Editors’ Blog

Testing, Reopenings and Magical Thinking

TPM Reader PK follows up on reopening …

I was struck by reader JL’s comments and your statement that, “We shouldn’t assume that the states that are in the process of opening up will quickly see dramatic resurgences or outbreaks. There’s a lot of complexity under the hood distinguishing one state’s plan from another.”

I think that’s exactly right and it is why I was so disturbed by a NYTimes opinion piece that ran this weekend from Brown University President Christina Paxson. It offered a bold plan to reopen college campuses around the country by the fall, talking about changes ranging from keeping large classes online to wearing masks and minimizing large gatherings.

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43% in the Bronx Have Had COVID, Says ER DOC

In a widely-read column in The New York Post the Chair of Emergency Medicine at St Barnabas Hospital in the Bronx says it’s time to reopen the city. Though I disagree with him, as someone who has worked in an emergency room through the crisis and contracted COVID19 himself, Daniel Murphy has plenty of standing to share his opinion. I note the piece for a more particular reason though. Murphy says that 43% of Bronx residents have been infected with COVID19. He doesn’t say where he gets that number and he doesn’t say explicitly that he’s talking about antibodies testing. But context makes the latter point pretty clear and he must be drawing this from the serology testing the state has been doing over the last two weeks.

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Where Things Stand: More Reports That Trump Was Warned

There have been dozens of news reports in recent weeks suggesting President Trump was warned about the dire circumstances surrounding the coronavirus pandemic around the same time that he was downplaying the spread publicly.

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Trump: You Were Supposed to Be Loving Me

A few days ago I mentioned that if you took an observer from 2016 and showed her President Trump’s tweets today they’d think something had gone seriously wrong with the man. Yes, he was all the bad things in 2016. Almost everything that has happened connected to him was predictable. Much of it was in fact predicted. But the affect, the garbled speech, the dipping into vocabulary of Internet hate speech groups, it’s all much wilder and antic than the version we saw four years ago. But as I wrote this I noticed something different.

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Annals of Reopening

These points from TPM Reader JL are all, I think, well-taken. We shouldn’t assume that the states that are in the process of opening up will quickly see dramatic resurgences or outbreaks. There’s a lot of complexity under the hood distinguishing one state’s plan from another. And in many cases, the real restraint isn’t public orders as public fear and resistance to going back to normal.

I heard a news report of states planning substantial reopens in first week of May, and with the caution that unnamed and uncharacterized ‘public health officials’ were worried about it. (Another example, IMHO, of the BS corporate ‘information product’ slop we flatter as news reporting in the US)

The selection of states mentioned included CO, MN, MT, FL, GA, TN. And it occurred to me that is a collection of good, bad and ugly state political leadership.

So, I hope TPM keeps an eye on the whole range of ‘early reopen’ states and reports out the range of outcomes from a comprehensive representation of the good, the bad, and the ugly.

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More Exposure Data for New York City

New serology/antibodies data from New York State is out today. This is the second round of serology testing. Gov. Cuomo said the state has now tested 7,500 people. Presumably that’s a rough count and I assume it is inclusive of the previous number, which was 3,000 tests. This second round had 14.9% positive statewide, up from 13.9%. In New York City, the number is 24.7%, up from 21.2%.

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Where Things Stand: Mark Meadows’ ‘Biggest Concern’
This is your TPM early-afternoon briefing.

In what appears to be an attempt to contradict a recent report in the New York Times — that President Trump spends his days eating french fries and obsessing over the TV — newly minted chief-of-staff Mark Meadows told the New York Post this weekend that his “biggest concern” as a top White House official is making sure Trump eats lunch.

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Our Evolving Knowledge of the Insidious Disease, COVID19

One of the most fascinating and ominous things about COVID19 is that as clinicians and researchers have learned more about it that knowledge has not simply filled out the details of a broadly understood story. Rather, more knowledge has confirmed how little we knew and still know about the disease. For lay people like most of us the original story was that COVID19 was a viral respiratory tract infection. It was more deadly, less predictable in its course and had no known therapies to treat it. But broadly speaking a disease that attack the lungs, leads in severe cases to pneumonia and from there a cascading series of failures that can lead to death. Doctors had a more sophisticated but broadly comparable understanding. Four months plus into the history of the disease they know that COVI19 can attack most of the body’s major organs – heart, liver, kidneys, brain, et al. It’s far more insidious and copious in its range of potential attacks on the human body than they realized only six weeks ago.

A new emerging issue is how COVID19 attacks or disrupts a patient’s blood – specifically the delicate and critical balance of regulating when to flow and when to clot. When I first read articles about this I assumed these clotting issues were just part and parcel of the failure or near failure of the various organ systems. COVID19 attacks your liver or kidneys and clotting issues are just a manifestation of injury. But that does not seem to be the case. It seems to be a distinct way COVID19 attacks the body.

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The Growth of COVID19 Testing

Good news has been hard to come by in the COVID19 Crisis. But testing capacity across the country did appear to grow substantially over the last week. Here is daily COVID19 tests across the country along with a 7 day moving average.

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Another Antibodies Data Point

Today researchers at the University of Miami released the preliminary results of serology (antibodies) testing in Miami-Dade County. They estimate that 6% of the population – or 165,000 residents – have been exposed to the disease. According to this write-up: “The researchers say they are 95% certain that the true amount of infection lies between 4.4% and 7.9% of the population, with 6% representing the best estimate.” The methodology for the sample appears to have been more robust than that applied in the Stanford group’s studies in California. Researchers say they used data from electrical utility Florida Power and Light to generate phone numbers in targeted demographic areas who were then contacted asked to voluntarily provide samples. Read More

Mask and PPE Patronage

If you haven’t had a chance I hope you’ll take a moment to read Josh Kovensky’s exclusive on federal government confiscations of masks and other PPE during the COVID19 Crisis. It’s the kind of piece we’re very proud to publish and the kind of weeks’ long effort your memberships and contributions to the TPM Journalism Fund make possible. Explicit partisan politics or political motivation did not turn out to be an issue in that particular story. But this story from NBCNews brings the broader story into focus. At every level, the White House is using access to PPE, medical supplies and testing as patronage. Friends get help; enemies can talk to the hand.

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Where Things Stand: How Will We Even Begin To Explain This?
This is your TPM early-afternoon briefing.

I think we all may be very numb at this point. If you’re not already, I am sure you will soon join the cynics.

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COVID19 and the Wisconsin Election

Let’s go back to Wisconsin after the April 7th in-person election. We have a couple more days of data since we discussed this last. Did it lead to a bump in COVID19 infections?

Let me show you the data with first a seven day and then a three day moving average.

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Preliminary Antibodies Study Shows 21% of New York City Infected

Gov. Cuomo released some very important data today from New York State’s first COVID19 serology (antibodies) testing. They’re preliminary. So keep that in mind as more than just fine print. (Details on that in a moment.) The key data: 21.2% of New York City residents tested positive for COVID19 antibodies. 16.7% for Long Island; 11.7% for Rockland and Westchester (the suburbs just to the north of the city); and 3.6% in the rest of the state.

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Where Things Stand: Trump Forced To Butt Heads
This is your TPM early-afternoon briefing.

Reopen, but not like that.

While it took some goading, President Trump criticized his friend and fellow Republican Brian Kemp on Wednesday evening for his plan to push businesses in his state to reopen, a move that the President has been hyping for weeks.

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The Great Distractor

One of the many things Donald Trump has done badly for the country in recent months is focus this debate – largely around himself – about whether to ‘open up’ or not. This argument is good for generating intractable arguments. But it’s not terribly productive. Jeremy Konyndyk, a former Obama administration official involved in the US ebola response and other international aid efforts, suggests this analogy. Your house is on fire. You can shut the windows to deprive the fire of oxygen. That will slow it down. But eventually you’ll suffocate. We’ve now got a public debate which amounts to whether to be incinerated or suffocate. What we need is the fire brigade to show up and hose down the house. The fire brigade, as Konyndyk explains, is a system of widespread testing, contact tracing, isolation for the infected and beefed up hospital capacity to make an interim new normal possible.

This is very hard work to do.

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Schrodinger’s Trump

One of the enduring features of the early Obama administration and the 2008/2009 global financial crisis was how quickly the Republican party pivoted to being the chief critic of efforts to clean up the mess their incumbent President and party had in many respects created. Suddenly the GOP barely knew George W. Bush and the 43rd President was retrospectively rebranded as the exponent of something called ‘big government conservatism’ that the GOP absolutely had nothing to do with and had never truly supported. Months into office Barack Obama was the spendthrift leading the country toward hyperinflation, decadence and ruin.

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Where Things Stand: Now The Trump Org Wants Equal Treatment
This is your TPM mid-morning briefing.

They’ll have what everyone else is having.

Eric Trump, who is overseeing the operations of the Trump International Hotel in Washington, D.C. while his father is president, has requested the same rent relief from the General Services Administration that other federally owned buildings are getting while the nation grapples with the COVID-19 outbreak.

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Have Fatality Numbers From New York Already Debunked the Santa Clara Serology Study?

Since the first reports in January of a novel coronavirus spreading out of control in China, people around the globe have been trying to figure out just how lethal the disease is. As the pandemic has ravaged the United States and shuttered large sections of the national economy the question has only become more controversial and politicized. An infected individual’s chances of dying or becoming gravely ill from COVID19 are not only important in themselves. They directly inform what costs society should be willing to incur to slow or halt the spread of the disease.

That question is now engaged again in the furious public debate over when or how quickly to restart economic life in the country. We’ve seen the crazy talk and denial on Fox News and other pro-Trump media. But I want to discuss a version of this debate being carried on by real doctors and public health scientists, with very direct impacts on what Americans do next as they combat COVID19.

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Not Good

It’s still an initial study, not the kind of double blind controlled study that is the gold standard of drug studies. But the largest study to date, based on data from the VA, shows that hydroxychloroquine, the purported miracle drug repeatedly touted by President Trump, showed slightly MORE deaths from COVID19 among those who were treated with the drug. Read More

How Deadly is COVID19? NYC Sets a Lower Bound

There’s been a lot of discussion about how deadly COVID19 is. It’s always seemed highly unlikely that the number of fatalities per lab-confirmed cases is at all representative of the true percentage of people who die from being infected with COVID19. That number was over 3% in China, about 5.4% in the US currently and has ranged as high as 10% in Italy. Far too many cases are escaping lab confirmed detection for those to be close to accurate.

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Where Things Stand: What Does Trump’s Immigration Tweet Mean?
This is your TPM early-afternoon briefing.

Beyond perpetuating his own political objective, President Trump’s latest Twitter announcement on temporary immigration action likely won’t bring much substantial change to policies or programs his administration has already halted in the wake of the pandemic.

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Did The Wisconsin Primary Spark New Infections?

You remember the controversy. To me it was one of the most unconscionable acts of the whole COVID19 Crisis in the US, which is saying a lot. The Wisconsin GOP forced an in-person in election in the midst of a deadly epidemic because they believed that a low turnout election would help them retain a seat on the state Supreme Court. As it happened, they lost the seat. But did forcing Wisconsinites out of their houses and to voting stations spur new infections in any documentable way?

Let me start by saying the evidence looks ambiguous to me at least. But it’s gotten some discussion online. So I put together a chart to see what happened.

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An Extinction Level Event for the News

I’ve told you a few times that the news business has been thrown into severe crisis by the COVID19 epidemic. It’s not necessarily the most hard hit industry. Hospitality, travel and related service industries have been far more drastically affected in absolute terms. But those industries were all doing well pre-crisis. They faced no structural challenges to their business models. The news business has been in an evolving and protracted crisis for years.

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Where Things Stand: Rick Gates Also Hopes To Avoid COVID-19 Spread In Jail

The pandemic and the Russia probe have collided, in more ways than one.

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Time’s Arrow, Backwards
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In the last couple years I’ve seriously upped my daily exercise game. Until about six weeks ago I spent about an hour on an elliptical machine almost every day. An elliptical was key because a few years ago I tore my ACL and in consultation with my doctor decided not to have it repaired. It didn’t hurt and I had basically full function. Jogging as a regular exercise was out. But I never liked jogging anyway. But without access to a gym that became more of an issue. Don’t get me wrong. I can run and even sprint. But I can feel in my knee that an hour of it a day over time is not a good idea. So I’ve resorted to long walks which meant I needed something to listen to.

That led me to the back catalog of our house podcast. It’s pretty good! If you haven’t checked it out definitely give it a listen. For me though it has been fascinating to retrace the last eight weeks in reverse: the slow machinery of impending crisis half a world away accelerating into a full national emergency and perhaps the greatest public crisis of our lifetimes.

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Seeing The ‘Open the Economy’ Protests In Their Proper Light

The protests we’ve seen in a handful of locations around the country have bamboozled a lot of the national press. Look closely and a lot of the turnout is heavily stocked with militia types and the kinds of groups who turned out for the Charlottesville protests a couple years ago. But the bigger thing is that for now they appear highly orchestrated. In Michigan, they appear to be in part in reaction polling showing severe declines in public support for President Trump. They’re organized by groups funded in large part by the DeVos family. These are basically Trump loyalists supporting Trump at his request and mobilized by key rightist groups. The key question, as TPM Reader TS explains, is whether what starts here as orchestrated and largely inorganic takes on a life of its own and gains political traction. They now have Fox and an incumbent President cheering them on as a demonstration of political identity.

As for the “open the economy” protests right now, I am keeping an eye on them. A modest number of places so far, and participants in the tens to hundreds to around a thousand apiece. These early events look very orchestrated by a few key national professional organizations – and more electorally aimed than early Tea P or resistance protests were in 2009 and 2017. The orchestrators are Americans for Prosperity, Freedom Works, Club for Growth, and the Trump reelect campaign, all national professional operations. The advocacy groups are all ultra-free-market operations that most certainly do not want most Americans to become reliant upon public benefits or more trusting of government.
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More on Emerging Serology Surveillance

Let me add a few more nuggets of information on this emerging topic.

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More on the California Serology Study

More on that serology study I noted below. My general point stands about how vulnerable and relatively untouched the California population remains based on these numbers. But there’s another key point to take note of. TPM Reader BR focused my attention on this. If we extrapolate the total number of infections across California, this shows just how massively the official infection numbers undercount what appears to be the actual number of California residents who’ve been infected.

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Very Important Data

We keep hearing about how we will know more once we get the first serology data to find out just how many people have been exposed, infected and thus (presumably but not certainly) immune to further COVID19 infection. We now have a preprint just released of a study from Santa Clara, California of over 3,300 people. The news is not great, though there are certainly many different ways of defining ‘good’ or ‘bad’ news in this case. The study found that 1.5% of people in the study were seropositive; adjusted for demographic weighting the number was 2.81%.

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