Pandemic mode, episode 6

First, the haps:

-Neuse Correctional in Goldsboro, NC made national headlines after 465 (and counting) inmates tested positive for the virus. A number of other prisons, nursing homes, and factories (especially meat-processing plants) across the country also reported major outbreaks, increasingly in rural areas.

-Georgia, South Carolina, and Oklahoma were the first states to dip their toes into the hazardous waters of relaxing restrictions this week. This, while many states including Georgia are still seeing a rise in new cases and testing capacity remains inadequate across the entire country, raising concerns about the inability to detect new hotspots before they get out of control.

-The West Coast states, which took the first aggressive social distancing measures (which are all still in place), have been the only states to not just flatten, but bend the "curve" of new cases downward.

-Confirmed US cases are just under 1 million and deaths right at 50,000-- with the true case count certainly in the several-million range accounting for inadequate testing.

-Far-right Brazilian president Jair Bolsonaro continues to minimize the impact of the coronavirus, and his country has only developed the capacity to test a mere 6,700 people per day. Meanwhile, hospitals and morgues there are starting to overflow. The only conceivable near-term scenario is a fate worse than Italy's, even if the country were to magically get their act together this week-- which appears unlikely.

-Testing continues to lag throughout much of the rest of the world. But whatever the numbers may show, it's a fact that the virus is making its presence more felt in developing countries, and that the worst is definitely still to come for the poorest nations.


On the political front:

-Trump's public musings about injecting people with bleach, instilling it into their lungs, and opening up their bodies to expose the virus to UV light prompted a huge backlash from across the political spectrum. The embarrassing episode appears to have finally put an end to his nightly 2-hour televised "briefings." Which is the best news I've heard in weeks.

-As the weeks turn into months, Trump's inadequacies have become only more obvious. The brief and anemic bump in support he received in March has already evaporated, leaving his support back at his baseline of 43%, and below 50% in all the swing states he needs to stay in office. Progressives are starting to truly hope against hope that this year's election will be a good one, while preparing for the worst tactics of voter suppression that Republicans can muster.


And on the home front:

-Eliza rolled from front to back for the first time this week, and continues to increase the complexity and frequency of her vocalizations. She's going to be a talker!

-Mindy and I had stone steps put into our side gardens this week, and they look great. The gardens are taking nearly all of our free time, but that's been a nice stress reliever. Photos coming soon.

-My knee is feeling better, but I haven't tried to run yet. I'll probably start moving that direction in another week.


Stay patient, everyone-- as you all know, we aren't through this by any stretch of the imagination. But despite all the bad news, good things still happen every day.

Be well.

Pandemic mode, episode 5

This week's biggest stories involved the protests against shelter-in-place orders in several state capitals (including N.C), which Trump tweeted his support for despite the recommendations from his administration that those orders not yet be rescinded. I think most people recognize these protesters (some of whom intentionally disregarded physical distancing ordinances) are idiots. But the numbers are starting to bear out that significant numbers of people are not taking physical distancing seriously enough. For one, N.C.'s number of new cases per week actually increased last week despite my hope last week that it was plateauing. And similar things are happening in many other places around the country, urban, suburban, and rural. Though case numbers are not exploding most places, the R-naught is still above 1 in many locales-- and we STILL don't have enough testing capacity to know even a ballpark figure on numbers of true cases. Though officially around 730,000, I'd bet that well over 2 million have actually contracted the virus.

Which brings me to the question: when to relax restrictions. The biggest limitation in our ability to relax restrictions is our testing incapacity. Hotspots will be missed for too long if we open up in the next few weeks before we have the ability to test enough people with enough frequency. And since new cases are still increasing week-to-week in many parts of the country even with our current restrictions, there's no question that many locales will see a major surge in new cases if enough people stop physical distancing. So in my mind, most of us have another month of this before we can even think about turning the lights back on.

I'd also like to offer my thoughts on the initial $2.2 trillion stimulus package, and the upcoming packages that are currently held up in Congress. Firstly, it's startling how quickly we burned through that much money. It's also frustrating that so much went to corrupt big business, and that basically no strings were attached-- but I get that they just wanted to get the money out the door to avoid widespread bankruptcies. The Community Care Clinic and several of my friends have benefitted from the relief package, so even though my job hasn't been hit, the stimulus does hit pretty close to home. Hopefully the next bill(s) will be more small-business- and environmentally- friendly. And it seems obvious that people and businesses will need much more money from the federal government over the coming months to keep the lights on and food on the table.

It's remarkable that Republicans have been so willing to pass large stimulus packages this time around after rebuffing Obama for additional aid after the initial $1 trillion package was passed in 2009. The obvious reason for the difference is that they wanted Obama to look responsible for a shaky recovery, while they certainly want to give the economy every chance to get back on track by November for political reasons (ie to effect Trump's reelection and Republican congressional victories). It's also remarkable that there are essentially no public voices condemning the aid, except probably a few hard-core libertarians. This belies the libertarian case for pure free markets. If we didn't have a government that could send out checks right now, the entire economy would crash and burn, with an enormous human toll. Much as my former self hates to say it, we desperately need the government right now. Although we will have to pay the price in the future.

It's simply cruel that Trump (who still has no coherent plan to face this crisis and whose approach has been to assume that nature will simply bend to his will, then blame everyone else when things go poorly) is in charge of said government, rather than someone like Elizabeth Warren who came up with a very impressive plan back in JANUARY. If we could roll the tape back to January and put her in charge, literally thousands of dead Americans would be alive today, billions of dollars would have been saved, and we would not be facing many more weeks of physical distancing. Once you read her plan, you'll realize that what I just claimed is as close to a fact as one can get in the realm of hypotheticals. The inadequacy and incompetence of the Trump administration's response remains staggering, and it's not getting any better with time.

Politically, Trump disastrous response to the pandemic has the significant potential silver lining of making him less likely to be reelected in November. Millions of people and the economy as a whole will almost certainly still be suffering no matter how many bills get passed. And the economy in the 6 months leading up to an election is the most important factor in whether a president gets reelected. I hate to get my hopes up about the Senate flipping to Democrat, but I am saying there's more of a chance for that, too. If someone like Corey Booker rather than Joe Biden was the nominee, I'd feel even better about the chances of those things coming to pass.

Stepping off my political soapbox... it's been a nice week around here. I had the whole week off, spent a lot of quality time with the baby, and Mindy and I got a lot done around the house. The vegetable garden is getting off to a good start, the mulch is getting spread, and we are having rock steps put into our side gardens, which has been one of Mindy's dreams since we moved into the house. We've enjoyed watching Boone UMC's live-streamed services every Sunday, and are keeping up with people pretty well with phone calls and video chats. Things have settled into a rhythm. And I've had a little time to literally dream and engage in a few Active Imagination sessions-- more of that to come shortly! 

Stay well, stay calm, and keep up that physical distancing.

Training update

As you can tell from the graph above, I spent the winter upping my running game and neglecting the bike, in preparation for the "Mortimer 100" relay running race on March 14th. Leading up to the race, I was feeling fit and had high hopes for my performance. But one thing I had noticed during my runs was that my iliotibial (IT) bands would consistently start hurting right around the 6 mile mark on runs-- which is what I limited my running distance to. Unfortunately, I was assigned three 7-mile sections of the race.

Sure enough, my IT bands started hurting with about half a mile left on my first leg. Despite massaging them as much as I could during my rest, they started back shortly after I started my second leg, and got worse... and worse... and worse. After alternatively walking and jogging for a couple miles, I threw in the towel. It just wasn't meant to be.

Though it was bad enough that I had to have other runners finish my portions of the race, the right knee pain I have experienced over the past month since the race has been much worse. I seem to have developed a moderate to severe case of patellofemoral pain syndrome, and am unable to run or do many of the other exercises I like to do. Fortunately, I've still been able to bike some, which has ticked up in the past month as you can see. I've also started doing daily rehab exercises to strengthen my quads, which I'm convinced is the underlying issue. But with the amount of pain I'm still experiencing, I anticipate it will be at least another month before I can start running again. I'm just going to have to be patient!

Taking my injury into account, and considering that triathlons may be cancelled anyway this year because of COVID-19, I've transitioned to thinking of this year as a rebuilding year. I'm going to rehab the heck out of my legs, and be stronger than ever this time next year. My IT bands have plagued me since high school, so I know that getting my legs stronger is not going to be a quick process. But if I'm ever going to complete a half-ironman, half-marathon, relay race, or any other long-distance running, I'm going to have to put forth the effort to get beyond this limitation.

Am I a little disappointed? Sure. But I'm also thankful that the relay race brought to my attention a nagging issue I would have needed to address sooner or later anyway... and that I hadn't yet signed up for any races or even purchased my yearly USAT membership yet. Plus, cutting back on triathlon training opens my schedule up for more kayaking!

I do wish I could still swim, especially on workdays, but it looks like the river is my only option until local pools open up again. As with many things over the past month, I've had to be flexible and adapt! And with this issue, I mean that quite literally.

Hopefully in another 16 weeks, I'll have good news about my leg. Who knows, maybe I'll be able to finish a sprint triathlon later in the year. Time will tell! Be well, everyone.

Pandemic mode, episode 4

The curves are flattening. Not everywhere, and not soon enough-- but it's happening. New York and New Jersey are seeing staggering losses, but not quite the knock-out figures that had been feared. Though many community hospitals are full to bursting and refrigerated trucks keep filling up with bodies, the "death panels" and ventilator-sharing many feared have not been required, and the main emergency hospital in NYC that was set up in a convention center is not even close to capacity. Unfortunately for many places in the country, the infection rate is still so high that shelter-in-place orders will need to stay in effect for many more weeks until it will be safe to start loosening restrictions.

The crisis is hitting the poor and weak the hardest-- as all crises tend to do. Outbreaks in New York and New Jersey nursing homes alone have already claimed about 2,000 lives, while homeless shelters across the country are experiencing disasters on a similar scale. Poorer neighborhoods, where population density is the greatest and the ability to physically distance is the worst, are being disproportionately affected. And hotspots in developing countries like Ecuador are starting to show the world how horrendous COVID-19 can make things: completely overwhelmed systems, people dying without even the semblance of medical care, bodies lying in bedrooms and on sidewalks for days.

Close to home, North Carolina is starting to see a reduction in the daily case count-- as illustrated in the darker blue line in this graph:

Thanks to prompt action on the part of Governor Cooper, we have been spared a big initial wave, giving us the time to build up testing capability and await clinical trials. At Watauga Medical Center, our turnaround time for a COVID-19 test is now just under 48 hours-- not great, but a lot better than the 5-7 day period we were dealing with a few weeks ago. And we have yet to see local transmission in Watauga County, thanks to our proactive local health department.

With those updates out of the way, lets reflect a little on Bill Gates. His Ted Talk from 2015 predicting a pandemic just like the one we're facing and laying out all the steps we needed to take to be ready for it has gone viral over the past few weeks. He was just interviewed on a new Ted Talk, and the gist of that discussion was that no one took his advice and we were totally unprepared, so... told ya so? Or.... maybe listen to one of the smartest people in the world the next time he gives a Ted Talk? 

It's hard to imagine that Bill Gates' recommendations were not heard by some in the federal government's bureaucracy. He's freaking Bill Gates, who along with his wife runs one of the largest charitable organizations in the history of mankind and is almost single-handedly wiping polio off the face of the earth. When he talks, smart people listen. But if you listen to the talk closely, you can tell that he realizes his prescriptions are a tall order, politically speaking. But nothing in the talk sounds all that hard to implement, other than finding the motivation to commit to it in the first place. 

Furthermore, you'd think we would have learned over the last few decades that Black Swan events are actually quite common-- and that we ought to prepare for as many of them as we can. Events like 9/11, the Great Recession, the Fukushima meltdown, and Brexit were all massive shocks at the time. Further back, the world wars, oil tanker spills, and the sinking of the Titanic are just a few other examples. The problem is that our lives are affected by them so much afterward that they don't seem that unexpected in retrospect. 

We can all plan for crises in the future by stocking up on essential supplies and gaining as many practical and survival skills as we reasonably can. But the government (I hate to say, as a recovering libertarian) is obligated to play a pivotal role in preparing society by taking steps that no one in a free market would take, but which will be critical in preventing and dealing with future crises. In addition to preparing for pandemics, governments should get out in front of AI technology in a way they have certainly not with Big Tech to date. There are plenty of steps that should also be taken to mitigate the risk of nuclear war, accidental nuclear detonations, and conventional wars. And climate change remains the greatest and ever-growing threat to our planet and human civilization. Yet lawmakers continue to dawdle and allow petroleum industry- financed Republican lawmakers to cast doubt on the very present reality of climate change with endless specious arguments. And every day, the planet heats up a little bit more.

I have grave doubts that our government can ever get out in front of any of these issues-- at least the way it is currently structured. Like Ezra Klein and Elizabeth Warren, I believe-- I know-- that "big, structural change" is critical if we are to be able to address the challenges we now face and those which are just around the river bend. These issues transcend any particular electoral cycle-- but nevertheless, each election is critical if we are going to be able to thread all the needles we need to thread at the same time and come out intact on the other side. Though I have doubts that Joe Biden is the right person to lead us into these changes, I know that until Donald Trump is out of office, every day that passes is precious time-- critical, life- and planet-saving time-- that is irretrievably lost. 

So although I didn't intend for this post to get political, here we are again. If you're an American eligible to vote and residing in a swing state (like North Carolina), perhaps the best thing you could do for the country and for the planet in 2020 is to vote for whoever has the best chance of beating Donald Trump. If enough people do that, we may start getting ready for coming crises before their waves crash upon our shores. 

Until next week, stay calm and self-isolate on.

Pandemic mode, episode 3

As expected, New York City exceeded 100,000 confirmed COVID-19 cases this week, and fully descended into Coronavirus hell. Watching the train wreck from afar, I could still feel a bit of the pain from the overwhelmed hospitals, doctors, nurses, and morgues-- and the heartbreak of thousands of personal tragedies. Obituaries of prominent people have started to appear. Shortages of ventilators, PPE (personal protective equipment), and beds are becoming acute, and testing shortages continue to plague the health system.

A silver lining is that the doubling time in the US increased from 2.5-3 days to 5-6 days. Most places are starting to see the effects of social distancing measures started 2-3 weeks ago. Though North Carolina confirmed about 1,500 cases this week, that is hardly an exponential rise from the nearly 1,000 cases the week before. Hopefully new confirmed cases will actually number less than 1,500 this week, but we'll see.

Watauga County, and a great many counties like it, has seen a few imported cases but is yet to see local transmission. With over two weeks of social distancing now under our belts, it seems that we passed the first test. The virus did not catch us unawares. Hopefully we will develop the ability to rapidly test for the virus here in the coming week, since it's inevitable that, sooner or later, local transmission will start to occur. But hopefully it will be a low rate of transmission, and we will not need the capacity we have developed at the hospital to deal with a huge influx of Coronavirus patients.

Confirmed US cases now exceed 300,000, though I suspect the real number is at least twice that when accounting for testing delays and untested cases. Soberingly, that represents only 0.1-0.2% of the population, while many experts predict over half the country will contract the virus before it burns itself out or a vaccine is available. With aggressive measures and improved testing, I'm not convinced that's necessary, and hold out hope that a relatively small minority of Americans will contract the virus before we have a vaccine. But again, we'll see.

Despite all the continued uncertainty, many things started to become clear this week. New Jersey, Chicago, New Orleans, and Miami have emerged as the next epicenters of the crisis. Smaller but more concentrated hotspots in the town of Albany, Georgia, and towns in Colorado, Connecticut, and Idaho, exemplify the danger the virus poses to communities of all sizes. A pattern of flare-> social distancing -> curve-flattening -> relaxation of restrictions -> resurgence seems to be emerging from Asia, and I'm sure we will see that pattern start to play out in the coming two months.

Italy's crisis peaked last week and started to improve, though thousands of new cases are still emerging there every day and their nationwide lockdown will continue to be enforced for at least a couple more weeks. A report also came out that the virus has a rapid 4 day average serial transmission time, and that asymptomatic transmission accounts for a disturbingly large percentage of the transmission, making social distancing an absolute imperative and public mask-wearing a very good idea.

Calls for a relaxing of restrictions in relatively spared regions will start to arise in the coming weeks. In fact, a few midwestern and southern states like Alabama, Iowa, and the Dakotas still haven't ordered residents to shelter in place, though that will change if a hotspot emerges in one of those locations. Which seems inevitable. As our ability to rapidly test becomes a reality, hopefully we will see the emergence of a smarter, more targeted approach to social distancing. Until then, stay calm and self-isolate on.