Editors’ Blog

Your COVID19 Turning Points #9

From TPM Reader MM

My story is like many others — not dramatic in itself but important to me. In February 2019 I was diagnosed with breast cancer. Treatment included surgery, chemotherapy, radiation therapy, physical therapy, and follow-up surgery. I lost count of the medical appointments in 2019, but it was somewhere north of 70. Needless to say, last year didn’t include much fun.

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Your COVID19 Turning Points #8

From TPM Reader IS

Like the professor who first was so wrapped up in his move to France that the reality of the whole situation didn’t hit him right away, our family was so wrapped up with some big changes that initially had no connection at all to COVID 19 that we too didn’t connect it with what would happen just a few weeks later. We are the parents of a 37 year old daughter who has Stage 4 breast cancer.

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Distinguishing the NYC Metro Outbreak from the Rest of the Country

From the beginning of the COVID19 epidemic in the United States the epidemic has been dominated by an outbreak in the New York City metropolitan area. That outbreak is distinct from the progression of the disease in the rest of the country. It has its own intensity, timeline, arc. The New York City metro is an integrated economic, transportation and population reality – and thus a distinct epidemiological reality – even though it is spread over three different states. So to understand the NYC metro outbreak and the progression in the rest of the country it is helpful to separate them out visually.

Here are the latest numbers as of yesterday evening, plotted out for the number of new cases per day as well as the new fatalities reported each day.

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What Are COVID-19’s Long-Term Medical Effects?

Fascinating email from TPM Reader JO, whose personal bio is tailor-made for TPM:

I’m a critical care nurse working in a COVID ICU.  I’ve practiced nursing in a variety of settings, from helping to run an Ebola Treatment Unit in Liberia to coordinating mass vaccination campaigns during the H1N1 pandemic.  I’m also a former political professional who really appreciates your insight and analysis.

One thing that I feel is really missing from the public discussion about COVID is the surprisingly high rates of (likely) permanent disability among those who become critically ill.
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A Dismal COVID19 Miscellany

Let me run through a few miscellaneous news items.

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Your COVID19 Turning Points #7

I am making my way through your COVID19 turning point emails. And really … they are so good. I struggle to know which to absorb myself and which to share in posts. I can’t post them all and many, in the nature of things, are similar. But each captures some unique angle on the story or human experience of it. There are entirely unexpected scenarios which aren’t turning points so much as collisions with life, like the – one imagines – quite awkward necessity of broaching with your fiance the possibility of postponing your wedding. That’s the experience TPM Reader JL shares.
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Where Things Stand: The Rewards Of Forcing The Desperate To Return To Work
This is your TPM mid-morning briefing.

The governors of Texas and Iowa will soon be rewarded for their reopening efforts with a visit to the White House this week.

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Going Once, Going Twice, SOLD

Your COVID19 Turning Points #6

TPM Reader KM tells us in the subject line of her email that she writes from Detroit …

My own experience of the pandemic is of something that was very distant and abstract up till the moment I was in the thick of it. So my turning point is more like a breaking point: the experience that split my life into a Before and a Now.

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Your COVID19 Turning Points #5

TPM Reader WC (not his real initials) is an emergency room doctor on the West Coast. His turning point is different from many of our who haven’t been on the front lines of the epidemic.

Like many of you listeners, I too saw the closure of schools and the cancellation of the NCAA championship/NBA season as big turning points. The other turning point for me was the day I walked into our ER at a large trauma center and it was totally empty, which is unheard of.

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COVID 36,000

One of the most depressing and least surprising developments in the last 36 hours is that the White House is apparently relying on a “cubic model” of the COVID19 epidemic prepared by White House economist Kevin Hassett to craft its crisis response. I have not seen any statisticians or epidemiologists who know precisely what “cubic” refers to the in this context – though there are some promising speculations based on simply plugging in one of the default trend lines (third degree polynomial) in Microsoft Excel. The more relevant point is that, according to The Washington Post, the model predicts the number of people dying of COVID19 in the US will fall to close to zero by May 15th – a scenario that seems all but impossible.

Here I can’t help but note a basic point. Hassett is not a health care economist, let alone someone at the crossroads of behavioral economics and epidemiologists. Indeed, his record as an economist is rather notorious.

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Trying to Make Sense of that Leaked CDC Model

As you may have sensed from my writing over the last two months I’m if anything a COVID19 pessimist. I have generally thought things would be worse than the consensus opinion anticipated. Unfortunately, I’ve generally been right. But let me strike a different note about this CDC model or forecast that has gotten all the news today. The numbers are stunning. And from a purely non-expert viewpoint they don’t seem credible. I put this forward purely on the basis of being very immersed in the current statistics and having at least some sense of how trends work.

Let me try to explain.

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The COVID19 Outlook Nationwide
William O. Douglas Federal Building and U.S. Courthouse, Yakima, Washington

Since the beginning of the COVID19 epidemic in the United States it’s been clear that there’s no single epidemic in the United States. There is more a series of urban and regional epidemics unfolding at different times and with different intensities. To a degree this is true for every country. But it is especially so for the US since the country is so large, both in terms of geography and population. More specifically or at least for now there is a New York epidemic and the rest of the country.

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Where Things Stand: The Rare Admission Of Error
This is your TPM early-afternoon briefing.

In the Trump administration, officials are more likely to dig their heels into errors than admit any level of wrongdoing.

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Your COVID19 Turning Points #4

From TPM Reader AL

My dad turned 80 on March 8th. I was already concerned about the coronavirus’s inevitable arrival, in no small part due to your excellent coverage, and it was in the back of my mind that he should cancel or postpone his birthday party and, if it wasn’t such a milestone, I might have pushed harder for it. But I didn’t, and I attended his party. Most of his friends were north of 70 and many of them weren’t taking the threat seriously (some of them wouldn’t for weeks after and at least one still doesn’t).

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Your COVID19 Turning Points #3

From TPM Reader Anon

I would say my COVID-19 turning point was January 25, 2020. I had also been following what was going on in Wuhan, but then saw a post at dKos by a member who goes by the name of AKALib. The post was titled “Wuhan Coronavirus – An Update, Prognosis and Projections”. It listed 18 countries that the virus was in, including 5 cases in the U.S. The post included clear graphs showing exponential growth of cases, and statements by virologists:

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Your COVID19 Turning Points #2

From TPM Reader BW

My turning point moment was in the first few days of March, when I happened upon this Feb. 29 Twitter thread from Trevor Bedford in which he concluded that the novel coronavirus had been spreading undetected in Washington state for six weeks.

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Your COVID19 Turning Points #1

TPM Reader BR’s turning points on the COVID19 Crisis while traveling abroad …

We left the US on 29 January for a 9 week stay in Ireland (through 5 April), to have been followed by 20 days in Portugal and Spain. Trip started off well enough when we realized that the legendary John Prine was on the same flight, and he was gracious enough to give us 20 minutes of his time chatting about all the places in Ireland he thought we should visit while we waited to board.

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Your COVID19 Turning Points

I have been fascinated by your accounts of your own turning points in the onrush of the COVID19 Crisis. They fascinate me both as a lapsed historian and also because they refresh my memory of an abrupt historical transition that is still less than two months old. Back in early March again and again we were hearing that the key signal of transition and the onset of a crisis footing was the closure of schools. Most people are only casual consumers of news. It is difficult for even important news to break through the routines of daily life. The closure of schools directly impacts almost every aspect of social life. It upends the life of kids. It upends the life of parents of school age kids. It upends all commercial and organizational life because vast numbers of workers have school age kids. Precisely because of these dislocations the decision to close schools unmistakably signals crisis. Again and again readers reported from around the country that it was in response to a school closure that the whole tenor of life in their community changed.

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What Was Your COVID19 Crisis Turning Point?

What was your COVID19 Crisis turning point?

For me it was February 25th when Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said on a CDC conference call: “We are asking the American public to work with us to prepare in the expectation that this could be bad.” It is not in my experience that public health officials make open-ended “bad” comments like that.

She went on to say: “Ultimately, we expect we will see community spread in this country. It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness.”

This wasn’t out of the blue for me. I’d been watching the ‘novel coronavirus’ developments closely since January. I just looked at back at my Amazon purchases and it was on February 2nd that I put in an order for a stock of hand sanitizer and cloth masks. But until Messonnier’s comments I had first assumed and then hoped I was making contingency plans for edge case bad scenarios. That made clear these were likely scenarios.

Equally ominous, the comments seemed aimed not only to alert the public but to alert the public precisely because the administration was refusing to do so, either didn’t know or didn’t want to tell citizens what was happening.

What was your turning point moment?

Must Read

Don’t miss this piece on a surge in cardiac episodes tied to COVID19 and how cardiologists have been forced to adapt.

May Day And The Other Government

International Workers’ Day, or May Day, comes on the heels of one of the worst periods for workers in quite some time. In the last six weeks, more than 30 million Americans filed for unemployment. At the same time, the S&P 500 gained more than 12 percent and recorded its best month since 1987.

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In Search of the COVID19 ‘IFR’

How deadly is COVID19? The question has mobilized countless researchers, become a political football around the globe and probably occurred to and triggered fear in the minds of most members of the human species. The question can be posed in various ways. But the closest to what people likely mean by it is what epidemiologists call an ‘IFR’, an infection mortality rate. That is to say, the percentage of people who will die from COVID19 after being infected by it. That’s different from the number of ‘cases’ since some infections never show symptoms and many never get recorded in any medical or governmental dataset.

The epidemic in New York City allows us to make initial calculations which, though imperfect, move us toward a real estimate as opposed to inferences, history and guesswork. For each variable in the formula we have an actual number based in science and quality record keeping, even if each is subject to substantial uncertainty and revision.

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Where Things Stand: The Long Lost Briefing
This is your TPM early-afternoon briefing.

After her predecessor rounded out her tenure as White House press secretary without holding a single press briefing, Kayleigh McEnany will hold one of those now-rare Q&A’s with reporters from the White House podium today. Read More

‘It Is Hard To Be Optimistic’

As a non-expert I’ve struggled over the last week or so to make sense of the status of the pandemic in the United States, but overnight a top expert laid things out in as clear a way as I’ve seen in a while. You probably know Jeremy Konyndyk as a disaster preparedness expert who served in the Obama administration and has since become a prominent voice on the U.S. COVID-19 response.

His rundown of why things aren’t getting dramatically worse but also aren’t getting any better helps pull together the various contributing factors to the brutal daily death toll at which we seem to have plateaued. By his own admission, it is not an optimistic assessment.

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Brutal Numbers and That Failing IHME Model

There is a common aphorism in the world of statistics: ‘All models are wrong but some are useful.’ It captures an important point: Models aren’t predictions as a psychic might make so much as attempts to organize data and think critically about uncertainty. The COVID19 model out of the Institute for Health Metrics and Evaluation at the University of Washington has become something of a canonical model for the COVID19 epidemic in the United States, in part because it appears to have been adopted by the White House task force. I wanted to take a moment to look at just how far out of line it has become even with current data.

The models estimates have bounced around a fair amount. It started high, jumped back considerably and has crept back up since. This isn’t a sign of a problem in itself. It is an attempt to model the course of a disease that didn’t exist six months ago. As we proceed it is supplemented with new data.

But consider these numbers. The latest estimate, released on April 29th projected 72,433 cumulative deaths through August 4th – a range from 59,343 to 114,228. But as of this morning the Johns Hopkins University data tracker shows that 63,019 people have already died. And if we look at the data compiled by the COVID Tracking Project 13,252 of those have died (or at least been reported) in the last seven days.

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China Says We’re a Joke. And, Alas, We Are.

This is a tweet from Xinhua News Service, the official state news service of the People’s Republic of China. Give it a look and then a few thoughts after the jump.

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Where Things Stand: You Know He’s In The Doghouse
This is your TPM early-afternoon briefing.
NATIONAL HARBOR, MD - FEBRUARY 28: Brad Parscale, campaign manager for Trump's 2020 reelection campaign, walks on stage during the Conservative Political Action Conference 2020 (CPAC) hosted by the American Conservative Union on February 28, 2020 in National Harbor, MD. (Photo by Samuel Corum/Getty Images) *** Local Caption *** Brad Parscale

Three different outlets published their own version of the same story: President Trump is not happy with his campaign manager Brad Parscale.

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More From the Annals of Excess Mortality
NEW YORK, UNITED STATES - 2020/04/04: First responders from The Brooklyn Hospital Center Emergency Medical Services arrived to treat patient at Greenpark nursing home The Phoenix in Brooklyn. (Photo by Lev Radin/Pacific Press/LightRocket via Getty Images)

Over the last week to ten days a wealth of new information has come to light about ‘excess mortality’ in the COVID19 Crisis. My last major installment in this series was back on April 15th when I pulled together preliminary data from a number of countries in Europe and compared them to the emerging data from New York City. As we discussed back in March, the basic formula is the same everywhere: collect data on average mortality in recent years, compare it to the total number of deaths over the same calendar dates this year and then subtract the official COVID19 death toll numbers from that “excess” amount. You are left with an approximate number which captures the true mortality levels, the true number of people who died, because of the COVID19 Crisis and the difference between the ‘true’ number and the official numbers we’ve grappled with in recent weeks.

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Where Things Stand: Workers Without A Choice
This is your TPM early-afternoon briefing.

Risk your health to return to work or lose your unemployment benefits.

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