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The Nooner for Tuesday, March 17, 2020, presented by SYASL Partners
Hello again, hello. I just write to say hello...
We could all use a little Neil Diamond right now. Anyway, thank you for your patience with the quantity of words I've been using and likely poor editing. I'm trying to get as much information out as possible and know that each of the 8,450 of you may be looking for a particular slice of the content.
Here's a crowd-generated Google Spreadsheet of restaurants in the Sacramento region offering to-go food. Empress Tavern on Kay Street this morning emailed to announce that they will be offering "to go" curbside in the loading zone across the street in front of Pizza Rock. This includes vegetarian items previously on the now-shuttered Mother which closed at the end of last year.
Of course, statewide there are more delivery options than ever with the various online platforms. Remember to tip drivers well who are braving the elements to keep us fed. I was a bit irritated with The White House presser this morning that was focused on fast food chains. I know lots of family-owned restaurants and larger but independent ones that are working hard to keep people fed and, equally important, people employed. Even in shelter in place areas, going to get take out is an acceptable reason to leave your home, like going to the grocery store.
Let's start with a laugh this morning, which we can always use. Former governor Arnold Schwarzenegger offers a video advising social distancing as a person in the home-bound 65+ age cohort and does it with his mini-horse Whiskey and mini-donkey Lulu. "We don't go to the restaurants. We don't go to the gymnasium." Say what you will about his time as governor, we had plenty of laughs and he continues to deliver.
On to what is on everybody's mind...
In a period of 72 hours we went from business as usual in the State Assembly with deference to committee chairs as to whether to hold hearings or not. In the State Senate, the decision was made late Friday to cancel all committee hearings, although even that came as a surprise to many senators who were already back in their district. As of Saturday, work-from-home requests were case-by-case basis and parents with kids with closed schools were told to use sick and vacation leave. By last night, staff were largely sent home to work, although we know that there will be little work to do as much of California grinds to a halt.
For those that have been around the Capitol for summers when the Legislature is gone, I would note that if we forced staffers to stay in the building, there isn't even baseball to watch. That's no dis on legislative staff. They bust their ass for long hours during session and, unlike many Californians they advocate for, they don't get overtime for being there at 2am because some cray-cray threw menstrual blood from the Gallery onto the Senate Floor.
Meanwhile, the governor moved from "advisory guidelines" on restaurants, bars, theaters, and some other businesses announced at 1:30pm Sunday to legally enforceable mandates at 8pm announced via a Facebook video last night.
President Trump, who had yielded the podium to Vice President Mike Pence, dismissed the virus as less serious than the flu and overstating the nation's testing capacity, and continued business as usual with fundraisers and Mar-a-Lago parties, grabbed the podium. He announced yesterday a "15 Days to Slow the Spread." While the federal guidelines are advisory, the President held a conference call with the nation's governor's yesterday and urged those, like Governor Gavin Newsom, in the states with the largest outbreaks to take the sort of drastic steps announced last night that seemed to be a 180 from guidance only a week prior.
Before the President's announcements, New York, New Jersey, and Connecticut announced a coordinated closure of bars, casinos, gyms, and in-person dining. Announcing it, NY governor Andrew Cuomo said that the three states new that it was nonsensical for a "go at it alone" approach given the free-flow of people between the states. At least seven states have statewide school closures.
Even spending 16 hours a day mostly on this topic and its effect on California, its economy, budget, public health and education systems and more, I can't keep track of everything that is going on. What I do know is that things have changed as if we had suddenly entered wartime. Of course, the United States is not fighting with arms and our enemy is not human. But while I'm no historian and don't have time to study it this morning, I believe we're taking stronger actions than in World War II, except for as it pertained to Japanese Americans.
What changed so quickly?
Data from public health experts. In the NY Times, Sheri Fink reports on a new and sobering model out of Britain.
[White House Coronavirus Task Force member Dr. Deborah] Birx’s description of the findings were consistent with those in the report, released on Monday by an epidemic modeling group at Imperial College London. The lead author of the study, Neil Ferguson, an epidemiology professor, said in an interview that his group had shared their projections with the White House task force about a week ago and that an early copy of the report was sent over the weekend.
The group has also shared its fatality estimates with the C.D.C., Dr. Ferguson said, including that eight to nine percent of people in the most vulnerable age group, 80 and older, could die if infected.
“We don’t have a clear exit strategy,” Dr. Ferguson said of the recommended measures. “We’re going to have to suppress this virus — frankly, indefinitely — until we have a vaccine.”
“It’s a difficult position for the world to be in,” he added.
The report, which was not released in a peer-reviewed journal but was authored by 30 scientists on behalf of Imperial College’s coronavirus response team, simulated the role of public health measures aimed at reducing contact.
“The effectiveness of any one intervention in isolation is likely to be limited, requiring multiple interventions to be combined to have a substantial impact on transmission,” the authors wrote.
Dr. Ferguson said the potential health impacts were comparable to the devastating 1918 influenza outbreak, and would “kind of overwhelm health system capacity in any developed country, including the United States,” unless measures to reduce the spread of the virus were taken.
The purpose of the paper was to look at non-pharmaceutical interventions, such as those being encouraged by the federal government and enacted by state and local governments across the country. We're all hoping that they are successful. My purpose for covering this is not to provide epidemiological conclusions as that's not my realm, but rather to look at what is driving government (including public health) decisions that is transforming our lives for the time being.
So, what is driving these decisions since we still often hear them filtered through political angles from sides of the spectrum, which range from conspiracy theories on either end? What caused decision makers from local government to the governor to move from gentle nudges of human behavior to a strong hand so quickly? How did the message from The White House change so dramatically?
The White House Task Force and the President were presented the numbers that would arise if the paper from Britain was applied to the United States. Additionally, they are watching Italy, France, and Spain--three countries with advanced medical systems and, while generally more densely populated than the US and thus of greater risk, most relevant to the current strains of the virus (reportedly 500+ and growing) and what the US could face. The data of more than 50% of France's COVID-19 ICU patients being under 60 also has caused public health experts to shiver, with fear that the initial thinking of it being a deadly disease primarily among seniors based on the Chinese experience could be changing.
The same look at numbers has been occurring at the Governor's Office of Emergency Services State Operations Center, which is located at the decommissioned Mather Air Force Base, and they have been shared with legislative leaders as a rationale for moving fast and strong.
I don't have a number of 80 and over in California, but I have 75+, which was 1,707,795 in the 2010 Census. California total population has grown by 16.65% since then, so if the current population is distributed the same as in 2010, we would presume that the current Golden State population of 75+ residents is 1,992,143.
Here is the breakdown of cases reported Sunday by the California Department of Public Health (CDPH), which was based on a total case load of 353. CDPH generally puts out a daily report of these numbers, although we didn't get one yesterday.
CDPH also reports on mode of transmission and on Sunday it was:
If we're using the British study's overall mortality rate of 8-9% among 80+ year olds and apply it to 75+ residents of California, the range would be 159,371 to 179,293 deaths. If you add in the experience in France of those under 60 experience serious illness and mortality, we can surmise that without significant action, it will be much higher.
In addition to the numbers, government decision-makers are hearing from public health experts. The gold standard in the United States on epidemics/pandemics is the Johns Hopkins Center for Global Health Security in Baltimore, MD. They have provide daily situation updates on COVID-19 that is widely read by policymakers (you can sign up to receive them by email). Today, center senior scholar Eric Toner, M.D. writes today:
My colleagues and I just submitted to medRxiv a paper on what a Wuhan-like epidemic would do to US ICUs. https://medrxiv.org/cgi/content/short/2020.03.09.20033241v1 The bottom line is that demand would far exceed capacity, and some people in need of critical care would not be able to get it. But it is not just Wuhan; Italy is currently in the midst of a similar outbreak, and critical care services are overwhelmed there, too.
The encouraging news, however, is that it seems that community mitigation strategies—such as isolating the sick, home quarantining the exposed, canceling mass gatherings, and social distancing—have worked to tamp down the height of the epidemic wave and therefore have kept the healthcare systems functional in other parts of China, Hong Kong, Singapore, South Korea, and Japan. But to be effective, these measures need to be vigorously implemented several weeks before hospitals become overwhelmed.
The experience of Wuhan and northern Italy is as bad as or worse than 1918. The case fatality ratios in these locations now are twice what the United States experienced in 1918. Other places have been able to avoid such a dire situation by aggressive public health and community mitigation interventions. For hospitals, while we can hope for the best, we cannot exclude the possibility of a Wuhan-like outbreak in your city. Hospitals should be all-out preparing now for their worst-case scenario.
I do not write about this to create panic or drama. You're a smart bunch of people and you consider policy without a rush to judgment. I write about it to think about what is motivating unprecedented decisions by government that is radically changing our daily lives for an unidentifiable period of time.
I was criticized last night on social media for creating the chart that I shared with you in the Nooner Nightcap showing the possibility of exponential growth (doubling every three days) if mitigation measures such as social isolation are not implemented before the steep increase in the curve takes over and crushes the nation's health system. This is not dissimilar from the criticism 10 days ago that I was trying to take down President Trump by talking about what was happening. Today I am agreeing with President Trump on the status of the current situation. I easily could have been wrong about the gravity of the situation (and wish I had been), but here we are.
President Trump this morning essentially agreed with the various analyses, models, and projections and said that they are looking at all the models and they are taking actions to "save the maximum number of lives. Everything else is going to come back but a life will never come back. The economy will come back."
Again, I am only trying to explain
Even if we assume that the 5.3 million Californians 65 and over and those with underlying medical conditions are most at risk, many legislators have living parents and grandparents, as do the decisionmakers in public health and emergency operations agencies.
I have a new friend who doesn't speak English in Mexico City. As I found common there, the very friendly people who are quick to help strangers but often don't speak English (it ain't Cancún or Cabo) jump to use Google Translate. And, let's just say that when I studied Spanish at Orange Coast College, to great regret now it was for a language requirement and not a growth in my linguistic ability.
Anyway, last night she said that Mexíco City is a relative ghost town and that the number of unemployed folks has skyrocketed as tourism disappeared seemingly overnight. When I was there exactly one month ago, it was bustling with lines for museums and crowds in places like la catedral in el zócalo primario. From what I hear on the ground, that has disappeared seemingly overnight even though they aren't currently experiencing the crisis of many countries around the world.
Mexíco currently reports 82 cases to the United States's 4,661, but like the US is likely drastically undertesting. Regardless and even if there isn't a widespread outbreak, what has been a strong economy will be brought down by the reduction of visitors from the United States and Western Europe. After she told me about that, I was thinking about Cancín where I went each year for over fifteen years and the fishing and diving spots in Baja. You know that Cancún is a Spring Break hot spot for American college students, but the same is true particularly from the UK. That is essentially canceled this year, causing devastation to the Mexícan economy and its people.
No, ella no es una nueva novia. Pero ella me está ayudando a hacer lo que debería hacer hace mucho tiempo: aprender español.
...with a little help from Google Translate.
...the Capitol, the numbers, and the governor's guidelines after the jump...
BALLOT STATUS: We're getting closer...
Take the unprocessed ballots with a grain of salt as it relies on counties to update. Why I display this after the first report is a damn good question.
BALLOT MEASURE FAILURES: The Secretary of State's Office announced this morning that the return to the ballot effort by the California Association of Realtors to allow transfer of a property's assessed valuation to a replacement residence for homeowners 55 years or older or seriously disabled individual has failed. As the 25% of required signatures report was never filed, it was an abandoned measure. Also abandoned and formally declared as dead was the climate resiliency bond, although the Legislature may consider it for November in the very uncertain session ahead although the failure of the state education and many local bonds on March 3 have many legislators who ordinarily would support wary, and that was before the stock market crash.
Okay, deep breath...
cakeday and classifieds after the jump...
CAKEDAY: Happy birthday to Owen Jones, Sarah Poss, and Tisha Rylander!