19 March 2020 – Thursday – #4

While Nate Silver and Elon Musk tweet about who needs ventilators, the Italians are printing them. Until there are treatments or a vaccine, the difference between life and death for anyone seriously ill from Covid-19 is a ventilator and there aren’t enough. The manufacturer of said US$11,000 ventilator is suing for patent infringement (see bottom of article). “But despite hospitals asking for the 3D plans, [3D inventor] Fracassi is wary about providing them because the manufacturer has threatened to sue. And has refused to share the blueprints too.” Perhaps Elon Musk can buy the ventilator manufacturer and put the 3D model in the public domain.

In treatment news, the Chinese claim the Japanese flu drug Avigan is effective in treating Covid-19.

Patients who were given the medicine in Shenzhen turned negative for the virus after a median of four days after becoming positive, compared with a median of 11 days for those who were not treated with the drug, public broadcaster NHK said.

However, tempering that news, the Japanese were more guarded.

But a Japanese health ministry source suggested the drug was not as effective in people with more severe symptoms. “We’ve given Avigan to 70 to 80 people, but it doesn’t seem to work that well when the virus has already multiplied,” the source told the Mainichi Shimbun.

In other words, as with most other treatments under consideration, severe cases aren’t responding well to therapy and still need ventilators.

In any case, Avigan needs to go through standard testing processes. There are two million doses available. If used prophylactically the manufacturer would have to produce orders of magnitude more doses, but two million is a good start for treatment of less severe cases. Like all the other treatment candidates, it’s unlikely there will be anything at scale as Europe and the US head toward peak infection in the next month or two.

If you want to get into the nitty-gritty of all the treatments under consideration, this report from last week gives a thorough run down on candidate treatments.

I’m trying to vet these reports and find second sources because not only does the president create confusion with his changing opinions about Covid-19, but the Russians are helping him. Adding to the problem of Russian disinformation campaigns, yesterday Facebook algorithms were mislabeling articles from trusted sources as spam, as well. Think about what you’re posting! Do a little research on what Facebook might not have shown you.

I’m sure you’ll be excited to know that I went outside yesterday. I was even more excited! I had a doctor’s appointment that required me to be in the office, so no choice but to walk thirty minutes there and thirty minutes back.While I was out, I went to the grocery store, too. I’m figuring out what makes me comfortable and seems feasible for now. Here are some things I did:

  • Washed my hands before I left and put a clean paper towel in my pocket.
  • Opened doors and pushed elevator buttons with my coat (could have used the paper towel!).
  • Kept a fair distance from other pedestrians (that wasn’t hard).
  • Kept my hands in my coat pocket so I wouldn’t touch my face.
  • No one else was inelse in the waiting room, so didn’t have to worry about distance.
  • Cleaned hands with sanitizer after doctor’s visit.
  • Stopped at grocery store downstairs while I was out. In Barcelona, only groceries and pharmacies are open. These are limiting the number of customers inside at the same time. The stores are reasonably well stocked, but no eggs again. I’m beginning to think that anyone who doesn’t know how to cook buys eggs to learn. Again, it wasn’t hard to keep distance.
  • Paid attention to not touching my face once I started touching the cart and items on the shelves.
  • Noticed that I touched my mobile when I paid, so I considered it contaminated.
  • When I got home, I took off my shoes and coat, dropped the groceries on the back porch except perishables that went into the “dirty” refrigerator, and washed my hands and my mobile. I’ll let the groceries stay outside for a day or two. I kept the mobile out of my pocket for a few hours.

Nested inside my Covid-19-free zone, I felt like I’d maintained a barrier from any Covid-19. This study about virus longevity indicates 1) that closed environments with other people are unsafe for hours as any virus present dissipates in the air (measured half-life of 66 minutes in air), and 2) that exposed surfaces are contaminated from hours to days depending on surface type. I also opened my windows, although I don’t think there’s any virus hanging out inside to air out. There is a lot of variation in Covid-19 viability on different surfaces and even on the same kind of surface, so I’m trying to err on the side of safety by leaving anything new to the apartment in the foyer or back porch. I’m assuming my clothes are not contaminated. I’m still thinking about that.

On side note. I’ve stopped applying deodorant because why. I’m alone here. Then I arrived at the doctor’s office yesterday.

Some quick Barcelona updates. On the medical front, I chatted with a lab technician at one of the nearby hospitals. He says everything quiet right at Barcelona hospitals. It sounds like they’re waiting for a tsunami to hit. Routine procedures are being postponed. This was confirmed by the technician at my doctor’s office today. Also, after debates in Spain about how to allocate medical supplies, there are reports this morning that medical supplies are being held up at customs.

The other Barcelona update is that, in addition to our 8p local applause ritual, a 9p local pot banging ritual was added last night. The main difference seems to be in decibels and pitch. I don’t know how people find out about these rituals, nor do I know if last night’s ritual was a one-off or if we’re going to be doing community sound-offs every hour on the hour soon. [Update 21 March 2020: the pot banging was an anti-government protest.]

As in the beginning of the AIDS epidemic, there are debates about what behavior is safe. There are always trade-offs. My San Francisco friends report very different circumstances from Barcelona and its community sound-offs. Most bay area stores are still open and most don’t limit the number of customers. I heard that Whole Foods has set aside special shopping hours for elders and others at risk. There seem to be a lot more people outside in San Francisco than in Barcelona. The Mayor of San Francisco is having a spat with Jake Tapper from CNN about what is safe. I personally feel people in Barcelona would benefit physically and mentally from being outside a bit more. On the other hand, keeping people inside communicates the severity of the problem.

The Chinese imposed much more severe constraints during its Covid-19 battle and today was the first day with no new infections in China. So, at one extreme, lockdowns with frequent fever and Covid-19 testing appear to work. The Italians, on the other hand, have a robust lockdown and still haven’t seen country-wide payback from their effort. Italy suffered its worst one day Covid-19 death toll yesterday.

Anecdotally, my niece in New York City starts working at home today. Her insurance brokerage closed its office yesterday. She said most New York City companies are working remotely now and the city expects a shelter-in-place order any time.

All this is tough on the economy. I chatted yesterday with a musician who plays Broadway shows. No work for the foreseeable future. I was supposed to host a guitar player and his wife this weekend, but all concerts cancelled in Barcelona. My friend Leslie played her last scheduled gig last weekend. It’s not just the performing arts. I noticed that Delfina, one of my favorite San Francisco restaurants, closed. Every day I read that many more small businesses are closing.

I also chatted yesterday with a friend who runs P.R. for a large retailer about how much cash to keep on hand. He didn’t sound optimistic about job prospects and his apartment lease runs out at the end of April. Impossible choices. Another friend who manages accounting for a small technical writing consultancy is worried about cash flow. Brad didn’t get an offer on his house in San Francisco, indicating housing market illiquidity in one of the country’s hottest markets. I haven’t got any encouraging reports from friends.

The problem when an economy gets gummed up is getting it back on its feet.

In response to Covid-19, even conservative politicians have become Keynesian converts, with Europe and the US pumping trillions of dollars into the economy. This seems correct in form to me, but I’m not sure about substance. In the US, with elections around the corner, the Republicans probably don’t have any other hope to retain power, even though the spending goes against decades of Repubican party wisdom. With the Trump administration, though, it’s hard to know whether the amount or the placement or the timing will help anyone but the wealthy. Already pundits are worried that an inevitable airline bailout will go into the pockets of owners and management after the airlines spent their free cash flow repurchasing shares rather than investing in people or assets.

Random musing: what happens to all those airline miles I’ve accumulated?

Last, but not least, the Covid-19 virus has infected two members of the US Congress. I wish them a speedy recovery.

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