Testing for any disease is imperfect. There are almost always some tests that come back negative when the individual is actually positive and there will be some tests that come back indicating that someone is positive when they are really negative. Different diseases will have different priorities as to what type of error is more acceptable. The imperfection of testing was shown this weekend in the White House:
The officials said General Joseph Lengyel tested positive on Saturday but then tested negative the same day in another test. He will undergo another test on Monday to confirm his negative status, the officials said. https://t.co/IkpGdr7vwH
— Patricia Zengerle (@ReutersZengerle) May 11, 2020
Further reporting shows that the general has a second negative test.
Why does this matter?
We know that there are good faith testing errors going in both directions. Someone who is originally identified as positive but is actually negative does not require too many additional resources unless they are symptomatic in the short run. Antibody testing would later identify that the false positive had actually been a negative which will have its own set of behavioral responses but the first week response of a positive test is self-isolation and further testing. Given that the White House is becoming a potential cluster, that testing would have occurred anyways.
However the opposite where someone is actually positive but tests negative leads to more uncontained spreading potential. There is no immediate demand on medical resources but a false negative error could lead to increase medical demand in a week when the original person is symptomatic and people who were infected by the original person become symptomatic.
Testing can not be a one and done deal. The anti-body tests are fundamentally not good enough for that while the diagnostic tests merely measure a point in time. People who are not infected in the first time period could readily be infected in a second or third time period.
Testing, with all of its imperfections, will need to be widespread, persistant and repetitive across time, space and risk.
Chetan Murthy
John Oliver quoted some public health official as saying that 35m tests/day was what was needed. Doing the math, that’s … a test every 10 days for every American. Sounds about right, though a bit low TBH. Yeah: as long as this thing is a rampant outbreak, we’re going to need frequent (re-)testing.
ETA: and that doesn’t even address the false positives/negatives.
Barbara
What I don’t know and probably no one does is whether a false negative of a certain kind of test is going to continue to be negative for the same person. One false negative will have fewer repercussions if you are getting tested daily and the test is likely to be correct the next day. But if it consistently misses certain patterns or disease presentations, then there could be a long lead time while certain people assume they are “safe” right up until they start exhibiting symptoms. And this is just one additional reason for the uncomfortable truth that testing negative doesn’t reduce the necessity to continue precautions.
WereBear
Also, the testing method used in the White House was reported as having a high rate of false negatives.
trollhattan
With a positive antibody test result, I would want verification from a different test. IF we find that having the antibodies offer meaningful resistance, having the antibodies informs us on future behaviors, such as returning to work, doing all the family shopping and errands, caring for ill relatives, volunteering, etc. A false positive could lead to very poor decisions.
OTOH if I were showing symptoms and got a negative result from a virus test, I might want that second test to verify I truly did not have covid-19. My life and that of those around me could depend on it.
dmsilev
It should be noted that antibodies are a trailing indicator because it takes a while for the immune system to start producing them, so even with a perfect test they’re not ideal for identifying infectious people. Antigen tests, which test for the proteins on the virus’s outer shell, are better suited for that role, but I think so far there’s only one such test which has gotten approval for wide deployment.
trollhattan
@WereBear:
Have to keep reminding myself that the WH support staffers are exposed to these morons to stop from wishing the virus would just plow through the joint and lay them all flat. Those folks don’t deserve to be dragged along with the cultists.
MomSense
Is anyone here tracking the cases in the opened states? I’m concerned that the lack of testing will mean that the numbers of positive covid cases, hospitalizations, and deaths will not be accurate and will be used to justify really dangerous public health policy.
Barbara
@dmsilev: One antigen test received approval over the last few days. This test has the other big advantage of being run on a machine that is already in 40,000 doctors’ offices. Probably urgent care centers as well.
mrmoshpotato
Spot on.
The Moar You Know
@WereBear: They’re using that Abbott POS. 15% false negatives. You might as well take a poll on Balloon Juice, it would probably be more accurate.
Fleeting Ex-istence
John Oliver was in error about the USPS in one key point, which is that the appropriate website is not stamps.com but USPS.com. The former is a commercial site which is for shipping mostly, and has a monthly fee. USPS is still a .com because it isn’t a government agency. I explored those two several months ago in order to avoid my local p.o. They do have commemoratives and whatnot, including a gorgeous Year of the Rat coffee mug which you cannot put in the microwave because it has gold paint on it.
New Deal democrat
@MomSense: I will be tracking it.
But it is too soon to see any impact. Give it another week.
Also,, keep in mind that even in “reopened” States, you cannot force people (especially retirees) out of self-quarantine if they do not feel safe. And the overwhelming initial evidence is, they don’t.
JoyceH
What drives me nuts about this testing discussion (and it is all over the news as well) is that it throws the emphasis on the expensive and difficult thing that the nation is simply unable to do right now. And yet if the administration simply modeled and encouraged the practice of wearing masks in public, this pandemic could be brought to an end, quickly, easily, and cheaply. The one solution that would work and is within our capability today, and it’s the one thing they refuse to do.
When Pence met with those business leaders in Iowa the other day, he told them to take their masks off!
I swear, sometimes I think they must be taking orders from Putin, because if they were deliberately trying to decapitate American leadership across all sectors, they would be doing exactly what they’ve been doing.
'AsYouKnow' Bob
Last week brought us the spectacle of listening to Trump musing about someone “tested negative, tested negative, and then one day just tested positive.” As if this somehow invalidated the idea of testing.
Why, it was just as if he was SO stupid that he STILL could not understand that a person’s ‘testing’ status could ever CHANGE. Or not understand that a person could catch the virus between one day and the next….
Just breath-taking stupidity.
Nicole
@JoyceH: Or, just displaying their feelings of insecurity about their own masculinity:
https://www.theguardian.com/commentisfree/2020/apr/13/leaders-trump-bolsonaro-coroanvirus-toxic-masculinity
There are articles and studies already about how much of the higher complications/death rate of men from Covid-19 is due to toxic masculinity influencing their actions about the illness.
The Thin Black Duke
What’s depressing is realizing that nothing intelligent regarding the pandemic isn’t going to happen until Biden is sworn is as President of the United States.
David Anderson
@Chetan Murthy: There is significant variation as to how many tests are needed and under what type of infrastructure for an effective and reasoanbly safe-ish re-opening plans. Basically, the more tests in a given plan, the less intensive and/or effective other actions need to be and vice versa.
Gottlieb, Rivers, McClellan (my boss), Silva plan has a testing level that we’re starting to approach as minimally adequate and pairs that with extensive and effective contact tracing and isolation procedures… Roemer on the other hand tests half the country each week for months on end.
wvng
@JoyceH: even if it doesn’t get us to the end of this thing, everyone wearing masks certainly could get us to R<1 pretty quickly.
Soprano2
@JoyceH: They don’t want to wear masks or have anyone around them wear masks because they want all of their photo-ops to make it look like everything is completely normal now. That’s what Trump wants, so that’s what they’re doing. And now it’s bitten them in the butt big-time. I hate to think of all the regular workers who are now at risk because of Trump’s idiocy.
wvng
@David Anderson: what do you think about testing samples pooled from groups of people (10, 20) for surveillance, followed up with individual testing of every member in a pooled sample that was positive?
Roger Moore
@Chetan Murthy:
That number seems ridiculously high. It’s enough to test everyone in the country about once every 9 days, which seems like overkill. In particular, even if you needed that level of testing to figure out who in the country is sick so you could quarantine them, you wouldn’t need to maintain that level of testing for very long. In practice, I think you could do a much lower level of testing by doing contact tracing on everyone who tests positive, test everyone they’ve come in contact with, and so on recursively. The required number of tests would still be very high with the prevalence as high as it is, but nowhere near 35 million tests per day.
wvng
A friend’s husband’s ex just took her son for a Mother’s Day romp. He has cystic fibrosus, so terribly at risk. She took him to visit a bunch of people, including a nurse, because “this thing was never a big deal” and she’s been out and about for weeks visiting people. Stupid people are going to kill us all.
burnspbesq
@JoyceH:
Speaking of Iowa, the number of confirmed cases at the Tyson plant in Waterloo doubled overnight from last Wednesday to Thursday—the day the plant reopened.
https://www.desmoinesregister.com/story/money/agriculture/2020/05/07/infected-workers-waterloo-plant-more-than-double-earlier-figure/3092376001/
Roger Moore
@The Moar You Know:
Bear in mind that the White House is apparently now testing everyone daily. That makes a 15% false negative rate more tolerable, since someone who is missed one day will very likely be caught the next. Given how the disease spreads, and given that the miss is almost by definition going to be at the very beginning of the disease, catching it the next day is probably good enough. That’s especially true if you do a good job of contact tracing and quarantine the people the sick person came in contact with.
The bigger worry, IMO, are the outside people the White House is bringing in. The could potentially miss someone who is an asymptomatic spreader. One asymptomatic spreader could potentially infect a whole room, and nobody would know to quarantine those people until they started to test positive days later. By that point, it could be too late.
dmsilev
@JoyceH: Here’s what we’re up against:
LA Times link
Aleta
False test results are one of many reasons that the lies of the No-NoMasks cult headquartered in the WH are dangerous and should be held to account.
Has DC issued requirements for workplaces? The WH isn’t a private business. The government is responsible for safe working conditions for every worker, yes?
HumboldtBlue
It’s preaching to the choir in these here parts, but Greg Sargent writes another good piece on the horrible absurdity that is the current White House.
Roger Moore
@JoyceH:
Wearing masks is helpful, but it’s not enough. This thing is very contagious, and masks aren’t enough to get it under control by themselves, even if everyone had the right masks and wore them properly whenever they were out.
One thing I’ve seen mentioned as another important intervention we aren’t doing is isolating sick people. Most of the time, when someone is sick but not sick enough to be hospitalized, they’re sent home and told to avoid contact with their families. That isn’t good enough. In practice, they often just spread it to their families because they aren’t good enough at isolating at home. We need to rent out some of the underused hotels and turn them into isolation wards.
JustRuss
You did that on purpose, didn’t you?
Amir Khalid
@Roger Moore:
I believe this is in the WHO pandemic-management playbook. I do know that it’s what Malaysia is doing, alongside testing everyone in infection-cluster zones and anyone who turns up at a clinic with influenza-like illness or severe acute respiratory infection. To go by the numbers I post every day from the Director-General of Health’s daily media briefing, it’s an effective strategy.
debbie
Well, Governor DeWine is providing a nice twist to his press conference today. He’s got an ER nurse providing an account of his coming down with COVID, going to the hospital, spending 10 days on a ventilator, and his two-month struggle to recover. This ought to poke at the stupid protesters marching around Amy Acton’s front yard with their stupid guns.
West of the Cascades
I’m starting to develop a liking for this Biden fellow: https://www.washingtonpost.com/opinions/2020/05/11/joe-biden-coronavirus-op-ed/
Joe Biden is the presumptive Democratic nominee for president of the United States.
The coronavirus, to date, has taken the lives of more than 79,000 Americans. One of every 5 U.S. workers has filed for unemployment — with the unemployment rate now the highest since the Great Depression. It is an extraordinary moment — the kind that begs for urgent, steady, empathetic, unifying leadership.
But instead of unifying the country to accelerate our public health response and get economic relief to those who need it, President Trump is reverting to a familiar strategy of deflecting blame and dividing Americans. His goal is as obvious as it is craven: He hopes to split the country into dueling camps, casting Democrats as doomsayers hoping to keep America grounded and Republicans as freedom fighters trying to liberate the economy.
It’s a childish tactic — and a false choice that none of us should fall for.
The truth is that everyone wants America to reopen as soon as possible — claiming otherwise is completely absurd. Governors from both parties are doing their best to make that happen, but their efforts have been slowed and hampered because they haven’t gotten the tools, resources and guidance they need from the federal government to reopen safely and sustainably. That responsibility falls on Trump’s shoulders — but he isn’t up to the task.
It’s been more than two months since Trump claimed that “anybody that wants a test can get a test.” It was a baldfaced lie when he said it, and it still isn’t remotely true. If we’re going to have thriving workplaces, restaurants, stores and parks, we need widespread testing. Trump can’t seem to provide it — to say nothing of worker safety protocols, consistent health guidelines or clear federal leadership to coordinate a responsible reopening.
In addition to forgetting the tests, he seems to have forgotten that ours is a demand-driven economy — you can shout from the rooftops that we’re open for business, but the economy will not get back to full strength if the number of new cases is still rising or plateauing and people don’t believe that it’s safe to return to normal activities. Without measures in place to prevent the spread of the virus, many Americans won’t want to shop in stores, eat in restaurants or travel; small-business owners know that a nervous public won’t provide enough customers to ensure they thrive.
Georgia Gov. Brian Kemp (R) began “reopening” his state’s dine-in restaurants on April 27 — 12 days later, according to data from restaurant-booking service OpenTable, there were still 92 percent fewer diners than there were on the same day a year ago. States and cities that have attempted to reopen are discovering that the economy isn’t a light switch you can simply flip on — people need confidence to make it run, and that confidence must be earned by credible leadership and demonstrable safety.
Again, the solution isn’t a mystery. The Trump administration could focus on producing and distributing adequate testing and protocols that conform with the guidance of public health experts; doing so would speed up the reopening process considerably and make it a whole lot more effective. The administration is fully aware that this is the right path, too — after all, the president and his staff are now reportedly receiving daily tests. They knew exactly how to make the Oval Office safe and operational, and they put in the work to do it.
They just haven’t put in that same work for the rest of us.
If Trump and his team understand how critical testing is to their safety — and they seem to, given their own behavior — why are they insisting that it’s unnecessary for the American people?
And why does the president insist on trying to turn this into yet another line of division, pitting strained, grieving Americans against one another across manufactured battle lines of “health” and “the economy”? Everybody knows that we can’t revive the latter unless we safeguard the former — and pretending otherwise is the most transparent of political ploys. Instead of once again seeking to divide us, Trump should be working to get Americans the same necessary protections he has gotten for himself.
It’s the right thing to do, and the only path to truly getting the economy back on track.
trollhattan
Oh hi, state that gave us Mike Pence and Mother.
LuciaMia
@’AsYouKnow’ Bob: The idiots in the West Wing act like they think the act of getting tested will somehow prevent them from getting the virus at all!
debbie
@debbie:
And Dr. Amy provides the second punch herself by announcing five cases discovered through antibody tests of people who contracted COVID back in January, before the presumed start date of early February. Take that, bitches!
Another Scott
@MomSense: I think you’re right to be concerned about the lack of testing. But raw numbers probably aren’t going to be as useful as we hope (“We’ve tested more than anywhere else in teh World!!1”).
Yesterday I posted a summary of numbers from NoVA. Given the lumpiness of the data (outbreaks still seem to be in big “clusters”, not just distributed more-or-less evenly through a jurisdiction), one could conceive of one area having big numbers and rising numbers, but the rest of the state being nominally “safe” (at least in that point in time).
But humans are really bad at nuance (as we’re seeing in places that are starting to “reopen”).
And most of what we know now is based on averages with a lot of weird outliers. When should a quarantine end? How many times should people ending quarantine be re-tested and when? Should people be required to have a certain antibody level before being declared safe to be around others again? If the state has declining cases for 2 weeks except for 3 areas, is that good enough to end the lockdown? 5? 12?? I don’t think there’s going to be a set of guidelines that everyone can agree on – especially because there will be tremendous pressure to fudge the numbers. :-(
We really, really need effective contract tracing and rigorous isolation policies in place now. In addition to much more testing (of all kinds). We’re never going to get a handle on this unless we start working on preventing new infections via concentrating on areas with known outbreaks and working outward. (Yes, Martin, it’s a huge job, but that doesn’t mean we can’t start the process of doing it.)
My $0.02.
Cheers,
Scott.
Dorothy A. Winsor
The Chicago Trib has a headline about contact tracers being hired and trained in Illinois. Our case numbers keep rising, but that could be an artifact of the testing the state is doing.
Mikeindublin
Does anyone honestly think if Trump or Pense test positive we’ll know the truth?
Only way we find out is if they have visible signs.
jl
@West of the Cascades: The economy isn’t coming back until people feel safe, and feel that they can keep people they know safe. Studies are coming in on population level withdrawal from normal economy from late Feb through end of March. You can’t tell the difference in reduction in activity between early and strong shut down states and states that never shut down. A few yahoos who go wild at the first opportunity are not enough to run the economy, and a lot of them will be sick soon anyway.
Edit: doesn’t mean that we should not constructively criticize the shut downs. They were planned for pandemic flu when several means of rescue would come so that time horizon for them would be short. So, everyone is flying blind on how to handle this one. Bottom line is each state needs to get outbreak control, which includes lots of testing but also contact tracking and isolation capacity on line. Also to be proactive and creative in managing public expectation, and helping guide public in gradual reopening in a way that won’t blow up. If your state govt. isn’t doing what you think it should, need to let them know.
Amir Khalid
@Mikeindublin:
If either one suddenly disappears from public view and the White House is suspiciously vague about why, that might be the tell.
dmsilev
@jl: Another data point, which was mentioned in Biden’s WaPo op-ed this morning:
jl
As for testing, false positives and negatives aren’t a huge problem for clinical treatment, since should be other procedures to confirm or contradict test (clinical history, blood tests, imaging, oxygen monitoring), IMHO. Also not a problem for surveillance if test characteristics known fairly precisely since for estimation of prevalence you can adjust for them.
Big problem is use of tests for quelling an outbreak, since you have to make a real time decision on risk of spread if person does not self-isolate.
LongHairedWeirdo
Thanks; this post also points out how indescribably stupid and incompetent Trump,et al, is, when bragging they don’t *need* masks because they’re *tested*. A false negative, or a pre-testable infection (somewhere between a single virus attacking a single cell, and having enough viral load that a test is generally reliable) makes general mask wearing appropriate, especially for people tasked with protecting the American people from attack.
(Have you noticed the current “what-about-ism”? “Other people were fooled too! Nancy Pelosi said Chinatown was pretty safe, just because the federal government said everything was fine! Why are you blaming the *president* for the federal government’s response, when a *legislator* got it wrong, too?” The very idea that the President is supposed to have a unique role in protecting the nation has gone out the window. )
Oh, and please keep this article away from Mr. “then one day something goes wrong, and they’re positive, so why is testing so great?” – he’ll insist that we just have to keep testing, assuming false positives, to try to get the numbers back down.
trollhattan
@jl:
That makes sense. Retail and restaurants in particular seem unlikely to generate traffic, because “political shoppers and diners” will prove to be a very small cohort of the population as a whole. You have to staff up to open for anything but takeout/curbside pickup, and the traffic won’t pay the nut on staffing.
I suspect some types of manufacturing and office work can finagle safe distancing by splitting the standard labor force in two, using shifts. And if the boss is a fucking hands-on A-type micromanager, he can bloody well be there sixteen hours if it floats his boat.
They better not get that blanket liability immunity for employers that Trump et al have been floating.
?BillinGlendaleCA
@Amir Khalid: The old Soviet method works the best…”he has a cold”. A few days later the solemn music plays on Radio Moscow.
artem1s
@JoyceH:
it’s not too expensive, if you take into account the cost will be offset by businesses being able to safely open up again AND gain the trust of their employees and customers. Otherwise we seesaw back and forth for another 6 months between total shut downs and trying to reopen. The biggest failure of the Orange Plague is that he has guaranteed no sane human trusts him to do the right thing or follow the lead of experts and those who have the public’s welfare in mind, not just their own stock portfolio. If your governor, employer, co-workers, friends, or family follows the advice of this WH, will you believe they are acting in your best interest? No of course not. Unless we know that our governor, employer, co-workers, friends, or family are ALL being routinely tested, traced and quarantined, will we feel safe to venture out of our homes and expose ourselves to new groups of people and spaces. TRUST BUT VERIFY! Testing, tracing and quarantining is the only way to restore trust.
narya
@Dorothy A. Winsor: I think it is, in fact, in part an artifact. My health center has set up temp sites in two neighborhoods w/ lots of barriers to care, and the positivity rate is extremely high (approaching 40% at some locations); much lower across the rest of the city. Mayor just announced even more new testing sites in underserved areas.
?BillinGlendaleCA
News feed just came up on my computer that all West Wing staff are required to wear a mask, except for Trump, of course.
LongHairedWeirdo
@Roger Moore: I’ve seen too many numbers thrown around to know for sure, but you’re right that 35 million a day sounds too high.
That said, I could imagine a situation where we needed, say, 5 million a day, but might need as many as 35 million results in 24 hours to clamp down on multiple hotspots – or, possibly, 24 million in 16 hours, or even 12 million in 8, all of which require 35 million a day in capacity. Or, maybe we only will ever need 5-8 million a day, but we need 35 million a day in testing capacity, because that’s the only way labs can also work on their normal tests, as well.
Alternately, it might be that 35 million is what we need in a situation like we’re in today, where we’d like to know who’s sick, and who isn’t; or for studies as to how badly a population cluster is infected, etc..
So there’s a lot of reasons the number might be surprisingly high; but I confess, do find half-a-million and 5 million per day to be a lot more reasonable if we’re doing test, trace, and isolate.
Elizabelle
WaPost:
Fuck Trump for being such a delicate wuss that he can’t model considerate behavior by wearing a mask.
I really hope we see the Obamas and Biden sporting masks a lot. Maybe that say “Vote.”
Nancy Pelosi has her beautiful silk scarves that she pulls down to speak, once she’s socially distanced.
Trump is such a wanker. But we knew that.
Baud
@Amir Khalid:
I look forward to North Korea speculating about what happened to the American president.
cain
@MomSense:
That’s the point of the whole thing. Not to report. But people are going to smell a rat regardless and the local news is going to be all over it because people will be talking. They aren’t going to escape.
The old people especially will be particularly incensed and will be quite loud and angry. You know, the people who vote Republican.
?BillinGlendaleCA
@Baud: So I don’t miss that, I follow the DPRK News Service on Twitter.
Nelle
My cousin, a pediatrician, got scolded by a patient for wearing a mask. Think about it. That’s how far this “masks are a sign of weakness” and a sign of political affiliation has gone. She was told that she was scaring people. Why aren’t they already scared?
I don’t go out except to walk and, being on the edge of town, I can totally avoid people. But my husband does and I’m getting his script ready if accosted. “I’ve done three tours of combat in Vietnam and am the only critical mission pilot here for Civil Air Patrol. The planes are stationed at the Air National Guard Base where everyone has to wear masks, except someone ordered them to take them off when Pence landed. Why are you guys so afraid of masks?”
jl
@Elizabelle: Yeah, more you read about Trump, the more obvious he is a very bad person. I read a report that portrayed a situation behind the scenes where Trump was expecting everyone to follow sound public health advice, except for him, and except when inconvenient for him, or he thought there was a photo op. And then blaming everyone else but himself when something went wrong. Behind the scenes Trump’s been pissy about people keeping their distance when working, not ‘protecting’ him properly through others, but not him, following protocol. And fact that Trump is too dim to understand how anything works probably doesn’t help.
Probably not needed to point out that Trump is a stereotypical ‘crazy boss’.
Brachiator
Yep. That’s why you work to develop alternative tests and better tests.
The White House spins that lie that since tests are imperfect, nobody needs them. Except of course, for Trump and those around him.
jl
Below is link to a study on business activity through middle of April (sorry I misremembered, forgot it went that far). I think it shows that economy would have gone into the tank regardless of shutdown orders. Look at how many business sectors were impacted in states without shut down as severely as they were in states with a shut down.
Bill Gates nailed it, the economy won’t run when people are dying of a mysterious new disease and it’s spreading and killing people. You can order people to go out and work and shop and eat while bodies are piling up around the corner, but they won’t obey. People can judge for themselves.
WEEK 3 AND 4: LABOR MARKET IMPACTS OF COVID-19 ON BUSINESSES: UPDATE WITH HOMEBASE DATA THROUGH APRIL 25
Alexander W. Bartik, Marianne Bertrand, Feng Lin, Jesse Rothstein, and Matt Unrath
https://www.chicagobooth.edu/research/rustandy/blog/2020/week-3-and-4-labor-market-impacts-from-covid19
Brachiator
What is this, Bizzaro Trump, who does everything backwards?
Doesn’t this seem like the opposite of what should be done?
ETA: Yesterday, my sister in Texas went to the grocery store. She noted that almost all of the people NOT wearing masks were white, and almost all of those wearing masks were non-white. Trump has partially succeeded in making the issue of masks racial and politically tribal.
David Anderson
@wvng: Great question; I don’t know enough to have an opinion
trollhattan
I think he’s making, or has made the transition from sociopath to psychopath. Doubt there’s a single human left who he cares about. And Fred Sr’s not available for Donny to work out all the daddy issues.
cain
@Brachiator:
Here in Hillsboro, OR – we have a mix. It’s not racial at all and plenty of people are wearing masks from all races and plenty not wearing them at all. There doesn’t seem to be any representation..
JoyceH
@Elizabelle: “Fuck Trump for being such a delicate wuss that he can’t model considerate behavior by wearing a mask.”
Sigh. Don’t you people understand? Trump CAN’T wear a mask!
It would smear his makeup.
Brachiator
@jl:
The number of cases continue to ramp up in areas where the re-openings are haphazard and stupid, but it is not clear that the number of deaths will skyrocket.
The fear is that a surge in active cases might overwhelm the medical system’s ability to treat people. This alone could be catastrophic even if there is not a spike in fatalities.
jl
On the other hand, states do need to work hard to make shut downs feasible by keeping population informed, and bending over backward to be cooperative and work with local governments (that might be interpreted cynically as ‘stringing them along’ until OK to reopen, but whatever, if it works, go with it, I think).
I think the California public health brass has gotten complacent and arrogant with how well they handled the early outbreak with its big contact tracking and quarantine program, and early shut down. But these are going on longer than originally planned for pandemic flu and that has to be kept in mind. So, counties that wanted to open early went from 3 to 22 in less than a week.
Hair cut industry claims that it wanted to do some field experiments and review guidelines to see if they could open earlier, and state public health sent a letter back ordering it to ‘STFU until we tell you’, I guess intended in more than one way. So, industry filed a lawsuit against the state, so maybe we’ll see the evidence.
State had a plan for opening rec centers and gyms early, then pulled it back with no explanation. So, now some gyms are suing, and state has to explain why they did that. So now, gyms are starting to file lawsuits. Seems to me state has more to explain if it published one thing, then decided to do another thing without explanation.
State and local public health and Newsom have issued vague orders that people should go outside and exercise, and then get pissy whenever they think too many people show up at one place (and this is happening all over not just Orange County where there are some yahoos). And govt says people should not go ”during peak hours’. So, OK, so, with a shut down, what does ‘peak hours’ even mean, and everyone cannot avoid peak hours at the same time. Population needs more guidance so they can coordinate their behavior.
Part of an earlier plan was talk about innovative public/private partnerships to provide supervised organized activities outdoors so people would have something to do, and safely, and something to help gyms and rec centers limp along through the shutdown. But that idea disappeared.
Other countries have shown that very direct and honest public communication is needed. California bigshots have gotten into the habit of waving the slogan that they are guided by ‘data and science’ when challenged on their decisions. But, I don’t think there is much science about how these extended lock downs would work, and everyone in muddling through. Might be better for CA poobahs to admit that, and bend over backward to at least appear sympathetic, and at least try to follow through on their plans very consistently, and if the find out that can’t give a public explanation.
Hoodie
@JoyceH: I recall reading something to the effect that Trump thinks his visage conveys some sort of message, and that he deliberately scowls because he thinks it makes him look tough and serious. I suspect wearing a mask is so abhorrent to him because it essentially deprives him of this imagined identity. Trump has no identity outside of his appearance, the sad irony being that his appearance is, to say the least, more than a bit underwhelming. It’s not like the guy is Paul Newman or even Arnold Schwarznegger. The mask might be an improvement.
Elizabelle
@JoyceH: That’s true. Smear his makeup and shrivel his penis.
How dare we!
Elizabelle
@Brachiator:
Right. All the more reason to slander Gates by rumoring that he helped spread the virus.
Although he is rich enough and smart enough to laugh it all off.
jl
@Brachiator: Swamping the medical system is the big elephant in the room that justifies extreme policies that do interfere with personal freedom, like mandatory shut downs.
And that is the one issue that all the folks claiming that covid-19 isn’t serious enough to justify shut downs studiously avoid. They never do a calculation on how any reasonable estimate of a low infection fatality rate will affect the demands on the health care system, and not swamp it. Because, they can’t make their case. Even with the lowest new estimates of morbidity and mortality of covid-19, US health care system crashes for months on end.
Covid-19 is just more dangerous than seasonal flu in terms of both demands for care of those who get sick, and has a higher fatality rate no matter how you estimate it.
I think given experience of more and more countries, now growing around the world, the need for extreme and extended lengthy shut downs is a sign of serious policy failure at the beginning of the epidemic. But, problem for US is, it did fail big time, and better to admit it and do what needs to be done as effectively and quickly as possible.
So, no one forced the need for these horrid shut downs on the country. Incompetence and malfeasance in fed response made them inevitable.
Brachiator
@jl:
This is simply not true. Every country and every government agency is trying to figure out what to do, and sometimes retreat on previous statements.
And most recently, UK prime minister has been openly mocked for his incoherent and inconsistent Sunday speech on re-opening the country.
Interesting idea that every dope with an opinion is exactly equivalent to the informed opinions of health experts, but NO.
jl
@Brachiator: Did you pick out the right quote you want to fight over. Seems like you want another one from my comment.
Anyway, the focus of my concern was about problems I see in California with best way to get out from under shut down responsibly, not UK.
I have to go, so will check back later on your criicism.
LuciaMia
Made the mistake of landing on Youtube’s Fox News live feed of Trumps address today. And the side chat comments were everything youd expect-rabid and insane. Half of them were chanting “Obamagate.” Please explain to me what the hell this is supposed to be? Is it just cause Obama said some mean things about Trump?
MagdaInBlack
@Elizabelle:
Well, thanks for that visual ? ??
jl
@Brachiator: My point was that the population has to be managed. Everyone who disagrees with public health is not a dope, even if they may be wrong, or their opinion overly influenced by self-interest. And even if most of them are dopes, they cannot be insulted or wished away. Dopes and non-dopes who start to not like the shut down can wreck the progress made during the shut down, even if they are a small minority and spread around widely enough in the population.
You need to suggest an alternative to my take on it. The US doesn’t have the capacity to send out the police to beat heads until people stay inside, it is not the PRC. Not even enough police to think about it here.
Managing population attitudes and behavior is a problem that has to be solved, whether you think the population is full of dopes or not.
Dorothy A. Winsor
Here’s a Rolling Stone article that analyzes the administration’s failures, naming names.
Brachiator
@jl:
This is nuts, and full of false equivalence. You confuse issues of science, public health and even civic responsibility with some strange, narrow and reductive political ideology.
So, let’s get down to fundamentals. The virus does not care about your personal freedom. It will be transmitted based on its biological characteristics.
So, even if you are allowed 100 percent personal freedom, how will you guarantee that you don’t spread the infection?
You don’t live on your own, or in a cave. The general welfare, not just individual personal freedom has to be protected.
Baud
@Dorothy A. Winsor:
I didn’t think the servers that run the Internet had that much storage capacity.
jl
@Brachiator: You are completely missing my point. We live together with the virus and with human dopes who, if they want can spread the virus and if there are enough of them who decide to act irresponsibly, cannot be stopped from doing that. Both can kill us. State has to figure out a way to manage both.
Maybe you are in a bubble where those in charge can bark orders and everything happens the way they like, but that ain’t the whole state of California.
Matt McIrvin
@Soprano2: They don’t want to wear masks because when Jimmy Carter wore a sweater it got him derided as a wuss, and when Michael Dukakis showed up in that tank he looked like a dork. That’s the level of reasoning.
Duane
@Elizabelle: Trumpov missed a great money-making opportunity to peddle N95 ‘MAGA’ masks to the rubes. For once in his conman existence he could have profited and done something good. Not much of a stable genius businessman.
Brachiator
@jl:
Anyone who does not argue from the facts is a dope. I don’t particularly care if dopes feel insulted.
No, I don’t.
Dorothy A. Winsor
That Colorado restaurant that had the crowd on Mother’s Day has had its license revoked.
?BillinGlendaleCA
@jl: It’s a sad day to see you fall into the clutches of Big Hair and Big Exercise jl.
dmsilev
From TPM’s live-blog of Trump’s press conference:
It’s not confusing at all. He simply doesn’t understand what “per capita” means.
JustRuss
Clap harder, Gov Kemp.
Brachiator
@Elizabelle:
This stuff is just crazy, though I guess to be expected.
And he continues to try to help. It’s typical that these conspiracy nuts and Trump supporters can’t point to any of Trump’s plutocrat buddies who are contributing anything to fight the virus.
Duane
@Brachiator: So the thinking in the WH has been to wait until you’ve been exposed then wear a mask. They really can’t get anything right.
Soprano2
My big concern right now is what happens if either my husband or I get it. He’s higher-risk – 73 and has Type 1 diabetes. We have a 1 bedroom, 1 bath house with a workshop in the back with a toilet and a sink. Hubby was joking about living in the shed, but honestly that would be our only alternative to really isolate from each other. Then we’d have to check on each other regularly to make sure we were still not critical. I wish we had the system the Chinese used, where if one of us were sick we’d go to an isolation center or a hotel to get better.
dmsilev
Apparently “prevail” was his word-of-the-day.
rikyrah
I have made my stance clear.
Once my workplace opens up again, it is going to take everything that I have to get to and from work COVID-19 free.
You think that I’m going to do anything extra?
PHUCK.OUTTA.HERE. ‘
They can open up anything they want to.
IT.WILL.NOT.BE.ME.
Brachiator
@Roger Moore:
Do we really know that this is the case? I have been listening to the daily Los Angeles County briefings on the pandemic. I have not heard this raised as an issue. However, I note that I have not heard much about follow-up to attempts to isolate people. In the most recent briefing, I heard about special quarantine wards for prisoners in federal and state lock-ups.
A number of hotels and motels have been used to house the homeless, and the hotel owners are not happy about this, and itchy to toss these people out and get back to business.
However, I think you raise some good issues. Too many people don’t want to think these things through and have some bland idea of just getting back to the way things always were.
Elizabelle
@dmsilev:
President Echolalia.
Will not prevail.
Sloane Ranger
I’m watching Trump’s propagandabroadcast (with supporting acts) and I have a question.
Is the Surgeon General, Deputy SG etc. a military officer? I ask because every time I see them they seem to be wearing a uniform. If they aren’t, why are they in uniform?
Thanks in advance.
MisterForkbeard
@Elizabelle: It’s sad, but when I pictured Biden wearing a “VOTE” mask, the very next thing I pictured was left twitter replacing “VOTE” with a reference to their rapey or dementia fantasies.
Still worth doing. Illustrate the right way to do things, Joe.
debbie
@Dorothy A. Winsor:
Jared’s name should be included in that list at the beginning of your snippet.
bemused
@Nelle:
That’s stunning. What in the world was the criticism of that person for a doctor wearing a mask? I can’t even imagine.
MisterForkbeard
@LuciaMia: It is mostly because Obama said mean things about Trump in a private phone call. Sorta.
In a more precise sense, Trump and Barr are trying to pretend Obama personally coached and drove the ‘fake’ investigation into Flynn and it was all a big conspiracy theory along with ‘RussiaGate’. They’ve decided to ignore that Flynn admitted he lied to the FBI and to Pence and pled guilty.
Basically, the standard horseshit.
Elizabelle
@Sloane Ranger: US Public Health Service. Not military, and no previous military service — from his bio, but … from his website @ hhs.gov:
Elizabelle
@MisterForkbeard: I hope Democrats wear masks like crazy over the next week. It is what. adults. do.
WRT left twitter: fuck ’em.
trollhattan
@rikyrah:
?
Work tried to pull me in in order to complete a file digitization project begun before covid, by lugging boxes down to the loading dock. This required going in, taking the elevator to my office then taking the freight elevator down to the loading dock.
“Do you have PPE for us?”
“No.”
“Are the elevators being decontaminated?”
“We have wipes for the buttons.”
“What about the air, it’s a confined space entry.”
“Crickets”
I politely declined. The bloody scanning contractors can bloody well wait. And this is just a bog-standard office building, nothing like a medical facility. We just have the wrong kind of engineers.
Elizabelle
@Sloane Ranger: I think higher ups in the CDC can also wear uniforms.
MisterForkbeard
@dmsilev: I’m having trouble following this, but is he saying that we did really well and won the testing battle, but we aren’t ‘winning’ the war because 80,000 dead people is bad?
I suppose that’s true, if stated in the most nonsense way possible. Except for the part where we completely fucked up the testing.
Gvg
@Amir Khalid: this administration couldn’t keep a secret if their lives depended on it. They lie by reflex so I expect them to deny, but we’ll know pretty quick.
Elizabelle
@Sloane Ranger: Yeah, CDC officers may also wear a uniform.
It’s the Center for Disease Control (and Prevention) now, and still headquartered in Atlanta, but that’s a name change. It’s also under the umbrella of HHS (Health and Human Services — secretary is Alex Azar).
Sloane Ranger
@Elizabelle: Okaay, seems a little odd but if this is normal in the US, fine.
Thanks for the info.
Elizabelle
from top of WaPost website just now:
Scuttled by the factory. Trump was fine with virus-spreading and work-interrupting if the staged visit made him look like a wartime president. Moar of this, please.
Brachiator
@Elizabelle:
RE: Factory officials asked to postpone the event, worried that a visit from the president could jeopardize both worker safety and the plant’s ability to produce special material for masks and other medical equipment.
I love this. Trump got slapped in his orange face by people concerned about the safety of others.
LongHairedWeirdo
@Hoodie: Yes, Trump has his shtick. Having a phone next to his ear means he’s “working”, and he thinks it’s a good look, going so far as to ape it during *video* calls. And, of course, the “I’ve got my arms crossed and look like a cranky toddler,” which I’m sure makes him think he looks firm and resolute, and not like a cranky toddler.
He loves the thumbs-up, even though his thumbs are *weird*. Seriously, it looks like he’s really pointing his thumb at himself, the way a person might when saying “that’s right, *I* did it!” (extended thumb pointing at him for effect).
And, of course, he loves trolling, and gets praised regularly for it on Fox News, because otherwise, people would realize what an emotionally immature person he is. When Very Serious People insist that he’s acting in a Very Serious Manner, they can get the rubes to deny their own view of reality.
LongHairedWeirdo
@Brachiator: I’ve heard that very thing: if a person tries to isolate with their family in the same house, the whole household is *likely* (not certain) to be affected.
Human contact is the primary driver; that’s the one thing we *know*, with certainty, spreads it. Surface contact *might* – think of how hard it would be to be sure it spreads by an infected surface, versus by being in proximity to the infected people, right? You’d need something like… well, like a phone booth (they have them, for quiet cell phone calls, in my office) to spread the virus before you’d be sure, and even then, contact seems to be the overwhelming driver of infections.
So: removing contact is a *big* deal. Deep cleaning might not be as much of one.
As a side note, so far, there hasn’t been a case where an infected food worker infected a food customer – this is why they say takeout is safe. I saw an article saying “and believe me, the CDC watches new infections with an eagle eye, watching for food-borne contamination.” I confess, I still prefer, say, kung pao chicken (everything is hot) to a hamburger (the bun and condiments weren’t heated enough to kill the virus, and, conceivably, it could be infected during assembly), but they’re pretty sure that no one has gotten it via food, yet, be it a cold sandwich or a hot entree. So that’s good news.
Anyway: yes, the idea of “use hotels for quarantine” is a pretty good idea, because contact is the one thing they’re sure of as a driver, though, obviously, this is more of a lockdown idea than a normal business model – “come on, you haven’t got anyone staying there anyway, so we might as well use the space, and give you some money!” is a lot stronger than “kick out your guests, or expose them to danger”.
Brachiator
@LongHairedWeirdo:
I’ve heard this, too, but have not seen any actual analysis. There may be some good stuff, but it is hard to look for and to try to read every story about the pandemic.
In the Los Angeles County briefings, they suggest that people self-isolating at home use a separate bathroom from the rest of the family, etc. Not too sure how this works in actual practice.
And it may not have much to do with food temperature. It may be that the digestive juices kill the virus. Inhaling though the lungs or touching your face, eyes, mouth seem to be more of an issue.
As I noted, in some California cities, hotels have been used to house the homeless. Business owners are anxious to get back to normal use, and may not be happy about using their properties to house people who may have the virus. Also, I think you might have to take steps to make sure that the infection is not spread to hotel workers, or you would have to displace the regular staff for people with medical training.
So, hotels might be useful, but it still would require some re-tooling or re-modeling.