Saturday, May 23, 2020

Covid-19 messages: scientists warn, but Trump still seeks 'miracle'


Gordon L. Weil

On Covid-19, Americans have been misled, lied to and confused.

In a crisis, people need clear, concise and authoritative messages from leadership. This crisis has lacked that.

At one extreme are politicians who put their careers ahead of the public good. At the other end are scientists, who must try to explain their complex work. In the middle are governors who seek to protect both public health and diverse state economies.

At the outset, President Trump dismissed the Covid-19 threat, because it threatened the booming economy on which his reelection depended. His ignorant assurances allowed the virus to spread unopposed. At this point, he may been engaging less in outright lying than in wishful thinking.

When it became obvious that Trump's “miracle” would not occur and the disease would keep spreading, Trump's new hope was that a ready cure would quickly stop it. Without evidence, he began to tout one medication after another.

The problem was that some proposed cures could be worse than the virus and might even cost lives. Though hydroxycholoquine carried warnings, Trump doubled down on advocating the drug and began taking it. “What harm can it do?” he asked. It could cause fatal irregular heartbeats.

Serious scientists were more truthful. Their warnings about the onset of the virus were ignored by the White House. Their efforts have focused on the need to stop the spread by protective measures and the time-consuming and detailed effort to find a drug to treat the virus and develop a vaccine.

Science has rules, because it produces facts. The rules require great care in order to provide great certainty. “Do no harm” is the first rule of medicine, so scientists must avoid rushing to conclusions that could mislead or, even worse, cause harm.

Politicians have fewer rules and produce fewer facts. That makes them impatient with scientists. In a crisis as big as Covid-19, the conflict breaks into the open. Unscrupulous politicians accuse scientists of having political motives, perhaps because they think everybody does.

Scientists do not usually lie or intentionally mislead. That puts them at a disadvantage in a political world. They must do their best not to alienate political leaders while defending their findings.

Trump's followers soon began to distrust them, because they did not follow the president's lead. They were politicized by their critics, some of whom argued that they lied to support the Democrats. Eventually, they faced a wave of politically inspired phony science.

Congress tried to save the situation. It appeared to believe that pouring out trillions of dollars would fund necessary research and reduce economic dislocation. But it put funds into the hands of Covid deniers or favored firms who could dip their hands into the cash flow as it passed to its supposed recipients.

Many Americans believed the fine promises and thought that massive federal spending would help them. Many are still waiting. They learned that even members of Congress who wanted to help them were misleading them and perhaps themselves.

Between the vast flood of federal misinformation and scientists who provide unwelcome forecasts are governors who are left with trying to protect their populations. But they also have to find ways to avoid protective measures destroying their economies.

While they struggle to find the right policy balance, they may send confusing messages. Increasingly, they have lined up by political party. Most Republican governors are more aggressive about reducing protection, repackaged as “opening” the economy, than are Democrats. Perhaps they reflect the political will of the more conservative states they serve.

One political rule is “when in doubt, don't do it.” A majority of people, confused and probably fearful, are not “opening” as fast as Trump and his supporters would like.

In the absence of clear and consistent presidential leadership, governors are left to develop policies for
both vulnerable people and local business. Most of them are probably sincere in their efforts and try to suit their constituency.

But the careful efforts of almost all governors of both parties have returned the crisis, in one view, back to the point where it began – from “miracle” to “magic.”

"And they [Democratic governors] think they're taking away Donald Trump's greatest tool, which is being able to go into an arena and fill it with 50,000 people every single time, right?” said Eric Trump, the president's son.

"So they will and you watch. They'll milk it every single day between now and November 3, and guess what? After November 3, coronavirus will magically all of a sudden go away and disappear and everybody will be able to reopen."

At last do we have a clear, concise and even hopeful statement on Covid-19?

Thursday, May 21, 2020

Covid-19: More questions than answers


Maine struggles to resolve doubts as policies evolve

Gordon L. Weil


We don't know a lot about Covid-19.

Our lack of knowledge results from the at least three facts: this is a new virus; scientific studies are difficult to understand; and people with political rather than technical credentials try to minimize the crisis or even find a miraculous cure through sheer will power.

We do know that the world faces a deadly virus that spreads easily, even from people who are unaware they have Covid-19. We also know we must rely on science to come up with solutions.

Some people, whose hopes and expectations are disappointed by scientific advice, simply reject it. Their views don't make science less true, but the delays and distractions they cause may impose an added human cost.

In Maine, only last week did the CDC to provide a running count of the new cases added each day. While it had provided cumulative data, it had not shown if the famous “curve” was flattening. It turned out that it wasn't.

It continues to provide gross numbers of cases by country and by age group, but does not show if the impact is disproportionate in any of them. As reported here last week, Cumberland County and people over 70 are suffering more from the virus than their percentage of the population would indicate

For obscure reasons, the Maine CDC refuses to provide data for each municipality. This makes Maine a national outlier. Maine counties are generally larger than those in many other states, so differences within a county could be great. Aroostook County, with only a handful of cases, is larger than the entire state of Connecticut, which publishes town data.

With better information, people would know more about any local need for protective action. Town governments could take steps appropriate to any enhanced needs.

Guidelines describe the conditions necessary to ease protective measures. But the Portland Press-Herald has revealed that opening in Maine has taken place without “key benchmarks,” set by the federal government and public health doctors, being met. Why? The economy over science? Politics over both?

Many people do not like government imposing restrictions on their daily life. They may fail to recognize that their actions in ignoring the threat may unknowingly increase the spread of the virus to vulnerable people.

The Maine CDC presents dry daily updates to a limited viewing audience, allowing journalists little follow-up questioning and leaving them to fill in the same blanks every day in their news reports. Depth and analysis are often lacking. Numbers can be numbing.

Do people need face coverings, which reduce the chance of passing the virus to others, provided they keep their social distance? The answer is unclear. Yet we know that, if everybody wore a face covering, the number of people infected by the virus would fall, probably to the point it would become manageable.

What about face masks, which differ from coverings by protecting users from the virus? When will they be available to more people and what efforts are being made to speed up the process?

Testing is touted as the solution. If everybody receives a test, we are told the virus should abate. Do tests really work? There are stories of false results. Will people submit to testing? The Washington Post reports than many won't. With the need for retesting, how many will we need?

Maine is tripling the number of tests, thanks to Idexx, a Maine-based company. The news could easily have given people the impression that anybody could be tested. But it takes a doctor's recommendation and probably having some signs of the illness.

A count of ventilators continues, and Maine seems to have more than enough. Why does keeping up the daily count matter, possibly providing a false sense of security? Doctors have been finding that ventilators may cause more problems than they are worth and many sufferers do not survive their prolonged use.

Both parties in the Legislature gave Gov. Mills extensive powers to deal with Covid-19, and she has acted to protect the state. At the same time, she has grappled with restoring economic activity for the summer in an economy that depends on tourism. Finding the balance raises issues that merit bipartisan debate.

So, why are former Gov. LePage and Republican leaders attacking her policies? Is LePage using Covid-19 to launch a new run for the Blaine House, as he has threatened?

Republican leaders often bring up Sen. Susan Collins in their criticism of Mills, though Collins has no state responsibilities. Has the GOP decided that opposing Mills' handling of the virus helps Collins' campaign?

Questions about the Covid crisis abound. People want answers. Waiting patiently for them may be the one of the toughest challenges posed by Covid-19.

Saturday, May 16, 2020

Say 'goodbye' to handshake; post-Covid-19 'next economy' won't be the same


Gordon L. Weil

Everybody looks forward to life after Covid-19.

The combination of strong protective measures and slowed economic activity cannot go on indefinitely. Even with Covid-19 as a threat, the economy cannot be suspended for many months.

Scientists warn about the threat of more Covid-19 outbreaks if “opening” moves too fast. Some supporters of President Trump say the scientists are lying, even about the current death rate. Economists wonder if the country can afford to wait indefinitely.

Some aspects of what is already called “the next economy” become increasingly clear. Here is what is likely:

New health restrictions will become a part of daily life.

More people will work from home.

Travel, from commuting to visiting clients, will be reduced.
The U.S. will depend less on imports for essential products.

Say “good-bye” to the handshake.

Without a “cure,” a two-tier society will be created.

Even before this crisis, remote work was known to yield greater productivity, less employer cost, more free time for employees and significant environmental improvement. Covid-19 has given more people the chance to learn about these advantages.

Some question whether the exchange of ideas would suffer from the lack of face-to-face contact. Others argue, however, that a lot of productive time was wasted in such contact.

Just as Amazon has reshaped shopping and Facebook has affected contact among people, Zoom or something like it may transform the remote work experience. When people can organize visual contact from a home computer, remote work may become far more routine.

Similarly, business travel will be reduced. Formerly, personal contact was seen as essential to making sales or closing deals. But managers have been learning that, forced to use remote contact, customers and clients accept it. The experience may now be extended even without the crisis.

One result should be fewer cars on the road. That automotive American revolution could improve both air quality and personal finances. Major insurers are now rebating some premiums as the number of accidents has decreased. Gasoline prices have tumbled with drivers purchasing less.

Though the future of air travel is less clear, it, too, will be transformed. Less business travel is likely. Perhaps airlines will be required to provide more space between passengers, boosting fares.

The U.S. will probably become less dependent on imports to meet essential needs. Vital medical supplies and other goods like computers cannot come primarily from countries who are America's adversaries or competitors. The relationship with China will change.

People have learned about the “supply chain” in which a product passes through several manufacturers, some of them abroad. The need to improve security will require shortening the chain, though it may mean forgoing some low-wage countries. Still, this is a form of national defense, which people generally support.

Domestic production should grow, though prices may rise somewhat. Security of supply has a cost. But achieving it may do more for the negative trade balance than today's tariff wars with the rest of the world. Slightly higher prices paid for local goods may end up costing customers less than increased tariffs.

The economy will almost certainly reflect a greater use of personal protection and more social distancing as a regular part of life. In Tokyo and elsewhere in Asia, people wear face masks for reasons of health, hygiene and social preference. That may become the way of the world.

Unless a successful vaccine is found, the virus will have emphasized that some people need special protection and cannot engage fully in life. Millions of older people and those with existing illnesses will need to accept less direct, personal contact and an almost certain dependence on face masks.

Governments may have to impose directives that meet their special needs. Separate hours for seniors at supermarkets and in other public places may become a legal requirement. People serving them may be required to wear face coverings. This could become a permanent part of life.

From these changes may arise a two-tier economy. With safeguards, most people may be able to take part fully in the new economic life of the country, even if that entails some degree of risk. As their involvement increases, the economy will revive. Such change will not take place at the same time all across the country but will reflect local factors and personal acceptance of risk.

The second group will be those who need or want a higher level of protection from Covid-19. For them, protective measures may be imposed on businesses and public services.

Of course, the elimination of the coronavirus as a massive health threat by a vaccine could restore full social contact. That could take years. Whatever the scientific outcome, the legacy of Covid-19 will survive and, life will never be the same.

Thursday, May 14, 2020

Advocates of Maine 'opening' belittle virus threat, but it could harm thousands


Maine CDC should provide better information

Gordon L. Weil 

The main argument of a legal case against Gov. Janet Mills' directives to protect Maine people is that the Covid-19 situation is not bad enough to warrant her actions. The economy should be “opened.”

The complaint misses four key points:

● Older Mainers are especially hard hit by Covid-19.

● Cumberland County, an economic center, has double the average virus impact.

● Maine's curve is not flattening.

● Some people may remain cautious, not boosting the economy, even if rules are relaxed.

According to the complaint, only a small percentage of the population is dying, so the state should be open. This theory is based on ignorance of the impact of Covid-19 in Maine, partly due to insufficient data and testing, plus back-of-the-envelope calculations.

The complaint amounts to saying that, if crime is low, police are not needed. No thought need be given to the role of the police in keeping crime down just as protective measures get little credit for limiting Covid-19 cases.

An unknown factor is the percentage of the population that has the illness without being aware of it. To be sure, they may be able to go about their business. But they are also able to spread Covid-19 to others who may not be so minimally affected.

The Maine CDC provides a daily scorecard on the illness. But its reports lack vital context. For example, as of last weekend, Maine CDC reported that 11.7 percent of the known cases involved people in their 80s. These people are only 4.9 percent of the state's population.

In short, Mainers in their 80s are 2.4 times above average in their likelihood getting Covid-19. Here is the table for all of the age groups used by the Maine CDC.

Age     Cases     Population     Proportion
<20        2.4%        21.0%           0.1
20s       10.9%       11.5%            0.9
30s       11.3%       12.0%            0.9
40s       15.4%       11.8%            1.3
50s       19.7%       15.0%            1.3
60s       16.2%       15.0%            1.1
70s       12.3%         8.7%            1.4
80s       11.7%         4.9%            2.4

The table shows that people in their 20s, 30s and 60s are just about as likely to contract Covid-19 as the average person. People under 20 are far less likely and people 70 and older are more likely. The data confirms that the older you are, the more vulnerable you are.

While those complaining about Mills' policies want the court to believe that only a tiny number of people would be affected, a calculation using the state's total population (population x share of 80s in population x share of 80s with Covid-19), shows that 7,641 Maine people in their 80s can be expected to contract the illness.

Older people succumb to the illness at a higher rate than others. According to the U.S. CDC, 59 percent of deaths from Covid-19 occur among people 75 and older.

In short, the case against Maine's efforts at protection, alleging a low incidence of death, targets seniors. The opponents implicitly accept that economic recovery is worth human lives, especially several hundred older Mainers. (Disclosure: I am an older Mainer.)

In an attempt to minimize the Covid-19 impact, critics suggest that the total state death rate has not increased very much. In other words, if there's little increase in the number of people dying, why worry about Covid-19?

This argument is false science. Its proponents have no idea about what drives the general death rate and how it has varied, under a wide range of influences, over the years. It's like saying a little snow a few days ago proves that the climate has not been growing warmer over decades.

Maine CDC reports the number of new cases each day and the cumulative number. To see the trend line of new cases over time, the best source is the New York Times. It shows the famous curve that needs to flattened so that health care is not over-stressed. Because Maine's curve is rising, it is not as encouraging as the lawsuit would make it seem.

While Maine CDC reports cases by county, similarly to the age question it does not determine how hard hit counties may be. By last week, Cumberland County had 48.7 percent of the known cases, but only 21.8 percent of the population. People there were 2.2 times more likely to contract the illness than the state average.

Daily reports may have led people to shrug off the Cumberland County numbers as being normal for the state's most populous county. Obviously, it was far from “normal.” Only two other countries joined Cumberland as being especially vulnerable – York (1.2 times) and Waldo (1.2 times). The discussion of the virus' impact never mentions this fact.

Mills relaxed rules in all but four counties, which had community spread. Along with Waldo, Kennebec saw requirements eased , though it had more cases than Androscoggin, still under higher protection. Presumably, the heavy loads in Waldo and Kennebec were due to effects at single sites.

The governor's order, which splits the state into two zones, contains a border problem. People in one county, living close to a relaxed rule county, can drive a short distance and go shopping relatively freely in stores that would be closed in their home county.

The border problem is obscured by the failure of the Maine CDC to provide Covid-19 impact information by municipality. Unlike other states, it declines to issue this information, making it seem that it is inappropriately trying to manage the public. This information could both aid local officials in supporting state efforts and warn residents where greatest caution is needed.

Asked about the stay-at-home rule, Mills seemed to say that it was still in effect. If a non-essential business could open but people could only leave home for essential purposes, there would be no use in opening non-essential businesses. This conflict needs to be resolved along with the border problem. Obviously, the stay-at-home rule will be honored in the breach.

It's possible that only truly isolated areas can have different rules. Maybe that's why Maine can relax its rules faster than other New England states. Relatively isolated, it is the only state bordering on only one other state and Mills' 14-day quarantine for new arrivals discourages the flow from elsewhere in the U.S. The border with New Brunswick and Quebec is effectively closed.

Morning Consult, a national polling organization, has added one more piece of data – consumer confidence by state. It plummeted in all states in mid-March when the impact of Covid-19 became well known.

Since then, some states have eased restrictions. Yet, in no state, notably those that have lifted tough rules or never imposed them, has consumer confidence in the economy recovered appreciably. Maine has gone from a March 1 rating of 111.3 to 74.9 on May 1, third lowest in the country.

The clear message is that governments may relax protection in an effort to restore the economy, but the real decision will be made by the people. They need to feel more comfortable about threats to their health before they will take advantage of all economic opportunity.

To help them make their decisions, people need more information. Maine CDC can do better.

Friday, May 8, 2020

Leaders, including Biden and Trump, challenged as women gain power


Gordon L. Weil

The final field exercise in Marine Corps basic training was the one time men and women recruits trained together. The task was to carry heavy ammo cans across a rope bridge.

A young man was in charge. A young woman trainee suggested to him how to move the cans without a person having to bear the full weight. The men were strong enough to do it, he said, and rejected her idea.

When the men struggled, she grabbed a can and showed them how to do it. They followed and the cans were moved in time, according to the New York Times story. Later, the designated leader told her, with what the reporter called “a tinge of humor,” that “the females can sometimes think.”

Congress had passed a law ending gender-segregated Marine basic training. But Marine generals still interpret the law to allow dual systems.

The story teaches a couple of lessons. First, there is a “dark state” in which unelected government officials pursue their own agendas. Critics may worry about anonymous liberal bureaucrats, but it turns out some of them are Marine generals.

The second and more important story is that women must be recognized. This case was a simply matter of brains over brawn. In a broader sense, the historic domination by men has to give way to the equality of the sexes.

This is the major change that society in many parts of the world is undergoing. Canada, the U.K., Germany, Australia, New Zealand, Liberia, Chile, India, Israel, Denmark, Norway, Finland, Iceland, Ireland and Belgium have all had women leaders.

But not the U.S. Some criticize Joe Biden, the presumed Democratic nominee, for narrowing his vice presidential choice by vowing to select a woman. He may see picking a woman as the best way to be sure that his successor will be the first woman president.

But Biden faces his own problem relating to women. Public opinion demands close scrutiny of the hidden history of some men using their power to sexually exploit women. Tara Reade, a former member of his Senate staff, now accuses Biden of sexual harassment in 1993.

Like many other such cases, it is probably impossible to verify the charges by direct evidence. Instead, information about the behavior of both the accuser and the accused may influence judgments about the truth. Each person applies her or his criteria or opinions in evaluating the available information.

When he testified on his nomination to the U.S. Supreme Court, Brett Kavanaugh faced a charge made by Christine Blasey Ford about his alleged abuse of her. He heatedly denied the charge, and it was left to each senator to make a judgment. The Republican Senate confirmed the nominee of a Republican president.

Direct evidence was lacking. Not lacking was the clear evidence of Kavanaugh's angry and undisciplined reply. Senators might have opposed his appointment, not because of the Ford charge, but because of his intemperate response, displaying demeanor far below what is expected on the Supreme Court.

Biden's response also raises concern, though for the exact opposite reason. After Reade made her charge, Biden did not immediately provide a personal response and or make all his records available. He did not subject himself to any questioning. His slow reaction allowed suspicions to be raised. Does this say anything about his conduct as president in a crisis?

Should Biden get a pass because he is running against Donald Trump, against whom there is evidence of sexual abuse? After all, it might be argued, we need urgently to defeat Trump and Biden is nowhere nearly in the same league.

That is the kind of judgment people will have to make. The truth about Reade's claim may never be known, but Biden could have helped himself and shown more respect for women, if he had been prompt and forthright in his response.

The media is also implicated. Trump's exploitation of women was revealed during the 2016 campaign and since he has been in office. But he never conceded any charge and forgave himself for his own words.

The media recognizes that Trump was elected despite his record with women, They have allowed the election to let the issues fade. Meanwhile, they demand that Biden come completely clean about any possible charges Reade may have filed 27 years ago.

Fair enough on Biden. But this is a new presidential campaign. Every time the media makes demands of Democratic candidate Biden, it should be making the same demands of GOP candidate Trump. The new campaign should not mean he gets a free pass just because he is president.

Thursday, May 7, 2020

Politics the biggest problem in fighting Covid-19; Maine becomes battlefield


Gordon L. Weil

The biggest problem with combating Covid-19 is not the struggle of science to come up with an answer. It's politics.

The coronavirus is now the center of a war by the ideological right, led by the Republican Party, and against efforts, led by many governors of both parties, to let science set the pace of recovery.

The anti-protection forces are composed of three elements, whose apparent purpose is to support reopening the economy, even if that means sweeping aside measures that have worked in limiting the spread of Covid-19.

First, there are believers that personal freedom beats any common interest. They see government action to shut businesses, limit free movement and mandate wearing face coverings as illegal invasions of what should be their unfettered rights.

Second are right-wing opponents of issues from gun control to immigration who seek to exploit an opportunity to strengthen their movements. They may be able to tap into new pools of people who could share their views. And current Covid-19 policies, like shutting down immigration, might help their cause later.

When the list of “essential” businesses that could avoid a shutdown was published, the gun lobby noted the lack of gun shops. After it was belatedly added to the federal list, Maine GOP legislative leaders asked Gov. Mills to do the same. She did.

Third are Trump Republicans, who oppose governors undertaking necessary but unpopular measures, as a way of rebuilding support for President Trump and other Republicans. By making reopening their cause, they hope the economy kicks back into high gear, an essential element of the Trump campaign and helpful to Republicans riding his coattails.

Now Maine Republican leaders want the Legislature to come back and strip Mills of the emergency powers they joined in giving her by voice vote when they left Augusta. Their claim, refuted by the governor, is that she did not consult them sufficiently.

They did not attempt to create a bipartisan group, but made the appeal purely partisan. They apparently figure that opposition to the stay-at-home, wear-a-mask rules will grow to a point that Mainers would line up with the GOP in favor of reopening and re-elect Susan Collins and even Trump.

With their emphasis on economic values over health risks, some opposition groups either inaccurately assert that the overall death rate has not increased or argue that added Covid deaths are the reasonable price for people getting back to work. At the same time as the Trump administration pushes reopening, it openly recognizes there will be a major increase in cases and deaths.

Many governors, ranging from Janet Mills in Maine to Jay Inslee in Washington, emphasize the health of their citizens and follow the warnings of science about the risks arising from an unknown and deadly illness. Their states have produced better health results than others that are more politicized.

Their opponents want to exploit unhappiness with their tough measures. Opposition is also based on a desire to distract attention from the failure of the federal government and some states to be prepared for the crisis or to react to it in a timely and appropriate manner.

The federal government should have been better prepared. Its reserve of medical supplies was supposed to be sufficient to meet emergency national needs. A presidential administration in office for three years cannot blame earlier presidents when it has done nothing, even after having been warned.

Instead, it simply changed the role of the national reserve by stating it was meant only as a backup to the states. The market power of the federal government in buying needed medical supplies was lost, forcing states to compete with one another and other countries with poor results.

In 1951, the Epidemic Intelligence Service was created. It is composed of thousands of trained medical personnel who know a lot about handling a crisis such as the U.S. now faces. It includes “disease detectives.”

Its policies suggest that there should be a single, reliable spokesperson. That person, who must convey bad news and tough rules, should be a scientist, not a politician. By having a single spokesperson, the message can be conveyed clearly. And this person should always show compassion and sympathy.

Maine does well in following E.I.S. practices. Dr. Nirav Shah, the state CDC director, is the spokesperson. Mills does not offer medical opinions but explains what she is doing, using the powers given her by the Legislature. While Shah appears daily, she does not.

Contrast Maine with the daily federal briefing, usually dominated by Trump. There are several spokespersons and they contradict one another. At first, Trump downplayed the threat, hoping, using his word, that he could be the “cheerleader” for an early recovery, helpful to his reelection. He displays ignorance of science and research. Politics matter more than health.

Covid-19 can be brought under control, even without a universally effective medicine or a vaccine, by limiting the spread so that its dwindles. That can be done by everyone wearing a face covering. But it takes time, full participation and keeping the effort out of politics for that to work.

Politically, it takes some courage to require compliance. It is more appealing to favor unfettered freedom.

The opponents of fighting the spread have raised the issue. By advocating rapid reopening, they have also raised the stakes. In the end, it's up to each person to decide.