By Steve Haner
This is how we solve the coming hospital bed crisis. This is how we stretch our ventilators supply. No politician is going to say this, neither Donald Trump nor Andrew Cuomo, and doctors won’t start this conversation. Lester Holt won’t bring it up on Nightly News.
It is called a “do not resuscitate” order. DNR. It can stand on its own or be part of package of advance medical directives and powers of attorney. If you don’t have one, sign one. If you are 40 and think yourself healthy, consider one anyway. Today.
It may not solve the problem but it surely will help.
Most people who are dying are not dying of COVID-19, they are dying with COVID-19. Yes, there are outliers, but most people who cannot survive this virus already had an underlying problem. It might be a 65-year-old with COPD from smoking, two by-passes, or half a lung removed for cancer, or it might be a 30-year-old who vapes or who has already eaten themselves into diabetes and hypertension. Continue reading
My first post in two weeks. What the heck, I should join the parade and give a bunch of advice to our beleaguered Governor which he is likely to ignore. This first appeared today in the Fredericksburg Free Lance-Star. It has one of those annoying “take a survey” paywalls, but in this case asks a question we should all answer. Try it.
By Steve Haner
The assumptions underlying the most contentious debates of the 2020 General Assembly session are gone. Sixty days ago, activists were arguing that this was a rising economy and state government should mandate raising workers to a higher level.
This is a now sinking economy, and the General Assembly’s actions have piled bricks on the life rafts that workers in the commonwealth will need to survive.
The priority now is containing the spread of this respiratory virus, but soon it becomes reviving an economy that has come to a near stop. Nobody knows when or where unemployment will peak, but this is starting to look more like 1929 than 2009.
Gov. Ralph Northam’s lasting legacy will not be his response to the virus, but the speed of the following recovery. Continue reading
By DJ Rippert
From Outer Banks to Outer Mongolia. Dare County, N.C. issued orders last week closing its borders to non-residents. Dare is a coastal county just south of Currituck County, N.C., which borders Virginia. Many Virginians know Dare County from Outer Banks vacations in towns such as Duck or fishing trips launched from Manteo. Checkpoints into and out of Dare County are apparently now manned by law enforcement officers who will check IDs to ensure that travelers are residents of Dare County or have pre-authorized transit permits issued by Dare County. As of last week there were no confirmed cases of COVID-19 in Dare County, and it seems county officials want to keep it that way.
Is it legal? Some are questioning whether officials in Dare County can legally enforce a prohibition against non-residents entering the county. Apparently they can. North Carolina law, specifically N.C. General Statute 166A-19.31, allows local officials to control access and ingress to their jurisdiction during times of emergency. Given the Coronavirus outbreak, local officials in Dare County have decided to invoke that law.
We want your taxes but not you. Dare County has many vacation homes owned by non-Dare County residents. These homes are typically expensive and generate a material amount of tax revenue for the county. Originally, non-resident owners of these homes were allowed entry into the county by showing their tax receipts for the property along with valid ID. Yesterday that changed. Dare County is now excluding non-resident property owners from entering the county.
Commentary. I was originally predisposed to giving Dare County officials the benefit of the doubt regarding the border closure. For one thing all those expensive and unoccupied beach homes could be targets for burglars taking advantage of the Coronavirus outbreak. However, my perception changed when those same officials decided to bar entry for non-resident property owners. These are people who have invested in the county, who pay taxes to the county and who should have every right to go to their properties. I have no idea if Virginia law would permit the same type of buffoonery from our local officials. Let’s hope not However, even if such actions are allowed, I hope no Virginia jurisdiction would follow the selfish, arrogant and small minded actions of the officials in Dare County, N.C.
By DJ Rippert
Early Spring Break. Last Thursday Virginia Governor Northam somewhat suddenly decided to shut down all K-12 schools starting the next day. The shutdown is for “at least two weeks.” The question of how to manage continuing free and reduced price meals during the shutdown has been left up to the individual school districts. Yesterday a man in Virginia’s peninsula health district died of COVID-19. Today, Northam banned all gatherings of more than 100 people. As of this writing (1:30 p.m. .Sunday, March 15) there have been 45 cases of Coronavirus recorded in Virginia with one death.
After a “wait and see” start Northam now has Virginia taking actions in parallel with more aggressive U.S. states. However, every state is taking action. West Virginia shut down its schools “indefinitely” despite the Mountain State being the only state in America to have no confirmed cases of Coronavirus. Future actions by the Virginia state government are hard to predict. Senior officials in the Trump Administration are urging a 14-day national shutdown which would obviously apply to Virginia. A good look at how the U.S. Coronavirus outbreak compares to other countries can be seen here. If the federal government does not declare a national shutdown, Virginia could still take any number of actions depending on the severity of the situation. Let’s look at what’s happening elsewhere.
Photo credit: Patch (McLean)
by DJ Rippert
Danger! Danger! Yesterday, Governor Ralph Northam declared that the Old Dominion was in a state of emergency due to the Coronavirus. Northam exercised these emergency powers five days after the first Coronavirus case was confirmed in the state. The online Patch newspaper from McLean reports that “a statement from the governor says the declaration gives the state flexibility to east [SIC] regulatory requirements and procurement rules, continue federal and multi-state coordination and continue access to critical services.” Northam also announced plans for state employees to work from home.
Northam’s declaration of emergency was considerably slower than in many other states. In Maryland, for example, Republican Governor Larry Hogan declared a state of emergency on the same day that the first cases of Coronavirus were confirmed. Yesterday, Maryland detected the first case of Coronavirus caused by community spread. Continue reading
All I need is the air that I breathe. Recent research indicates that the coronavirus can live in air for 3 hours post aerosolization. The Hill reports that, “A study awaiting peer review from scientists at Princeton University, the University of California-Los Angeles and the National Institutes of Health (NIH) posted online Wednesday indicated that the COVID-19 virus could remain viable in the air up to 3 hours post aerosolization, while remaining alive on plastic and other surfaces for up to three days.” Previous media reports maintained that the Coronavirus required direct human contact in order to be transmitted. To be clear, this research has not been peer reviewed. However, public policy decisions would seem to be impacted if the Coronavirus can survive for hours suspended in air.
Overstaying your welcome. Researchers have evidence that people infected with the Coronavirus will remain infectious longer than previously believed. The Hill reports on a study by The Lancet, a British medical journal, indicating that people suffering from COVID-19 may be able to spread the disease for up to 37 days. If true, this finding calls into question the previously held expert opinion that recommended an isolation period of 14 days after infection.
Cancel culture. Cancellations of anything and almost everything continue to pile up. Examples include Ireland closing its schools and colleges, the NCAA Men’s National Basketball Tournament being held without fans in the audience, Italy closing almost all shops (other than grocery stores and pharmacies) and the NBA suspending its season starting today.
Implications for Virginia. Virginia’s response to the COVID-19 breakout remains sporadic at best. Continue reading
By DJ Rippert
Timing. As Jim Bacon wrote, “Now comes COVID-19. Everyone is in a blind panic. The concern may be overwrought, whipped up by the media. Or maybe things could get worse than anyone could imagine. Nobody knows. Uncertainty reigns.” Jim is right. Uncertainty does reign. But what are the costs of indecision if things do get worse than anybody can imagine? The graph at the left qualitatively describes how early action can change the shape of the infection curve and avoid a peak that overwhelms our health care system. Do Virginia’s leaders understand this?
By DJ Rippert
OK, Boomer. A study conducted last month from the Chinese Center for Disease Control and Prevention provides statistics about the lethality of COVID-19. Those statistics were analyzed by Business Insider. You can see those statistics in the graph on the left. Younger people have a one in 10,000 (0.01%) chance of dying from the flu and a one in 500 (0.2%) chance of dying from COVID-19. So, COVID-19 is 20 times more lethal for a 15 year old than the flu. That mortality rate rises quickly as the victims get older. Between one and two 55 year olds out of 100 who contract COVID-19 will die of the disease. That’s 22 times the mortality rate of the flu. However, the real jump occurs in those who are 60 and above. Almost 15% of those aged 80+ will die if they contract the coronavirus.
Old Dominion. The average age of a Virginia resident is 38.1 years. There are 142,300 Virginians over the age of 80, 518,900 between 70 and 79 and 934,400 between 60 and 69. That’s 1,595,600 Virginians (19% of the population) with more than a 3.5% chance of dying if they develop COVID-19.
Hysteria? There is no vaccine against COVID-19. There is no cure. The only way for a 60+ year old Virginian to avoid a 3.6% – 14.8% chance of dying is to avoid the disease. The real odds of dying are the infection rate multiplied by the mortality rate. But once you contract the disease you are far more likely to die than if you contracted the flu. Is there any activity on Earth that a rational person would undertake with a 3.6% – 14.8% chance of dying? For comparison purposes an American sent to fight in Vietnam had about a 0.5% chance of dying. Given those odds, is it really “hysteria” to cancel fan participation at sporting events or to insist that people in contact with the public wear gloves? Our only defense is containment and containment comes with a fair amount of inconvenience. What is the alternative? Hope, as they say, is not a strategy.
Health care workers in protective suits, Wuhan China. Photo credit: China Daily / Reuters
By DJ Rippert
Sprichst du panik? Liz Specht is an biologist and engineer. She is currently the Associate Director of Science and Technology at The Good Food Institute. On Friday Dr. Specht (who holds a Ph.D. from UCSD) posted a long series of tweets regarding the spread of Coronavirus and the limitations of America’s healthcare system. You can read her tweets here.
Dr. Specht is vitally concerned about COVID-19 and the supply of hospital beds and protective masks in the U.S. She calculates that by May 8 all the hospital beds in the U.S. will be filled. That’s just over two months from now. She further believes that America’s low inventory of N-95 and surgical masks required for healthcare workers will only make matters worse. As those tending to COVID19 patients get sick we may run out of healthcare workers as well as hospital beds.
This may differentially impact Virginia. As Bacon’s Rebellion guest commentator James C Sherlock noted, Virginia has a shortage of docs and nurses. In addition, experience in Italy shows that up to 10% of cases which tested positive required mechanical ventilators as part of the treatment. Whether Virginia’s very questionable COPN practices have held down the number of hospital beds and / or mechanical ventilators is an open question. Meanwhile, as Jim Bacon notes, our state government’s reaction to COVID-19 is somewhere between “just trust us” and “what, me worry?”
Very important note — Dr. Specht is a trained biologist who certainly holds some strong opinions as to the public health severity of COVID-19 in the United States. However, she is not an epidemiologist. Other equally expert people, including some epidemiologists, do not share her pessimism. The crux of Specht’s argument is that the number of Coronavirus cases will double every six days. I have no idea whether Dr. Specht will be proven right or wrong on that count. I do know that if she is right, Virginia is in a world of trouble. Continue reading