Pandemic May Not End If We Don't Address Anti-Vax Hysteria

The quickest way to end the Covid-19 pandemic is by reaching herd immunity, which is to say, getting enough people immune to the disease that it no longer spreads easily, thus protecting everyone, including those few who still haven't acquired immunity. Typically, there are two ways to reach herd immunity: mass vaccination programs, which have effectively eradicated many deadly diseases in the U.S. (e.g., small pox, tetanus, polio, diphtheria) and mass infection. Problem is, unlike influenza, chickenpox, mumps, measles and many other familiar diseases, Covid-19 infection does not appear to produce long-lasting or robust immunity, meaning people could, theoretically, catch it multiple times and continue spreading it through the community. This leaves mass vaccination as our best hope.

Anthony Fauci said he was cautiously optimistic that by the end of 2020, we would have data confirming that at least one of the current vaccines being tested for Covid 19 was safe and effective. In theory, that could mean we'd have enough doses by mid-2021 to vaccinate a sufficient number of Americans to reach herd immunity, thus bringing an end to the pandemic. (For the current status of vaccine trials, click here).

Problem is, 20% of Americans say they will refuse to take the vaccine, and another 31% say they are unsure. So, even if the vaccine was 100% effective (no vaccine is), that would mean only 49% of American would develop immunity, which is not enough to reach herd immunity. Consequently, the virus would continue to spread through communities, sickening and killing people. In reality, a vaccine could be approved if it is at least 50% effective. So, worst-case scenario, we get a 50% effective vaccine, with only 49% of Americans taking it, and we end up with only 24.5% immunity, far far away from the 60-75% needed to reach herd immunity.

While it is easy to disparage these anti-vaxxers as stupid or selfish (the behavior certainly is), doing so won't browbeat or shame them into changing their behavior and is, therefore, unproductive. And at this critical time, it is imperative to find solutions that are effective. If the 31% of Americans who are on the fence can be convinced to change their minds, we'd have 80% of Americans willing to take the vaccine, and that COULD bring us to herd immunity (assuming the vaccine was 75% effective).

Part of the problem, of course, is STUPID and SELFISH behavior by politicians, particularly Trump, which have contributed to the misperception that this disease is not that serious or that it's a hoax. As long as people believe this, why should they want to do anything inconvenient or unpleasant (like wear masks & socially distance themselves), or that they erroneously believe is risky (like get vaccinated)? So, the first challenge will be getting all leaders and media to start listening to, respecting and complying with the health experts and encouraging the rest of us to do so, too.

However, there were already plenty of Americans who were terrified of vaccines well before the current pandemic started. So, even if all leaders were to suddenly start wearing masks and telling everyone to comply with social distancing policies, these people might still refuse to take the vaccine, thus perpetuating the pandemic. Therefore, we also need a well-researched and well-executed public health campaign that acknowledges their fears, but then convinces them of the safety of the vaccines and encourages them to participate in the mass vaccination program, not only for their own health and safety, but because it will help end the pandemic and return us to normal more quickly.

Crisis Continues to Worsen

Over the past week, the U.S. surpassed 4 million covid infections, more than 25% of the world's total, despite having only 4.3% of the world's population. We are also on track to surpass 150,000 deaths by the end of the day. These grim milestones can be blamed on oligarchy's relentless drive to force people back to work under unsafe conditions and their unwillingness to provide any financial relief to the millions of unemployed and underemployed Americans, as well as Donald Trump's continual lies about safety, the science of covid, and his undermining of the scientific experts.

There are now 12 states in the Critical Red zone (>25 new daily infections per 100,000 residents), with California poised to join this rogue's gallery soon, and 23 in the orange. According to Harvard's Path to Zero website, regions in the Red need to implement immediate lock downs, and those in the Orange are strongly recommended to do so, both to bring down cases to a manageable level and not overwhelm hospitals, but also to reach the Green zone, where an opening of the economy can be more effectively monitored and controlled. This means that 70% of the country needs to immediately lock down (compared with 64% just 5 days ago). Indeed, health experts have been saying for days that the entire country needs to shut down.

California, which once led the nation in caution, now has had more covid cases than any other state, including New York. 71% of its counties are now in the Critical Red or Dangerous Orange zones and require immediate lock down.

It is clear from the map that U.S. and South America are the hardest hit regions of the world, but the WHO just announced on Friday that Europe's premature lifting of restrictions is driving a resurgence of infections there. Eastern Europe has been particularly hard hit, with record or near record daily infections in Romania and Ukraine, and 5,000 or more daily infections in Russia.

From Bad to Dire: 64% of U.S Requires Immediate Stay-at-Home Orders

As you can see from the map, the U.S. no longer has any green states (On Track for Containing the Virus), whereas less than 2 weeks ago, we still did. 32 states are now in the Red (>25 new daily infections per 100,000 residents) or Orange zones (10-24 new daily infections per 100,000 residents), or 64% of the country, and should implement Stay-at-Home orders, according to Harvard's Path to Zero website. This is a 10% increase over 4 days ago, and a 52% increase in the past week!

California now has 16 counties in the critical red zone (a 33% increase over 4 days ago), and 20 countries in the dangerous orange zone, for a total of 36 counties (61% of the state) requiring immediate mandatory lock downs in order to bring the infection rate back to a manageable rate. Additionally, while the state had 6 counties in the green zone (less than 1 new daily infection per 100,000 residents, and on track for containment) just 4 days ago, it now has only 3, indicating that even its most remote and sparsely populated regions are getting slammed and that the state is moving further away from containment.

U.S. on Track to Hit 8 Million Covid Cases By Labor Day

It took 99 days to reach 1 million Covid-19 infections in the U.S.

It took only 43 days to reach 2 million.

And only 28 days to reach 3 million.

And only 14 days to hit 4 million.

Will we reach 5 million by the end of the month?

Even more alarming, we doubled from 1 million to 2 infections in roughly 40 days, and doubled again to 4 million in roughly another 40 days. Does that mean we'll hit 8 million infections by Labor Day?

Most of California Now in Danger Zone, Newsom Shuts Down Schools

12 California counties are now in the highest alert red zone (as of 7/16/20), with over 25 new infections daily per 100,000 people, while an additional 28 counties are now in the dangerous orange zone (10-24 new daily infections per 100,000 residents), including San Francisco, which shot up from around 7 last week to well over 10 this week. (Data as of 7/16/20, from Harvard's Path to Zero website)

That's 40 counties in the red/orange combined. Governor Newsom has declared 33 of these counties to be on the "watchlist" severely limiting which businesses can be open. Further, he mandated that all schools, public and private, must be closed to in-person learning if located in one of these 33 counties. That means that both Marin and Orange Counties, which had both recently declared schools to be open this fall, will have to back down and close their schools, since they are both on the watch list.

California has been chalking up over 8,000 new infections daily for the past week and is on track to catch up with New York, though their mortality rate is substantially lower.

Pandemic Spiraling Out of Control

Four days ago, there were 7 states in the critical Red Zone (over 25 daily new infections per 100,000 residents) averaged over the past seven days, a critical situation which researchers at Harvard say should trigger automatic mandatory lockdowns. In none of these states has a statewide lockdown been implemented. Now there are 11 states in the red zone (as of 7/14/20), with Arkansas and California poised to join this group by the end of the week. Yesterday, the nation broke the world's one-day record with 71,750 new infections, according to Worldometer, while California, Florida and Texas chalked up 9,687, 10,181 and 12,235 new infections respectively.

The number states entering the dangerous Orange Zone, where the Harvard researchers say statewide lockdowns are highly recommended, has also been on the rise. Four days ago, there were 14 states in the orange, or 21 states in the red/orange zones combined. Now there are 26 states in the red/orange zones combined, or more than half the country that should be in lockdown.

Things Worsening Quickly: 7 States in Dangerous Red Zone, Require Mandatory Lock Downs

AZ, FL, LA, SC, GA, TX, AL in the red zone (>25 cases/100k residents avg over past 7 days)

According to Harvard's Path to Zero Covid Tracker website, in order to be on track for containing the pandemic, a region must get their rate of new infections down to 1 or less per 100,000 residents, averaged over a 7-day period. Fewer and fewer states and counties are meeting this goal. In the past several days, the number of states in the Dangerous Red zone (25 or more new infections per 100,000 residents) has in creased from 4 to 7. In California, the number of counties in the Red Zone has recently jumped from 7 to 12.  According to the website, regions in the red zone are at the Tipping Point and Stay-at-Home orders are necessary to prevent catastrophe. However, even those regions in the orange (10-24 new cases per 100,000 residents) are strongly recommended to impose Stay-at-Home orders. If we combine those states in the red and the orange, that's 21 states, nearly half the country that should be sheltering place!

Imperial, Stanislaus, San Joaquin, Tulare, Merced, Orange, Riverside, San Bernardino, Fresno, Madera, Colusa, LA counties are now in the red zone

Do Educators Die of Covid? Yes They Do! Do Children Die of Covid? Yes, They Do, Too!

Chalkbeat reports that 78 educators have already died from Covid in NYC, just from the first wave of the pandemic to hit the city. Health experts are warning that NY will likely see a resurgence, like the rest of the country, threatening the lives of countless more educators.

Of those 78 deaths, 38% were among paraprofessionals, even though paraprofessional represent only 17% of the education workforce. They are also disproportionately people of color.

And in Arizona, 3 teachers caught Covid after sharing a classroom for Summer School & one of them died.

Despite the mounting evidence that kids, even very young ones, not only catch covid at the same rate as adults, but can also transmit it to others, and despite averaging close to 10,000 new covid infections daily for the past week, Florida has mandated that all schools be open for live, in-person instruction in the fall. A seventeen-year old has already died of the virus in Florida, and more are likely to die as Governor Desantis allows the pandemic to rage out of control in his state. Florida is also seeing rising numbers of the deadly multi-system inflammatory syndrome (MIS-C) in children, a problem that will also likely rise with the reopening of schools and the failure to initiate a mandatory state-wide shelter in place, as recommended by many health experts.

In New York, over 80 kids were diagnosed with MIS-C as of early May, and 5 had died. If they reopen their schools to live, in person lessons in the fall, they, too, will likely see a tragic increase in MIS-C diagnoses and deaths, as well as the deaths of more teachers and paraprofessionals.

Nearly 50% of California is Orange or Red-Why Isn't It Under Lockdown?

A new Covid tracker from Harvard maps out the number of new daily infections U.S. counties per 100,000 residents. Regions with at least 25 new daily infections per 100,000 people are designated code-red and stay-at-home orders are necessary. Regions with 10-24 new daily cases per 100,000 residents are designated code-orange and it is highly recommended that they, too, implement stay-at-home orders. 

Looking at this map of California, it is clear that nearly half the state is in the orange or red zone (24 counties), while 34 are in the yellow or green (as of 7/2/20). However, of the counties in the yellow, four of them are at 9.5 or higher, and are therefore very close to slipping into the orange zone. In all, six counties are in the 9.0-9.9 range, putting them at risk of slipping into the orange.

Join the Pledge to NOT Reopen Schools in the Fall

LAUSD and SDUSD have pledged to NOT reopen in the fall for in-person classes until their budgets are fully restored AND the state implements universal weekly covid-19 testing, contact tracing and quarantines. ALL school districts should join them and here is why:

Racial and Social Justice

As millions of people worldwide continue to risk covid-19 infection, tear gas and beatings in protests demanding racial and social justice, forcing teachers and students back to the classroom would likely have the opposite effect. Consider that the cops kill around 225 African Americans a year, but Covid has already killed around 27,000 African Americans in just three months (roughly 23% of Covid deaths in the U.S. are among African Americans), far higher than their representation in the population. Since African Americans, Latinos and Pacific Islanders are the groups most affected by illness, complications and death from Covid-19, reopening the schools to in-person learning places them at particular risk. For these reasons, reopening the schools would be potentially genocidal.

Another social justice issue in the schools are the rights and the safety of students, staff and teachers with disabilities, many of whom are at increased risk of complications and death from Covid-19, due to age and underlying health conditions (including one-third of all teachers).  Both CDC recommendations for returning to school, and common decency, suggest these people should be allowed to work from home for their own safety. Not permitting this could be a violation of the Americans with Disabilities Act (ADA) and would certainly undermine the districts’ goal of creating equity and socially just classrooms.

Economic Necessity

School districts across the nation are facing historical budget shortfalls due to the lost tax revenues caused by the pandemic. Up to 300,000 teachers could lose their jobs. Yet all proposals for reopening the schools have included extreme measures of increased hygiene, social distancing and the use of PPE inside the classroom, as well as enforcement of social distancing outside the classroom, temperature checks and screenings before class, and arrival and departure control. All this will require increased staffing and would be impossible with the budget cuts.

In contrast, implementing a 100% Distance Learning (DL) model would save districts tens of thousands of dollars in reduced utility bills and maintenance costs. They would need far less PPE and hygiene equipment and disinfectants. They wouldn’t have to spend any money on screening students and staff and isolating sick individuals.

Furthermore, if one-third of teachers and staff exercised their right to work from home because of their age or underlying health conditions, there would not be enough staff on campus for in-person learning to be possible. Even if the districts had the money to hire more teachers or substitutes and classified staff, there aren’t this many available. On the other hand, if districts compelled teachers and staff to return to their school sites, many might refuse, for their own safety, and the districts would still have a shortage. Or they could sue their districts for violating their rights under the ADA, costing the districts millions in legal expenses at a time they are already facing historic budget shortfalls.

It has been argued by many, most notably Donald Trump and Steve Mnuchin, that the country cannot afford to shut down again. However, just the opposite is true. Without mitigation, the CDC and WHO predict 60-70% of all humans will catch this disease (that’s 196-230 million Americans). At a 3.8% mortality rate, that would be 7.6 million U.S. deaths! Even if only half that number got sick or died, this would still disrupt the production and distribution of food and other basic services because of the lack of sufficient healthy workers, and could result in famine, even here in the U.S.

In contrast, a study of the Spanish flu pandemic showed that regions with the most aggressive social distancing policies had the fewest deaths and the quickest economic recoveries. Keeping schools closed is an essential part of this. The longer you spend indoors with people outside your immediate family, the greater the exposure to germs and the greater your chances of becoming infected. This is true for students and even more so for teachers and aids, who must spend hours inside a potentially infectious room. Studies show that Keeping Schools Closed Significantly Reduces Transmission rates. Closing schools early and keeping them closed is one of the best ways to curtail a pandemic. Keeping them closed reduces infection rates by 40-60%.

Protecting the Mental and Social Health of Our Children

It has been argued that the mental and social health of our children are suffering because of the lock downs, the denial of in-person classes and the opportunity to interact with friends, peers and teachers. It has been further argued that since children do not get as sick or die as often as older people, we are doing them more harm than good by keeping them home.

There are numerous problems with this reasoning, the most significant being that children do get infected and can spread the disease to their teachers, family members and community, thus exacerbating the spread of the pandemic and the devastating social and economic costs, even if they don’t personally die from it. Worse, some of the people who die from the reopening of schools and businesses could be their own family members, turning them into orphans. This would arguably be much worse for their mental and social well being than distance learning.

While it’s true that children tend to not get as sick or die as often as older adults, some still do, particularly if they have underlying conditions. About 3.6% of all U.S. cases have been in children. Their illness can last for up to two weeks, and 20% of them required hospitalization, either of which can severely impair their performance in school. And, of course, there’s the rare, but deadly, Kawasaki-like syndrome that has affected dozens of kids so far.

But even if an individual student made it through the school year without any family members getting sick, it is still unclear that the social benefits of being in the classroom would outweigh the costs. Under the strict rules required for in-person learning, schools will feel unfriendly, scary, and dystopian to children. After waiting in long lines to take their temperatures, instead of being greeted by a warm smile or touch, they will face adults who repeatedly warn them to stay 6 feet apart from their friends and to keep their masks on and their hands away from their faces. They’ll have no idea what their peers or teachers might be thinking or feeling with their faces hidden behind masks. They won’t be able to sit together at lunch, or hug or high five each other. And what about K-5 students? Do we really think they will be able to keep their hands off their own faces, let alone those of their peers and teachers? When they fall down and get hurt, will their teachers stand with their arms crossed, admonishing them to suck it up and get back to work because there can be no touching during a pandemic?

Even if we could make a strong case for reopening the schools, they will almost certainly have to shut down again, well before the end of the semester, forcing everyone back into a full-time distance learning (DL) model. This would be much more disruptive to their learning and social development than starting with DL in the fall and sticking with it until the pandemic ends. We already know this will happen based on the many countries that have tried it. Israel was prompted to reclose their schools because of renewed Covid outbreaks, including 130 cases at a single school. France had a similar experience when they reopened their schools. In the town of Skellefteå, Sweden, a teacher died and 18 of 76 staff tested positive at a school with only 500 students. Preliminary results from an antibody study in Sweden showed high rates of infection among children, suggesting there was significant spread in the schools. And in Montreal, nearly an entire class tested positive after one student fell ill, despite social distancing. Health authorities believe this was a case of classroom transmission.

Frankly, as a teacher and a parent, I am appalled and perplexed that my district has not already announced its intention to implement 100% DL for the 2020-2021 school year. We know we are still at the beginning of this pandemic. We know that it will get worse, particularly when schools and businesses open up further. We know people will continue to die at rates far exceeding seasonal flu. We know that the deaths, critical illness and long-term organ damage will disproportionately affect people of color and poor people and that this will be exacerbated by anything that increases the spread of the disease, like opening schools. And we know our children’s education and social-emotional health will suffer throughout this pandemic, no matter what we do, but will certainly suffer worse if the pandemic spirals out of control because we have irresponsibly and prematurely opened everything up. 

So why aren’t we doing the one thing we know will save lives: Distance Learning?

Disease Far Worse Than Cure-Just Look At the Numbers

In their attempts to reopen economies and relax social distancing measures, many people (including Trump, Boris Johnson, Dr. Michael Katz, Thomas Friedman) make unfounded claims like Covid-19 is not that dangerous, it's like a bad flu, you can't hide from germs, you're going to catch it eventually, anyway, so why not just go out and get it over with.

Problem #1: We do not currently know if people gain any robust, long-term immunity that protects them from future infections

Problem #2: There is evidence that the newer mutant strain that evolved in Europe and has become the dominant strain worldwide, is both more infectious and makes people prone to 2^nd infections, 

Problem #3: It's already clear that this is much worse than a bad flu. In a bad flu season (Oct-April), we generally get around 50-60,000 deaths in the U.S., primarily among the very old, infants, and immune-compromised. Whereas with covid-19, we already have nearly 80,000 deaths, and that was primarily from Feb-April. Since we know this is going to continue for another 12-24 months, we can assume there will be at least tens of thousands (if not hundreds of thousands) of more deaths by the end of the pandemic, even if the nominal mitigation efforts currently in place continue. 

One of the big problems with people like Katz, Friedman, Trump and Johnson, and others who claim the "cure" is worse than the disease, and who are calling for us to just go out there and take our chances with this "bad flu," catch our immunity and move on, is that they don't bother to extrapolate the number of deaths that would occur, let alone put that into a context that is meaningful to the general public.

But here's an attempt:

• Because  Covid-19 a brand new zoonosis, humans have no natural immunity (unlike the flu, where we have been exposed to dozens of different flu strains over our lives and have developed immunity to many of them. And there are vaccines. This gives us the possibility of some protection against novel flu viruses). Consequently, in a typical flu season, 9-40 million Americans catch the disease, which translates to 2.5%-12% of the population.
• With Covid-19, we have no natural immunity, nor a vaccine, which means almost everyone is vulnerable. Consequently, the CDC and WHO predict that, without mitigation, 60-70% of all humans will catch the disease.
• In the U.S., that translates to 196-230 million people getting infected.
• Even if no one died, and if only 10% of these people got too sick to work, that's still 19-23 million people not working. When you consider that we currently have 30 million unemployed (official count), we are now looking at the disease doing as much damage to the economy as the "cure."
• But that's assuming it spreads in a random, heterogeneous manner. In reality, diseases don't spread heterogeneously. For example, Amazon warehouses, food warehouses, grocery stores, nursing homes, meat processing plants, are all places where we've already seen the disease spread rapidly among workers or patients who, by the nature of these facilities, are either crammed close together or have human vectors (eg nursing homes) passing the disease from person to person.
• So, if we let the disease run its course and see millions of people too sick to work, with concentrations in the food industry, we could see severe food shortages, even in a wealthy country like the U.S. In poor countries, particularly war-torn ones, it is nearly certain that we will see famines of biblical proportions.
• Now let's talk about deaths, since that's what really scares people. If we take the WHO-estimate of 3.8% mortality and multiply it times 200 million sick Americans, we're talking about 7,600,000 deaths, which would easily be the deadliest pandemic in history. The Spanish flu, which up until now was the deadliest pandemic in history (at least that we're aware of) killed 675,000 Americans and 50-100 million people worldwide.
• But the true mortality rate is, no doubt, lower than 3.8%. Let's be generous and give Covid-19 the same mortality rate as a bad flu (0.1%). That would still translate into 200,000 deaths, which is far worse than seasonal flu, and serious enough that to suggest we should just let it run its course, rather than doing everything in our power to mitigate it and reduce the deaths, is like proposing premeditated mass murder, just so the economy can reopen.
• The actual mortality rate, however, may actually fall somewhere between 3.8% and 0.1%. We just won't know for a while, probably not for a few years. But let's say it's actually 1%. That would translate into 2 million deaths.

To deliberately send us back into unsafe schools and workplaces knowing that it could result in 2 million deaths--That is Genocide!

Remdesivir: Panacea for Wall Street or Sick Americans?

Remdesivir has been fast-tracked by the FDA to be used as a "frontline" treatment against Covid-19. In an emergency-use authorization, they claim the benefits of using the drug, without having complete data from the NIH clinical trial, far outweigh the risks. Keep in mind, the NIH study upon which their decision is based is only one of many Remdesivir studies currently going on, and they made their decision before all the data was even released. A recent study from China, published in The Lancet, showed no difference between Remdesivir and a placebo. Experts say the results from a single study, like the NIH study, are rarely game changers and safest approach is to pool data from several equally rigorous studies, which has not happened yet.

So, what are these benefits?

The only benefit that has been shared from the study, as of this posting, is that patients hospitalized with severe symptoms had a 31% faster recovery time than patients who received a placebo (11 days versus 15 days). There was a statistically negligible improvement in mortality.

Of course we'd all like to be sick for a shorter period of time when we are sick. But this drug does nothing to prevent us from catching Covid-19, and it does little to nothing to reduce our chances of dying from it. It does nothing to flatten the curve, reduce the infection rate or make the world a safer place. It does nothing to lower the risks associated with a premature return to work or relaxing social distancing policies.

And there are risks, though these get little mention in the press. For example, many patients dropped out of the Chinese study because of side effects and adverse reactions. The drug is toxic to both the liver and kidneys.

So, what's the real benefit? Why fast track its approval before all the data are in? Particularly when the drug is produced by a private company, Gilead, which expects to turn a handsome profit on the drug, meaning many people who need it won't even be able to get it?

1. Big profits for Gilead and their investors
2. A propaganda victory for Trump (See, we've got a drug to keep you safe. So, go to work. Go get your tattoos and massages.)
3. Shorter recovery possibly means less time away from work, assuming the sick person had a job in the first place and still has one now

Once all the data are in, Remdesivir may, in fact, become a "game-changer" for sick patients, but the real game-changers will be drugs that cure people quickly and reduce mortality. Even better, how about a vaccine that is effective against the entire coronavirus family? 

While we don't know if the latter is even possible, the need is urgent. Epidemiologists have known for a while now that Coronaviruses and Influenza viruses were the most likely culprits in causing the next deadly pandemic. And they believe another deadly pandemic, like the current one, is likely.

One reason is that both virus families are spread easily through the air and remain viable on surfaces, making them easy to spread from person to person, even by strangers in public places, in contrast to Ebola and HIV, which require fairly intimate contact with sick individuals. Another reason is that both virus families reproduce by RNA, rather than DNA, and the enzymes used to replicate RNA make far more mistakes than the DNA enzymes, resulting in highly mutable viruses. Consequently, even if you gain immunity to one strain, either through illness or vaccination, you could still be susceptible to next year's strain. This is why we need to get a new flu vaccine each year.

A third problem is that there are already 50 new coronaviruses discovered in bats that have the potential to cause deadly pandemics in humans. Due to climate change and habitat destruction, humans are coming into contact with wild animals far more now than in the past, causing a rapid increase in zoonoses.

While we don't know which, if any, of these new coronaviruses will jump species and cause a pandemic, we certainly should be prepared. If SARS and MERS weren't sufficient warning, Covid-19 certainly is. A corona-family vaccine, effective against all coronaviruses, might be the best hope against a repeat of what we're going through now.

Whatever the final results of the NIH study show us, and regardless of how the emergency use authorization plays out for sick individuals, we still need to continue with social distancing, drug and vaccine research and development, rebuilding the health infrastructure to prepare for the next wave, produce sufficient PPE for frontline workers, and provide a much more effective and generous safety next for the millions of Americans who are struggling to survive.

Stop Trump's Genocide Against America

As Trump, state governors, and other world leaders callously and selfishly send us back to school and work, experts are predicting that the Covid-19 pandemic will last another 18 months to 2 years, until 60-70% of the population has been infected and developed some degree of immunity. This prediction is similar to what we saw with the Spanish Flu pandemic of 1918.

In the United States, where there are 328.2 million people, that would translate into at least 197 million infections (at the 60% rate). At the currently accepted mortality rate of 3.2%, that would translate into 6.3 million deaths in the U.S., alone. But even if the mortality rate were an order of magnitude lower, let's say 0.3%, it could still result in 600,000 deaths.

Trump's argument that we've survived the worst of the pandemic and that it's safe to return to work and school are clearly not true. But is he simply ignorant or naive, as some have argued?

No!

The butcher knew full well that reopening the economy would result in a massive death toll. He ordered 100,000 body bags on April 21, in anticipation of the mass casualties that he knew would occur from "opening" the economy. Additionally, FEMA has order 200 refrigerated trailers to store the corpses because the morgues will be so backlogged. So, maybe he is a little naive, or simply can't do math, since this won't come close to covering 600,000 dead Americans, let alone 6.3 million.

At least the Veterans Administration, that bastion of corruption and incompetence, has done their math.  They've bought $12 million worth of body bags. If they paid a similar price to FEMA, that would get them around 250,000 body bags, plenty to cover their 9 million patients.

So, are we left with only these two miserable choices: (A) go back to work and school, get sick, and watch millions of our friends, relatives and neighbors die from Covid-19; or (B) continue sheltering in place and struggle not to starve to death?

Of Course Not! 

We could do what health experts, including Anthony Fauci, keep telling us to do, and what South Korea has effectively done: 

1. Universal repeated testing of Everyone
2. Contact tracing of all infected individuals
3. Mandatory quarantines of all infected individuals and their contacts

These 3 measures, according to Fauci, and anyone with an ounce of common sense, will help make the next wave LESS deadly and make it less dangerous to return to work and school. They will not prevent a 2nd wave. They will not eliminate the risk of infection and death. And they should be accompanied by the following:

1. Continued social distancing whenever and where ever possible (ie, no concerts and live sporting events; no tattoos and massages; continued restrictions on the number of people entering stores and classrooms)
2. Rebuild the medical infrastructure, purchase PPE for everyone who needs it, increase hospital capacity, continue developing and testing vaccines and anti-viral drugs, 
3. Give everyone what they need to survive, including sufficient cash and food

Teachers, Students-Do NOT Go Back to School!

In California, Governor Newsom has extended the Shelter-in-Place (SIP) through May, but at the same time, he wants to reopen schools early, in July. This would be a deadly mistake and should be opposed by everyone.

What should happen before anyone is sent back to work:

1. Infection rates need to decline to 1 new case per million residents, as prescribed by epidemiologists at UW. California is currently at 1,289 cases per 1 million residents. So, we're not even close. This low infection rate is required both to ensure that the medical system is not overloaded, like we saw in New York and Italy and Spain, AND to ensure there is sufficient time, resources and human beings to implement #2, below
2. Universal testing, contact tracing and mandatory quarantines of all infected people and their contacts. This is the only way to significantly reduce the chances that infected people don't show up at schools and work and infect others. But to do this, we'd need 20 million tests per day, and we're currently only at 150,000.

So far, there has been no serious attempt to achieve either of these goals. California is certainly flattening the curve, but we're still seeing over 1000 new cases a day. We're definitely not yet on a downward trajectory. Consequently, there's no way it'll be safe to go back to work or school in July or August.

The current proposals to "safely" reopen the schools are pathetic and absurd, and FAR FROM SAFE. Indeed, even Anthony Fauci has said that massive testing, contact tracing and quarantining will only help ensure the second wave is LESS DEADLY. Not risk-free. There will still be a second wave. There will still be more infections and death.

People are talking about blended learning systems with 10 kids per class, so that social distancing can be continued at school, and continued online learning for the 2-3 days per week students aren't in school. But why not stick with SIP and online learning for everyone, every day? Logistically, it's much easier and it's obviously safer.

More importantly, the 10 kids per class proposal is predicated on the assumption that the disease spreads entirely through droplets and that 6 feet distancing is sufficient protection. But we know the virus aerosolizes and remains viable in the air for up to 3 hours. So, even after an infected student or teacher leaves the room, and there is no one to stay 6 feet away from, the germs are still present and could still infect students and teachers in that room for the next few hours. 

Also, what about desks, doorknobs and lab benches? Who is going to disinfect them? Are custodians going to clean each classroom between every class period? And what about K-5 students? Are they going to suddenly behave with the maturity and punctiliousness of doctors with respect to washing their hands and not touching people's faces?

Administrators and politicians will be able to hide in their offices and make video announcements. Teachers will be forced to spend hours inside of potentially infected rooms. They will not be given N95 masks because there aren't any to give. Probably the same with gloves. And even if they did, these PPE are designed for brief interactions in uncrowded conditions and to be replaced often with clean, uncontaminated ones. And what about shoes and clothes? Are teachers going to have to "suit up" in special work clothes before they get out of their cars and then decontaminate before getting into them again at the end of the day?

Also discussed in some of the planning phases has been how school districts can avoid liability. This implies that they know full well they are forcing students and employees into a dangerous, potentially deadly environment. They should not be allowed to do this and certainly not without any accountability. If children are going to become orphans because their parents were forced to work in unsafe conditions, then the employer should be held liable.

Speaking of compensation, what about sick leave? If teachers or classified staff catch covid-19, they could be out for more than 2 weeks, much longer than the amount of paid sick leave most school employees are given. And what about other leave, like staying home to care for sick family members? Are school districts going to increase the amount of paid sick leave provided to their employees, or are they going to be jettisoned, like so many other workers, and left without income when sickened with covid-19?

And what about work hours? If teachers have to teach both in person and online, if they lengthen the work day or the school year to compensate for the reduced in-person learning, are they going to double or triple teachers' pay to compensate for all the extra work? Many districts are laying teachers off because of lost revenues. Where's the money going to come from to pay teachers more? 

Even if they paid teachers double to work year round, this would not be desirable. Summers are when teachers develop their curriculum for the following year, something that will be even more urgent and critical if schools reopen before the pandemic is truly over. Teachers need time to reconfigure their curriculum and develop new curriculum compatible with these new conditions.

And what about teachers' own children? If all the schools move to a blended learning model where students attend classes in person for 1-2 days per week and do online learning at home the rest of the time, who will look after teachers' children when they have to go into work? Many teachers have children who are too young to leave at home, unsupervised. Are they going to force teachers to subordinate their own children's health, safety and education to those of their students, by placing them in overcrowded childcare settings at public libraries and recreation centers, or bringing them to work with them? 

It's complete madness to be talking about reopening schools under these conditions. The only sane option is to continue with distance learning until the pandemic truly ends. Education is one of the few industries that can be done remotely. It's not ideal. Learning in a live classroom is far superior, as children benefit from the social interactions and there are countless important learning opportunities that cannot be replicated as effectively or efficiently remotely (e.g., labs).  But children are a major vector driving this pandemic, spreading it to older people with underlying health conditions. Sending children back to school too soon risks turning them into orphans, as they spread the disease to older family members.

Politico says the CTA opposes a July reopening, and that both the NEA & AFT would authorize strikes if teachers were sent back before it was safe. Problem is, there is phenomenal pressure on unions, politicians and even the health experts to get everyone back to school and work, and to say whatever they have to convince us it's safe. It would be naive to trust that the unions will continue to oppose July or August starts.

This whole thing is a terrible tragedy. Frankly, it scares the hell out of me and I see no quick way out of it. But as terrible as it is now, both in terms of deaths and economic and social hardship, this is truly just the beginning. It is likely to get far worse, even if California continues with the SIP. Too many other states have already "reopened." Infections and deaths are going to go up in those states. And in fall, when influenza picks up again, the deaths and economic problems will worsen further, possibly to the point of mass food shortages and even starvation, if too many people in the food industry get sick (as we have already seen on a small scale at Tyson, JBS and Smithfield).

Keeping the schools closed is not just about protecting students, teachers, and their families. It is a necessary tool for protecting all of us. 

Covid Tests Now Available for Healthy SF Residents, But the Results Could be Meaningless

San Francisco-based One Medical is now offering coronavirus tests to anyone without symptoms. While this is step in the direction of universal testing, a prerequisite for relaxing the shelter-in-place, the test results could be meaningless without (1) repeated testing; (2) contact tracing; and (3) mandatory quarantines for those infected and their contacts. Also, One Medical is not offering the test for free, which should be a prerequisite before the shelter-in-place restrictions is relaxed. They claim they will bill your insurance company, assuming you have one.

One reason why a single test is meaningless is that a person's viral load varies over time. During the first few days after exposure, the viral load could be undetectable, even with a test. Hence, a person who runs off for a test immediately after coming into contact with an infected individual might get a negative result, but a few days later start showing symptoms. In those days when they thought they were corona-free, they could have gone out and exposed vulnerable people, family members, colleagues.

2nd, when they do open the economy back up, every time we go into public, whether it's work or school or shopping or religious or social events, we will risk coming into contact with infected individuals. So, until the pandemic has truly died out or we have developed an effective vaccine or treatment, universal testing, contact tracing and quarantines will need to continue and be repeated regularly. Indeed, perhaps the least risky approach is to develop a 5-10 minute test that is administered at the entrance of every facility that is open and operating and require a negative result before anyone is let in.

Should you go and get a test? I don't see the benefit, unless you think you might have been infected recently, or you are a front line worker where the risk of exposure was high, or you are worried about infecting your clients. The rest of us in the Bay Area have supposedly been staying home, staying at least six feet away from others on our walks, and wearing masks in grocery stores. So, our risk of infection should be extremely low.

Workers Resist the Drive Back to Work

San Francisco-based One Medical is now offering coronavirus tests to anyone without symptoms. While this is step in the direction of universal testing, a prerequisite for relaxing the shelter-in-place, the test results could be meaningless without (1) repeated testing; (2) contact tracing; and (3) mandatory quarantines for those infected and their contacts. Also, One Medical is not offering the test for free, which should be a prerequisite before the shelter-in-place restrictions is relaxed. They claim they will bill your insurance company, assuming you have one.

One reason why a single test is meaningless is that a person's viral load varies over time. During the first few days after exposure, the viral load could be undetectable, even with a test. Hence, a person who runs off for a test immediately after coming into contact with an infected individual might get a negative result, but a few days later start showing symptoms. In those days when they thought they were corona-free, they could have gone out and exposed vulnerable people, family members, colleagues.

2nd, when they do open the economy back up, every time we go into public, whether it's work or school or shopping or religious or social events, we will risk coming into contact with infected individuals. So, until the pandemic has truly died out or we have developed an effective vaccine or treatment, universal testing, contact tracing and quarantines will need to continue and be repeated regularly. Indeed, perhaps the least risky approach is to develop a 5-10 minute test that is administered at the entrance of every facility that is open and operating and require a negative result before anyone is let in.

Should you go and get a test? I don't see the benefit, unless you think you might have been infected recently, or you are a front line worker where the risk of exposure was high, or you are worried about infecting your clients. The rest of us in the Bay Area have supposedly been staying home, staying at least six feet away from others on our walks, and wearing masks in grocery stores. So, our risk of infection should be extremely low.

Are You Willing to Die for the Economy?

With the Covid-19 pandemic still raging across the country, President Trump and state governors, (including Gavin Newsom, of California, and Andrew Cuomo, of New York), are already talking about getting people back to work. Yet, as of now, there is no plan in place for doing this in a way that won't lead to hundreds of thousands of more deaths. Most of the health experts are saying that it is way too soon to relax social distancing policies.

Like with traffic fatalities, excess deaths from air pollution, and workplace mortality, our lives are expendable in the pursuit of corporate profits. Our injuries, sickness and deaths are merely costs of doing business.

Trump and others have argued that the cure is worse than the disease. No question about it, people are suffering, including healthy people who no longer have an income or enough food to eat. People are waiting in lines that are miles long, just get food from food banks. They're going stir crazy from being cooped up in their houses, deprived of social and physical contact with their friends, family and neighbors. But if people are forced back to work prematurely, while the pandemic is still raging, without adequate social distancing measures and personal protective equipment, AND most importantly, universal testing, contact tracing and mandatory quarantining of all infected individuals and their contacts, we will not only see a dramatic increase in new infections and deaths, but we could see far greater disruptions in the production and distribution of basic necessities, like food, water and utilities, because so many workers in these essential services have become sickened. 

Famine is already a very real possibility in many of the poorer nations of the global south, but with the proposed economic cure of sending us back to work prematurely, we could easily see famine here, in the United States, as well. While the wealthiest Americans will survive in their fortified bunkers and offshore retreats, with their stockpiles of toilet paper and prime rib, they will see their corporate profits plummet even more than they currently are, when so many Americans become sick that their businesses will no longer be able to operate, and their consumers are dropping like flies.

If that happens, the economic cure will prove to be far worse (both economically and in terms of human life) than the current social distancing program.

61% of Covid-19 Infections in S.F. are People Under 50

61% of Covid-19 infections in San Francisco are in people under the age of 50 (Graphic and more data available from the SF Dep of Public Health)

Supreme Court Sentences Wisconsin Voters to Death

Bowing to demands from the Republican party, the Wisconsin Supreme Court has declared that in-person voting must happen today, despite the clear and obvious risk to voters. The consequence of this stupid, callous, self-serving act will no doubt be an upsurge in infections and deaths in Wisconsin.

Fears of infection have caused thousands of volunteer poll-workers to opt out, forcing the use of National Guard troops to run the polls. 

Staying Home is a Luxury--Coronavirus Disproportionately Kills the Poor

Family scavenging for food in Paraguay

The New York Times reported yesterday that Staying Home Was A Luxury.

Well. . . duh. Who would've thought otherwise? 

Poor and working class folks are much more likely than wealthier folks to work in essential industries, like food production and distribution; shipping and delivery services; public transit and utilities; even a large segment of the healthcare industry. They cannot stay home. And their kids are more likely to be continuing to attend crowded day care to allow them to continue working.

The poor and working class, especially those who've lost their jobs, have to stand in long, crowded lines to get food from food banks and pantries. The desperately poor and hungry, like the family in the photo above, must brave crowds to get food from whatever sources they can. The homeless are being infected at crowded shelters, even in liberal cities like San Francisco, which has commandeered thousands of hotel rooms for the unhoused residents, but has been slow in getting them into the units. In many cities, like Las Vegas, which has 30,000 unoccupied hotel rooms, they are continuing to force unhoused folks to continue living in the streets and parks.

However, the worst outcomes for the poor will likely be seen in the poorest countries of the global south, where malnutrition is high, and access to clean water and medical care is very low.

Anyone with a computer and internet can check out the real time data on social distancing themselves, on Google's new Covid-19 Mobility Tracker. Check out the comparisons below:

Here was see California, with the 5th richest population in the U.S., with significantly more compliance with the stay at home orders, than Alabama, the 7th poorest. And below, I've compared California's wealthiest County, Santa Clara, with its poorest, Lake County. (Santa Clara County, until very recently, was the epicenter of California's outbreak, until Los Angeles surpassed it. Perhaps their compliance with the social distancing policies are having the desired effects???)