JustOneMinute

Sunday Morning Open Thread

Here we go again.

Here's something to chew on. In a month, maybe literally:

Coronavirus may cause some food shortages, warns government task force

WASHINGTON — The nation could begin to see food shortages for some products if the people working on the supply chain lack personal protective equipment, warns an internal Trump administration document obtained by Yahoo News.

Empty supermarket shelves have become one of the most jarring images of the coronavirus pandemic, which has sickened 270,000 Americans and killed 7,000. But so far, there have been no food shortages, despite 90 percent of the American population being under state-enforced lockdown orders.

And despite the difficulties people have had in obtaining certain foods, like pasta, grocery stores are generally well stocked. Government officials have argued that any temporary shortages are the result of unprecedented demand, as people have bought more than usual, rather than an actual supply-chain breakdown.

“I want to assure you that our food supply chain is sound,” Sonny Perdue, the secretary of agriculture, said on March 20.

That, however, could change if the people who make, package and deliver food lack personal protective equipment, or PPE, including face masks and gloves, according to the internal document shared with Yahoo News, which provides a daily update on various aspects of the coronavirus response, including details ranging from state-by-state infections to hospital capacity and test sites.

The document, titled “Senior Leadership Brief COVID-19” and dated April 2, 2020, bears the seals of the Federal Emergency Management Agency, the Department of Homeland Security and the Department of Health and Human Services. It contains a brief description of findings made by the Food Supply Chain Task Force on the availability of PPE. 

Such equipment has been in short supply in hospitals, where doctors and nurses are routinely exposed to high amounts of coronavirus. The food industry also relies on a variety of protective equipment for food safety.

The April 2 briefing warns that the task force had completed an analysis and there could be “commodity impacts if current PPE inventory is exhausted.” There would be shortages of milk within 24 hours and of fresh fruits and vegetables “within several days.” The document estimates that “meat, poultry, seafood, and processed eggs” would become scarce within a period of two to four weeks, while “dry goods and processed foods inventories” — that is, the non-perishables that are pantry staples — could become scarce “as soon as four weeks” after face masks and gloves run out across the food supply chain.

The document is a warning, and is not descriptive of the current situation. There are no signs of a food shortage across the nation. But the coronavirus pandemic is putting strain on every aspect of the food supply chain, from the people who raise and grow what we eat to the people who deliver it to our supermarkets.

Here's hoping.

Drafting Doctors?!?

The greatest city in the world is teetering on the brink so its Mayor seizes the opportunity to remind us he is a useless buffoon:

Covid-19: De Blasio urges US enlistment program for doctors and nurses

• • Mayor calls for medics to be moved to places in greatest need
  • New York City prepares for surge in coronavirus cases

 

"Enlistment program"?!? WHAT did he say?

New York City’s mayor, Bill de Blasio, has called for a national enlistment program for doctors and nurses, to handle an expected surge in coronavirus cases in New York and across the US.

 

“If we’re fighting a war, let’s act like we’re fighting a war,” he told reporters on Friday.

...

"...unless the military is fully mobilized and we create something we’ve never had before, which is some kind of national enlistment of medical personnel moved to the most urgent needs in the country constantly … if we don’t have that we’re going to see hospitals simply unable to handle so many people who could be saved.”

OK, that won't be happening. As a minor point, there is no time for Congress to pass the relevant legislation. As a major point, this is still America, we abandoned the draft decades ago, and we don't force people to work at gunpoint.

And how would it work? NY hospitals are short of Protective Personal Equipment. So the Feds are going to threaten to arrest some doctor in Vermont unless he gets down to NY and imperils himself by treating coronavirus patients? And if the good people of the great state of Vermont need health care down the road, NY promises to send their doctor back, unless he's sick or dead or super busy saving New Yorkers in which case, well, that's a problem for another day?

I saw a poignant story of a retired 50-ish nurse from New York. She was planning to answer Gov. Cuomo's call for volunteers but had qualms  she lives with two youngsters and her elderly parents. Working with coronavirus patents all day puts her at high risk of infection; going home puts her at risk of infecting her high-risk parents.

Her intention was to respond because Duty Calls, and I applaud her fighting spirit. But I have a hard time imagining a state legislator or judge would agree to lock her up if she chose to sit this one out and take care of her mom and dad.

As a further illustration that desperate times require desperate short-sightedness, this order by Gov. Cuomo is outrageous:

Cuomo said he would sign an executive order that allows the national guard to take ventilators and personal protective equipment from institutions that don’t need them right now, and redistribute them to those that do. He said those institutions would either have their ventilators returned to them or get reimbursements. Cuomo said there may be several hundred ventilators available because of the order.

Right now, the state is fielding a daily need for about 300 additional ventilators, he said. Those ventilators, officials have repeatedly explained, make the difference between life and death.

“Am I willing to deploy the national guard and inconvenience people for several hundred lives? You’re damn right I am,” Cuomo said.

Upstate NY legislators are pushing back. I haven't studied their local budgets and planning process but I imagine some of them are thinking they spent years in investing in appropriate capacity for their town and now, at the moment of crisis, its being taken away by people who couldn't plan far enough ahead to buy hot dogs for the Fourth of July.

As to the idea that they'll will get it back if they need it - oh, stop. NYC won't start unhooking people and letting them die just to return ventilators to some upstate burg. The absence of trust makes sharing difficult and this brute expropriation outrageous.

Apparently they won't take more than 20% of the ventilators from any hospital, so the plan isn't fully insane.

Some pushback from the Rochester area upstate:

Rochester Regional Health deferred questions to Monroe County. Both County Executive Adam Bello and U.S. Rep. Joseph Morelle, D-Irondequoit, expressed concerned over Cuomo's executive order.

"While it’s reasonable to share resources across communities when available, the reality is that Monroe County’s positive cases, hospitalizations, and ventilator usage increase daily," Bello said in a statement. "We do not have excess capacity to send supplies out of the region.”

Morelle echoed those sentiments.

"Unfortunately, our regional health systems have repeatedly indicated that excess ventilator capacity does not exist at this time," Morelle offered in a statement.

Rich Azzopardi, senior advisor to Cuomo, said, "...it is essential that we all work together."

He continued, "Ventilators literally save lives. They will be returned or reimbursed to those hospitals. Moreover, when the pandemic wave hits upstate New York, the Governor will ask downstate hospitals for similar help."

I guess Gov. Cuomo's message is "tough luck".

More pushback from Erie County Republicans:

We cannot allow the state to confiscate our public health resources by force and redistribute them to New York City.  The offer to pay for them only adds insult to injury.  Once they are taken, we will not get them back when we need them, and clearly none are available for purchase.  We want to help, but if we hit our peak while our resources are elsewhere, Erie County residents will die.  We cannot let that happen.”

No trust.

Mask Up!

Trust the experts! The folks who told us not to bother with masks are changing their minds. Right the second time!

Oddly, the Bush-era guidance was that masks could be helpful even for the healthy in a crowded situation. That changed during the Obama-era preparation for the fall '09 swine flu. Weird.

2007 CDC:

2009 Updated CDC guidance:

 

Grim Forecasts

Drs. Fauci and Brix are now forecasting 100,000 to 240,000 UDS deaths due to coronavirus IF we stick with the social distancing.

I hope to track down the models they were looking at. This University of Washington/IHME model projected a cheery 82,000 deaths. It is ambitious in that it estimated hospital capacity and disease spread by state to estimate where the system will collapse (short answer - everywhere I've looked.) Check the interactive feature and do note - they update the actual deaths and forward estimates daily, so the forecast totals will change.

Caveats about the model to follow. Very briefly, it relied heavily on data from the early-stricken areas, to wit, Wuhan and Italy.  The reliability of the Wuhan data is in serious doubt.

KEY INTEL: Breitbart ran the UW/IHME model and put up the expected Peak Day for each of out 57 states. Or most of 'em.

Derek Lowe On The Latest Chloroquine/Azithromycin Trial From France

The good news is that trials of ydroxychloroquine/azithromycin to treat COVID-19 are underway in New York so the French doctor will be overtaken by science.

The bad news is, well, not so good. Trial results promising, methodology and Dr. Raoult himself lacking in credibility:

This is going to be a long post on the whole issue, so if you don’t feel like reading the whole thing, here’s the summary: these new results are still not from randomized patients and still do not have any sort of control group for comparison. The sample is larger, but it’s still not possible to judge what’s going on. And on further reading, I have doubts about Dr. Raoult’s general approach to science and doubts about Dr. Raoult himself. Despite this second publication, I am actually less hopeful than I was before. Now the details.

I have been shifting into the Chloroquine Bears camp on this for obvious reasons - first, if it was an overnight miracle cure we'd have heard rumors and innuendo from the NYC effort. And second, this protocol is hardly a secret - the Chinese and South Koreans have approved it in their hospitals in late February and Medical Twitter has buzzed about it since then (including a "Hands off your malaria pills" PSA in Nigeria!).

The silence starts to become deafening after a while. Doesn't mean it won't work, but it won't be a Game Over treatment either. Well, that's my current guess, which is no doubt influenced by a third day with no sunshine.

YES: To paraphrase Bryan Cranston of "Breaking Bad", "I am the sunshine!". Although not lately. But I hear the Comeback Pony whinnying in the barn!

Don't Trust The Experts

The Times probes the "Lost Month" during which the US dropped the ball on testing for coronavirus.

Although I'm confident their preferred script depicted Trump as the obstacle, the story they tell is of foot-dragging, incompetence and cover-up by the senior professionals leading the FDA and CDC.

One might argue that more energetic civilian leadership from the top could have salvaged this, but its hard to reconcile that view with "trust the experts". This is a ghastly example of the testing program running into a ditch (my emphasis):

But soon after the F.D.A. cleared the C.D.C. to share its test kits with state health department labs, some discovered a problem. The third sequence, or “probe,” gave inconclusive results. While the C.D.C. explored the cause — contamination or a design issue — it told those state labs to stop testing.

The startling setback stalled the C.D.C.’s efforts to track the virus when it mattered most. By mid-February, the nation was testing only about 100 people per day, according to the C.D.C.’s website.

Dr. Redfield played down the problem in task force meetings and conversations with Mr. Azar, assuring him it would be fixed quickly, several administration officials said.

To be fair, those sources may be protecting Azar rather than sharing the truth. Pressing on:

The C.D.C. gave little thought to adopting the test being used by the W.H.O. The C.D.C.’s test was working in its own lab — still processing samples from states — which gave agency officials confidence. Dr. Anne Schuchat, the agency’s principal deputy director, would later say that the C.D.C. did not think “we needed somebody else’s test.”

...

Throughout February, Dr. Redfield shuttled between Atlanta, where the C.D.C. is based, and Washington, holding multiple calls every day with Mr. Azar and participating in the coronavirus task force.

Mr. Azar’s take-charge style contrasted with the more deliberative manner of Dr. Redfield, who lacked the kind of commanding television presence that impressed Mr. Trump. He was “a consensus person,” as one colleague described him, who sought to avoid conflict. He relied heavily on some of the C.D.C.’s career scientists, like Dr. Schuchat and Dr. Nancy Messonnier, the director of the agency’s National Center for Immunization and Respiratory Diseases.

Under scrutiny from Congress, Dr. Redfield offered reassurances. Responding on Feb. 24 to a letter from 49 members of Congress about the need for testing in the states, he wrote, “CDC’s aggressive response enables us to identify potential cases early and make sure that they are properly handled.”

Uh huh. Meanwhile,over at the FDA a new commissioner was stumped by his underlings (my emphasis again):

Dr. Stephen Hahn’s first day as F.D.A. commissioner came just six weeks before Mr. Azar declared a public health emergency on Jan. 31. A radiation oncologist and researcher who helped turn around MD Anderson in Houston, one of the nation’s leading cancer centers, Dr. Hahn had come to Washington to oversee a sprawling federal agency that regulates everything from lifesaving therapies to dog food.

But overnight, his mission — to manage 15,000 employees in a culture defined by precision and caution — was upended. A pathogen that Mr. Trump would later call the “invisible enemy” was hurtling toward the United States. It would fall to the newly arrived Dr. Hahn to help build a huge national capacity for testing by academic and private labs.

Instead, under his leadership, the F.D.A. became a significant roadblock, according to current and former officials as well as researchers and doctors at laboratories around the country.

Private-sector tests were supposed to be the next tier after the C.D.C. fulfilled its obligation to jump-start screening at public labs. In other countries hit hard by the coronavirus, governments acted quickly to speed tests to their populations. In South Korea, for example, regulators in early February summoned executives from 20 medical manufacturers, easing rules as they demanded tests.

But Dr. Hahn took a cautious approach. He was not proactive in reaching out to manufacturers, and instead deferred to his scientists, following the F.D.A.’s often cumbersome methods for approving medical screening.

Again, maybe table-pounding from Trump and Azar could have gotten these guys going. But that that hardly jibes with the "Let the professionals do their job" mantra.  A recent Joe Biden tweet illustrates this mindset (Joe Biden? Yeah, he's the guy who used to be running for President):

It's hard to believe this has to be said, but if I'm elected president, I will always lead the way with science. I will listen to the experts and heed their advice. I will do the opposite of what we’re seeing Donald Trump do every day.

Well. Trump blaming the health care subdivision of the DC establishment for lack of energy and imagination would be a bit rich. Trusting the experts didn't work well for Bush with Iraq and it didn't work well here.

 

 

Saturday Evening Wind-down

This lockdown stuff gets old fast on a rainy day.

Good Intel From Tyler Cowen

Tyler Cowen of Marginal Revolution looks at the variety of epidemiological models for coronavirus and stays with the "better safe than sorry" approach. I concur. He also links to this excellent non-firewalled FT piece by Tim Harford.

A major part of the controversy revolves around the question of just how many people could already have contracted COVID19 asymptomatically. We can test for antibodies so it should be possible to answer this question. A project is proposed in the UK and this Dutch blood bank study of donors should be interesting. I would guess we'd hear about results somewhat promptly. A few weeks, maybe?

They're Still Having Fun In Merrie Olde England

People helping people - that's what its all about, amirite? This video from the UK should inspire all of us.

Stimulus Deal - Any Night Now!

The latest reporting from Politico is that the Senate has overcome some last minute objections by four Republican Senators and will vote out the stimulus deal while a nation sleeps.

My summary of the hold-up, based on stuff I read elsewhere: Lindsey Graham (R-S.C.), Tim Scott (R-S.C.), Ben Sasse (R-Neb.) and Rick Scott (R-Fla.) had a problem with a wrinkle in the expanded unemployemtn insurance. Their concern was that the formula might allow some laid-off workers to collect more than the minimum wage, so they'd be paid more to stay home rather than take a minimum wage job. Was it a drafting error, they wondered, or was that Senatorial intent?

Apparently the latest compromise is this:

To mollify those concerns, leaders have agreed to allow an amendment vote on the floor, according to sources familiar with the matter. After that vote — which is expected to fail — senators can turn to final passage, sending it over to the House.

Whatever. There will be drama on the House side as well:

Pelosi had originally hoped to bring the bill up via unanimous consent after Senate passage, a voting method that would not force lawmakers to return to Washington. But she said later Wednesday that House leaders were looking at other options, noting that at least some Republicans were on their way to Capitol Hill to object to the legislation when it moves to the House.

Congressional leaders are now hoping to pass the package in the House with a voice vote — similar to unanimous consent in that members aren't required to be present but the lawmakers in the chamber can verbally register their opposition or support. The Democratic whip team is also figuring out a process for potential proxy voting, which would require a rule change but would mean fewer members have to return to the Capitol compared to a roll call vote.

Still, a single member could object and demand a roll call vote. Pelosi has already advised her members that they may need to return to Washington, telling Democrats Wednesday that House leaders are talking to Capitol Police and the attending physician in preparation.

Multiple members would not be able to attend votes, including the two lawmakers who are battling the coronavirus — Reps. Ben McAdams and Mario Diaz-Balart — as well as several others who are self-quarantining after possible exposure. Rep. Seth Moulton (D-Mass.) also said Wednesday that he has developed symptoms of the virus — but cannot get a test because of the national scarcity — and will be self-quarantining at his home.

House Republican leaders have privately acknowledged that there's a strong possibility that a member will object to a unanimous consent agreement.

Some Republican will object just to force everyone to fly all over the country and pass this anyway. DC leading the nation by example as we try to pull together (while staying apart!) and get through this.

 

4th And Goal, or, Hey, Dudes and Dudettes, Where's Our Stimulus Package?

Per Politico:

Negotiators on ‘2-yard line’ on coronavirus economic rescue plan

Well, are we close to a touchdown or hoping for a Brady-esque 98-yard drive? And what's with football metaphors? There will be no football this year!

I assume there will be a lot to not like for both sides in whatever emerges. But what is taking so long?

Congressional and Trump administration negotiators signaled Tuesday that they are on track to clinch a bipartisan agreement on a nearly $2 trillion emergency stimulus package, though the timeline for final passage has likely slipped.

Senate Minority Leader Chuck Schumer and Treasury Secretary Steven Mnuchin are still expected to announce an agreement later Tuesday night under immense pressure from President Donald Trump, a dire economic outlook and the growing number of Americans losing their livelihoods amid the crisis.

And Speaker Pelosi?

While senators may not vote until Wednesday — despite initial hopes that the chamber could wrap things up by Tuesday evening — negotiators may be eager to at least announce a "deal in principle" before the markets open back up.

We share their eagerness.

This is dreadful news:

Schumer took to the Senate floor on Tuesday to declare that senators were “on the 2-yard line” and said there were no remaining disagreements that couldn’t be resolved over the next few hours.

“There are lots of good things here,” Schumer said. “In the last few days, we have made huge progress in achieving these goals.”

Schumer with the football lingo already? My word, he hails from the land of They-Might-Be-Giants and Jets. From their opponents 2 yard line they are safer punting and conceding the touchback rather than waiting for the inevitable Pick-Six. What will not be happening is a touchdown.

 

Groan. And this from a seemingly optimistic Pelosi is dire (my emphasis):

 

“I think there is real optimism that we could get something done in the next few hours,” she said during an interview on CNBC, saying Senate Democrats did a “great job” in the negotiations. Hours later, Pelosi told MSNBC that negotiators were “in the red zone,” in her latest of several media appearances on Tuesday as she sought to promote her own members’ priorities.

 

They are in "the red zone"? Now I wish we were talking football - that must be a strong signal to the Sanders wing of her asylum. They should bring their Hammer and Sickle flags to the bill signing because there will be a lot for a commie to love.

 

SCORE! The existence of a deal is announced by Schumer and McConnell. Details to follow.

Drug Trials In New York

From Trump's lips to Cuomo's ears:

New York Gov. Andrew Cuomo said Sunday that his state is set to begin clinical trials this week for a malaria drug that President Donald Trump has touted as a possible treatment for coronavirus.

“The president is optimistic about these drugs, and we are all optimistic that it could work,” Cuomo said at a daily press conference in Albany.

This therapy delivers results (or doesn't) pretty quickly. The normal course of treatment is ten days [eg, French mini-trial] but if we don't hear rumors of success or failure before then we need to revisit HIPPA.

Are You Ready For Some Football?

Are you ready for some football? I expect the coronavirus to return this fall (if it ever goes away) and the fall football season to be either cancelled or played as Made For TV spectacles in empty stadiums.

The second most dangerous play in football is leaving your QB unprotected on the blind side. The most dangerous play is getting between the owners and their money. Bet on empty stadiums. Play ball!

Fashion Hints

This is the look Social Distancers are looking for. Wear this, enjoy a zesty onion/garlic sauce on your scrambled eggs, and you're safe to go shopping.

If anyone gets within six feet, start mumbling. I recite the 1978 NY Yankees lineup but you do you.