3 April 2020 – Friday – #19

I had a doctor’s appointment yesterday and walked to his office. It felt great to get outside and stretch my legs. Here’s how quiet it was on Passeig de Gracia in the middle of the day.

Passeig de Gracia, Barcelona on a Covid-19 day – https://photos.app.goo.gl/GM84NzP4Qpn8snw6

That’s the edge of the Gaudi Pedrera building on the right. It’s usually swamped with tourists, even in the off-season.

This story of former Hahnemann University Hospital in Philadelphia interests me. In a nutshell, the city recently negotiated with its owner to re-open the hospital, which closed last summer, to house the expected increase in Covid-19 cases. The owner wanted $910,000 per month rent. After going back and forth, Mayor Kenney moved on.

“We had to go back and forth … with a multi-millionaire owner who wanted to maximize his profits. So we decided, rather than continue to go back and forth with him, we moved on.”

Philadelphia Mayor Kenney describes negotiations with hospital owner Joel Freedman

US oligarchs generally can afford to take the long view during the Covid-19 economic recession (or depression). For most of them, income of US$1 million a month is small compared to the value of assets like this hospital building. They have plenty of resources to wait out the downturn and little incentive to take any risk to the value of their asset for what amounts to them as a small amount of incremental cash.

In the 28 March Covid Diary BCN entry, I wrote about how US oligarchs respond to the pandemic depending on the nature of their wealth. The unfolding economic story is how different oligarchs deploy their wealth. At the limit, as governments in the US, Europe, and other regions stimulate their stalled economies, they probably have to raise taxes on the wealthy to cover the cost of these stimuli. Because the US dollar acts as the world’s reserve currency, it may not have to tax as much as other governments, but it probably can’t sustain US$3 trillion in deficit spending for too long without creating inflation, which is effectively a tax on assets.

It seems to me that the tension in the story comes from the conflict between individual interests of oligarchs and interest in the public good. The owner of the Hahnemann Hospital made a rational decision for himself, but not a decision in the public good. If all oligarchs act in their self interest this way, the chances for higher taxes or inflation that redistributes their wealth increase. On the other hand, if they are willing to take actions that stimulate the economy but have only marginal economic benefit to themselves, they may avoid taxes, whether in the form of taxes or inflation.

So far it looks like the oligarchs are sticking up for their self-interests.

There are two debates taking up energy that might be better focused elsewhere. One debate is about wearing masks. This is a good summary of where the science world is with masks, which is to say there are a lot more questions than there are answers.

I don’t wear a mask, but I’m glad people do who work at stores I frequent. At this point, I think the best advice is to follow your government’s orders. WHO says masks are not necessary. In the US, the CDC is re-evaluating its position on masks. In different countries mask policies vary.

I have three reasons I don’t wear a mask. First Italy, Spain, and Germany are all turning the corner on Covid-19 infections without mandatory masks, so it doesn’t seem to me that they are necessary to end a Covid-19 outbreak. It’s true that Italy and Spain are having worse outcomes than South Korea and Vietnam, but there are are other differences besides mask wearing in these countries’ responses. Italy and Spain had less testing and delays in their lockdowns than South Korea and Vietnam.

Second, as long as I know there are healthcare workers who don’t have masks, I’d prefer not to use one they might need.

The third reason is that when I worked as a hospital orderly, I learned from surgeons who worked in the Army that their post-op infections rates vanished when they worked in fresh air field hospitals. Not that all infections works the same way but, in general, a well-ventilated outdoor space is not a good home to infectious matter.

The second debate wasting energy is whether hydroxychloroquine is a treatment for Covid-19. I don’t know whether or not it treats Covid-19 because no one knows. There are a lot of people who think hydroxychloroquine treats Covid-19. Ask them to provide a single proper study of its benefit.

One proponent who gets lots of media coverage is Dr. Vladimir Zelenko. Right wing media like OAN and pundits like Herman Cain are promoting hydroxychloroquine largely based on Dr. Zelenko’s claims.

OAN reports hydroxychloroquine is an effective Coivd-19 treatment

All this sounds great until you realize that Dr Zelenko has to be seeing one patient every ten minutes in order to treat the hundreds of patients he claims to have saved. His own community is saying that there aren’t that many Covid-19 cases to treat. Even if Dr. Zelenko somehow found hundreds of cases to treat online, I don’t see how a self-avowed country doctor has the organization to perform proper follow ups with hundreds of patients to make his claims.

People really want to hear about a Covid-19 cure right now. The confidence men know what they want to hear.

Trump promotes hydroxychloroquine as Covid-19 cure at 2:18 mark

In other Covid-19 news, President Sanchez has extended the Spanish lockdown until 26 April. As I’ve mentioned before, the Spanish government will need a robust testing program in place in order to avoid a second Covid-19 infection peak. Without adequate testing, it may be able to relax restrictions about going outside, a la California, but it won’t be able to send people back to work safely.

The United States is no longer issuing passports except for life-and-death situations. The move discourages foreign travel. The US embassy in Madrid and consulate in Barcelona are closed except for emergency services.

In the wake of Covid-19, New York has started rationing emergency services.

I’ve been questioning the White House Covid-19 death estimates the past few days. The White House said it expected 100,000 – 240,000 US casualties. Now the people who provided the data for the White House estimates have questions, too.

I’m beginning to question my own estimate of 350,000 – 500,000 US casualties. My estimate assumes the US response looks similar to the Italian response in terms of mortality. The Trump administration, however, has failed to ask all governors to lockdown and provided clear lockdown guidelines. There are still several states that have not locked down fully yet. Florida’s governor ordered a lockdown, but granted an exception for religious organizations. The clock doesn’t start ticking on a US lockdown until every state is on board. Every three days of delay is potentially a doubling in US mortality. Each day Trump waits to get all governors to lockdown is potentially another 30% more deaths. Given Trump’s delay, a million US casualties now seems likely to me.

Trevor Noah’s interview with Dr. Fauci is one of the best educational pieces I’ve seen on Covid-19. Please pass it around.

Trevor Noah interviews Dr. Fauci about Covid-19

Over the weekend, I’ll be working on adding interviews and other outside views to Covid Diary BCN. Thanks for reading! You can show your support by sharing Covid Diary BCN with friends and family.

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