What the States Should Do

In an op-ed in the Wall Street Journal Scott Gottlieb and Mark McClellan make some recommendations about the steps that states should take:

A patchwork of local policies won’t be potent enough. People move across borders and bring the virus. Governors and local leaders should first reinforce steps known to be effective: wearing a quality mask, avoiding gatherings and maintaining social distance, especially indoors. Halloween gatherings contributed to the current spread, and Thanksgiving will be no different without more vigilance. At least while infections are widespread and surging, governors and local leaders should mandate the use of masks and impose clear and consistent plans to restrict gatherings. They should remind people to avoid large groups at Thanksgiving and stay home if possible.

This doesn’t mean broad lockdowns.

Somebody tell the governor of Illinois. Here we’re moving towards “broad lockdowns”. I just received an email advising me that the office would be closed for the next month. They continue:

State and local leaders can tie restrictions to expected hospital strain, tailored to hot spots and not necessarily the entire state. Restrictions can focus on known sources of spread, such as bars and nightclubs.

Congress should help by supporting affected businesses with another round of paycheck protection. A priority should be helping schools that are open, especially elementary schools, where the risk of infection is lower and the benefits of in-class instruction are considerable.

Governors should also work with local leaders to use new countermeasures that have only recently become available. This includes a valuable new treatment: monoclonal antibodies, man-made versions of naturally occurring ones that neutralize the virus. But these drugs are challenging to administer, requiring special sites for infusions and public education. People in high-risk groups with symptoms should get tested and treated before their condition deteriorates. Governors need to get the message out that Covid is now a treatable condition at the early stages, and work with local leaders to ensure that access to antibodies is available, especially in underserved communities.

Rapid testing is also more widely available, which allows for better detection of outbreaks in settings where people must be together, such as assisted-living facilities, essential workplaces and schools. With so much coronavirus spread through people without symptoms, especially younger people, it’s now possible to consider using these tests routinely as one more tool. Governors can work together to develop a consistent national screening protocol for containing outbreaks.

Although I continue to think that the authority of the federal government to impose measures is actually quite limited, there is no barrier to regional collaborations among states and the Congress can encourage them, possibly even tying some money to such collaborations. Stringent measures in New York don’t do a lot of good when New Yorkers just boogie out to New Jersey, Connecticut, or Rhode Island. The same is true in northeastern Illinois. That’s where a collaboration among Illinois, Indiana, and Wisconsin would be most useful. Too bad we don’t have a governor interested in anything other than throwing his weight around and Lord knows he has a lot of it to throw.

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A National Mask Mandate?

The editors of the Washington Post recommend a national mask mandate:

NO METHOD of blocking the spread of the coronavirus is perfect, but many of them are good. The use of cloth face masks is not a guarantee against broadcasting or receiving the virus, but when combined with other measures such as hand-washing and distancing, it can sharply reduce the spread. That’s why it is entirely wrongheaded for some Republican governors to resist the face mask mandates that President-elect Joe Biden has urged. Thirty-four states and the District have mandated face coverings in public; as the pandemic dangerously escalates, the others should join them.

I have no objections to state mask mandates given a few provisos:

  1. The mandate should be issued consistent with state law.
  2. Who should wear a mask, when, where, and the specific design of the mask required should be spelled out clearly and consistent with the present state of knowledge. Bandanas and face shields are not masks.
  3. Any mandate should be enforced. Failing to enforce a mandate sends the signal that it is not particularly important. Selective enforcement is a path to abuse.
  4. Any state mandating masks should also be issuing them to the needy.

Short of a declaration of martial law the president doesn’t have the authority to issue a national mask mandate and the Congress does not have the power to give him that power. It’s a state matter. As should be virtually needless to add, practically none of those provisos are being heeded in Illinois.

Why worry about such details in an emergency? An emergency is precisely when we should be most concerned about such details. That is what it means to have a rule of law.

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Traces Found on Packages from New Zealand?!

I found this news article from Reuters interesting:

BEIJING (Reuters) – The Chinese city of Jinan said over the weekend it had found coronavirus on beef and tripe and their packaging from Brazil, Bolivia and New Zealand, while two other provincial capitals detected it on packaging on pork from Argentina.

China is ramping up testing on frozen foods after repeatedly detecting the virus on imported products, triggering disrupting import bans, even as the World Health Organization says the risk of catching COVID-19 from frozen food is low.

Brazil or Bolivia I could understand but New Zealand? It’s reputedly been very successful in controlling its outbreak of COVID-19. I think that by far the greatest likelihoods are (in descending order):

  • There’s something wrong with the tests that are being used.
  • The Chinese authorities are upset with New Zealand.
  • The samples from New Zealand acquired their traces somehow during handling.
  • There’s more COVID-19 in New Zealand than they’ve reported.

It’s that last alternative that I find thought-provoking.

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The Holderness Take on Hallmark

If you’ve never watched a Hallmark movie, the Holdernesses have saved you the trouble by creating a video of their version of a Hallmark movie. This one is titled “A Christmas for Christmas”.

And if you’re not familiar with the The Holderness Family Vlog, they’ve got some pretty amusing stuff up on Youtube.

Hallmark also uses a formula in their casting. Expect the female leads to be superannuated juvenile actresses, e.g. Brooke Shields, Candace Cameron Bure (Full House), Lacey Chabert (Party of Five) and the biography of nearly every male lead starts with the words “Canadian actor…” Whether that’s good or bad depends on what you think of nice, cleancut-looking Canadian actors who, maybe, made a couple of B movies 20 years ago and have been acting in soaps since then.

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My Mom’s Birthday, 2020

Today is my mom’s birthday. That’s her above. I would guess she was in her mid to late 20s. It was before I was born.

I’ve been thinking a lot about this lately, considering preparations for the centenary of her birth. One of the mysteries about my mom is that we don’t really know the year she was born. It might have been 1921. It might have been 1922. It might have been 1923. “Check her birth certificate” you might suggest. I have official birth certificates for her showing each of those dates. So, had she lived, this might have been her 99th birthday. Or it might have been her 97th. We’ll probably never know for sure.

My mom was almost literally “born in a trunk”. She was born in St. Joseph, Missouri while her parents were performing there. Within days she was on stage and I have photos of her as an infant and toddler performing and a copy of her first contract and the first dollar she ever earned performing.

She had a hard childhood. For her first several years she lived in hotels all over the U. S. She sometimes said that when she was a kid she thought that all food came with tin covers over the plates.

She probably wouldn’t appreciate my sharing this but I will. After her parents split up, she was shuffled back between them, sometimes living with her mom, sometimes her dad, sometimes her dad’s brother’s family, sometimes her dad’s sister’s family. I believe that the 1921 birth certificate was one her mom or dad obtained so he (or she) could put her in school during the day. Her first school was Shenandoah School in St. Louis. I’ll write more about this later.

I’ll probably celebrate next year as her centenary but if the pandemic is still in full swing I may defer the commemoration for a few years.

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COVID-19 Sitrep, 11/15/2020

From the Chicago Tribune:

The total number of new confirmed and probable COVID-19 cases in Illinois is 11,028, a little lower than Friday’s record-breaking 15,415, state public health officials reported on Saturday.

But the number of new deaths on Saturday spiked to 166, at least six times higher than Friday’s figure, 27.

Dr. Ngozi Ezike, the IDPH director, noted during Friday’s COVID-19 state briefing that due to a data reporting issue there was a delay in deaths reported that day. According to a news release, 66 of the deaths “that occurred yesterday are being reported with today’s total.”

The total number of known infections statewide is 562,995, The total number of fatalities since the pandemic began now stands at 10,670, official said.

Meanwhile, Gov. J.B. Pritzker announced Friday he was extending a host of coronavirus-related executive orders for another 30 days, including an extension of a moratorium on evictions.

The state also updated the data that it posts related to contact tracing, which involves reaching out to people diagnosed with COVID-19, urging them to isolate and asking them where they’ve been and whom they’ve seen during the two weeks prior to their positive test so those people can be asked to quarantine.

There have been multiple news reports that contact tracing has been next to useless in the Chicago metropolitan area. Only about 20% of the individuals whom they try to contact respond and some of those lie.

I should probably go to the trouble of putting together a timeline. Illinois’s lockdown mandate began in March (right after California) and continued until the end of May. Since the beginning of April Gov. Pritzker has continued to issue orders beyond his statutory authorization as has been found by more than one court. He still is. There have been no legal or political barriers to his actions.

I’ll ask the question I’ve asked before: what did he do wrong? His policies definitely had an effect on thousands of businesses in the state and state tax revenues. IMO it is now fair to say that the effect of lockdown mandates is not to prevent the disease from spreading but to timeshift its spread. What did he do with the period during his previous lockdown to ensure that the continuing spread of the disease would not overwhelm Illinois’s health care resources? As I pointed out last week it is clear that, if he is responding to data, it’s not data that’s available publicly.

I’ll answer that question. He squandered it. He assumed, incorrectly, that the disease would just go away or that a vaccine would be available soon enough to make additional actions unnecessary. We can now be pretty confident that the earliest that an effective vaccine will be be available for mass distribution will be sometime next year and it may be much later. It remains possible that a safe, effective vaccine will never be available. It’s still early days in vaccine trials.

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Origin Story

The editors of the Washington Post remark on the search for the origins of SARS-CoV-2, closing their editorial with a quote I think they should have opened with:

“Preventing the next pandemic,” wrote Dr. Relman, “depends on understanding the origins of this one.”

I’ll summarize the story they tell:

  1. It is probably zoonotic which is to say that dit originated in animals and at some point was contracted by humans.
  2. No one knows what animal was the original host. Bats and pangolins (insectivorous mammals of Asia and Africa, whose bodies are covered in scales made of keratin, the same stuff your fingernails are) have been suggested.
  3. The bat virus closest to SARS-CoV-2 isn’t particularly close.
  4. The suggestion that it was genetically modified has been widely debunked.
  5. “Community spread” of the virus may have started in the Wuhan “wet market”, a market where live animals are sold.
  6. 30 of the first 100 reported cases of COVID-19 have no known connection to the Wuhan market.
  7. Some have suggested it spread from a virology lab in Wuhan known to possess and study bat viruses.

If preventing the “next pandemic” depends on understanding the origins, we’re stuck. There is no real prospect for finding its origin definitively.

Intelligent people may differ about this but I think the conclusion we should draw from all of this is that the benefits of commerce with China have been wildly overstated while the risks, which, obviously are now well known, have been ignored. More than a million people have died of the virus, rather few in China. The costs of coping with the disease have exceed any imaginable benefits of trade with China by an order of magnitude.

Conditions there are distinctively conducive to the development of zoonotic diseases while the present government is far too predisposed to silencing anyone who might be giving people bad news. If we are to prevent the next pandemic we very much need to re-evaluate.

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Another Possibility

Another, somewhat unexpected at least to me, approach for making it less likely that COVID-19 becomes serious, has been discovered according to this report from UPI:

The antidepressant drug fluvoxamine — best known by the brand name Luvox — may help prevent serious illness in COVID-19 patients who aren’t yet hospitalized, a new study finds.

The study included 152 patients infected with mild-to-moderate COVID-19. Of those, 80 took fluvoxamine and 72 took a placebo for 15 days.

By the end of that time, none of the patients who took the drug had seen their infection progress to serious illness, compared with six (8.3%) of the patients who took the placebo, according to researchers at Washington University School of Medicine in St. Louis.

“The patients who took fluvoxamine did not develop serious breathing difficulties or require hospitalization for problems with lung function,” said first author Dr. Eric Lenze, professor of psychiatry.

They have a potential explanation for its effectiveness:

Fluvoxamine — widely used to treat depression, obsessive-compulsive disorder and social anxiety disorder — is a type of drug called a selective serotonin-reuptake inhibitor (SSRI). This class of drugs also includes medicines such as Prozac, Zoloft and Celexa.

But unlike other SSRIs, fluvoxamine has a strong interaction with a protein called the sigma-1 receptor, which helps regulate the body’s inflammatory response.

“There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules,” explained study senior author Dr. Angela Reiersen, associate professor of psychiatry.

“Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients,” she said in the release.

By reducing inflammation, fluvoxamine may prevent a hyperactive immune response in COVID-19 patients. That, in turn, may decrease their risk of serious illness and death, Reiersen said.

You might see how that underscores some suggestions I’ve made.

I find no evidence of drug company involvement in the study which may provide some increased credibility for it.

If this study proves out in the larger follow-up study, it might provide another arrow in the quiver of treatments for COVID-19.

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Contacts Are Everything

I found Peggy Noonan’s Wall Street Journal column interesting for the quotes she solicited from some of her prominent Republican contacts. I’m reproducing them here:

The past few days I reached out to some wise people, accomplished individuals whose love of country has been expressed through their careers.

I told the former Indiana governor and current president of Purdue University that I was calling people I knew to be sane. “That won’t keep you busy,” Mitch Daniels said.

He was upbeat on the election. “It seems to me the country just basically said it hadn’t lost its mind. I was stunned at the success the Republicans had in the congressional elections and in the state initiatives.”

He was hopeful about the presidential impasse. “I honestly think this mess offers an opportunity to, at the right moment, have a Goldwater moment.” That was when Republican members of Congress went to President Richard Nixon, during Watergate, and told him it was over. It was a moment of country over party. “It would signal that we got to get on with the business of the country now,” Mr. Daniels said.

I think that Mitch Daniels is one of the best pols on the scene today. He got out while the getting was good.

Bill Brock, a former representative, senator, cabinet member and head of the Republican National Committee, believes in his party as a constructive force in the world. He doesn’t like the president using words like “stolen” when he speaks of the election: “Of course there was some fraud. Did it change the outcome? No. . . . This leaves a situation where President Trump uses his words and his desire to go out in the field again, but the effect will be to disillusion his own supporters. He’s using their loyalty to justify the fact that he lost an election that he did not believe he’d lose. He’s using their loyalty to cover the fact he lost. And he exposes them to the hazard of finding out that the election was over and that there was no theft of adequate size to change the outcome.”

He believes Mr. Trump sent his followers on the field without weapons. His voters chose him because they were “desperate for someone who they felt understood them, that no one else hears them. They wanted a voice and they got him and he was a loud voice and he’d be heard, and he changed the world in many good ways. But that voice now is in defense of his own situation.

“Nothing will change the results in a given state. The Biden margin is now sufficient that it would take all the close states. That is not possible. To leave the impression it is possible will leave many people disillusioned.”

As for Mr. McConnell, “Mitch is trying to keep people together so there’s some coherence” when the process is over.

If you don’t remember him, Mr. Brock had a lengthy career as a representative, senator, Secretary of Labor, and trade representative.

Former Secretary of State Condoleezza Rice calls for sensitivity and a sense of mutual give. On Sunday she tweeted: “Congratulations President-elect @JoeBiden and Vice President-elect @KamalaHarris.”

But she also told me, “We need to worry about how bitterly divided we are. The level of anger is so high.” Trump supporters feel he was never given a chance: “I think we all need to take a deep breath. More than 70 million Americans voted for President Trump, and some reassurance through the process that this has been done fairly is not a bad thing.”

“It will be better when all this is over, and done expeditiously. I trust, and I think most Americans trust, the courts to get this right.”

As for the transition, “most of what you need to do in a transition you can do without the formality. The hardest part is getting your team in place, making personnel decisions, and then vetting those you’ve chosen. It’s not ideal that it hasn’t formally started. It would have been ideal to have it settled on election night and ideal to have a ‘normal’ transition, but they are experienced people.”

On the withholding of the presidential daily briefing, she says, “Sen. Harris has served on the Intelligence Committee, there is not much that will surprise her. Joe Biden has been vice president for eight years. The idea that we’re endangering national security is, I think, overblown.”

She is a veteran of Bush v. Gore. The official Bush transition didn’t begin until after the Supreme Court ruled on Dec. 12, 2000. Until then everything was uncertain—“it all came down to 537 votes in Florida, not multiple states with significant margins. I remember Gov. Bush calling me and saying, ‘I’d like you to be national security adviser.’ And I thought but didn’t say, ‘Yes sir, if you’re president.’ ”

Like everyone else I spoke to she wanted to see election reform.

Beyond that: “Trust the process that we are in. Our institutions work.”

I have considerable respect for Secretary Rice as well.

I’d be interested in what form they think that election reform should take. I don’t think the problem is election reform so much as the stakes in winning an election.

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After Redistricting

I encourage you to read Sean Trende’s two part analysis in RealClearPolitics of the possible outcome of redistricting following the census, the recent election, and reapportionment. Short version: Republicans may well get control of the House.

The one aspect of it that he doesn’t take into consideration is the prospect of incumbents facing off against each other in New York, Illinois, and California in 2022. That could have some bearing on things as well.

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