COVID-safe restaurant chain idea

by philg

Even as thousands of Americans continue to be felled by SARS-CoV-2, state governors are lifting COVID-related protections. Soon it might be possible for a 5-year-old, for example, to go to a restaurant without anyone checking to see if the 5-year-old has been injected with an experimental use-authorized vaccine against a disease that kills 80-year-olds. Mask requirements are being dropped as well. People will be unmasked as they walk into the restaurant, not just when they’re sitting at tables.

Let’s assume that at least 20 percent of Americans Follow the Science and are extremely concerned about COVID-19, albeit not concerned enough to stay home. That’s a potential market of 67 million people (source for total population) who want a restaurant where they are fully protected against COVID-19 by cloth masks and vaccines that cut risk by a further 97X.

Even in the Florida Free State, there is no law against a restaurant checking vaccine papers (as mine were checked at Art Basel) and requiring masks. The legislature has blocked government agencies from engaging in this kind of behavior, but private companies can do whatever they want (e.g., hassle unvaccinated employees with periodic testing demands).

How about a restaurant chain that voluntarily imposes all of the restrictions that mayors in Washington, D.C., New York, San Francisco, Boston, et al. imposed by force of law? You will need to show a photo ID and vaccine papers to get in. You will need to wear a mask, preferably cloth but N95 is also okay, as you walk from the door to the table. The restaurants will close at 10 pm in honor of the curfews that many European nations imposed to prevent SARS-CoV-2 from spreading during the night hours.

Because obesity is not a significant or newsworthy cause of death compared to COVID-19, the menu will be 100 percent items that people love. Fettuccine Alfredo, potatoes au gratin, crème brûlée, etc. Because cancer is also insignificant next to COVID-19, smoking and vaping will be allowed.

What will the new chain be called? Karen’s.

Before everyone heaps ridicule on the above idea, remember that the U.S. government thought that there would be a significant number of people who would remain concerned about COVID-19 prevention immediately after a nuclear weapon had destroyed one or more cities. From https://www.ready.gov/nuclear-explosion (retrieved 2/28/2022; it was still all about the hand sanitizer!):

When you have reached a safe place, try to maintain a distance of at least six feet between yourself and people who are not part of your household. If possible, wear a mask if you’re sheltering with people who are not a part of your household. Children under two years old, people who have trouble breathing, and those who are unable to remove masks on their own should not wear them. … If you are told by authorities to evacuate to a public shelter, try to bring items that can help protect yourself and your family from COVID-19, such as hand sanitizer that contains at least 60 percent alcohol, cleaning materials, and two masks per person.

The authors of the web page assume that the nuclear weapon(s) did not take out the 9-1-1 and health care systems:

If you are sick or injured, listen for instructions on how and where to get medical attention when authorities tell you it is safe to exit. If you are sick and need medical attention, contact your healthcare provider for instructions. If you are at a public shelter, immediately notify the staff at that facility so they can call a local hospital or clinic. If you are experiencing a medical emergency, call 9-1-1 and let the operator know if you have, or think you might have, COVID-19. If you can, put on a mask before help arrives. … Many people may already feel fear and anxiety about the coronavirus 2019 (COVID-19). The threat of a nuclear explosion can add additional stress. Follow CDC guidance for managing stress during a traumatic event and managing stress during COVID-19.

There is a helpful photo:

Anyway, if there are people who want to wear an anti-COVID mask in the fallout shelter after a successful nuclear attack on the U.S., my theory is there are people who will want to have dinner in a fully masked environment (except for all of the customers who are unmasked because it is a restaurant and they’re eating).

Related:

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Open house today in our neighborhood

by philg

There’s a house for sale in our neighborhood (we rent a 2BR for $2800/month). It went on the market about a week ago. The first showings are today, 10a-4p, and “All contracts must be submitted by 5:00pm on March 3rd.” This million dollar home (built in 2012; re-sold in 2017 for $1.3 million) sits on a princely quarter-acre lot and offers a vast interior space of 4,574′. It was “coming soon” at $2.95 million two weeks ago, but the asking price now is $3.225 million (escaping NY, MA, and CA vaccine coercion and mask orders is not cheap!). The house comes with the opportunity for a lifetime close friendship with the appliance repair brothers, sisters, and binary resisters (i.e., there is a Sub-Zero fridge).

Zillow estimates the value at $2.225 million. Redfin admits “we don’t have enough information to generate an accurate estimate at this time.”

Your entire collection of hard-to-buy vehicles, e.g., Honda Accords, has to fit in the two-car garage. There is no basement or attic, so the garage also needs to serve as storage.

Let’s compare actual inflation in the cost of this house compared to the government’s official inflation rate. $1.29 million in April 2017 was equivalent to $1.48 million in January 2022 (the most recent month available for the BLS calculator). If the house sells for $3.225 million, therefore, it will represent an additional 118 percent inflation over the officially published rate.

Update, May 13: The house closed at $3 million, according to Zillow/Redfin.

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Potential explanation for the Ukraine situation

by philg

A reader comment on Why didn’t Ukraine become a NATO member back in the 1990s? highlighted this 2018 lecture at Yale by a French-Russian-American guy, 83 years old at the time(!), who was formerly a Soviet spokesman. Starting at about 19:00 he summarizes the various insults that the U.S. and NATO have inflected on the post-Soviet Russians. These include the 1998 expansion of NATO, breaking explicit promises made to the Soviets, recognizing the split off of Kosovo from Serbia, rejecting Putin’s proposals to join NATO and the EU, returning nothing for Putin’s assistance post 9/11.

He highlights Thomas Friedman, not for being smart enough to marry the daughter of a billionaire and fret about global warming from inside an 11,000-square-foot mansion, but for a 1998 article about the NATO expansion:

So when I reached George Kennan by phone to get his reaction to the Senate’s ratification of NATO expansion it was no surprise to find that the man who was the architect of America’s successful containment of the Soviet Union and one of the great American statesmen of the 20th century was ready with an answer.

”I think it is the beginning of a new cold war,” said Mr. Kennan from his Princeton home. ”I think the Russians will gradually react quite adversely and it will affect their policies. I think it is a tragic mistake. There was no reason for this whatsoever. No one was threatening anybody else. This expansion would make the Founding Fathers of this country turn over in their graves. We have signed up to protect a whole series of countries, even though we have neither the resources nor the intention to do so in any serious way. [NATO expansion] was simply a light-hearted action by a Senate that has no real interest in foreign affairs.”

The point about “neither the resources nor the intention” reminds me of a question at a Chinese New Year party in Miami: “Why does Joe Biden want to defend the Ukraine border when he won’t defend our own?”

”I was particularly bothered by the references to Russia as a country dying to attack Western Europe. Don’t people understand? Our differences in the cold war were with the Soviet Communist regime. And now we are turning our backs on the very people who mounted the greatest bloodless revolution in history to remove that Soviet regime.

If we are unlucky they will say, as Mr. Kennan predicts, that NATO expansion set up a situation in which NATO now has to either expand all the way to Russia’s border, triggering a new cold war, or stop expanding after these three new countries and create a new dividing line through Europe.

Thanks to Western resolve and the courage of Russian democrats, that Soviet Empire collapsed without a shot, spawning a democratic Russia, setting free the former Soviet republics and leading to unprecedented arms control agreements with the U.S.

And what was America’s response? It was to expand the NATO cold-war alliance against Russia and bring it closer to Russia’s borders.

As he said goodbye to me on the phone, Mr. Kennan added just one more thing: ”This has been my life, and it pains me to see it so screwed up in the end.”

Geopolitics is a complex topic so I don’t think Pozner or Kennan has access to the whole truth (but Friedman does! Marry a rich woman and live under Maryland family law so that she can’t get rid of you without ruinous financial consequences). However, the Pozner lecture is a good refresher for Americans who’ve forgotten everything that we’ve done in Europe during the past 30 years.

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Why didn’t Ukraine become a NATO member back in the 1990s?

by philg

In a comment on MIT weighs in regarding the war in Ukraine, Paul wrote the following:

https://www.nato.int/cps/en/natohq/opinions_190542.htm

sure looks like NATO poking the Russian bear to me.

What’s inside the referenced January 10, 2022 NATO document?

Jens Stoltenberg, NATO Secretary General: On membership. We have reiterated the decision we made at the Bucharest Summit in 2008 and we stand by that decision. We help Ukraine to move towards a NATO membership by implementing reforms, by meeting NATO standards. … Meaning that it is for Ukraine and the 30 NATO Allies to decide when Ukraine is ready for membership.

Let’s ignore for the moment the question of whether it was wise, as Russian forces gathered on the borders of Ukraine, to talk about the inevitability of Ukraine’s future membership in NATO, exactly what the Russians were objecting to. The question for today’s post regards “NATO standards”.

Let’s step back and look at Jens Stoltenberg? Wikipedia says Mx. Stoltenberg is “a Norwegian politician”. He/she/ze/they is not someone with military experience, in other words, and yet he/she/ze/they leads what is supposedly a military enterprise. Below is a 2018 meeting where we can see how mild-mannered he/she/ze/they is compared to Donald Trump, who points out that Germany’s continued fossil fuel purchases from Russia work against the organization’s mission.

Hindsight is 20/20, but if the goal was to have Ukraine as part of NATO, why wasn’t that done in 1994, when the Budapest Memorandum was signed? Putin’s leadership of Russia did not begin until 1999.

NATO in January 2022 said that Ukraine could join NATO “by implementing reforms” and “by meeting NATO standards,” but what was deficient about Ukraine from NATO’s perspective? It can’t be about fighting spirit, can it? There are plenty of countries in NATO that are not renowned for military valor. What “reforms” did Ukraine need? They had already stopped paying Hunter Biden (and, indirectly, “the big guy”, though $2.5 million of this cash was harvested by a retired-stripper-turned-family-court-entrepreneur; see BBC for a summary), right?

If countries that have historically crumbled at the first hint of a foreign invasion can be part of NATO, what was the obstacle to Ukraine’s membership years or decades ago?

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Restaurant closures point to more inflation ahead?

by philg

A popular restaurant in booming South Florida, February 22, 2022:

(“Sorry, we are closing for lunch due to staffing. Our new hours of operation are Monday through Saturday, 4:00 pm to 9:00 pm.”)

It took them nearly an hour to put a $28 stew over spaetzle on my table on a Tuesday night (about 80 percent full). Most of this dish would have had to be pre-cooked. The waitress explained “we have only two cooks on the line tonight”.

A few days earlier, I had talked to a restauranteur and chef from Maskachusetts. After several decades, she’d closed her usually-busy restaurant. “I was paying 14-year-olds $20 per hour to wash dishes and I had to train them,” she explained.

With tax and tip, my entrée cost about $36, but what would have been the cost to get food in an amount of time considered normal back in 2019? To me, that’s the inflation that is pent-up in our economy. Maybe the cost to the consumer needs to go to $45, for example, (a 25% bump) in order to give the restaurant enough money to hire additional kitchen staff. The lunch closure, for an Econ 101 student, suggests that whatever the prices that a restaurant can charge to serve lunch aren’t high enough to yield a profit after paying staff to come in during lunch. (A counter-service or fast food restaurant might still be able to survive, though, because their labor cost percentage is lower than at table-service restaurants.)

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Did the Deplorable explanation for COVID-19 deaths hold up?

by philg

Back in September 2021, we looked at a New York Times article that explained the #Science of Deplorability leading inevitably to death from COVID-19. States and counties in which people voted for Trump were subject to high death rates. Cities packed with righteousness (Biden voters) were sailing through whatever SARS-CoV-2 could dish out more comfortably than a New York City hospital executive holed up on the Palm Beach waterfont.

In the comments, Steve wrote “Coastal America (blue states) tend to have mild summers, and long dreary wet winters.” I responded with a throwback to pre-coronascience, suggesting a hypothesis to test:

Maybe Vermont would be a good test for your theory. They have the nation’s highest vaccination rate. They have the nation’s lowest cumulative COVID-19 death rate (still higher than India’s, though, which was portrayed as a world-ending disaster by our media). They enthusiastically voted for Joe Biden in 2020 (largest margin on the NYT chart).

Also, California and Maryland. The NYT says that these states are being spared currently because they’re populated by Democrats. Presumably that isn’t going to change and, in fact, they’ll become more solidly Democratic as Deplorables seeking freedom move to Florida, South Dakota, and other comparatively free states.

If we want to be scientific about this, where “scientific” has its pre-Covid definition of put forward a hypothesis first rather than retrospectively providing an explanation for how it is the fault of the unvaccinated or the Republicans, etc., we need a date and an outcome.

How about if the hypothesis is that Vermont suffers a fall/winter Covid wave that kills at least 50 percent as many people, adjusted for population, as the current wave in Wyoming, singled out for Deplorability in the NYT article? We pick March 1 as the “end of winter” (and September 1 for the start of fall?)? And the hypothesis test is discontinued if some dramatically effective medical treatment for COVID-19 becomes available prior to March 1 (i.e., the treatment that I wrongly predicted would be available no later than March 2021; see https://philip.greenspun.com/blog/2020/04/06/best-guess-as-to-when-the-first-successful-covid-19-therapy-will-be-widely-available/ (I give myself credit only for saying “I’m a big believer that viruses are smarter than human beings.”)). Wyoming has such a small population that it might be challenging to say when the current wave is over. The NYT characterizes Wyoming as a place where people are dying left and right. Your horse or pickup will have to navigate around corpses in Jackson. Yet the Google shows a 7-day average death rate currently of 6 people. Not 6 people per 100,000. 6 deaths per day total in WY. The wave can be declared over when this falls to 1?

California and Maryland have already suffered the loss of quite a few residents tagged to COVID-19. They’re thus more similar to West Virginia, also singled out for Deplorability in the NYT article (relatively high death rate right now on top of a medium cumulative death rate; many evil voters who chose Trump). So the hypothesis for those states can be that they have fall/winter waves that kill at least 50 percent as many people, adjusted for population, as the current wave in West Virginia. We look at deaths from September 1 through March 1 in these states. We say that the current “wave” in WV is over once the number of deaths per day comes down to fewer than 6 per day.

Although true coronascience is done by looking at the data and spinning a retrospective hypothesis, let’s look at the above hypothesis from September 2021 and compare to data received since. What do we find? Is whether a person voted for Donald Trump sufficient to predict his/her/zir/their chance of being felled by the mighty coronavirus?

Note that the New York Times didn’t formulate a hypothesis other than “red states bad” but it did a February 18 update:

It looks like the NYT’s hypothesis might be correct. Supporting Biden, and having neighbors who support Biden, protects a person from COVID-19-tagged death. On the other hand, the above chart is not adjusted for median age. Younger people are more likely to vote for Democrats and much less likely to die from/with COVID-19. There are huge state-to-state variations in the percentage of population over 65 (California is very young, for example, which helps it look good in the COVID Olympics; 15% of population over 65 compared to 21% in Florida). Especially when looking at all counties in the U.S., there would have to also be huge variations in the percentage of over-65s in those counties (just comparing all California counties to all Florida counties, for example, would result in a massive disparity in COVID-19 vulnerability). Rural counties were more likely to vote for Trump and they’re also packed with COVID-vulnerable seniors (19 percent of population compared to 15 percent in urban/metro counties (USDA)).

We might also need to adjust for the type of work being done in these counties. A county packed with work-from-home, welfare-from-home, or cash-alimony-and-child-support-checks-from-home Zoom heroes might be more protected from COVID-19 deaths than a county packed with people whose job requires in-person effort (God forbid!).

Jay Bhattacharya’s fall 2021 tweet reminds us that adjusting for demographics gives a different picture than a raw death rate.

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Book recommendation: The Great Siege, Malta 1565

by philg

Sadly topical, let me recommend The Great Siege, Malta 1565 by Ernie Bradford. For Americans softened by 150+ years without war on our soil, this is a sobering reminder of the nature of war and life in a besieged city. For those who are concerned about the fighting abilities of the innumerate 79-year-old whom Americans elected as our Commander in Chief, the book may provide some comfort. Suleiman the Magnificent, who ordered the siege, was nearly 71 years old at the time. Dragut, “The Drawn Sword of Islam”, who proved to be Suleiman’s best military leader, was 80 years old. Jean Parisot de Valette, who led the defense and gave his name to Malta’s capital, was 70.

Trigger Warning: the book’s author died in 1986, when Science was but poorly understood, and thus the book lacks coverage of how the 2SLGBTQQIA+ and BIPOC communities experienced the siege.

Related:

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Central Planning Success! (COVID-19 tests are arriving today)

by philg

Today is the day that muscular government action brings relief from COVID-19-related shortages. Our “free” (taxpayer-funded) at-home test kits are arriving. From USPS:

These were ordered on January 19, the first day of official availability. They’ll arrive approximately 5 weeks after the tests became generally available at retail in local pharmacies.

Related:

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Medical School 2020, Year 3, Final Weeks (Emergency Medicine)

by philg

Night shift: midnight – 8:00 AM. My resident is a 28-year-old whiz kid with slicked-back hair. An ED nurse rooms our first patient and drops off the paperwork. She teases, “Have fun, he’s here for bugs!” My resident sends me in there alone. “Good luck!”

The 55-year-old is presenting from home complaining that there are bugs crawling all over him. He wants us to write a note agreeing with him, so he can sue his landlord. “The bugs are everywhere. They are crawling inside me now.” I ask him where they are. “Everywhere. See.” He pulls out a zip block bag with a q-tip with ear wax on it. “See the bug.” He denies any drug use except marijuana. He is so convinced that he is convincing. Searching for the bugs, I am almost as confused as he seems to be. 

I present to my attending and resident. Within a few words, my attending has already figured out the problem. She states, “MJ is laced with meth around here. These delusions can be so strong that nothing will change their mind. I’ve had people bring in zip-lock bags with tampons claiming there are bugs. I just hope there are not any bed bugs on him.” We go in to see him together, and try to explain that there are no bugs on him but he may have taken meth. We offer to do a UDS [urine drug screen].” He becomes combative. He storms out of the ED.

My attending summarizes, “EM would be amazing if not for the addicts and psychotics. They suck out your soul.”

[Editor: Maybe she would be happier practicing medicine in a country where the government-run health insurance system doesn’t purchase opioids in tractor trailer quantities?]

My resident asks me what I want to do. I respond that I am not sure. “Well, if you’re debating between EM (emergency medicine) and IM (internal medicine), it’s easy. If you like to perseverate on stuff that probably doesn’t matter and will get better with time, do IM.” He continues, “EM is for people who have ADHD and want to fix things quickly and do procedures. We deal with putting out the fire. I’m not going to be great at everything, but we get the job done. We do eye procedures and central lines. We’re not as good at eye stuff as the opthamologist and we’re not as good at central lines as the intensivist. I had to put in a suprapubic catheter to drain 3 liters of urine [the bladder ordinarily holds no more than 0.5 liters]. I’ve never done that so I looked up the procedure steps and watched it on youtube. I got the job done.”

After a slow few hours, a neighboring resident comes over to our pod and asks if I want to do a lumbar puncture (LP)? A 45-year-old female presented with a several-week history of worsening headaches, gait disturbances, and visual changes. Neurology evaluated and is concerned about the possibility of a rare encephalitis. Neurology is busy so they asked if the ED wanted to perform the LP. After we consent the patient, the attending and resident help me prep the patient and numb her up with lidocaine. We lay her on her left side and ask her to bend over, thereby flexing her spine to open up the lumbar vertebrae. I insert a long spinal needle into her back, slightly off midline, while aspirating on the plunger. I keep hitting bone. After 3 attempts, the resident takes over and also struggles. The attending gets it on the second attempt. “That was hard, she must have some bad arthritis.”

After the last clinical day of M3 year, our entire class gathers in the medical school lecture hall for the M4 lottery. We are each assigned a number and go in order selecting M4 rotations. Straight-Shooter Sally is stressed because she would like to do “Acting Internships” at other institutions. “If I get the wrong order, I won’t be prepared when I have to do my AI.” (For example, someone interested in a cardiology AI would try to do the cardiology rotation at the home institution just prior.)

Statistics for the week… Study: 12 hours. Sleep: 7 hours/night; Fun: 2 nights. House party at Buff Bri’s house to celebrate the conclusion of M3 year. Sarcastic Samantha talks about her job distributing new admissions among the hospitalists.. She explains, “I have to fight with the hospitalists. They act like children. When we get a new heart failure exacerbation in the ED, they whine, ‘Why is it my turn?’ Because you haven’t taken one all week.”

The rest of the book: http://fifthchance.com/MedicalSchool2020

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MIT weighs in regarding the war in Ukraine

by philg

Portion of yesterday’s email from Rafael Reif, president of the Massachusetts Institute of Technology. Note the implication that Russians are suffering just as much as Ukrainians (in bold):

To the members of the MIT community,

Though 4,500 miles separate Kyiv and Cambridge, several factors make the shock of the Russian invasion and its terrible consequences feel very close to home.

I write to let you know how MIT is responding to this catastrophe and to offer some personal reflections.

Caring for members of our community [bold in original]

First in our minds are our students, staff and faculty who are from the region or have family there; we have reached out directly to everyone we are aware of from Ukraine. We have in addition been in touch with our students from Russia, who are also a long way from home in a difficult time. (As always, support is available to all students at doingwell.mit.edu).

A fellow MIT alum pointed out “Catastrophe makes it sound like an earthquake or a tornado.”

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