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When a stupid man is doing something he is ashamed of, he always declares that it is his duty. George Bernard Shaw

Pandemic Diary Day 30

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April 23, 2020

I was relieved to find that 88% of Americans consider the protestors demanding the instant opening up of the country to be wrong.

These wantwit’s will be the death of so many should they get their way, most of which will either be themselves or their loved ones.

We keep on asking “What’s the ‘right’ time to re-open?” But that’s a hard question to answer without a more philosophical one: “How much death are we okay with?” Esther Choo, MD

There is a new program bouncing around called Box It In. The CDC has suggested the US abide by these guidelines. A rather big leap considering the desultory way our federal government has acted in co-ordinating the fight thus far.

Most health experts are horrified of our opening up the country until these four guidelines have been met.

At a minimum a massive increase in testing from the current 150,000 a day to what scientists say should be 500,000 to 700,000 a day.

Positively tested people must be isolated. Hospitals need to protect their workers, nursing homes need to minimize spread and people unable to remain in their own homes, either because they are alone and can not care for themselves, or have at-risk family members need to be housed in temporary facilities such as hotels.

Then a system of contact tracing , which seems a herculean task at this point, because protestors standing on the steps of the Minnesota capitol weren’t exactly wearing name tags.

Former CDC director Tom Frieden has estimated that as many as 300,000 contact tracers will be needed, and the Johns Hopkins Center for Health Security and the Association of State and Territorial Health Officials — which represents state health departments — estimate 100,000 more contact tracers are needed.

We then need to quarantine those that have been exposed. The Chinese did a terrific job of this because they had quarantine facilities built during the SARS epidemic, and had kept them in wait for another crisis. We have been seeing the building of temporary facilities by the US Army Corps of Engineers. Many of these were built to be overflow hospitals, but they can easily function as isolation centers.

Time will deal with another issue, not called out in the Box It In campaign, but embraced by the CDC, which is to wait to lift shelter-in-place until communities show a 14-day plateau in new infections and then a downward trend.

There is a major problem with two of these steps. There is no actual money for testing or tracing in the President’s guidance, while the senate has passed a bill giving $25 billion for disease testing, we will have to wait and see how far it goes. The President sits in a unique position to step up to the plate and budget more, he has not. Instead he insists that the responsibility for combatting Covid-19 lies with the our country’s governors while they are battling the overwhelming unemployment claims and other drains on their budgets trying to keep people fed and housed.

In times of war it is the federal governments responsibility to get the ball rolling towards peace, and yet we have a system where nasopharyngeal swabs and reagents (chemicals need for testing ) are not even available to get a viable program off the ground.

The largest manufacturer of nasopharyngeal swabs is Northern Italy, the only other company in the world producing these is Puritan, located in Guilford, Maine

The shiveringly annoying thing about this is that despite the fact that this problem had been on the government’s radar since February the FDA did not give approval to corporations to make cheaper, easier-to-use swabs until April 16th.

There are plenty of labs geared up to provide tests from private entities to universities, that is not the problem, the problem is simply supplies. Shame on us. A two year wait for a vaccine, anyone can understand, no nasal swabs, that is an unforgivable lack of oversight and management.

The bad news just keeps on rolling in. The director of the Centers for Disease Control and Prevention has said that the second wave of Covid-19 in the fall will be far worse because it is likely to coincide with the start of flu season.

So we need to be preparing for a probable second shelter-in-place order come the fall.

We have a national election this November, if we have not accomplished the items above to make people feel safe we must begin looking at expanding mail-in ballots.

I live in California where we have no-fault vote by mail. What that means is I don’t have to have a reason to obtain an absentee ballot. In fact years ago I checked the box to make myself a permanent voter by mail.

All 50 states will provide an absentee ballot to voters that request one. Twenty states require voters to provide a qualified excuse before they can receive an absentee ballot. Twenty-seven other states and the District of Columbia, however, offer “no fault” absentee voting. Of these, seven states offer the opportunity for voters to join a permanent absentee voting an additional nine states have a provision for some but not all voters — often overseas voters or voters with disabilities — to join a permanent absentee voting list.

Washington, Colorado and Oregon have all-mail voting, think of it as absentee voting for everyone.

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The resistance to mail-in voting is interesting. Trump said that if the United States switched to all-mail voting, “you’d never have a Republican elected in this country again.”

This is patently false. According to Rice University professor Robert Stein, who has been instrumental in putting in place vote-by-mail systems says “in the states and counties that have transitioned to all-mail voting, there has been little evidence of partisan advantage for either side because of mail voting”.

There is one thing for sure that mail-in voting accomplishes higher turn out. Oregon and Washington, the states that pioneered all-mail elections, have long been among the highest-turnout states in presidential elections.

A 2013 study of voters in Washington by professors at Yale and the University of California, San Diego, found that voting by mail increased turnout by two to four percentage points.

There is of course the idea that there is more voter fraud with mail-in ballots. In 2014 Sage Journals conducted a study and published this concluding statement: existing scholarship has failed to produce conclusive evidence concerning the existence or frequency of electoral fraud, especially the type of fraud that would be prevented by photo identification laws and signature verification protocols for voting by mail.

The down side is that studies have found that people voting by mail skew white. This was pointed out to the Maryland Board of Elections during their June 2nd primary and as a result the board decided to keep a limited number of polling places open, a sensible and rather easy answer, but a concern if we are sheltered-in-place in November.

Approximately 3500 people in Wisconsin stood in lines for hours during this pandemic, showing how much voting in today’s environment means to people. The fall out from that is, that as of the time I am writing this, 7 of those people have been infected with the virus, 6 voters and one poll worker.

This country is still tragically short of PPE’s, I have little faith we will see adequate testing anytime soon. Buckle up, it is going to be a bumpy ride.

Trivial Things

My Horoscope for today: It’s been a while since you and a relative touched base. A catch-up phone call leads to a profound and deeply moving conversation.

The NYT Crossword Puzzle: easy for a Thursday and a groaner to boot

San Francisco weather: 66 degrees

NYSE DOW opened at: 23543

Italian word of the day: inoltre (moreover)

Spanish word of the day: escritor (writer)

OED word of the day: philobiblist (A lover of books)

Days under Shelter In Place: 41

Reading: The Great Influenza by John M. Barry

Studying: I finished the Inferno, giving myself a break before beginning Purgatorio by Dante

My Black and White Picture of the Day

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Something Silly From the Internet: Guess who is open to do your hair, nails and eyebrows? The funeral home! If you want an appointment, keep running around.

If you liked this please clap once or twice and let me know. Thank you

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