Long-time reader/subscriber, first time writing in. I work in the leadership of a local government unit that has a pretty significant number of COVID-19 cases, but isn’t one of the biggest national hotspots. We have been progressively locking the area down since last week, with changes the last few days that basically shut the doors on all public life.
From the Atlanta Journal Constitution:
Phoebe Putney Health System’s flagship hospital in Albany, a city anchoring southwest Georgia, has exploded with possible COVID-19 patients in the last five days. The hospital now houses 65 patients who’ve either been diagnosed with the disease or are waiting for tests to confirm the diagnosis. That’s just the inpatients; 115 more with less severe symptoms are at home, waiting for test results. The hospital released the numbers along with a plea to speed up testing.
As we’ve moved into the shocking events of March one of my central experiences has been what I would call time dilation. My experience of the passage of time has changed radically. Some of this is the mundane fact that many of the markers of my daily life are falling away or shifting — getting the kids out the door in the morning, getting up and going to work, hitting the gym in the afternoon, various small trips around my neighborhood. Far more though it is what I suspect many of you have experienced: an escalating series of events none of us have any lived experience with and which most of us, I think, could scarcely imagine would ever happen. What’s unthinkable Thursday is quaint by Sunday. Such rapid shifts in our perceptions of the world and reality we’re living in are profoundly disorienting. I suspect more disorienting than many of us yet understand simply because there’s no respite from the rush of events.
As folks struggle to get their heads around how long the fight to “flatten the curve” might have to last to be truly effective, Josh Kovensky has a new story out framing up how to think about an essential paradox of the fight against COVID-19.
All else being equal, a successful mitigation strategy will tend to require sustaining extreme measures for longer than if we simply endure a short, fast, and brutal blitz of cases that overwhelm the health care system. As Josh puts it, it’s the difference between a tsunami and an extended high tide. Understanding that dynamic helps to begin to come to grips with how long the current disruptions may have to last.
That said, some expert readers responded to the story noting some other advantages to slowing COVID-19 down. They make some good points.
Today’s White House press conference with the President and other members of the COVID-19 team just concluded. It seems like someone had a serious talk with the President or perhaps he had a serious talk with himself. Because his affect seemed significantly different from what we’ve seen in other appearances. More orderly, less stupid, more candid. For the first time he shifted to the message that we’re not focused right now on the stock market – which lost 12% of its market today on the S&P. Once we’re through the health crisis the market will rebound, he said. Whether that’s true or not, it’s at least the right message.
We’ve all learned the critical role of testing capacity for the current national crisis and how far behind we are. There is some tentative good news on this front. The number of tests being conducted is rising rapidly. They are moving into the ballpark of daily testing numbers in South Korea, though of course the US has a population roughly six times greater than South Korea. Here are the very latest numbers compiled by the COVID-19 Tracking Project.
While it’s not quite 1600 Pennsylvania Avenue, this is still a big deal.
A few states in the West already have mail in voting that appears perfectly suited to a possible pandemic era election. States around the country, while managing the crisis response to the outbreak itself need to be into discussing, planning and implementing new plans for the November elections. Under normal circumstances this wouldn’t be nearly enough time. Obviously these are far from normal circumstances. And seven-plus months is just enough time to make major changes. The country is already in the midst of a profound public health crisis and heading into a deep and likely protracted economic crisis. We must now guard against a crisis of political legitimacy which would not only be a disaster in itself but dramatically compound the difficulty of dealing with the public health and economic crises.
The Governor of New York and Mayor of New York City have announced the city’s schools are closing down. It appears they are still figuring out plans to leave some facilities open for meals, children of critical workers, etc.
You’ve likely seen this referenced in a number of emails I’ve posted. But I wanted to draw it together in a single post because to me it is a significant piece of information.
The decision to close schools involves a complex social and epidemiological calculus. But the act of closing schools itself seems to play a decisive role in public messaging. Populations don’t move into a true crisis footing until they hear that school systems are closing. Then they do.
The Times just pushed this article reporting that the US is definitely not running out of food. That is news that is very important to amplify. We should also use common sense. Our supply lines are not remotely equipped to produce the amount of hand sanitizer that is currently being used. Food is different. People will not be eating more food. People will panic buy and some limited, responsible stocking up may be warranted to help with general social distancing. But Americans are not and will not be eating more food. This is a critical and when you think about it obvious difference from goods that are currently running low like hand sanitizer and medical supplies.
From TPM Reader BC …
I live in a rural area [in Michigan]. But, though rural, I’m close to a road that serves as a minor spoke connecting a few small towns. Typically, lots of people use this road to avoid larger traffic flows. The State of MI closed schools on Friday. The general storyline was hunker down and avoid social gatherings. So, this weekend, just about the only sounds around my house have been spring birds, a few dogs barking now and then, and an overarching silence. Virtually zero traffic on the roads around. Only thing that has ever come close to this was 9/11.
From TPM Reader XX, an emergency room doctor in the Bay Area. The email is from yesterday. The note contains a lot of sobering, scary information. I urge you to read it as one person’s rapid fire report in a chaotic situation and put it in the context of other news reports from other sources. I share it with you mainly to highlight the decisions, sacrifices and experiences of health care workers who are knowingly putting themselves in danger because it is what their professional commitments require and what they choose in a moment of crisis. I have removed a few brief asides to preserve XX’s anonymity.
From XX …
I’m a long time reader, but have rarely (if ever?) taken the time to write in. I’m an emergency physician at a hospital in the Bay Area … Perhaps this is all common knowledge and not informative – but I find the disconnect between what I see at work and in the news disconcerting so figured I’d add my two cents.
Everyone I work with seems resigned to a sense of impending doom, and an expectation that we will all be infected in the weeks ahead, and that we have no alternative course of action without abandoning our patients.
Here’s an interesting artifact of information from what seems like a mounting rebellion within the New York City public system against the Department of Education. Minutes ago, I received an email from the PTA of the public school our children attend. It was a statement from the leader of the UFT (the city teachers union) basically denouncing the Mayor and the DOE for not closing the schools. A taste of the tone: “The mayor is recklessly putting the health of our students, their families and school staff in jeopardy by refusing to close public schools.”
On many levels, governmental leaders are failing us. This shouldn’t be entirely a surprise. In crises things break. Public leadership is one of them. Yet we are also seeing decisive, smart actions by governors and mayors across the country – and the countless civil servants and emergency responders who they speak for and direct. I have no doubt that people are working heroically within the federal government’s public health and emergency response bureaucracy, though their work can be obscured by the decision makers at the top. We are also seeing mass action emerge organically from citizens across the country.
Over the last 18 hours I have done my best to research the situation and decision-making for the New York City public school system. Everything I’ve seen confirms my impression that the Mayor and Chancellor of the school system are in the process of committing a grave and even historic error. It is highly notable that, to the best of my knowledge, in none of his public statements has Mayor DeBlasio shared with the public what the city’s Department of Health and Mental Hygiene has advised him with respect to schools.
Important new developments in a story we’ve been working since Friday: two emergency room doctors on opposite coasts are in critical condition in what could be the first U.S. cases of occupational transmission of COVID-19. Josh Kovensky has been on the story day and night. Here’s his report.
TPM Reader MG on new hospital bans on visitors …
This makes sense but is an extra strain on my family… Our adolescent daughter suffers from a chronic illness and was hospitalized last Thursday at our local children’s hospital in [REDACTED] for the second time this year. Her hospitalizations are lengthy. Her previous stay was 3 weeks long. A nurse called me from the unit this evening to tell me that a new rule requires that only one parent may ever visit. You have to pick. It needs to be the parent most in charge of the patient’s care because that person will also attend what were formerly called “family” sessions with doctors and other caregivers in lieu of both parents. It’s a tough situation. Meanwhile, Ohio has banned visitors all together.
Crying for all the parents with hospitalized kids.
In a memo released late Saturday evening, White House Doctor Sean Conley said President Trump tested negative for COVID-19.
“Last night after an in-depth conversation with the President regarding COVID-19 testing, he elected to proceed. This evening I received confirmation that the test is negative,” Dr. Conley wrote.
Read the full memo after the jump.
Here’s a note from TPM Reader GH. It echoes DB’s points about the social effects of school closures. I print this not as something in favor of school closures (I can see the opposite argument) as simply a description of their impact …
I’m a parent of 3 children in Seattle Public Schools and am an employee of Amazon and have been working from home for close to two weeks now. I think there were two things that brought on the decision to close the schools. First, I think teacher absenteeism was approaching a breaking point and they could see the writing on the wall. But secondly, the equity lens. Many of our lower-income students live in multi-generational households. They were, correctly in my opinion, starting to stay home.
Here’s an update from TPM Reader DB from the Greater San Diego metro. Let’s understand collectively that each of these notes is a snapshot, not necessarily representative of what is happening in other areas or addressing every issue. Taken together though they can give us some partial understanding of what is unfolding in our country …
As usual TPM is out ahead of the curve, educating readers on pros, cons, and consequences of school closings to slow the spread of COVID-19. It was with this foundation that I followed the five (so far) very thoughtful emails from my daughter’s school district over the last few weeks.
Things in the San Diego area just changed suddenly. On Thursday evening my daughter’s district was going to stay open with the email citing the services offered by the schools. On Friday morning, the district decided to close until April 6, which would be the end of spring break, with the email citing the need to limit community transmission. I’m sure the decision was motivated by announcement that the Los Angeles and San Diego Unified school districts are closing. The executive order by the Governor of California issued on Thursday has had a big impact. It looks like it is governors who are stepping up.
Let me return again to the issue of school closures. Though I’m talking about New York City I’m giving this focus here because the issues are applicable to communities around the country and most or all will be facing these questions in the near future.
(For those who are coming to this as the first thing I’ve written on this subject which you’ve read and think I’m not addressing various issues, I invite you to read this post from Thursday March 12th.)
The most constructive point that has come out of my conversations with readers and also stakeholders either in New York or other parts of the country is that the decision-making can break down when we’re thinking about it in zero sum or binary terms. For instance, TPM Reader DW explained that he can keep his kid home (and plans to do so) but many other parents don’t have that option. As I explained in my response, this is a very good argument for switching to offering both remote and in-person instruction. TPM Reader TP notes rightly that the close or not close discussion can leave out a lot of options for what amounts to triaging different parts of the community that are able to do different things.
Before signing off after this chaotic day, let me make a final point about the schools. I’ve written very critically today about the decision – perplexing to many – to keep open the New York City public schools. I fear the Mayor is making a grave mistake. That is not because I think he’s making a bad public health decision but because he doesn’t seem to be approaching it as a public health decision at all. He’s looking at it through the prism of the city Department of Education which has many critical equities it manages. But public health, certainly not in this crisis context, is not one of them.
From TPM Reader MS …
I have rooted for Mayor de Blasio since he took a strong stand against stop-and-frisk and for a bold affordable housing plan in 2013. I’ve been an observer of him for many years from inside and outside city government. And I am completely perplexed by his very-in-character decision to not close the schools.
Until today I was on the fence about closing the schools, and have two public school kids myself who need a lot of supervision. But after talking to other parents and some teachers, it’s just inexplicable. (I will acknowledge that I can weather a school closing, as I’m a white collar worker with remote capability and some control over my schedule.)
I say ‘chaos’ in the title. But I remind myself and you that everybody here is working in a frightening, unprecedented situation. Here from TPM Reader XX in Washington State …
I see your email about de Blasio being lost …
I’ve written in a couple of times recently about this. I work with schools in Washington. In the heart of the problem. District leadership had been looking to health departments for guidance. They simply didn’t get it in an actionable way. I hope someone with good investigative skills does a deep dive into the Snohomish county health department’s response. Woefully lacking or criminally negligent. Or worse.