Wednesday, March 25, 2020

Coronavirus News (15)

NYC morgues near capacity, DHS briefing warns
New Orleans is next coronavirus epicenter, catalyst for spread in south, experts say
How the Pandemic Will End The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out...... the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. ..... has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. ..... Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed. ......... More transmissible and fatal than seasonal influenza, the new coronavirus is also stealthier, spreading from one host to another for several days before triggering obvious symptoms. ......... To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not. ............. Overstretched hospitals became overwhelmed. Basic protective equipment, such as masks, gowns, and gloves, began to run out. Beds will soon follow, as will the ventilators that provide oxygen to patients whose lungs are besieged by the virus. .......... With little room to surge during a crisis, America’s health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency. That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. ........ some worried hospitals have bought out large quantities of supplies, in the way that panicked consumers have bought out toilet paper. .............

the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018.

.......... Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. .......... “The U.S. may end up with the worst outbreak in the industrialized world.” ......... As of last weekend, the nation had 17,000 confirmed cases, but the actual number was probably somewhere between 60,000 and 245,000. .......... The U.S. has fewer hospital beds per capita than Italy. ......... By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one. By the end of the summer, the pandemic will have directly killed 2.2 million Americans, notwithstanding those who will indirectly die as hospitals are unable to care for the usual slew of heart attacks, strokes, and car accidents. This is the worst-case scenario. ..................... The first and most important is to rapidly produce masks, gloves, and other personal protective equipment. If health-care workers can’t stay healthy, the rest of the response will collapse. ........ invoke the Defense Production Act, launching a wartime effort in which American manufacturers switch to making medical equipment .......... after invoking the act last Wednesday, Trump has failed to actually use it, reportedly due to lobbying from the U.S. Chamber of Commerce and heads of major corporations......... tag in the Defense Logistics Agency—a 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak. ............ a massive rollout of COVID-19 tests. ...........

On March 6, Trump said that “anyone who wants a test can get a test.” That was (and still is) untrue

.. Regardless, anxious people still flooded into hospitals, seeking tests that did not exist. ............... social distancing. .......... Fauci has advised every president since Ronald Reagan on new epidemics, and now sits on the COVID-19 task force that meets with Trump roughly every other day. “He’s got his own style, let’s leave it at that,” Fauci told me ............

even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care. There are only about 180,000 ventilators in the U.S.

......... “It could be anywhere from four to six weeks to up to three months,” Fauci said, “but I don’t have great confidence in that range.” ........... Even a perfect response won’t end the pandemic. As long as the virus persists somewhere, there’s a chance that one infected traveler will reignite fresh sparks in countries that have already extinguished their fires. This is already happening in China, Singapore, and other Asian countries that briefly seemed to have the virus under control. ......... three possible endgames: one that’s very unlikely, one that’s very dangerous, and one that’s very long. .......... the odds of worldwide synchronous control seem vanishingly small. ........ the virus does what past flu pandemics have done: It burns through the world and leaves behind enough immune survivors that it eventually struggles to find viable hosts. This “herd immunity” scenario ............. SARS-CoV-2 is more transmissible and fatal than the flu, and it would likely leave behind many millions of corpses and a trail of devastated health systems. ................ The third scenario is that the world plays a protracted game of whack-a-mole with the virus, stamping out outbreaks here and there until a vaccine can be produced. This is the best option, but also the longest and most complicated. ........... it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into people’s arms. ......... “we need to be prepared to do multiple periods of social distancing” ......... seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect. ......... immune citizens can return to work, care for the vulnerable, and anchor the economy during bouts of social distancing. ....... There’s no reason that the U.S. should let SARS-CoV-2 catch it unawares again, and thus no reason that social-distancing measures need to be deployed as broadly and heavy-handedly as they now must be. ..........

the virus might simmer around the world, triggering epidemics every few years or so.

.............. COVID-19 may become like the flu is today—a recurring scourge of winter. ........... About one in five people in the United States have lost working hours or jobs. Hotels are empty. Airlines are grounding flights. Restaurants and other small businesses are closing. ........ “We’re far more urban and metropolitan. We have more people traveling great distances and living far from family and work.” ........... After infections begin ebbing, a secondary pandemic of mental-health problems will follow. At a moment of profound dread and uncertainty, people are being cut off from soothing human contact. Hugs, handshakes, and other social rituals are now tinged with danger. People with anxiety or obsessive-compulsive disorder are struggling. Elderly people, who are already excluded from much of public life, are being asked to distance themselves even further, deepening their loneliness. Asian people are suffering racist insults, fueled by a president who insists on labeling the new coronavirus the “Chinese virus.” Incidents of domestic violence and child abuse are likely to spike as people are forced to stay in unsafe homes. Children, whose bodies are mostly spared by the virus, may endure mental trauma that stays with them into adulthood. .................. “My colleagues in Wuhan note that some people there now refuse to leave their homes and have developed agoraphobia” ...........

washing your hands for 20 seconds, a habit

that has historically been hard to enshrine even in hospitals, “may be one of those behaviors that we become so accustomed to in the course of this outbreak that we don’t think about them .............. Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements.

“This is the first time in my lifetime that I’ve heard someone say, ‘Oh, if you’re sick, stay home’”

............ Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs.

Having internalized years of anti-terrorism messaging following 9/11, Americans resolved to not live in fear. But SARS-CoV-2 has no interest in their terror, only their cells.

............. When an administration prevaricates on climate change, the effects won’t be felt for years, and even then will be hard to parse. It’s different when a president says that everyone can get a test, and one day later, everyone cannot. Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs. .................... After 9/11, the world focused on counterterrorism. After COVID-19, attention may shift to public health. ............ Despite his many lapses, Trump’s approval rating has surged. ......... The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation. Buoyed by steady investments and an influx of the brightest minds, the health-care workforce surges. Gen C kids write school essays about growing up to be epidemiologists. Public health becomes the centerpiece of foreign policy. The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.....

In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.







AOC warns she may force House members to return for stimulus vote, potentially delaying final passage
Fox's Brit Hume says it’s an “entirely reasonable viewpoint” to expect that grandparents would be willing to die to protect the economy
Biden calls Trump's Easter back-to-business goal 'catastrophic'
The Changing World Order I believe that the times ahead will be radically different from the times we have experienced so far in our lifetimes, though similar to many other times in history. .......... I was seeing the confluence of 1) high levels of indebtedness and extremely low interest rates, which limits central banks’ powers to stimulate the economy, 2) large wealth gaps and political divisions within countries, which leads to increased social and political conflicts, and 3) a rising world power (China) challenging the overextended existing world power (the US), which causes external conflict. The most recent analogous time was the period from 1930 to 1945. ......... roughly 10- to 20-year transition phases between big economic and political cycles that occurred over many years (e.g., 50-100 years). ..... the 1930-45 period but also the rise and fall of the British and Dutch empires, the rise and fall of Chinese dynasties, and others ......... My biggest mistakes in my career came from missing big market moves that hadn’t happened in my lifetime but had happened many times before. ..........

most things—e.g., prosperous periods, depressions, wars, revolutions, bull markets, bear markets, etc.—happen repeatedly through time.

......... when I paid attention to the details I couldn’t see the big picture and when I paid attention to the big picture I couldn’t see the details........ there are only a limited number of personality types going down a limited number of paths that lead them to encounter a limited number of situations to produce only a limited number of stories that repeat over time .......... gaps in wealth and values led to deep social and political conflicts in the 1930s that are similar to those that exist now. ........ I have been going to China a lot over the last 35 years and am lucky enough to have become well-acquainted with its top policy makers. This has helped me see up close how remarkable the advances in China have been and how excellent the capabilities and historical perspectives that were behind them are. These excellent capabilities and perspectives have led China to become an effective competitor with the US in production, trade, technology, geopolitics, and world capital markets. ......... At the start of 2020, more than $10 trillion of debt was at negative interest rates and an unusually large amount of additional new debt will soon need to be sold to finance deficits. .......... all reserve currencies in the past have ceased to be reserve currencies, often coming to traumatic ends for the countries that enjoyed this special privilege. ........... Wealth, values, and political gaps are now larger than at any other time during my lifetime. By studying the 1930s and other prior eras when polarity was also high, I’ve learned that which side wins out (i.e., left or right) will have very big impacts on economies and markets. ........... printing money and buying financial assets (now called “quantitative easing”) also widen the wealth gap because buying financial assets pushes up their prices, which benefits the wealthy who hold more financial assets than the poor. ............... the rises and declines of all the major empires and their currencies over the last 500 years, focusing most closely on the three biggest ones: the US empire and the US dollar which are most important now, the British Empire and the British pound which were most important before that, and the Dutch Empire and the Dutch guilder before that. .......... six other significant, though less dominant, empires of Germany, France, Russia, Japan, China, and India. .......... important empires typically lasted roughly 250 years, give or take 150 years, with big economic, debt, and political cycles within them lasting about 50-100 years. ......... a sequential picture of the world’s evolution via the events that led the Dutch empire to rise and decline into the British empire, the British empire to rise and decline into the US empire, and the US empire to rise and enter its early decline into the rise of the Chinese empire. ........ the Chinese leaders who all study these dynasties carefully for the lessons they provide.

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