Others will be doing it a lot tougher. But, as I said earlier, this is the only way to go and I think we’ll look back on this as a lesson to the world on how it should be done.
@satby: Speaking of Churchill*, our local NPR station broadcast RadioLab‘s episode on the 1918 flu this afternoon. It had lots and lots of ramifications (e.g. Wilson probably had it during the negotiations over the end of WWI and basically caved on all of his principles because of it, giving rise to the Nazis; etc. And the virus was introduced to Bombay/Mumbai by returning Indian soldiers who fought in WWI and it killed 10s of millions in India; and Gandhi probably had it and it took him months to recover and during that time he conceived his ideas of nonviolent protest; and every human flu virus since 1918 has been a relative of that virus; and…).
Fascinating show. They interviewed Fauci briefly.
(* – And Churchill’s history with India, as schroedinger’s cat has reminded us.)
@TaMara (HFG): Keep getting better! I lost 40 friends and lovers to AIDS. It was a miracle when the anti- retrovirals finally arrived. Hopefully we’ll have treatments and vaccines in a year.
Link goes to FTFNYT, and I haven’t read it, but this is infuriating if true:
@Another Scott: Thank you for that link. I will listen to this.
Because you pointedly mentioned to read the Science website article, I did.
It gives a complete picture, of what they know and suspect, of this virus’ effects, even with little to no symptoms. Great read, and it’s going to everyone I know.
Thanks A.L. for another welcome report that reminds me to keep up the safety measures and remind others if need be. Living in SF Bay Area where most, not counting teens, take this seriously, but others prefer to do only the minimum and don’t want to know what this article presents.
@Another Scott: My father had the “Spanish” flu in 1919. He had an open draining sinus until the 50’s. We got every vaccination and booster shot. Personal history changes attitudes.
@satby: usually sheriff is an elected position, not subject to being fired. Not subject to much oversight, either. They operate independently, hire their cronies, and in too many cases do pretty much whatever they want.
I don’t know how people are getting information about the pandemic. TV just gives short snippets.
I confess that I do not buy physical newspapers anymore, and don’t subscribe. A couple of local papers have paywalls, but generally allow free access to pandemic related stories. I don’t do Facebook.
So, in Southern California and particularly LA County, there is an effort to get community spread under control. But I don’t know how clearly the message gets out to people, and to people who don’t speak English. The information is on the LA County health site, but you kinda have to know how to get there.
So, in Los Angeles and other places, people keep foolishly thinking that it is okay to “get back to normal.” So I hear about people socializing again with family and friends, having large ish parties and entertainments, restaurants and bars (until they got shut down again). And I’ve had conversations with business owners who translate understandable fear of losing money into stupid non-compliance with government health department directives. There is magical thinking that ignoring the virus will make it go away.
Anyway, apart from trying to stay home, how many people know that they should try to have social parties mainly outside, and should probably have social distance contact with at best a small group of friends and family until the virus is brought better under control?
Again, in LA (and of course elsewhere), you get this from the regular briefings, but you have to know when they happen and be able to watch and to listen.
Gov Evers finally ordered statewide masking and I drove by several bars and large outdoor/indoor parties yesterday and there wasn’t a mask in site.
I have a nephew and niece getting married in a few weeks and my siblings still can’t understand why my wife and I will not be attending. My sister actually said its only going to be a hundred or so close relatives. Apparently she thinks our family is immune or something.
Also too, our little city has less than 3,000 residents and, as of yesterday, 90 confirmed cases! almost all originating from one graduation party.
Chief of police walked into my wife’s store the other day sans mask despite statewide order and company policy. MF’er has said publicly that he won’t enforce the order. If it were me I would have confronted him and booted his ass out of the store. I hate every one of those fuckers.
@MoCA Ace: Stand your ground. You are making the right choice.
Science > wishful thinking
@dnfree: Yup, that’s my understanding too. All they need to do is have a hand on the pulse of the local yokels that elect them and they are good. There is no higher authority In the organizational chart to hold them accountable.
I was on a very long hike through AZ and NM in March to May when the virus was of most immediate concern in the NW and NE. The willful ignorance I encountered in the small towns and hamlets I passed through was difficult to fathom.
Oh no problem there. Just got back from a long-planned camping vacation. All outdoors and we brought our own facilities so never entered an enclosed space. limited others visiting our campsite and no group meals etc.
As we drove away my wife and I both swore we were done with all of it until a vaccine is widely in use. Even camping with a few relatives was just too stressful. I’ll be on pins and needles for the next two weeks just imagining how may exposures I may have had.
BIL thought it went well and is shocked we are pulling out of a planned camping/reunion with the wife’s MAGA relatives scheduled for mid August. Same BIL hit the town doing the tourist thing and announced that he always wore a mask… when it was required by the establishment he was entering!
@MoCA Ace: Most of my relatives are being very foolish.
“My god daughter was coming for the weekend. They asked if she could bring a friend, and I said yes. Then it was two friends.”
No discussion of how careful the other families were being, etc. And I know my sister won’t wear a mask in her own house and I know she would never ask anyone else to. So once again they are all sitting together every evening – 8 people in the same room, watching TV all evening.
I’ve stopped saying anything. All I can do is cross my fingers.
My sister has had exactly the same amount of visitors that she has every summer, which is a lot because they have a pool and a hot tub, so lots of people like to visit.
So frustrating to see!
@TaMara (HFG): Yeah, the hot days have been murdering me. But then I get a a room with AC and I’m good. Seems like whatever it was (and I’m starting to think I had it, but had two false negatives for tests) has taken off the top 3% of my lungs, but only when it’s hot and humid.
@Dan B: My great aunt’s first husband died, when they were young newlyweds, from the Spanish flu. She told me about that, several times, 50 plus years later. She never wanted to forget him.
I came along just after polio, etc., but vaccines were appreciated in our household, too.
People forgot the terrible diseases we used to have. Just a generation or two earlier. And the economic peril, and lack of rights for women. But here is 2020, back to remind us all.
And AIDS. I am sorry for all your losses there.
I hear you. We are constantly made to feel like we are the problem because we choose to be safe. We recently cancelled a family reunion (my side) to be held at our place in September. No outward blowback but the rumor mill is all ablaze with relatives who “feel sorry” for us because we are so consumed by fear :(
And the wedding thing… I was scolded for trying to convince my 82 year old father not to attend them.
The real curveball here with summer ending is the return of both school and day care.
I have a four-year-old and daycare is re-opening in two weeks. He has a low immune response and has been sick (mostly colds but a few other things) for about 85% of the time since he started daycare 3 years ago.
Daycare has been shut down for the past 4 months, but the unexpected upside (among many downsides) is a healthy kid! In two weeks, with daycare being on a college campus, this is all about to change — and possibly really badly. Scary shit…
(Hugs to you TaMara!)
Getting a 404 Error on the Science Mag article linked in the tweet.
Anyone have a working link?
@BellyCat: Is this it? Friend put this up on FB.
@Elizabelle: Looks like it. Thank you!
BTW: I just saw the Cole rant on schools reopening a couple floors below. All I can say is, yup.
Since we are pretty clearly going to limp along, diseased and stressed, until the new Administration takes office this coming January…go big, I say! Let’s get rid of the flu along with this stupid coronavirus!!
Seriously, screw it. We’ve all had to deal with this crap all year (and the flu since forever). Let’s lock down, test our brains out, trace and isolate, and party our $&%*es off next summer when we’ve eliminated Covid-19, the flu, the common cold, and possibly a half-dozen other PITA diseases.
Of course by then the obesity epidemic will be off. the. hook. But that’s probably me just going on a data point of 1 ;)
@Jeffro: Obesity epidemic. ?
(Also, too, you forgot the Alcoholism Epidemic!)
I live on the north shore of Lake Superior where tourism is life and there seems to be an extra helping of asshole tourists this year. Local businesses all require masks and from what I hear beyond a few jackasses most are complying. I usually don’t wear mine outside because I have a German Shepherd on a six foot leash for social distancing and keep away from other people. I do go have a meal and a beer ? at my friends bar with a big outdoor patio but try to avoid going inside at all, winter is going to suck because we’ll have to stay home so I want to enjoy a little socially distanced enjoyment before then (and help support my friends place ).
@BellyCat: yes, that too!
Lock down, shape up, dry out, America! Also, my god, just having the Ill Douche out of office alone has got to lower almost everyone’s hypertension by 50%.
“Some longer pandemic reads.”
Don’t think I had that on my 2020 bingo card at the start of the year. How time flies!
I confess. I haven’t read your site for months and I was only hurting myself.
But I am so sad. The people who, sometimes violently, refuse to wear a mask, the people who crowd into bars and beaches and party spots, with no masks, simply baffle me. Why would you not want to protect yourself from a deadly disease? It’s because Trump turned it into a political football, which has caused tens of thousands of deaths, and will cause tens or hundreds of thousands more.
But what makes me really sad is those who say: When this is over! When we can get back to normal! We have to face it. The world we knew is gone, and it’s never coming back. Because the coronavirus is going to be with us for the foreseeable future, and by that I mean centuries.
But yes, we will have improvements. We may get a vaccine, or better treatments, and that may help. In time. But what we thought of as normal life is now The Before Time. And we’ve got to face that.
The doctors are overlooking the number one reason why the disease is out of control, and their remedy list should show a blank for item no. 1. Their plans will not curb the disease. Not that they have any power to address the number one cause.
The problem is not public health remedies or education. The number one problem is political, and starts with Trump, and extends down a huge portion of the rotten GOP and its base.
For political reasons, these people refuse to act properly to resist disease, as if the coronavirus is a Democrat. Trump and Kushner has sabotaged the national effort to respond. One third of the GOP Senate sees no reason for further action. Something about the GOP mindset (selfishness and empathy is a character flaw) means that its adherents refuse to do anything for the greater good.
Anymore, all that you hope for until 2021 is that they inflict more harm on themselves than the innocent.