21 March 2020 – Saturday – #6

After closing land borders earlier in the week, the Spanish government ordered all hotels closed by 26 March. The US State Department sent an email advising US citizens and residents who didn’t have a place to stay long term in Spain to catch a flight to the US while there are flights to be had. There was chatter on the Expat Facebook pages about whether to return. I discussed this with my friend at the US Consulate here. We both concluded we were safer in Spain.

It’s clear from the most recent Financial Times chart why we might think we’re safer in Spain.

I can’t tell whether other people are noticing what I notice, or I’m noticing what other people are noticing. After my rant yesterday, I saw that US doctors called on the Trump administration to deliver:

  1. Adequate supply of PPE (Personal Protective Equipment)
  2. Best practices for sanitizing and reusing PPE during the pandemic
  3. Adequate supply of ventilators
  4. National strategy for sharing best practices
  5. Clear guidelines for clinical staff to avoid infection
  6. A national postponement of elective surgery

This has similar points to the action plan I published yesterday. Italy is losing many medical professionals during the Covid-19 crisis. It’s probable that Spain and the US will, too.

I was going to write a section today on why it’s pointless to ask the Trump administration to do anything, but Rachel Maddow provided a list of “happy talk” Covid-19 promises the president has failed to deliver. To be fair, other governments have been non-responsive in the face of Covid-19, but no other leader has promised so much and delivered so little. The US is rudderless.

Remember eight days ago when the CEO of Walmart stood with the president in the Rose Garden and promised drive through testing? Yeah, no one else does either. That’s why Trump gets away with his snake oil.

By the way, I’m all for Walmart and other private companies delivering on Covid-19 testing. A San Francisco telehealth startup called Nurx has made a Covid-19 testing kit available. In the coming few weeks, that can help healthcare professionals screen and protect themselves. The problem is that the most important step is applying that vital Covid-19 test data to public health. The administration hasn’t articulated how that happens. Why is that important?

The consensus I see forming on the Covid-19 response is that the best short-term strategies are lockdowns until there is adequate testing, and then testing and quarantines until there is either a treatment or a vaccine. Optimistically, treatment or vaccine is six months away, but more likely twelve to eighteen months. Testing gets people back to work quicker. Antibody testing in particular identifies people who’ve been exposed and recovered. These immunized people can go back to work safely. Testing is the thing that allowed the gay community to get to some semblance of normalcy living with HIV. Testing is what will enable the economy to recover from Covid-19.

Language is important. There’s a significant cognitive dissonance when Trump says “[Covid-19] could have been stopped right where it came from, China.” The same may well be said soon about the US response to Covid-19. It’s true that China made mistakes, but it has turned the corner on mortality in three months. Other than in the president’s mind, the US response has been so poor that the US likely will become a larger exporter of Covid-19 than China. That’s likely why Canada and Mexico have closed their US borders in the past day.

Language is important. The administration is adopting America’s favorite word: “war.” Covid-19 is now a war or a battle in the US. The country needs a wartime response. America is a bellicose country and Trump wants to be its brilliant general. The problem with a wartime mentality is that our biggest enemy is ourselves.

One aspect of Covid-19 that’s not getting much attention is how the virus attacks red blood cells. China measured significantly more susceptibility to severe reaction to Covid-19 in patients with type A blood, and significantly less with Type O. Don’t go out partying if you have Type O blood. Like all results right now, these are preliminary. However, I think they are guiding scientists figuring out a treatment or cure.

If you’ve forgotten about blood types, they characterize the antigens presented by an individual’s red blood cells. One reason Chloroquine, or hydroxychloroquine, may be effective against Covid-19 is because it’s a heme polymerase inhibitor. The drug is being tested for possible COVID-19 use to improve virologic clearance. What David Sinclair mentions in a Twitter thread that I posted a few days ago is that Covid-19 is mutating in ways that may make Chloroquine less effective. That’s one reason we need tests rather than promises that there is a cure. [UPDATE 23 March: Check the comment thread here for other issues with the French hydroxychloroquine study.]

Promises are easy, science is hard. I don’t have a good answer for the incompetence of the current administration other than state and local government have to compensate. That means Americans will have to respond to Covid-19 without one of its best resources, the federal government. Minority communities, it turns out, are good at responding when the government fails to provide resources. They’ve had lots of practice.

So, it’s dawned on me that I may be holed up in this Barcelona apartment not for a few weeks, but for a few months. As Green Day sings, Wake Me Up When September Ends. As I was waking this morning, I was thinking about where I get a haircut these days. I guess I don’t. I also was thinking about finding some new recipes. I cook pretty well, but I could get tired of my own cooking in quarantine after three months.

I had more Zoom calls last week than I had all last year.

What are other people doing?

My friend Heidi is making masks because of the shortage and leaving food at her neighbors’ doors.

My sister and brother-in-law are working on a new jigsaw puzzle and considering the neighborhood backyard cocktail social hour.

Some of my nieces seem to have gone mad baking banana bread. Is that genetic?

My friend Francis canceled his work travel. It hasn’t been too large an adjustment because his company is the largest remote employer in the world (at least it was before March). He’s role-modeling how to work at home. His company is leveraging its remote work expertise to land sales calls with new prospects. Even if you don’t need Gitlab’s products, you, too, might benefit from its remote work expertise. It’s online and free.

Brad’s niece is back from Guatemala. That’s her story to tell, and it’s good. I’ll just mention that she wasn’t screened for Covid-19 entering the country in Miami. Everyone working for Peace Corp was fired last week, lost their health insurance, and was shipped back home to a Covid-19 rich environment. Thanks for your service!

I’ll end on this. My niece in Connecticut, one of the family banana bread bakers, reported her neighbor tested positive for Covid-19. She also noted that many people from New York City are fleeing early in spring to their summer homes in Connecticut and elsewhere. In Spain, the same thing was happening. The well-to-do from Madrid, the country’s Covid-19 hotbed, were escaping to their second homes on the coast. The protest from other regions was loud and police set up roadblocks to keep Madrileños in Madrid. That, in a nutshell, reflects the difference between the two countries’ responses to Covid-19.

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