Meanwhile, the Rudderless Ship Sails into Foreign Waters

The pandemic has the focus of most Americans, even as we are at each other’s throats as the above rather genuine sign from Tennessee (one of the southern states that is in the process of reopening without adhering to federal guidelines) suggests. The great red state “it’s a blue state big city problem, not ours” mantra vs the blue state “stacking bodies and watching healthcare workers go down” desperation have been exacerbated by Trump’s open encouragement of “go back to work” protestors against the very restrictions in his own federal “reopening” guidelines. Trump is laser-focused on the economy, his strong suit of electability vs the pandemic which is losing him voters in big city swing states. Getting that stock market metric back up by the election is his goal. 

“States are safely coming back. Our Country is starting to OPEN FOR BUSINESS again,” tweets the President ignoring the death tolls that continue to rise in many parts of the nation. “Even as states move ahead with plans to reopen, the director of the Centers for Disease Control and Prevention warned a second wave of the coronavirus could be worse if it coincides with the start of seasonal flu season… ‘There's a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through,’ CDC Director Robert Redfield said in a Washington Post interview published on Tuesday [4/21].” Reuters, April 22^nd. A statement amplified below.

As was the case in the 1918-20 Spanish Flu outbreak – which killed more than 50 million people worldwide and about 675,000 in the United States – second and additional waves in major pandemics often infect and kill many more people than the first wave. “The director of the U.S. Centers for Disease Control and Prevention warned that a potential second wave of the novel coronavirus could be far more fatal than the current phase of the pandemic because it may overlap with the beginning of flu season this winter.” Huffington Post, April 22^nd. The second wave could hit right after the November election. After. Thus, not a concern for a President who has prioritized the economy as a priority over life. “We cannot let the cure be worse than the problem itself.” Donald Trump, March 24^th, a policy he has stuck with right up to the present.

But Trump can’t put all his cards on the economy, and while he may be able to convince his base – mostly red state rural value voters – he’s been an effective leader in the pandemic, focused on their wellbeing by accelerating reopening the economy (what they want to hear), that position isn’t gaining traction with the much-needed independent voters. He needs more issues.

Tough on immigration remains a most basic policy in his political quiver – embracing both the xenophobia if not outright racism in a very large segment of his constituency – so shutting down all forms of non-temporary farmworker immigration is now the subject of his latest executive order. The base just eats that up. The US actually admitted 110,000 permanent immigrant residents during the Spanish Flu pandemic, erecting no special walls to that process. This ban will have little or no impact on containing the virus, as experts continue to point out. It’s all show for the base.

In foreign policy, Trump seems to be inviting a confrontation with both China and Iran, perhaps believing that a few get tough bullets and blasts would bolster his perception with voters as a strong and decisive leader. There are obvious risks that could backfire. Unfortunately, little of this machismo is a product of deep strategic planning. Most of it is a reflection of his “shoot from the hip,” ad hoc policy-making. Clearly foreign affairs are not a particularly strong suit for Trump, and he is lucky that but for overt xenophobia, his base simply does not care much about what goes on outside of our borders.

Let’s start with Iran, which just surprised the West by launching a rocket to place its first military satellite in orbit. Doesn’t seem that shutting down the nuclear containment accord is generating any immediate enhancements American security. Trump wants to appear tough with Iran, particularly now that the oil markets have collapsed, taking away Iran’s biggest potential threat (by mining the seaways where oil tankers ply their trade). Although US and Iranian naval vessels have been playing cat and mouse in the Persian Gulf, particularly in the narrow Strait of Hormuz, for years, Trump believes it is now time to shoot. “Amid tensions with Iran, President Donald Trump said Wednesday [4/22] on Twitter he has given orders for the Navy to ‘shoot down and destroy’ any Iranian gunboats found to be harassing U.S. ships.

“A U.S. Navy video last week [mid-April] showed small Iranian fast boats coming close to American warships as they operated in the northern Persian Gulf near Kuwait, with U.S. Army Apache helicopters… ‘I have instructed the United States Navy to shoot down and destroy any and all Iranian gunboats if they harass our ships at sea,’ Trump tweeted.” Associated Press, April 22^nd. Why now? There’s an election pending. And his theme against Joe Biden is that the former Vice President is weak against our traditional enemies. Really? Who cozied up to Russia’s Vladimir Putin, North Korea’s Kim Jong Un and China’s Xi Jinping? Trump’s admitted buddies?

China raked Trump over the coals in recent trade negotiations. Phase one, which had an out in event of a pandemic at time when China had reason to believe one was building, is thus no longer operative, even as Trump is paying to send cargo planes to China to pick up increasingly pricey (read: profitable to China) PPE supplies that are made there and not much here. But with global focus on COVID-19, given the dramatic escalation in Cold War-like tensions between China – blamed for the virus pandemic – and the United States, Trump needed to show his voters his “toughness against China,” clearly building a campaign strategy that Biden is just a pro-China weakling.

In particular, the United States seemed to want to press against China’s continued efforts to build out its man-made island military base in the Spratly Islands, which initially drew other nations in the region to object… until they realized that Trump’s America was no longer a reliable ally and that China was the new kingpin on the block. Ready to capitalize on any regional tensions to reverse that perception, the Trump administration just made its move: “The USS America (LHA-6) is steaming into the South China Sea, where a Chinese survey ship along with its Chinese Coast Guard escorts are currently locked in a standoff with Malaysia.

“Reports said the amphibious assault ship was carrying a combat element of at least five Marine F-35B Lightning II fighters as well as MV-22Bs tiltrotors and CH-53 helicopters. The USS Theodore Roosevelt, which was deployed around the waters earlier as a countervailing influence to Chinese actions, is now docked in Guam after coronavirus infections spread among its crew. That probably explains the decision to send the USS America in a show of solidarity with Malaysia and Vietnam, which have been alarmed by the latest aggressive actions by China.    

“Previously, the U.S. had asked China to cease its ‘bullying behavior’ in the sea. Several alarming reports on a series of provocative actions by Beijing inside what Malaysia claims as its Exclusive Economic Zone (EEZ) have surfaced in recent days. Those actions probably prompted the U.S. warship to leap into action.” International Business Times, April 21^st. 

But Trump is also anxious to show himself as a peacemaker, succeeding where no other president has achieved much of anything. The nuclear menace: North Korea. Despite major showmanship, lots of “let me make you seem really important Kim” meetings where a US president traveled to Asia to meet with Kim Jong Un and a flurry of positive messaging, Trump appears mired in same litany of US failures to disarm North Korea as his predecessors. He has accomplished nothing. The nukes are still there and growing. Rocket and missile tests continue as North Korea continues to increase the range of these weapons. Yet Trump continues with platitudes that everything is under control, that he and Kim (who seems to be recovering from major heart surgery) are in constant and cordial communication. Except they aren’t.

“Trump said during a press briefing on the coronavirus pandemic Saturday [4/18] that ‘I received a nice note from him [Kim] recently. It was a nice note. I think we’re doing fine.’ Trump also defended now-stalled nuclear diplomacy with Kim, saying the U.S. would have been at war with North Korea if he had not been elected.

“North Korea’s Foreign Ministry said in a statement that there was no letter addressed to Trump recently by ‘the supreme leadership,’ a reference to Kim… It said it would examine why the U.S. leadership released ‘the ungrounded story’ to the media.” Time Magazine, April 19^th.

Donald Trump does one thing particularly well: spinning utter failure into evidence of his successful leadership. And his base keeps buying into that mythology. Given his complete ability to dominate media coverage during this pandemic, which could easily overwhelm Joe Biden’s efforts for campaign visibility, do not be surprised if Donald John “are you tired of losing yet?” Trump wins a second term in November. Those regional state alliances formed to create a more coordinated response to COVID-19 just might just represent the borders of new nations formed if that election result fractures the United States. It almost happened in 1861. And it definitely could happen now.

          I’m Peter Dekom, and as internal polarization further fractionalizes the country into even harder lines, as the nation continues to underscore its growing global perception as an untrustworthy rogue player, these words from Abraham Lincoln echo in my mind: "A house divided against itself, cannot stand."

Reopening - The Missing Piece

I wanted a credible government source for a model of how continued social distancing vs opening the nation looks. The above chart, generated by the UK’s National Health Service, tells us what should be obvious: the more we practice social distancing – until there is a cure or a vaccine – the faster we end this. Pressures to open early pose an immediate threat to ignite second or more waves of the virus, a lesson we should have learned from the 1918-20 killer Spanish Flu debacle (which killed around 675,000 Americans, and well over 50 million worldwide).

Without that cure or prevention, highly contagious pandemics do not dissipate in a couple of months. For those unwilling to practice common sense social distancing, remember that the virus does not recognize state of national borders or follow human wishes. Politicians are under pressure to open and resume to normality, so even the most responsible governors are loath to project a true timeline; they seldom go more than a month or so in their self-limiting requirements. The President, who has always prioritized the economy over health – from supporting litigation to kill the Affordable Care Act because it would impose new financial burdens on business to a belief that the damage to the economy could be far worse than the toll of COVID-19 – made it clear than any longer term imposition of social distancing that did not reopen the economy in a relatively short time was “unsustainable.”

We also face two longer term realities: First, we need to adjust to a real, economically and socially reconfigured post-COVID-19 world. Second, given the rash of recent serious outbreaks (COVID-19, SARS, MERS, Ebola, HIV, Zika, H1N1, cholera), this is not the last pandemic. We will have exhausted massive resources in our COVID-19 war, which will put pressure on limiting our future preparedness (which absolutely includes the pandemic-accelerator, climate change), but failure to prepare for the next outbreak could be fatal, even politically terminal.

“President Trump announced new federal guidelines on Thursday [4/16] for the easing of social distancing orders put in place to slow the spread of the coronavirus, leaving their implementation and timing up to state governors. At first glance, the three-phase guidelines seem unlikely to alter the ‘new-normal’ routine for many Americans.

“At a White House briefing of the coronavirus task force, Trump said government experts believe that the peak of new COVID-19 cases ‘has been flattened.’ [It has only in certain states and not otherwise.] As a result, Trump said his new guidelines ‘will allow governors to take a phased and deliberate approach to reopening their individual states.’

“The deference to state governors comes days after Trump boasted that his ‘authority is total’ on the question of reopening the country. But the president also made clear that he wanted a quick return to normal life.

“While Trump painted an optimistic picture of his administration’s efforts to curb the spread of COVID-19, his health experts — Dr. Deborah Birx and Dr. Anthony Fauci — made clear that the criteria they helped develop to guide states in their decision to lift shelter in place restrictions were stringent.

“Saying that the reopening would be staggered and that states and counties would have to go through ‘gated criteria of 14 days of decreasing evidence of illness,’ Birx outlined the tiered recommendations for loosening restrictions… ‘Phase one begins with all vulnerable individuals, including those with comorbidity continuing to shelter in place, and insuring that those that first go out in public are not those that are the most vulnerable to bad outcomes in this disease,’ Birx said. ‘And then insuring that we continue to do 6-feet [minimum] physical distancing in public spaces and continuing to avoid large gatherings and all non-essential travel.’” Yahoo News, April 17th.

“As talk turns to how the United States can at least somewhat safely reopen its economy amid the world’s largest and deadliest coronavirus outbreak, this three-part strategy has become the closest thing to a consensus among experts, epidemiologists and even the Wall Street executives on President Trump’s newly formed economic task force… That’s the good news.

“But there’s bad news too. According to the latest data, the U.S. is nowhere near being able to test or trace at the scale necessary to transition out of lockdown. Meanwhile, Americans have yet to accept the idea that isolation will continue to be a part of everyday life…

“Without widespread immunity, the coronavirus will start to spread as soon as social-distancing measures are lifted. Hundreds of thousands or even millions of Americans could die. That’s where test-trace-isolate comes in. The more people you can test — both for current infections and the antibodies created by prior infections — the more accurately you can determine who’s safe from the virus and who’s spreading it to others. The more robust your ability to trace the movements of people infected with the virus, the more rapidly and comprehensively you can inform everyone they’ve come in contact with. And the more you can do that, the more everyone can isolate and stop spreading the virus further… This is epidemiology 101. But when you compare where we are today to where we need to be, the gap is startling.

“Take testing. Experts disagree about how many tests we’d need to do per day in order conduct effective coronavirus ‘surveillance’ in a post-lockdown America. Nobel Prize-winning economist Paul Romer says 22 million or more.  The Edmond J. Safra Center for Ethics at Harvard University says ‘millions’ (at least). Five hundred thousand is generally considered the bare minimum required just to test everyone with symptoms and their close contacts… During the week of April 6, the U.S. averaged 150,000 tests a day.

“This isn’t a backward-looking blame game about the testing lapses that made America’s coronavirus outbreak worse than it had to be. It’s about what happens next. We’ve made a ton of progress since early March, when daily tests numbered in the hundreds. But that progress has basically stopped. So far this week we’re actually averaging fewer tests per day — 145,000 — than last week. Why? Because we’re running out of swabs, pipettes and chemicals, according to commercial labs.” Yahoo News, April 16th.

As Donald Trump has left getting the necessary medical supplies and equipment to the states, which are now forced to operate in an open market in competition with each other and the federal government (FEMA) bidding up the price (sapping the state budgets to insure rising profits to the sellers – oddly, many of whom are Chinese), getting what is needed just might not be achievable within any timeline we find acceptable. And without some uniform enforced standard of accuracy and effectiveness, what some states are buying just might not work.

For example, “some COVID-19 antibody tests, including those being used by public health departments in Denver and Los Angeles and provided to urgent care centers in Maryland and North Carolina, were supplied by Chinese manufacturers that are not approved by China's Center for Medical Device Evaluation, a unit of the National Medical Product Administration, or NMPA, the country's equivalent of the U.S. Food and Drug Administration, NBC News has found.

“Two U.S. companies — Premier Biotech of Minneapolis and Aytu Bioscience of Colorado — have been distributing the tests from unapproved Chinese manufacturers, according to health officials, FDA filings and a spokesman for one of the Chinese manufacturers. Many of the unapproved tests appear to have been shipped to the U.S. after the FDA relaxed its guidelines for tests in mid-March and before the Chinese government banned their export just over two weeks later.

“If COVID-19 antibody tests are unreliable, they can produce false results, either negative or positive, health officials said. The use of such tests has been widely discussed as a way to ensure that employees are healthy enough to go back to work and to find COVID-19 survivors who may be able to provide blood plasma to severely ill patients.

“Officials at the Association of Public Health Laboratories have expressed concern about the reliability of the numerous antibody tests being sold or used across the country with little scrutiny. Scott Becker, the association's chief executive, told NBC News that FDA officials are working with the Centers for Disease Control and Prevention, the National Institutes of Health and the Biomedical Advanced Research and Development Authority to evaluate the performance of the tests.” NBC News, April 17th. That Chinese companies might be the biggest beneficiaries of our upward-bidding purchasing frenzy is galling. I wonder if those companies are sending “thank you” notes to the President.

The problem, of course, is how much pain can the United States stand before all hell breaks loose. Protestors, already gathering unhealthy groups to let state governments know that they will no longer tolerate intrusion into their life choices, are just the tip of the iceberg. On the other hand, nature has given the COVID-19 virus the most aggressive need to infect and replicate of any infectious agent since the Spanish Flu. It does not respect governmental policies, borders or our deepest psychological and financial fears. It wants to grow! The yearning to be able to reopen added to the contagious drive of COVID-19 just might be the perfect, and most horrible, storm.

                I’m Peter Dekom, and being in that older, vulnerable group that many are willing to write off, I am acutely aware that so much of what we need to do get past this to the cure/prevention stage will come down to what we, as individuals, actually do with or without a government mandate.

102 Years Later

In the final year of WWI (1918), there was an outbreak of what folks thought was a deadly form of pneumonia at a Kansas US Army training facility. Troops were packed together, in barracks and in the field. The disease rapidly spread to most of the troops there, and those that did not die were sent across the United States by seriously crowded rail and then by ship transportation to Western France, where they disembarked to fight the "Huns." Desperately needed troops. The disease followed wherever they went. And well beyond.

The nature of that disease was deemed classified (“top secret”) by the anti-German allies (even as soldiers on all sides were dropping like flies... an outbreak that rapidly spread to the general population). Even after the War, that classified status was not lifted. Individuals leaking stories about this pandemic were subject to arrest; no newspaper would dare to speak out. News about the pandemic was never declassified during the outbreak. "Liberal" Woodrow Wilson, the man who threw blacks out of the US Civil Service, led the secrecy mandate, and all the allies followed suit. They felt they owed the US for coming to their rescue in WWI. For whatever reason, that “don’t talk about it” tradition seemed to carry over into history books, which uniformly unreported one of the greatest pandemics in world history, one that killed far more people than any other outbreak in history.

Because the second and third waves of the virus were so deadly, exacerbated by the secrecy, most Americans assumed that the outbreak began in Europe and that returning US soldiers brought it back with them. Indeed, one nation, Spain, had been totally neutral during the war. It was the Spanish press that carried accurate stories about this killer pandemic, and where people learned of its severity and the numbers of people all over the world dying from the disease (in multiple waves that did not end until 1920), they traced their knowledge to Spanish sources. Hence, the name "The Spanish Flu," even though Spain was hardly the source of the disease. It is estimated that one-third of the earth’s population had been infected. The death toll was staggering.

Not only did the US government (and its allies against the German coalition) do almost nothing to contain the disease, they made transparency illegal. The decimation of soldiers in the trenches, on both sides, may have hastened the end of the war, but political games exploded the impact of the flu well after the war. While the first wave of the pandemic was horrible, more people died from the second and third waves. There were no vaccines, and medical capacity back then pretty much assured there never would be. The disease simply burned itself out, mutating into a weaker strain as time passed. This “American” flu took almost three years to dissipate on its own. 

The burying the details of this pandemic influenza out of historical pressures is unfortunate. If we really were to take George Santayana’s most famous quote – “Those who do not remember the past are condemned to repeat it” – into a most necessary consideration, understanding the Spanish Flu could be exceptionally valuable in confronting the COVID-19 pandemic before us… in responding to all those protestors and Trump-adherents pressuring their local governments to reopen… way, way, way too early. We don’t even have remotely enough testing to track whether we are winning or losing our battle… and remember that subsequent waves of a pandemic can be much worse than the initial one. And there still is no vaccine or cure.

So, it becomes interesting to look back at how two California cities dealt with this flu 102 years ago. “Los Angeles and San Francisco in the early 20th century were vastly different places than they are now. But they already had distinct cultures and leaders who responded to the great Spanish flu pandemic of 1918 in markedly different ways, thereby producing distinctly different outcomes… The big, striving city on the south coast moved fairly quickly at the first signs of danger — shutting down bars, pool halls, sporting events and more.

“Its rival to the north waited at least a week longer to order closures, as its leaders went mask-happy, betting that their best weapon against the onrushing contagion was face coverings, and going slow on what is now referred to as ‘social distancing.’

“The two great cities charted their disparate paths in the months that followed, straining — amid rudimentary science and massive public pressure — to craft the proper response to the greatest infectious disease emergency in modern memory… Some 102 years later, this tale of two cities offers some cautionary insights as a few states, responding to President Trump’s urging, take steps to open up.

“At the helm in one city was a headstrong public health commissioner, who defied the mayor and City Council to lock down his city, but only so much. The other also had a physician as its chief health officer, but one who relied even less on quarantine-style limitations, grasping, instead, for a dubious solution.

“Yet Los Angeles, San Francisco and 20 other cities across America shared one common failing, a mistake that would spur a ‘double hump’ of contagion. That second surge of influenza infections in 1918 hit both Los Angeles and San Francisco and killed more people than the first wave in other cities, such as Denver, Kansas City, Milwaukee and St. Louis… ‘The really important lesson of 1918 is to keep interventions in place as long as possible,’ said Alex Navarro, assistant director of the Center for the History of Medicine at the University of Michigan. ‘Because once the controls are removed, it’s very difficult to reinstate them.’

“The Michigan center, along with the national Centers for Disease Control and Prevention, compiled and analyzed historical accounts of the 1918 plague. Their research found ‘a strong association between early, sustained and layered use of [non-pharmaceutical interventions] and mitigating the consequences of the epidemic.’

“In Los Angeles, the first signs of trouble arrived in mid-September 1918, when sailors aboard a Navy ship in San Pedro fell mysteriously ill. By the end of the month, 55 students at Polytechnic High School in downtown L.A. had the bug, which eventually killed 675,000 in the United States and an estimated 50 million worldwide.

“The city’s response in the coming months would be crafted largely by a headstrong North Carolinian, Dr. Luther Milton Powers. The doctor managed to remain in power through the tenures of at least half a dozen L.A. mayors… Publicly, city Health Commissioner Powers called the cases ‘alleged influenza,’ but he advised Mayor Frederick T. Woodman in private to prepare a campaign to stop an epidemic in Los Angeles, then a city of fewer than 600,000 souls.

“By Oct. 11, the mayor had declared a state of emergency. Commissioner Powers ordered most public gathering places — including movie houses, theaters and pool rooms — closed as of 6 p.m. that night. Adding a peculiarly L.A. flavor, Powers told the city’s ascendant movie moguls they would have to stop filming mob scenes, according to the Michigan archive.

Even though its first influenza cases appeared about the same time as those in L.A., San Francisco’s board of health did not vote to shut down “all places of public amusement” until a week later, Oct. 18. The city did not include churches in the shutdown, leaving that to their leaders’ discretion.

“The importance of acting promptly might not have been obvious in 1918. But this week, UC Berkeley biostatistician Nicholas Jewell and his daughter Britta, also an epidemiologist, calculated the enormous advantage of early social isolation. In the current pandemic, a one-week advance, nationally, in social distancing could have cut the total United States death count from something around 60,000 to 23,000, they projected…

“L.A. theater owners protested that the shutdown should be even broader, to stop the virus more quickly. They demanded the closing of shops and department stores. But Powers thought such a comprehensive shutdown would be impractical. The stores remained open.

San Francisco’s leaders eventually also closed a significant number of public facilities, but they obsessed on a singular response to the disease: face masks. That response came courtesy of the city’s health officer, Dr. William C. Hassler. He had first gained acclaim after the Great Earthquake of 1906, for helping fight off a rat infestation and fears of bubonic plague that menaced the city.

“Hassler came to believe that face masks would help San Francisco tamp down the influenza, which experts [incorrectly] theorized had been brought back from Europe by soldiers returning from World War I. It was later determined that the flu originated from an H1N1 virus, with genes of avian origin… The doctor began by ordering barbers to wear the coverings, quickly expanding the order to workers at rooming houses, banks, drugstores and shops, the University of Michigan archive says.

“By Oct. 25, the Board of Supervisors required every resident and visitor to the city to wear a mask. The Red Cross pronounced that ‘the man or woman or child who will not wear a mask now is a dangerous slacker.’ California Gov. William Stephens concurred, calling it a ‘patriotic duty for every American citizen.’.. The vast majority complied, with those who did not usually being fined $5. Eventually, ‘slackers’ were jailed, and San Francisco’s lockup soon filled with the malefactors. Even with less rigorous restrictions, new influenza cases had declined enough that, by Nov. 13, 1918, Hassler recommended reopening San Francisco…

“Los Angeles went in a different direction. Despite repeated attempts by Mayor Woodman and others, the City Council refused to order Angelenos to wear masks, with the exception of health workers and those known to be in contact with influenza patients. (It didn’t hurt that the U.S. surgeon general had questioned the usefulness of masks.)…

“Church leaders demanded to be able to restore group worship, but the city insisted that indoor services be put off. And civic groups fought (somewhat successfully, back then) to get hotel rooms set aside for the poor and infirm.

“Most significant, L.A. had gone into semi-quarantine a week before San Francisco and stayed shuttered longer, reopening public facilities Dec. 2. That meant L.A.’s controls (if not its face masks) stayed in place 16 days after San Francisco lifted restrictions; after beginning seven days earlier, it was a 23-day isolation advantage.

“Both locales would soon learn that they had not been cautious enough. A quick jump in cases in Los Angeles led to a re-closing of schools, which did not open again until January 1919. San Francisco saw its own spike in influenza deaths and ordered the public to put their masks back on as of Jan. 10. They could not cast them off again until February.

“The media may have been more rudimentary in those days, but politicians already knew something about spin. San Francisco’s Dr. Hassler soon proclaimed that San Francisco ‘was the only large city in the entire world to check its epidemic so quickly.’… But the U.S. Public Health Service disagreed. San Francisco had suffered more than all other major American cities, with a death rate from the Spanish flu approaching 30 per 1,000 people. The later CDC review showed that both of California’s landmark cities suffered ‘second humps’ of infection, though San Francisco’s was more severe.

“The researchers examined ‘excess’ death rates, the number who died of influenza above the normal yearly expectation, in 50 cities. L.A.’s rate was 494 excess deaths per 100,000 residents, lower than that of many other American cities. With its shortened public distancing requirements and preoccupation with masks, San Francisco suffered 673 excess deaths per 100,000… A century later, leaders in Los Angeles and San Francisco continue to act independently, if somewhat more uniformly than their precursors.” James Rainey and Rong-Gong Lin II writing for the April 20^th Los Angeles Times.

San Francisco did it wrong, LA a tad less wrong… But both cities seriously screwed up. Today, Donald Trump and those red state governors succumbing to public pressure to reopen way before the medical community believes prudent are even more dramatically and totally wrong. They are sending an engraved invitation to COVID-19 to bring on more sweeping killer waves of the disease that will eventually reach into every remaining nook and cranny of American life. Probably before the November election. How are those leaders going to be held responsible for the deaths they cause? How will they have to pay? If at all?

            I’m Peter Dekom, and succumbing to unfounded public pressure, against the advise of those who really know, is a sign of exceptionally weak and incompetent leadership, especially when the death tolls are ultimately calculated.

Profit Tears

There are obvious consequences when there are many buyers seeking a product verses a consortium of buyers joining together to act as a single unified buyer, an aggregation that may add additional price reductions by reason of the increased volume. It’s the most basic economic rule: supply and demand. And if the buyers are governmental bodies and hospitals, bidding against each other for the same supplies, the market automatically charges what the market will bear. While they may be confined by statutes and administrative governmental bodies to prevent “price gouging,” it takes a pretty egregious abuse of the ability to charge absurdly high prices to trigger governmental intervention. But when those who must foot the ultimate bill are taxpayers, hospitals and insurance carriers are assessed, not only do virtually all of us get slaughtered in the feeding frenzy, but often state and hospital budgets simply run out of funding, shutting down other valuable programs to pay for the excess.

Indeed, N95 masks, which cost way less than a dollar each before the COVID-19 pandemic now can cost ten times that sum in an open trading arena, even with gigantic orders. As Donald Trump seems to be willing to use his power to force domestic manufactures in emergency times under the Defense Production Act solely against his outspoken critics, only two so far (General Motors and 3M), he is instead proselytizing free market capitalism as the legitimate solution to most shortages of health supplies and equipment.

Oh, and the states have to bear most of the responsibility. Horrific prices and egregious profits, it seems, are right down Mr Trump’s core business philosophy. Let the rich get richer. But what is incredibly ironic is that most of those supplies are coming from the nation Trump blames for this outbreak: China. So, Mr. Trump is making sure that American taxpayer and hospital money makes China and her manufacturers even richer. And, of course, the big boy middlemen who are paid to ship these orders. So, we’re buying more from China, and they’re not buying much from us since that Trump-touted trade agreement had a pandemic out. Hmmmm. The best negotiator who ever lived!

Consistent with the President’s mounting pressure to reopen a plunging economy long before it is medically prudent to do so, he is encouraging protesting scoff laws gathering in their respective state capitals  (notably Minnesota, Michigan and Virginia), not exactly practicing safe-distancing, who are arguing to lift governmental lockdowns because these restrictions violate their rights. Gee, the second and even potentially third waves of CV19 that might result from such gatherings just might kick up the demand for those medical supplies, so who knows how much more profits can be generated at our collective expense. Way to go capitalist Trump!

“The president took to Twitter with the kind of rhetoric some of his supporters have used to demand the lifting of the orders that have thrown millions of Americans out of work… ‘LIBERATE MINNESOTA!’ ‘LIBERATE MICHIGAN!’ ‘LIBERATE VIRGINIA,’ Trump said in a tweet-storm in which also lashed out at New York Gov. Andrew Cuomo to stop complaining about the federal response.

“On Thursday [4/16], Trump laid out a three-step, weeks-long map for easing the restrictions in places where the virus is being brought under control, assuring the nation's governors: ‘You’re going to call your own shots.’

“But some governors around the country made it clear they are not ready to break out the roadmap, with some saying they badly need help from Washington in ramping up testing for the virus first. Cuomo accused the federal government of ‘passing the buck without passing the bucks… The federal government cannot wipe its hands of this and say, `Oh, the states are responsible for testing.' We cannot do it. We cannot do it without federal help…’” Associated Press, April 17^th.

As Trump chastised Cuomo for complaining too much, bits and pieces of new information continue to pour emphasizing just how devastating delays, lack of truth and inaction have been against this aggressive contagion.

“China acknowledged that the coronavirus death toll in the one-time epicenter city of Wuhan was nearly 50% higher than reported, underscoring just how seriously the official numbers of infections and deaths around the world may be understating the dimensions of the disaster.” AP.

And then there’s little game where the feds are showing how they are helping get those over-price supplies with government-chartered cargo flights from places like China. But there are no price negotiations. No ceilings on what can be charged, just a generic pledge to be “reasonable.” This federal subsidy of profiteers, helping them make even more money, has the euphemistic name, “Project Air Bridge.”

“[It’s a] secretive Trump administration project that enlists private companies to bring masks and other medical equipment to the U.S. to fight the coronavirus outbreak has provided tens of millions of dollars in taxpayer subsidies to the nation’s largest medical-supply companies with little public accounting.

“Over the last three weeks, taxpayers have paid to fly the companies’ supplies to the U.S. from Asia on government-chartered cargo flights, while the firms have been free to sell the material to hospitals, clinics and others at prices they choose… That has saved the companies more than $25 million in shipping costs, savings they are not required to pass on to the medical systems, state governments and others who buy their products. The supply companies’ profits topped $2 billion last year, financial statements show…. The administration has refused to disclose crucial details of the operation..., including its financial arrangements with the companies involved. These include multibillion-dollar firms such as McKesson Corp., Cardinal Health Inc., FedEx and UPS.

“Five of the six medical distributors involved in Project Air Bridge — the biggest companies — also wouldn’t answer questions about their participation… Only Medline Industries Inc., a private company based outside Chicago, agreed to discuss Air Bridge. A spokesman said the company’s agreement with the government includes a stipulation that it charge ‘reasonable’ prices, but the spokesman would not detail what that meant or how it would be enforced.

“The Federal Emergency Management Agency [FEMA], which is running Air Bridge, required The Times to file a Freedom of Information Act request to get copies of any contracts or other financial agreements with the participating companies, a process that can take weeks or months… Smaller competitors say the administration has effectively excluded them from the government-subsidized program.

“‘It seems like you have to be one of the big boys running things to get a ride on the bus,’ said an executive at a company that was not invited to participate in Project Air Bridge… ‘That seems pretty unfair,’ the executive said, noting that the cost of air freight can add 10% or more to the price of medical supplies for firms that have to pay to ship from Asia themselves…

“As of Monday, Air Bridge had brought in 400,000 N-95 masks, 25.7 million surgical masks and 24,000 face shields, the administration says. The program has included more than 35 flights, which have cost about $750,000 per flight, according to FEMA. Vice President Mike Pence gave a slightly different count on Wednesday, saying that 44 flights had taken place and roughly 50 more were scheduled.

“Medline spokesman Jesse Greenberg defended the company’s participation in the government-funded shipping operation and disputed the suggestion that Medline is getting preferential treatment… ‘The fact is that we are getting additional products in an expedited fashion at a time when they are needed most,’ he said.” Los Angeles Times, April 17^th.  

It’s always the same story: the federal government constantly tilts the field towards the biggest in the land. Shutting down major EPA restriction on heavily polluting industries. Slashing corporate taxes while running a deficit that the rest of us have to pay for and encumbering the federal government with so much more debt that it severely limits the ability to deploy needed cash for other more generally beneficial policies. Income inequality is the worst in the developed world. This pandemic is creating new opportunities for Mr Trump to further widen that gap, and he is making that happen.

Trump’s palliatives, misinformation, manipulating the market to cause prices for vital supplies to skyrocket have only made a terrible situation so much worse. And still his approval ratings hover around 45%, suggesting that there just may be a genetic cross-fertilization between human beings and lemmings.

            I’m Peter Dekom, and watching rolling mistakes that so obviously and consistently lead to results that are as bad, if not worse than, projected is deeply disheartening.

Totally Wiped Out?

Even on Amazon, what you see may not be what you get. There is a severe shortage of luxury brand, two-ply toilet paper, and “vendors” we’ve never heard of have suddenly appeared. Mostly from China. Beth Franssen, cited in Daniel Miller’s article in the April 16^th Los Angeles Times, bought a package of 10 rolls of TP for the alarming price of $28.70 from a Chinese seller on Amazon. Unlike orders from other such vendors that never show up, at least these arrived. But there was a catch: “They are doll-sized rolls.”

Daniel Miller also shared his experience with an Amazon TP order: “The toilet paper promised to be ‘gently textured’ yet ‘durable enough for the task at hand.’ The package’s lettering was in Chinese, save for one word: ‘Face.’… It wouldn’t come for several weeks, and at $23.90 for 10 rolls, it seemed pricey. But it was available for purchase immediately… So, on March 20, I did what countless other anxious Americans have done during the coronavirus outbreak: I clicked the ‘Buy Now’ button on Amazon.

“It’s been more than three weeks since I placed my order with the seller in Guangzhou, China, and I’m still waiting. A parcel tracking website indicates that China Post has created a logistics order for my toilet paper. Destination: Finland. (I live in L.A.)

“‘It’s likely that you will never receive your toilet paper,’ said Juozas Kaziukenas, founder of e-commerce research firm Marketplace Pulse. ‘I would not bet on it. Or you will receive a product that is not what you are expecting — specifically a lower-quality product or a different product altogether.’” The marketplace is flooded with inferior product, never intended for the US market, or scammers with no intention to supply anything. The visual jokes circulating around the Web may draw a chuckle, but there are lots of folks quite uncomfortable with their bathroom choices. And few such recently added vendors ever respond to direct questions or challenges.

“There are vendors in Amazon’s new toilet paper economy that are indeed delivering on their promises, but e-commerce experts said others appear to be carrying out byzantine schemes that are difficult to monitor and, in some cases, even fully understand. Certain sellers are offering toilet paper that doesn’t match product descriptions. Others, experts said, could be peddling nonexistent items, leaving consumers empty-handed — or, given the circumstances, caught with their pants down.

“Recent one-star reviews left for Amazon Marketplace sellers described a litany of issues, many bordering on absurd… ‘The company charged $127.96 for toilet paper that never arrived,’ one review said… ‘I ordered 20 rolls of toilet paper and after a month got 10,’ read another that complained of shipment in a ‘filthy black bag.’ It continued: ‘And are you kidding me WE ARE GOING THROUGH A WORLDWIDE PANDEMIC.’… ‘This is HIGHLY misrepresented,’ another said. ‘With no exaggeration, the size of each roll of toilet paper is not much larger than the size of a roll of register tape.’

“Amazon acknowledged in a statement that there are ‘bad actors’ in the [Amazon] Marketplace but said that it uses a ‘range of rigorous fraud detection and prevention measures’ to proactively protect customers. Among the Seattle company’s efforts is a vetting process that blocks ill-intentioned operators ‘before they are able to provide a single product for sale.’… ‘As a result, bad actors that attempt to abuse our systems make up a tiny fraction of activity in our store,’ Amazon said.

“A large swath of the mushrooming toilet paper business in the Marketplace is coming from China, recent Amazon sales show. An analysis of 306 one-star seller reviews mentioning toilet paper that were left from March 18 to April 8 found that 172 of the reviews — or 56% — were for third-party sellers in China, according to data provided to The Times by Kaziukenas, whose company tracks millions of online sellers… [Amazon Marketplace] profits by charging a commission for each Marketplace sale, with most sales incurring a fee ranging from 8% to 20% .” Miller.  I might add that the pandemic has exploded Amazon’s value to a $1.1 trillion market capitalization, and they are hiring tens of thousands of new workers at a time, all over the world.

Amazon is supposed to protect consumers, and they have indeed acted against other egregious sellers, for counterfeit items, price gouging and pure scamming. “In March, Amazon suspended thousands of seller accounts that appeared to be jacking up prices on items such as N95 masks and ‘gated’ certain products, such as hand sanitizer, requiring sellers to gain approval before offering them. That hasn’t happened for toilet paper.

“‘They are not going to gate everything,’ said Chris McCabe, who runs ecommerceChris, an Amazon seller consulting firm. ‘The more they gate, they are excluding people from potentially selling something and costing themselves that way.’

“Third-party sellers appear to have found a lucrative business, according to sales data provided to The Times by [James Thomson of Buy Box Experts, which advises Marketplace], who used the analytics tool Jungle Scout to generate the information… For example, over the 30-day period that ended April 9, a 10-roll pack of Face sold 800 times from multiple sellers, generating about $21,000. A 12-roll pack available via the same page sold 2,300 times, accounting for about $71,000… ‘It’s a pretty good way to make a lot of money quickly,’ Thomson said.

“Considering the delivery window for the Face toilet paper that I bought spanned from April 10 to May 1, I should have known that this was not a good way to receive such an important household item quickly.” Of course, Amazon is just the world’s largest online retailer (how about just “retailer”?). The scams, counterfeits and price gouging are spread pretty evenly across the Internet.

So why is this big news in the United States and not so much in Europe? The April 14^th The Guardian UK has a clear answer. Bidets. Americans had never taken to them. “America’s disdain for bidets has no clear basis. Douching was once thought to be a kind of birth control, and in 1936 an onlooker suggested that ‘the presence of a bidet is regarded as almost a symbol of sin,’ according to the Atlantic. One convoluted theory holds that American soldiers in Europe during the second world war visited French brothels and saw the basins, which they instantly associated with prostitution.” It was almost un-American to have one!

Until the pandemic, bidets and all-in-one toilet/bidets (like the one pictured above) were considered luxury items for premium or newer homes and upscale hotels, particularly venues that catered to European tourists. The modern versions, with heated seats, not only wash your derriere (or other “parts”), but some go so far as allow a quick blow drying as well. Suddenly, Americans want what Europeans have accepted as normal for years.

“In the first week of March, ‘we saw [US] sales starting to double what they had been the month prior,’ said Jason Ojalvo, CEO of Tushy, a bidet company founded in 2015. ‘Then two days later they were triple what they usually are, and then suddenly it was 10 times what normal sales are. A few days later it peaked at a million-dollar sales per day.’… Rather than chasing rumors of where toilet paper was last seen on shelves, some millennials see purchasing a bidet as a kind of pandemic lifehack…

“In Italy, where bidets are in every household, the American rush for toilet paper remains a mystery. It’s completely unthinkable that Italian bathrooms would be without such an essential piece of equipment. As far back as 1975, a hygiene law stated: ‘For each accommodation, at least one bathroom must be equipped with the following sanitary facilities: toilet, bidet, bath or shower, washbasin.’” The Guardian. Meanwhile, Amazon is attempting to redress the TP situation:

“First, sellers create listings with reasonable prices. High prices would trigger Amazon’s ‘anti-gouging algorithms,  said Thomson… They usually set shipping estimates at two to six weeks. The lag may lead a buyer to forget about the purchase and therefore not complain if it never comes, allowing the seller to pocket the proceeds.

“Customers who notice they never received an item can ask for their money back. And Amazon described forceful actions it takes when it detects fraud: ‘We notify and refund customers if we believe they will not receive their order, block the bad actor, withhold funds disbursement, and work with law enforcement to hold them accountable by pursuing civil and criminal penalties.’

“Amazon’s protocols also protect it from paying out the proceeds it collects from buyers to bad actors. For newly registered sellers, the company said it retains payments for a week after the expected delivery date to cover returns, refunds or other issues.

“Those protections safeguard Amazon, but they may be cold comfort [oy!] for consumers who find products to be of poor quality or different from what was advertised. As with Franssen, some may ask the seller for a refund. But there still could be room for the merchant to profit. After a back-and-forth with the seller, Franssen was given a refund of $8.82 — less than a third of what she paid.” Miller. Toilet/bidet anyone? You can buy a toilet seat that retrofits older ceramic thrones for a lot less than replacing the entire unit!

            I’m Peter Dekom, and I bought one of those toilet/bidet combinations after a surgery that made that a necessary choice; once you buy one, however, you won’t – you’ll pardon the expression – look back.

WHO, US? Responsible for Spreading COVID-19?

Nobody can honestly say that World Health Organization did a good job in detecting this virus and declaring a necessary declaration of a global emergency? They deferred that pronouncement a month to keep from embarrassing China. They were flattering to China’s later containment efforts, perhaps too effusively. They were also hamstrung because Taiwan is not allowed to be a member (the People’s Republic of China has ousted them from all UN activities, with full US support, beginning in the Nixon era). Donald Trump’s announcement, however, that pending a more detailed investigation, he is suspending financial support for the United Nation’s WHO may have serious negative consequences for all of us. In spite of the fact that several federal agencies are also digging into potential false statements from China that may have triggered this inadequate WHO response.

All things China are now toxic here. We have escalating the rhetoric of blame against the PRC, and they have reciprocated in kind. “Public anger, and the Chinese Communist Party’s massive response to fight the epidemic, has strengthened Xi’s grip on power and made it easier for him to pursue a crackdown on dissent.

“Many in China chafe at Trump’s effort to blame them for the pandemic as both unfair and factually wrong. They see China, with its isolation of Hubei province and other hot spots, as a model for how to contain and conquer the disease. Many also see China as having reached out to help other countries as its own crisis has abated.

“There’s a narrative widely accepted within China that the country has been able to bring the virus under control and ‘that China is — if not the savior of the world — at least sort of doing more than its fair share to help the rest of the world,’ said David Bachman, a China specialist at the University of Washington in Seattle… The COVID-19 pandemic, in an unexpected but potentially fateful twist, has moved the United States and China a big step closer to a new cold war.

“It has strengthened hard-liners in both countries, and political pressures stemming from the pandemic are making it harder for leaders to back away from escalation… For Trump, the antagonism with China has centered on trade. He has led a tit-for-tat tariff war with China, eroding what for many years had been seen as the ballast in the relationship.

“In January, there was a glimmer of hope that tensions might ease: The two sides struck a large [phase one] trade deal in which the Chinese promised to buy billions of dollars more in American farm products and other goods… But ‘the trade deal signed in January is already dead in the water,’ said Bachman. ‘There’s no possible way that the targets now are going to be met. And so that’s going to be a source of dissatisfaction on the U.S. side.’… What’s more, the pandemic exposed America’s heavy dependence on China for critical medical supplies and drugs, as well as many other manufactured products.” Don Lee writing for the April 15^th Los Angeles Times. Brick by brick, the Trump administration is tearing away at governmental policies and agencies that would normally have kicked into gear long before they did to stem pandemic disaster.

Having disbanded the federal group created to prevent and predict pandemics (White House National Security Agency’s Directorate for Global Health Security and Biodefense) early in his administration, peppered the American people with false palliatives plus piles of disinformation for months and shirked personal leadership responsibility, Donald Trump’s own delays and denials appear to have had even greater negative impact on Americans than anything WHO might have done. Adding another round of defunding to agencies, in this case the United Nations WHO, charged with pandemic responsibility – notwithstanding culpability – only makes a bad situation that much worse.

WHO pretty much knows it screwed up.  Its Director-General, Dr. Tedros Adhanom Ghebreyesus, should resign or be removed from office, but defunding WHO in the middle of a global pandemic – particularly after a recent spate of powerful pandemics/epidemics (COVID-19, SARS, MERS, Ebola, HIV, Zika, H1N1, cholera) – may play well with Trump’s anti-globalist base, but in terms of dealing with what we are facing now, it is sheer madness. WHO is obviously dealing with and repairing its own short-comings. We need every bit of global cooperation we can get. Trump’s bad habit of playing the COVI-19 as a political event, versus medical emergency, will only kill more people than his fostering delayed required measures already has.

But the sheer hypocrisy of lambasting and defunding an international pandemic-fixing authority, given what our own government has done, is staggering. We all know the headlines based on federal governmental failures and the exacerbation inflicted on future victims by governors unwilling to take individual responsibility for their own states simply to follow the misdirection of a clearly flawed Trump-led federal response strategy. But some of even the harshest critics of the administration might also have missed back page reports of how the United States is actually helping to spread COVID-19 to other countries. Under the guise of “immigration” reform.

The huddled masses aggregating below our southern border waiting for the right to apply are living in unsanitary conditions where the virus spreads easily with little or no treatment options. Immigration detention facilities on this side of the border have become breeding grounds for COVID-19, and as we implement deportation of many of these detainees back to their home countries, we a knowingly sending coronavirus with them.

“More than half the deportees flown back to Guatemala by U.S. immigration authorities have tested positive for coronavirus, the top Guatemalan health official said Tuesday [4/14]… Speaking to reporters in Guatemala City, Hugo Monroy, the minister of health, did not specify a time frame or the total number of deportees who had arrived home with infections.

“But hundreds of Guatemalans have been returned in recent weeks, including 182 who arrived Monday [4/13] on two flights from Texas… Monroy said that on one flight — which he declined to identify — more than 75% of the deportees tested positive… But he made clear this was not an isolated incident and said many deportees arrived with fevers and coughs and were immediately tested… ‘We’re not just talking about one flight,’ he said. ‘We’re talking about all the flights.’…

“For the first time under the modern immigration system, the mass removals include unaccompanied minors and asylum seekers, two groups specially protected under U.S. law… In the first week of April alone, Guatemala received about 100 unaccompanied minors expelled from the United States — as many as it took in during all of March… On March 30, Guatemalan Vice President Guillermo Castillo ‘begged’ the U.S. to stop deportation flights to Guatemala, according to an interview with a local radio station. The flights were paused again for a week but restarted Monday [4/13].” Patrick J. McDonnell, Molly O’Toole and Cindy Carcamo writing for the Los Angeles Times, April 15^th.

Treaties, multinational agreements, the law and the Constitution are taking hits during these perilous times. The President is declaring that he has peremptory powers reflecting near unchecked total power over every aspect of this pandemic, despite not a shred of supporting legislation or Constitutional authority. Including the ability to issue executive orders without question or to abrogate federal statutes without Congressional approval.

The President’s policies have helped spread infection far and wide, even to his own federal employees. “In the United States, at least 21 U.S. Immigration and Customs Enforcement employees working at migrant detention centers have tested positive for COVID-19, according to the agency… That includes 13 at the Alexandria, La., staging facility that has been sending deportation flights to Guatemala and other countries.

“An additional 80 ICE employees who work outside of detention have also tested positive. The agency has refused to provide a count for the number of cases among thousands of contractors and personnel at private facilities that contract with the federal government to hold migrants.

“The agency has been engaged in an ongoing review to determine which migrants are most ‘vulnerable’ and able to be released from custody as the virus spreads through its detention facilities. Only recently has it begun to test more broadly at facilities that have confirmed cases.

“Because of the pandemic, Guatemala is refusing to accept deportees who are not Guatemalan, putting on hold a deal it made with the U.S. last year. Under that arrangement, Guatemala had accepted some 900 Salvadorans and Hondurans who had been denied the opportunity to seek asylum in the U.S.

“As for Guatemalan deportees, officials said the first to test positive for COVID-19 was an adult male who arrived March 26 from Mesa, Ariz… A few minors have arrived with fevers, though U.S. immigration authorities have said that all passengers’ temperatures are taken before boarding and that no one is allowed to make the flight to Guatemala, or anywhere else, with a fever. [Federal administrative agencies, run by political appointees, don’t have much credibility these days.]

“On Friday [4/10], the White House threatened visa sanctions against any country that does not accept its citizens who are deported from the United States amid the pandemic — a move widely seen as directed at Central America, the biggest source of migrants arriving at the U.S. southern border.

“On Monday [4/13], U.S. Secretary of State Mike Pompeo said he had notified Congress that the Trump administration would continue ‘targeted assistance’ to Guatemala, Honduras and El Salvador, citing their continued cooperation on immigration and the asylum deals. Since January, the U.S. government has deported more than 11,758 Guatemalans.

“Since March 20, when the Centers for Disease Control and Prevention issued an order blocking travelers from Canada and Mexico regardless of country of origin, U.S. officials have expelled nearly 11,000 migrants with minimal processing.” LA Times. Until the November election, we cannot defund Trump’s failed efforts or fire him for his misdirection. As he evokes “rally round the flag” support, he is generating undeserved popular support which just could propel his reelection and place this nation into a death-spiral toward internal conflict that we have not seen since the Civil War.

            I’m Peter Dekom, and we really need to reverse those who believe in “listen to what we say, don’t look at what we do,” a mantra that has only encouraged Donald Trump to be the autocrat he wants to be.