It’s a coronamergency, but let’s not relax any of our rules

by philg

I made it out to the local supermarket recently. The folks in our town who previously said that helping the vulnerable was their only priority continue to keep it stripped of the hand sanitizer and toilet paper that their neighbors might need. The righteous boycott of Barilla pasta, which (initially) refused to feature same-sex couples in its advertising, was apparently forgotten. The only pasta shape left from any brand was lasagna (people don’t have time to boil and bake when they’re sheltering in place?). Nearly all dairy products, however, including the ricotta cheese necessary for a standard lasagna, had been cleaned out. When did ricotta cheese become an emergency ration?

What struck me the most was being carded for the small box of wine that I bought for the lasagna recipe. It’s a national emergency, many of our loved ones will be dead soon, and the nearest toilet paper is in Canada, but we will still put effort into verifying that someone in his 50s is authorized to buy alcohol?

When I returned home, there was an email from the airport. The strict regulations for renewing security badges remain in force. People have to come in, do computer-based training (at a shared computer) to review material that they saw two years previously, and then get a new badge. The idea of relaxing this policy and extended all expired badges for six months is unworkable, apparently. Instead there will be some additional rules, e.g., people whose badges aren’t close to expiring will be turned away, etc.

I had a checkup scheduled at a local physicians’ office. I called to see if it was still on (“no”; anything routine is pushed out until June). The automated phone system forces callers to listen to a lengthy message that hasn’t changed from pre-plague times. It gives the clinic’s FAX number so that they can continue to comply with HIPAA while the economy and society collapse.

I opened my email to find a bill for $4.98 in tolls accumulated while renting a Hertz car in Florida. The “PlatePass administrative fee” was an additional $17.85, i.e., the bureaucracy cost 358 percent more than the service consumed.

An immigrant friend used to say that the true religion of Americans is regulatory compliance because it consumes roughly the same amount of time that people in medieval times spent going to church and praying. I wonder if his perspective is borne out by how Americans are responding to coronaplague.

In this time of coronaplague, I do wonder if we need to make sure that we’ve budgeted for the fact that we can never be as responsive as societies where less time and money is invested in making rules and complying with rules. We might need a much longer shutdown than China, for example, since we have so many people dedicated to crossing Ts and dotting Is and therefore fewer who can perform tests, set up temporary hospitals, etc.

Related:

  • https://philip.greenspun.com/blog/2020/03/17/coronavirus-is-a-national-emergency-but-lets-not-do-anything-drastic/
  • “the coronavirus is forcing authorities to admit many of their regulations are unnecessary” (Reason): Something similar is going on in Massachusetts, a state well-known for high levels of regulation, including of the medical sector. Expecting a crush in medical care needs due the coronavirus, Gov. Charlie Baker has seen the light and agreed to streamline the Bay State’s recognition of “nurses and other medical professionals” who are registered in other parts of the United States, something that 34 states do on a regular basis. … And over at the Food and Drug Administration (FDA), bureaucrats have suddenly decided to approve overnight a coronavirus test that its former chief, Scott Gottlieb, has described as a “fairly routine technology.” The Roche test is 10 times faster than the process currently being used, but the FDA didn’t approve it until this past Friday—and then only for this particular emergency.
  • “I Got the Coronavirus Test. My Ordeal Was Just Beginning.” (Politico, 3/15/2020): “On Thursday, March 5, I began my own odyssey trying to determine if I, too, had contracted COVID-19 … I spent the next 11 hours at the ER getting tested for multiple contagions. A doctor wearing a breathing apparatus over his head and chest … She informed me they would send the two specimens to Maryland’s public health department for COVID-19 testing, which could take as much as 48 hours. I was then told to go home and await the results. Back at home, I noticed the paperwork did not supply me with a way to track my testing, nor did it provide me with a point of contact for my results… Late Sunday, March 8, I heard from an outbreak investigator at the county health department. She had discovered that only one of my two specimens had been sent in for testing, despite a two-specimen protocol; the other was still sitting in an ER refrigerator.”
  • Canada is apparently more holistic and flexible. On March 17 they decided to extend expiring pilot medical certificates at least to August 1 (AOPA).
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Towered airports reverting to uncontrolled fields

by philg

FAA Air Traffic Controllers have been there for us on Christmas, in the wee hours of boring weekdays, etc. Towers are shutting down, now, one by one, as coronaplague sweeps over the nation. Las Vegas, one of the world’s busiest airports (1500 operations per day), is no longer towered (US News). Here’s the NOTAM:

SVC TWR CLSD CTC LAS VEGAS APP CLR 125.9, CTAF 119.9 OR 725-600-7015. 19 MAR 17:44 2020 UNTIL 27 MAR 07:00 2020. CREATED: 19 MAR 17:44 2020

What happens when there is no control tower? That’s actually the normal condition at most U.S. airports, but not at airports where jets arrive on IFR flight plans every few minutes. AOPA publishes a good explanation of how pilots in radio-equipped aircraft (remember that some people fly antique airplanes with no electrical systems and no radios) are trained to do this. One key is broadcasting one’s intentions on the Common Traffic Advisory Frequency (CTAF). However, it is kind of a lost art among airline pilots, accustomed to talking to ground controller, tower controller, departure controller, center controller, …, center controller, approach controller, tower controller, ground controller.

Listen to the Vegas airplanes at liveatc.net (“KLAS Tower (Both)” and perhaps also the ATIS to see how the tower closure is conveyed via audio). Note that the tower frequency generally reverts to a CTAF whenever the tower is closed.

Chicago Midway, 670 operations per day, is in the same situation: liveatc.net to hear the Southwest 737 pilots self-announcing. The NOTAM, through April 18(!).

SVC TWR CLSD CLASS C SERVICE NOT AVBL CTC CHICAGO APP FOR IFR CLR 847-289-1326/READY FOR TKOF FREQ 119.45/IFR CANCELLATION FREQ 119.45. 19 MAR 01:42 2020 UNTIL 18 APR 23:59 2020. CREATED: 19 MAR 01:42 2020

Uncontrolled airports can be pretty busy and can handle quite a few flights as pilots separate themselves. But this depends on (1) planes being light enough not to interfere with each other via wake turbulence, and (2) aircraft not coming in and departing under instrument flight rules (IFR) in which only one plane can use the airport at a time. (The Approach controllers can’t guarantee separation if they authorize one airplane to take off and one to arrive, for example.)

[I did this exactly once during my brief airline career, flying regional jets for Delta. We were delayed for hours out of JFK (also on the potential list for a tower shutdown) by thunderstorms and the usual JFK afternoon/evening “international push”. A heavy Airbus to Europe gets priority over a regional jet to Burlington, Vermont. Currently, KBTV Tower is open 5:30 am to midnight. I don’t remember exactly when we arrived, but it was after Tower was closed and therefore we had to turn on the runway and taxiway lights ourselves (5 clicks on the microphone to activate “pilot-controlled lighting”), announce our position to other traffic (a bizjet landed shortly before we did), fly the visual approach (maneuver the plane by looking out the window), and look out for anyone else who might be on the taxiways.]

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Dogs profiting from Coronavirus and also yielding a profit for owners

by philg

Under the principle of cui bono we should suspect our canine companions of spreading coronavirus. The whole family is home all the time and formerly house-imprisoned dogs are getting walked six times a day.

A Spanish friend says that in her country the benefits are flowing in the other direction as well. A tail of coronaplague canine commerce: “It is illegal to go outside unless you have a dog, so people are renting their dogs for 100 euro.”

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Undocumented migrant population of U.S. jumps from 11 million to 19 million due to Coronavirus

by philg

For about 20 years, our official media tells us that there are 11 million undocumented residents of the U.S. But last week I was listening to NPR (temporarily bored by a lecture on 11th century Japanese history so tuned into the Channel of the Righteous as a last resort) and they casually used the number “19 million” in the context of how many people should get amnesty for violating U.S. immigration laws so that they would be encouraged to seek treatment for coronavirus and not kill all American natives. The 19 million number isn’t that different from the 22 million that Yale estimated in 2018, so it is not the number that is interesting but the radical jump from 11 million (when telling Americans not to believe Trump) to 19 million (when telling Americans about the risk of Trump policies designed to discourage the undocumented from getting on health care welfare).

Separately, as there is no treatment for coronavirus and hospitals at the time of the interview couldn’t order tests, it is unclear why anyone would want 19 million undocumented Americans to go to their nearest hospital.

(Is a constant number of undocumented plausible? To some extent, it might be. Most migrants arrive and have children in the U.S. Thus, 18 years later, the parents are entitled to a green card via chain migration (each legal immigrant will bring in an average of 3.45 additional migrants). On the other hand, with the recent migrant surge, the constant number over decades seems less plausible.)

Related:

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Bad news and worse news on coronavirus

by philg

Bad news if you’re unhealthy: “99% of Those Who Died From Virus Had Other Illness, Italy Says” (Bloomberg):

More than 99% of Italy’s coronavirus fatalities were people who suffered from previous medical conditions, according to a study by the country’s national health authority.

The Rome-based institute has examined medical records of about 18% of the country’s coronavirus fatalities, finding that just three victims, or 0.8% of the total, had no previous pathology. Almost half of the victims suffered from at least three prior illnesses and about a fourth had either one or two previous conditions.

More than 75% had high blood pressure, about 35% had diabetes and a third suffered from heart disease. … All of Italy’s victims under 40 have been males with serious existing medical conditions.

And now for the worse news… (for everyone)

My personal prayer has been that coronavirus will have a tough time surviving heat and humidity, as suggested by “High Temperature and High Humidity Reduce the Transmission of COVID-19” (a Chinese team). Rain on this parade: “Florida coronavirus cases jump by nearly 100, multiple new cases in Central Florida”. Highs are in the 80s right now in Orlando.

Readers: What do you think? If the coronavirus is spreading in the Florida heat and humidity, what hope is there for a summer slowdown in the rest of the country?

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Samsung dryer drum cracked

by philg

The Samsung repair guy came into our pantry/laundry closet last week to fix the dryer. I cleared mountains of clutter away from the appliance, including 11 rolls of paper towels, 29 rolls of Charmin, 161 Ziploc bags, 33 squeeze bags of apple sauce, and a six-pack of individually packaged roasted chestnuts from China. I moved the quart of vanilla extract and the 3 lb. bag of walnuts that was resting on a pallet of Kirkland AA batteries. I slid the four tubes of Colgate back and asked if he needed a few of the ibuprofen pills from the yoked-together 500-pill bottles.

He said “Wow, I’ve never seen a household that was this well-stocked for a quarantine before.” I replied, “Quarantine? Those are just the leftovers from shopping at Costco in January, before we’d even heard of coronavirus.”

[For students of state-of-the-art appliances, this was an extra large gas dryer, 9.5 cu. ft. capacity, DV56H9100GW, purchased six years ago for $1,200. The theory was that we’d have to do laundry just one per week in our monster front-loading machines. In practice, we end up doing a lot of small loads and regular-sized machines would have worked just as well. Engineering the huge drum is apparently a challenge. The cracked drum generated a vibration, which took out some of the drive mechanism. The warranty period is two years and the cost of repairs is about $600, including two visits.]

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We’re gender-neutral, but all children are either girls or boys

by philg

Our town is building what is, on a per-student basis, the most expensive school ever constructed in the United States. Thus, when it comes time to do sex ed they need to rely on materials from Procter and Gamble. The conservative Midwesterners try to be up to date regarding the irrelevance of biological sex:

But notice that they commit the sin of gender binarism. The school population falls into just two categories: girls and boys.

Separately, although the materials are targeted at the full rainbow of students, including those who identify as “boys”, the only available role models in the teacher slides appear to be cisgender females:

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Coronavirus is a national emergency, but let’s not do anything drastic

by philg

Email from the president of Harvard University:

I write to follow up on the message you received Wednesday from HUHS Executive Director Giang Nguyen regarding two members of our community who have been tested for Coronavirus Disease 2019 (COVID-19). One individual received a presumptive positive test and is receiving medical care off campus. We await test results for the second individual. Additionally, a third individual who had close contact with the person who tested positive, is now being tested.

Ensuring the anonymity of these individuals is paramount. If you are aware of their identities, please respect their privacy so that they can focus completely on their health. The last thing they need—or any of us would want for them—is public attention and scrutiny.

So… it is an emergency, but preventing millions of deaths is not as important as keeping the names of the infected anonymous? If we’re in an actual emergency and lives are at stake, wouldn’t it make more sense to abandon the standard procedures and publish the names of the infected so that people who were with them can self-quarantine? Or, if anonymity is actually more important than stopping the spread of coronavirus, should we choose some description softer than “emergency”?

[Follow-up from March 15, after the governor of Massachusetts had declare a State of Emergency, ordered all restaurants and schools closed, etc.: “I write to follow-up on President Bacow’s recent message to the community. While we wait for additional test results, I continue to emphasize that the anonymity of these individuals is paramount. If you know their identities, please respect their privacy so they and their loved ones can focus completely on their health.”]

Similarly, on Friday, March 13, the Boston Public Schools decided to close for six weeks… but not start the closure until the following Tuesday (today, March 17). If the problem is serious enough to require a six-week closure, why open the schools on a single Monday after everyone has had a chance to pick up the virus somewhere over the weekend (if anyone needed to come the school to retrieve an item, that could have been done over a period of days, without gathering everyone together in close quarters for 6+ hours).

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Will the human race be more susceptible to obsessive compulsive disorder going forward?

by philg

What do you call someone who washes his hands 30 times a day? “OCD,” right? As the coronaplague spreads, what do you call someone who washes his hands 30 times a day? “Alive”?

If it turns out that OCD is protective against coronavirus and the virus mutates such that it can kill a significant number of reasonably young people (i.e., not well past their child-producing years), could it be that OCD will become a significantly more common human characteristic?

Even without coronavirus, if the world population expands to 11 billion or more and the trend toward urbanization continues, will the dense living conditions favor those with OCD habits? There are plenty of existing diseases that are transmitted from person to person and that can be stopped with OCD-style hand washing, wearing of obsessively-fitted face masks, etc.

Related:

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More from the British on coronavirus

by philg

From three days ago: “If the British are right, everything the U.S. is doing about coronavirus is wrong”. If you’re not like my friends on Facebook who get all of their scientific, technical, and medical information from Donald Trump (and then complain that it isn’t accurate), you might be interested in “Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand” from Imperial College. It seems that the UK government policy is to some extent derived from this research.

It is tough to summarize, but the authors say that both “mitigation” and “suppression” are required. Mitigation is the “flatten the curve” idea that we’ve seen. Suppression is Asian-style crush: “the aim is to reduce the reproduction number (the average number of secondary cases each case generates), R, to below 1 and hence to reduce case numbers to low levels or (as for SARS or Ebola) eliminate human-to-human transmission.”

The optimum strategy seems to be to turn suppression on and off depending on how many ICU beds are occupied. The authors expect this fight to last roughly two years. If everything is done perfectly and the baseline transmission (R0, an assumption) is 2.4, deaths in the U.K. will be cut from a baseline of 510,000 (do nothing but sweep up bodies) to around 30,000. The authors are expecting social distancing policies to be in place for about 2/3rds of the time.

Some unwelcome news for a country that takes 100 years to build a subway line and maybe 1,000 years to build high-speed rail:

Perhaps our most significant conclusion is that mitigation [as opposed to mitigation plus suppression] is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

So a country like China that can throw together and deliver emergency hospitals may be able to get away with comparatively lightweight social distancing measures. But for countries that are mostly paralyzed with red tape and therefore that have to “go to war with the hospitals they have”:

We therefore conclude that epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.

Sobering. The only thing that would potentially save us from these shutdowns is a vaccine, say the authors. But other sources are saying that a vaccine probably won’t work, right? The virus evolves so fast that last month’s vaccine won’t help with next month’s infection.

Even more sobering…

we emphasise that [it] is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time. How populations and societies will respond remains unclear.

Related:

  • The hospital that the Chinese built in 10 days is 645,000 square feet (Business Insider). How big is that? The Blue Origin rocket factory at Cape Canaveral is 750,000 square feet (Florida Today). (anecdote: A program manager at Blue Origin told our aviation group about making a bet with the general who runs the nearby U.S. Air Force base. A base guard shack had been wiped out by a hurricane. Blue Origin was beginning work on their factory as the Air Force was planning the new guard shack. The Blue Origin guy said he’d get his rocket factory built before the Air Force guy had his new guard shack. 18 months later… the Air Force won, but only by a couple of weeks.)
  • “Flattening the Coronavirus Curve Is Not Enough” (MIT Press), by a University of Toronto professor, who says that we need surge capacity like the Chinese that our military and government will deliver it (after all, we mostly won the Afghanistan and Iraq wars in slightly less than 20 years while spending less than $1 trillion per year on our military, right?): “Building out that capacity requires a new mindset and it requires it quickly. The great news is that we — and by we I mean the generation who were adults in World War II — have done this before. Entire economies were shifted over to military production. This was done by abandoning market processes of resource allocation and moving to a planned economy.”
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