Thinking the Impossible

So another week in lockdown began, but at least no true patriots have started firebombing Chinese homes and businesses out here just yet. Still, people were being careful:

Gun shops around the San Gabriel Valley that cater to Chinese immigrants report a surge in business as customers grow increasingly anxious about their personal safety with each day COVID-19 widens its reach in the U.S.

Gun Effects, where Chang was shopping, said its customer base has jumped from half Chinese to about 70%. Arcadia Firearm and Safety reports a tenfold increase in business. Rowland Sporting Goods estimates sales are up 500%.

This isn’t just happening in Southern California, according to The Trace. Gun shops in Washington State, which has the highest number of coronavirus deaths in the U.S., are also seeing increased traffic from customers of Chinese descent.

Why would that be? Don’t be naïve:

Office clerk April Zhao came to Gun Effects with her father, whom she said was eager to buy a gun because all his friends were doing it. The Rancho Cucamonga resident said she herself was scared that she would be physically attacked for being Chinese because the coronavirus originated in the city of Wuhan.

“So I have to protect my family and my son,” Zhao said.

Has she experienced any racism so far?

“Not yet,” she said. “I just see the news.”

Everyone has seen the news. Old men who retired to Florida, or stayed home in Pittsburgh or wherever, bitter and angry and armed to the teeth – the oldest NRA cohort – post on Facebook that they’ll shoot to kill anyone who threatens their hoard of toilet paper, which is really their way of life, and then post that they’re really just kidding, and then post again that they’re not really kidding at all. And then they post again to praise Jesus. These are odd times.

But this week then got odder:

President Trump on Monday said he is considering scaling back steps to constrain the spread of the coronavirus in the next week or two because of concerns that the impact on the economy has become too severe.

But loosening restrictions on social distancing and similar measures soon probably would require him to override the internal warnings of senior U.S. health officials, including Anthony S. Fauci, who have said that the United States has not yet felt the worst of the pandemic, according to several people with knowledge of the internal deliberations.

Trump said at a news conference Monday night that at some point soon the damage being done to the economy could be worse than the threat of the virus spreading further.

Sure, tens of thousands of people will die if he calls off all the quarantine stuff, but the quarantine stuff is destroying the economy if not the country itself. It’s one or the other, except for this idea:

He said the decision could be based geographically with areas of the country with a low number of positive cases moving back to a normal routine while areas such as New York remain under restrictions.

That might mean that not quite so many people would die, so the question might come down to how many we kill to keep the economy from dying, and everyone saw where he was going with this:

“America will again – and soon – be open for business,” he said. “Very soon, a lot sooner than three or four months that somebody was suggesting. A lot sooner. We cannot let the cure be worse than the problem itself.”

When asked if he would make the decision to loosen social-distancing recommendations even if it went against the advice of federal public health officials, Trump said: “If it was up to the doctors they might say shut down the entire world.”

Trump later said he would consider the advice of Fauci and other public health officials before making a decision.

That is, he knows best, they do not, or they do know best, but he might overrule them, because he knows best, or something or other. And that called for an analogy:

He compared the effort to combat the virus to auto accidents.

“You look at automobile accidents, which are far greater than any numbers we are talking about,” Trump says. “That doesn’t mean we are going to tell everybody no driving with cars.”

No, it was time for a private intervention:

Fauci, the director of the National Institute of Allergy and Infectious Diseases and a member of the president’s coronavirus task force, and other leading public health experts have told administration officials and Republican lawmakers that prematurely scaling back social-distancing measures would hamper efforts to mitigate the virus and would devastate hospitals, according to the people with knowledge of the conversations, who, like others, spoke on the condition of anonymity to describe the private deliberations.

More than 40,000 people in the United States have tested positive for the coronavirus, a number expected to significantly increase in the coming days and potentially overwhelm the nation’s health-care infrastructure.

So what? They were too late:

The push to reopen parts of the economy has gained traction among some Republican lawmakers in both the Senate and the House, said two people with knowledge of the matter.

Conservative economists Steven Moore and Art Laffer have been lobbying the White House for more than a week to consider scaling back the recommendation that restaurants, stores and other gathering spots be closed, although exactly what that would entail remains unclear. Leading Wall Street and conservative media figures have also embraced the idea.

Trump has begun canvassing his advisers, GOP senators and other allies about what his course of action should be, according to a senior administration official. He is worried about the impact of soaring unemployment numbers and severe economic contraction on his 2020 reelection bid, and fielded phone calls for much of the weekend from alarmed business leaders.

He remains fixated on the plummeting stock market, is chafing at the idea of the country remaining closed until the summer and growing tired of talking only about the coronavirus, one person said.

In short, he’s had enough of this boring pandemic nonsense and he wants to get back to getting reelected, as is his right, so he sent out the tweet that said it all:

Trump signaled his concerns with the outbreak restrictions and the economy in a tweet late Sunday night.

“WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF,” Trump said. “AT THE END OF THE 15 DAY PERIOD, WE WILL MAKE A DECISION AS TO WHICH WAY WE WANT TO GO!”

And that worried a few Republicans:

“It would be a major mistake to suggest any change of course when it comes to containment,” Sen. Lindsey O. Graham (S.C.), a close ally of Trump, said in an interview. “I just spoke with Dr. Fauci – he believes that, if anything, we should be more aggressive and do more… You can’t have a functioning economy if you have hospitals overflowing. People aren’t going to go to work like that.”

Graham was pretty much alone here. Fauci decided it was time to humor the big guy:

Health officials have said there needs to be some flexibility on the restrictions even as they have argued for robust social-distancing measures to be put in place.

“There is a discussion and a delicate balance about what’s the overall impact of shutting everything down completely for an indefinite period of time. So, there’s a compromise,” Fauci told Science magazine in a recent interview. “If you knock down the economy completely and disrupt infrastructure, you may be causing health issues, unintended consequences, for people who need to be able to get to places and can’t. You do the best you can.”

Others would not humor Trump:

Public health experts are strongly warning against the idea of loosening social distancing measures. Marc Lipsitch, an epidemiology professor at the Harvard T. H. Chan School of Public Health and director of Harvard’s Center for Communicable Disease Dynamics, said “every well-informed infectious epidemiologist I know of” believes the United States should be tightening the restrictions.

“We haven’t yet even seen signs that the growth is slowing, much less reversing. Now is the time to tighten restrictions on contacts that could transmit the virus, not loosen them,” Lipsitch said. “If we let up now we can be virtually certain that health care will be overwhelmed in many if not all parts of the country. This is the view of every well-informed infectious epidemiologist I know of.”

But pressure is also mounting on Trump from top business leaders and conservative media outlets alarmed about the effect on the economy.

He’s getting hammered from both sides. Let the old and the weak and the unlucky die and save the nation! Save your big business buddies and you will have the blood of millions on your hands! Which will it be?

And then there’s his personality. The New York Times’ Maggie Haberman reports on his anger and ego:

President Trump has praised Dr. Anthony S. Fauci as a “major television star.” He has tried to demonstrate that the administration is giving him free will to speak. And he has deferred to Dr. Fauci’s opinion several times at the coronavirus task force’s televised briefings.

But Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases since 1984, has grown bolder in correcting the president’s falsehoods and overly rosy statements about the spread of the coronavirus in the past two weeks – and become a hero to the president’s critics because of it. And now Mr. Trump’s patience has started to wear thin.

So has the patience of some White House advisers, who see Dr. Fauci as taking shots at the president in some of his interviews with print reporters while offering extensive praise for Mr. Trump in television interviews with conservative hosts.

It’s an old Hollywood western. “This town isn’t big enough for the two of us” as John Wayne draws his gun. And those White House advisers want that showdown, but nothing is that easy:

Mr. Trump knows that Dr. Fauci, who has advised every president since Ronald Reagan, is seen as credible with a large swath of the public and with journalists, and so he has given the doctor more leeway to contradict him than he has other officials, according to multiple advisers to the president.

When Mr. Trump knows that he has more to gain than to lose by keeping an adviser, he has resisted impulses to fight back against apparent criticism, sometimes for months-long interludes. One example was when he wanted to fire the White House counsel, Donald F. McGahn II, in 2017 and early 2018. Another was Jeff Sessions, the former attorney general. Mr. Trump eventually fired both when he felt the danger in doing so had passed.

So far, the president appears to be making the same calculation with Dr. Fauci, who was not at the briefing room podium on Monday evening. When asked why, Mr. Trump said he had just been with Dr. Fauci for “a long time” at a task force meeting.

“He’s a good man,” Mr. Trump said. Dr. Fauci was scheduled to be on Fox News with Sean Hannity a short time later.

That’s the kiss of death. Trump will wait until the danger to him has passed and just fire Fauci – but not now. For now, this is just tricky:

Dr. Fauci and Mr. Trump have publicly disagreed on how long it will take for a coronavirus vaccine to become available and whether an anti-malaria drug, chloroquine, could help those with an acute form of the virus. Dr. Fauci has made clear that he does not think the drug necessarily holds the potential that Mr. Trump says it does.

In an interview with Science Magazine, Dr. Fauci responded to a question about how he had managed to not get fired by saying that, to Mr. Trump’s “credit, even though we disagree on some things, he listens. He goes his own way. He has his own style. But on substantive issues, he does listen to what I say.”

But Dr. Fauci also said there was a limit to what he could do when Mr. Trump made false statements, as he often does during the briefings.

“I can’t jump in front of the microphone and push him down,” Dr. Fauci said. “Okay, he said it. Let’s try and get it corrected for the next time.”

That’s insubordination, but not quite insubordination:

Dr. Fauci came to his current role as the AIDS epidemic was exploding and President Reagan was paying it little attention. He and C. Everett Koop, the surgeon general, were widely credited with spurring the Reagan administration to action against AIDS, a fact that underscores Dr. Fauci’s ability to negotiate difficult politics.

He has recognized Mr. Trump’s need for praise; in the president’s presence and with audiences that are friendly to him, Dr. Fauci has been complimentary. He told the radio host Mark Levin on Fox News of the administration’s response to the virus: “I can’t imagine that under any circumstances that anybody could be doing more.”

This man knows how to play Trump, but he’s playing with fire:

In the past two weeks, as Dr. Fauci’s interviews have increased in frequency, White House officials have become more concerned that he is criticizing the president.

Officials asked him about the viral moment in the White House briefing room, when he put his hand to his face and appeared to suppress a chuckle after Mr. Trump referred to the State Department as the “Deep State Department.” Dr. Fauci had a benign explanation: He had a scratchy throat and a lozenge he had in his mouth had gotten stuck in his throat, which he tried to mask from reporters.

And then he winked, slyly. No, he didn’t. He’s smarter than that, but Trump is under pressure, and the Washington Post’s David Fahrenthold, the investigative reporter who almost singlehandedly brought down Trump University and then the Trump Foundation – both frauds – was at it again:

President Trump’s private business has shut down six of its top seven revenue-producing clubs and hotels because of restrictions meant to slow the spread of the novel coronavirus, potentially depriving Trump’s company of millions of dollars in revenue.

Those closures come as Trump is considering easing restrictions on movement sooner than federal public health experts recommend, in the name of reducing the virus’s economic damage…

In his unprecedented dual role as president and owner of a sprawling business, Trump is facing dual crises caused by the coronavirus. As he is trying to manage the pandemic from the White House, limiting its casualties as well as the economic fallout, his company is also navigating a major threat to the hospitality industry.

That threatens to pull Trump in opposite directions, because the strategies that many scientists believe will help lessen the public emergency – like strict, long-lasting restrictions on movement – could deepen the short-term problems of Trump’s private business, by keeping doors shut and customers away.

Tens of thousands might die but so might his businesses, and yes, someone asked him about this:

The company, which Trump says is run day-to-day by his sons Eric and Don Jr., has not said whether it would apply for a bailout of the hotel industry, if Congress created one.

Trump has not, either. On Sunday, he was asked if his business would abstain from any federal bailout. He did not give a clear answer. “Everything’s changing, just so you understand, it’s all changing,” he said. “But I have no idea.”

Of course he doesn’t. Gabriel Sherman reports on that:

Trump’s view that he can ignore Fauci’s opinion may be influenced by advice he’s getting from Jared Kushner, whose outside-the-box efforts have often rankled those in charge of managing the crisis. According to two sources, Kushner has told Trump about experimental treatments he’s heard about from executives in Silicon Valley. “Jared is bringing conspiracy theories to Trump about potential treatments,” a Republican briefed on the conversations told me. Another former West Wing official told me: “Trump is like an eleven-year-old boy waiting for the fairy godmother to bring him a magic pill.”

But there is no magic pill:

Throughout the crisis, Kushner has counseled Trump that the crisis isn’t as bad as the media is portraying. Two sources said Vice President Mike Pence has complained to Trump about Kushner’s meddling in the work of the coronavirus task force. (Another former West Wing official disputed this, saying Pence wouldn’t openly challenge the Trump family. “Pence is politically smart,” the former official said.)

And there is that young and fit and smart and blunt and bold governor up there in New York:

According to sources, Trump has been jealous that Cuomo’s press briefings have gotten such positive reviews. “He’s said Cuomo looks good,” a Republican briefed on internal conversations said. Trump’s solution has been to put on his own show. “Trump wants to play press secretary,” a former West Wing official said. The live briefings have essentially replaced his rallies and given him a platform to air grievances and attack the media…

He’s now experimenting with a new approach to the crisis, but it’s unclear what legal authority he would have to supersede local shelter-in-place restrictions. Behind the bluster, he’s hamstrung. “He can’t make any big decisions,” a former West Wing official said. “He knows once you do, you can’t go back.”

Sherman has his sources. All of that may be true, or not, but Kevin Drum sees this:

On Saturday, Trump used his platform to tout the use of hydroxychloroquine as a therapy against coronavirus, despite the lack of evidence that it works. The result is that people who need it for other illnesses can’t get it because Trump fans are hoarding it. A man died after ingesting chloroquine phosphate, an additive commonly used at aquariums to clean fish tanks. And people returning from Peace Corps duty, some of whom need it as an antimalarial drug, have to do without.

On Sunday Trump said once again that we didn’t even know about the coronavirus because China waited so long to tell us about it. This is false. China hardly deserves any kudos for their handling of the initial outbreak in Wuhan, but Trump was being briefed about it in January. Everyone knows this. Asked why he stood by while Trump lied about this, Anthony Fauci said in frustration, “I can’t jump in front of the microphone and push him down.”

Over the weekend Trump also announced that Ford and other carmakers are already manufacturing ventilators. This is, yet again, flatly untrue…

I could go on, but I hardly need to. The bottom line is that Trump’s daily briefings are (a) run like campaign events, and (b) full of falsehoods, including some that can be deadly.

And now the new Trump daily briefings are literally deadly. Slate’s Susan Matthews explains why:

State after state issued edicts closing bars and restaurants, and those bars and restaurants started unprecedented mass layoffs. The economic disruption that has resulted from the protective measures we are taking is enormous, and it will have its own set of devastating consequences, including lives ruined in other ways, if not by a respiratory disease. The president raised this ineloquently on Sunday night, with the economy in mind more than human lives. But the question is the same: Are we absolutely sure we are doing the right thing?

In other words, trying to stop the spread of the virus now to avoid one set of terrible outcomes is causing another set of terrible outcomes. Rarely in one’s life is it so clear that even if you make every choice perfectly, you will at most help us stay on the least-worst path.

Trump may be oblivious to the moral complexity here but this is complicated:

The reason we are taking the drastic measure of staying home is, as we all now know, because we are trying to “flatten the curve.” The effort is universally supported by public health officials, and, to be clear, is one I believe we should follow. We’ve been told that the price of failing to slow the spread of the virus will be a health care system so overwhelmed that many people will not be able to get treatment, and mortality will shoot up to perhaps unimaginable levels, as is happening in Italy. Certainly preventing an unmitigated scenario of 2.2 million deaths is worth the price of a recession and the extra burden on struggling families.

But even as “flatten the curve” has become accepted shorthand, the details remain opaque. Where are we are on the curve? How flat is the right amount of flattening? Where is the line where hospitals become overwhelmed, at what speed are we moving along the X-axis, and have we lowered the number of cases enough? In other words, are we absolutely sure the dramatic actions we’re taking will result in less death, overall?

The answer is no. But “being sure” is going to be harder than anyone imagines:

We are currently quite lacking in data and sorely in need of it. We need to know many more things about the virus and what it does to the human body, including who it affects and how to treat it. We need better testing to figure out how many people in the United States have it, even as the people on the front lines are realizing that they themselves have to shift their efforts away from containment approaches and toward treatment and mitigation of spread.

We also need data on how our current approach is working and data on what the costs of this approach really are. We need to know how much our current version of social distancing, with everyone still going to the grocery store every few days, is affecting the rate of spread. We need to figure out how much people being stuck at home might lead to an uptick in domestic abuse or suicide. We need to know if more women are giving birth at home, and if more women are being forced to carry pregnancies that they don’t want as their right to abortion is interrupted. We need to know how the people who are laid off from their jobs are getting food, and if they are still willing to access health care when the financial cost of doing so might be very uncertain. We are all engaged in an enormous, high-stakes nationwide experiment right now, and we need all of this data to answer the question: Are we doing the right thing?

And still, the questions remain: How long can we really do this for? What else could we do? What should we do next?

But there is this:

Academic physicians Aaron Carroll and Ashish Jha have a piece in the Atlantic in which they consider the various possible scenarios in front of us. The extremes are helpfully familiar but Carroll and Jha argue that there is a third path available, somewhere in the middle of these two strategies. They think that once we do the social distancing necessary to get the initial numbers under control (which will still take time), we can create a new type of plan, a middle road that keeps public health manageable without keeping the country completely shut down.

But that too is difficult:

This third path essentially requires us to do all the things we failed at the first time around. Here is a partial list of what it would entail: An enormous scaling up of testing, the ability to test nearly everyone, regularly, the willingness of even asymptomatic carriers to self-quarantine and isolate while they are sick with the virus (and help notify and test those they have been in contact with), and not least, an enormous expansion of the capacity of our medical system to accommodate for all of this. There’s also the investment in the creation and distribution of the vaccine, which everyone is sort of taking for granted but is far from a gimme.

We don’t know how long the societal benefits of sheltering in place will outweigh the societal harms. It’s maddening to wonder who we can trust to keep track of this all, and who will be making the decisions as to what we should do next.

There’s no choice there. Donald will be making the decisions, as instructed by Jared, but they see only two options:

We either shelter in place indefinitely, without real, immediate relief from the federal government, or we just give up on mitigation and accept that the coronavirus will kill an incredible number of people. The problem with trying to do the latter for the sake of the economy is that two million deaths would have a devastating effect on the economy regardless. We can’t just “start it up again.”

What we need to do is simply much larger than what we currently think we can do.

But how do we think about what we cannot seem to think about? Maybe that’s why everyone is buying guns.

About Alan

The editor is a former systems manager for a large California-based HMO, and a former senior systems manager for Northrop, Hughes-Raytheon, Computer Sciences Corporation, Perot Systems and other such organizations. One position was managing the financial and payroll systems for a large hospital chain. And somewhere in there was a two-year stint in Canada running the systems shop at a General Motors locomotive factory - in London, Ontario. That explains Canadian matters scattered through these pages. Otherwise, think large-scale HR, payroll, financial and manufacturing systems. A résumé is available if you wish. The editor has a graduate degree in Eighteenth-Century British Literature from Duke University where he was a National Woodrow Wilson Fellow, and taught English and music in upstate New York in the seventies, and then in the early eighties moved to California and left teaching. The editor currently resides in Hollywood California, a block north of the Sunset Strip.
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