Tuesday, March 31, 2020

Morning Assortment

     I've got to get to the grocery this morning and see about assembling a week's worth of groceries, so today's post is a little hasty.  Along with that, Holden the cat is still learning that cats are not allowed on my desk at breakfast time, a rule about which he expresses great doubt.
 *  *  *
     But let's talk about a few things, data and ways to present it among them.

    One of the best books I can't remember the title of, a book ostensibly about commercial art, had a very good section on how to avoid telling lies with charts and graphs.  It is staggeringly easy to do so, intentionally or not, because of a few factors.

     The first is that we love a pretty picture.  If scales and hues need to be adjusted to get an eye-catching presentation (or just to fit the  page or screen), we will do so.  You end up doing things like over-emphasizing small variations between very large numbers (commonly done by rescaling or trimming bar charts or graphs to remove "all that wasted space.)

     Another is that while most of the growth (and decay) processes in the world tend to proceed logarithmically, our perceptions and expectations are linear.  Even our senses scale exponentially rather than linearly.  In the very short term, the straight line and the swooping curve track closely enough to get by -- but in the long term, they diverge rapidly.  Once a processes gets started, it ends up going like a rocket!  That's why, outside of a few hard-hit and early-onset areas, you're probably looking around and thinking, "Hunh.  Not much of a pandemic."  In NYC, ERs are packed, gurneys in the hallways, and they're nearly out of ICU beds.  Even here in Indianapolis, the biggest hospitals are starting to feel the pinch -- and we've got a couple weeks to go before the peak, if present predictions hold.

     A third is confirmation bias: we're good at cherry-picking what we see or read to conform what we already expect.  This is the bane of experimental work, and why in things like drug trials, there has to be a "control" group, who do everything your test group does -- except use the drug under test.

     A fourth is "granularity."  For the United States, the Johns Hopkins coronavirus map only goes to the county level; for Canada, case data is per Province or Territory, and for most of Europe, it's per country.  These are not sections of equal population; they're just handy chunks that probably reflect how the data comes in to JHU.  The IHME data and predictions, on the other hand, are state-by-state at their narrowest; you're not going to find anything about measures taken by cities and counties on their pages, though it may affect their predictive models.  You can't read this data any deeper than it goes.

     Fifth and last, our good old friend, Dunning-Kruger Syndrome: we don't know what we don't know.  Heck, I can do math, I can read a study written in plain English -- why shouldn't I make my own predictions?  One reason would be that I don't know how good a model a locked-down cruise ship full of the kinds of people who can afford to go on a cruise might be for a large American city, full of a wide assortment of people doing a wide assortment of things; YMMV, but remember, there are folks who make a living doing this sort of thing and the reputable ones are extremely cautious about inferring too much.

     Please, let's just do what we can to get through this.

Monday, March 30, 2020

Predictions

     There's a very good site with national and state-by-state predictions for the course of COVID-19.  It's run by the Institute for Health Metrics and Evaluation (IHME), a think tank that describes themselves as having "the goal of providing an impartial, evidence-based picture of global health trends to inform the work of policymakers, researchers, and funders."  They've got a nice, fat $279 million grant from the Bill and Melinda Gates Foundation to do it with, free and clear.*

     When it comes to COVID-19, they, like the rest of us, want to know what's going to happen next.  To that end, they are collecting and collating data as it becomes available, refining their models and updating it daily.  Unlike a lot of such sites, they include not just the median prediction, but error bands as well: they're willing to show the limits of their knowledge and their models.

     The state-level predictions I have looked at (many) are a good fit to what I know (not much) and have extrapolated.  New York and many of the surrounding states are in serious trouble; a lot of the Midwest is in better (but still worrying) shape.

     Have a look.
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* Paranoid rants incoming to comments in five, four, three....  You know, writing that in all caps isn't going to improve the odds of my letting it through the filters.  I have been patient with people's irrational suspicion for years, in large part because I figure all our institution need watching and it's a great way to keep the 'noids usefully busy; but there's a limit and I reached it some time last week.  Not every comment I sideline fits that category, and I am sorry to have had to hold up quite a few good ones because they included assertions I could not verify, or digressed into political partisanship that serves no useful purpose against this pandemic.

Sunday, March 29, 2020

"Flattening The Curve" vs. "Business As Usual"

      If you're a member of the "Oh, it's no worse than a bad flu season" set, you might as well leave now, and take a look at the video coming out of Italy and NYC on your way: this thing hits hard and fast, compressing a flu season's worth of deaths and cases requiring hospital support into a few weeks.  Too many, too quickly for hospitals to cope.  Health-care workers are falling ill at a much higher rate than the population at large: they have to get universal precautions right every time, while the virus only needs to get a solid toehold once.

     The thing that social isolation and stay-home orders sets out to accomplish is not quite like a classic quarantine order used to contain something like measles, where quarantine and contact tracing can stop an outbreak in its tracks.  COVID-19 appears to be infectious for a couple of weeks before symptoms appear.  By the time you know you're sick, you've already been spreading it.  The best we can hope for is to slow it down.


     Slowing it down will save lives.  It will save many more lives indirectly than directly: The goal is to keep from smashing our healthcare system so flat that it takes years to recover, and does a much worse job coping with the surge and its aftermath.

     Nobody seems to understand that facilities and personnel are not going to bounce right back from an Italy-type caseload. Few people grasp that every patient in a hospital suffers when it is overloaded by a surge of COVID-19 patients.  A lot of people will die of a lot of things while we learn this lesson.

     In Marion County, Indiana, my county, we've got 676 known cases as of midnight.  That's about fifteen to twenty times as many as a week ago.  We're two or three weeks away from the peak if present projections hold.

Saturday, March 28, 2020

How Do I know It's A Pandemic?

     Because the COVID-19 heat map at Johns Hopkins has nearly one-to-one correspondence with population density, at least for the United States.

     Like most of my generation and subsequent ones, I grew up in a world of cure (or at least treatable) disease.  Throughout my adult life, the planet has kept issuing little reminders that it's not a simple battle; we just got a big one.

     The models for coping with this look like the more-successful responses to the 1918 - 20 influenza pandemic, or London when they best coped with Plague.   We cannot stop it by sheer force of will.  There's no bluffing a blind, biological robot.

     And no matter what we do, this is going to hurt.

     We had good years, good generations.  My Dad and Mom grew up fearing polio but my sibs and I didn't; my nieces and nephews didn't.  We've all got the scar from our measles vaccination.  Antibiotics have been truly miraculous -- I would have succumbed to childhood rheumatic fever were it not for penicillin and later drugs.  It was a halcyon time and now it's over.

     We're back to the 1930s at best in dealing with this virus.   There's no magic bullet, not yet.

Friday, March 27, 2020

If You Like Crunching Numbers

     Here's a decent set of charts and graphs, presented with straightforward, factual description and discussion.

     Remember, having a helmet fire is never helpful.  Knowing the facts is usually helpful, if there's anything you can do; and if there's nothing you can do, it's at least entertaining.

     I'm still home with what I hope is kidney stones.

Thursday, March 26, 2020

Worried?

     CDC has an online coronavirus symptom checker.

Oh, Darn It

     I am experiencing what feels like a kidney stone.  The pain is....  Well, it's not as bad as the worst of one of these.  But it's not good.

Wednesday, March 25, 2020

Stay-Home Morning

     There's a remarkably beautiful and dangerously thick fog over Indianapolis this morning.

     It's a good morning for it.  Indiana is under a formal "Stay at home" order as of twelve this morning.  My industry is deemed essential, so I'll still be going in to work.

     I have yet to find a scaled-to-population graph of the progress of the infection per country.  There are so many of us in the U.S. that it's not as easy as it first appears to compare growth rates from country to county.  It appears the rate of increase in the U.S., the slope of the curve, is at par with that of Europe as a whole; we do not appear to be as bad off as Italy, we're not doing as well as the best; but it's not a huge difference and we're a week or more behind Europe.  The slope could change.  The data is so minimal that it's only a guide to making informed guesses.

     The world will get through this.  It is not going to be easy.  This is comparable to WW II; not as intense but breaking out all over, in the space of a few months.  It's going to take the same pluck and determination to get through it -- and there will be casualties.

Tuesday, March 24, 2020

Hard Lessons: Triage

     You've seen the headline or tagline: in Italy, patients above a certain age aren't getting respiratory support.

     I'd like to tell you it's a huge lie, but while the details may be a little askew or oversimplified, the gist of it is true.

     There are a lot of people sick with coronavirus in Italy.  The number of them who need respirators exceeds the number of respirators available.  There's no way to save everyone.

     Let that sink in: There is no way to save everyone.

     Pretty horrible, isn't it?  That's the position doctors found themselves in World War One, the biggest if not the first collision of 20th-Century military technology with 19th-Century tactics.  Men were falling in vast numbers and many of them were not quite dead.  There were only a limited number of doctors and medics; field hospitals were minimal, medical supplies were inadequate.  Men were dying of easily-treated injuries while doctors labored to save those who were unlikely to live.  Something had to be done!

     There is no morally-satisfying answer to such a dilemma.  All that can be done is to mitigate harm; all that can be done is to try to do the greatest good with the resources available.  It's called triage: doctors began sorting patients into three groups:
  • Those who are likely to live, regardless of what care they receive;
  • Those who are unlikely to live, regardless of what care they receive;
  • Those for whom immediate care might make a positive difference in outcome.
     The last group was the only one that received full-on medical care.  Any leftover time or materials was spent on the first group.

     It is cold, harsh and heartbreaking.  The only worse things are all the other available options.  You're hearing stories of doctors breaking down in tears in Italian hospitals?  This is why.  They're not military doctors.  They learned about triage but they have never had to practice so harsh a version; even landslides and floods rarely put so much stress on medical resources.

     And this is why you're social distancing.  This is why you're being asked to stay home.  Overload the health system and you get a sorting-out that leaves the weakest dying, that leaves the strongest gasping for breath to get through the worst of the illness, and focuses resources where they will do the greatest good.

     It can happen here.

     Let's do everything we can to keep things from getting that bad.
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     Further reading?  Tom Godwin's The Cold Equations.

Monday, March 23, 2020

Will You Please...?

     Another reminder: I will not publish rumor or hearsay in comments.  If your paragraph starts with "We're now hearing about..." and does not include a link to an actual Official Person In The Know saying this thing you have heard, it's not going to get published on my blog.

     Come on, this isn't that hard.  Distinguish between rumor and facts.  I encourage you to dig for facts -- and verification of them.  Don't speculate, guess, or repeat something some guy you know heard from his brother-in-law's cousin.  It doesn't help.

Week Two Of Taking It Seriously

     And, of course, since I set ground rules for comments, commenters are testing the limits.

     They're pretty strict.  If you have ideas, feelings, thoughts that you simply must get off your chest, and they are not supportive of your fellow humans trying to get through this thing, please get your own blog (they're often free!).  I'm not going to publish them.  I will try to answer them.

*  *  *
     For the RN, irked at the government's response and the limited supplies, I don't have much comfort.  I'm slightly less qualified to explain supply-chain logistics than a non-surgical nurse is to explain the subtler details of brain surgery: I sometimes see it happening and occasionally I help it along, but....

     Still, I'll give it a try.  In normal times, the usage of PPE is essentially constant. The factories know their market and produce about what they need; this probably doesn't get warehoused in any great quantity (the miracle of just-in-time manufacturing processes!).  Instead, it goes on train cars to a wholesaler, and on trucks from from the wholesaler to retailers and bulk purchasers.  Figure the whole process takes somewhere between one and six weeks.

     Ramping that up -- first, you need raw materials.  Assume them, and if the factory was running one shift, it can run three, if it can find the workers.  Congratulations, you have tripled the supply; a week to train them, and a week, minimum to get to get the PPE to the end users, if they have ordered them; better add another week to sort that out.  Meanwhile, hospitals and testing in the hardest-hit areas is burning through these supplies five or six times as quickly as normal.  And changing from a supply-and-demand model to a command model won;t make it any faster or ensure the supplies get to where they are most needed.

     Federalism plays into this as well.  Public health in this country is a good example of federalism; it's bottom-up, as FEMA and CDC keep trying to explain: locally run, state managed, Federally supported.  FEMA does not have any super-deep infinite stockpiles; they have some supplies, suitable to support a state's response to an ordinary disaster, to get them through the first few weeks while the supply chain reacts.  The scale of this problem is ten to a hundred times as great.  FEMA's stockpiles, your state's stockpiles -- they're like spitting on a bonfire. 

     I'm sorry the Feds and state-level agencies lack the power of precognition, but that's the case.  Complaining about it now won't help.  Chewing them out just wastes time better spent on doing what we can, while we can.  Take notes and write a searing analysis after we're through this.   Do what FEMA appears to have done after Katrina: take a good hard took at the mission and how to manage it, and try to figure out how we can avoid this kind of problem in our next response.

     Testing is a PPE problem.  I will keep explaining this: the only way to keep the testers from risking passing the virus from the infected to the merely worried is for them to discard their PPE -- gloves, at the very least -- every time they take a sample.  If you're low on PPE, you restrict testing.  You need that PPE for the caregivers treating the people who are already ill.

*  *  *
     Another commenter asked if I really believed that flattening the curve won't reduce the death rate.

     The answer is that it's probably not going to make a huge difference in the direct death rate.  Probably the overall deaths will be lower, though by how much is impossible to say.  People are saved by having equipment available to save them,m and the flatter we make the curve, the better that looks.  The virus puts the same proportion of the people it makes ill in mortal danger. 

     It is very likely someone you know is going to die of this, especially if you live in a large city.  And I'm damned sorry about that.

Sunday, March 22, 2020

Speed Of Response; Five Stages Of Grief

     One of the complaints that I keep encountering almost everywhere, from fairly reasonable people and conspiritards alike is, "Why didn't The Government do more, sooner?"

     In part, this is rooted in an odd corner of American Exceptionalism that wants our President, Party leaders and Congressthings to be bigger than life.  If we approve of them, they're philosopher-kings, wise, well-informed and malevolent; if we disapprove of them, they're crafty, malevolent Bond villains.

     What these two characterizations have in common is they describe people who are extremely smart and extremely competent.

     Think back to the kids who were in student government when you were in High School or college.  They're weren't nerds or geeks; they were often fairly bright.  But they were almost never the most bright, and were rarely gifted with great abilities in math or the sciences.

     Those are the people who grew up to run for office.  Other than a certain need for approval, and often a preoccupation with appearances, they're just about average.  They're not Bond villains.  They're not philosopher-kings.  If you compare the whole lot of them to an equal number of randomly-chosen citizens, they two groups will be neither more benevolent or more malevolent than one another.

     So we've got these more-or-less ordinary people, with their individual personalities, and along comes news of a new virus in China.  There are a number of reasons why this happens in China a lot -- population density, the sale of live animals for food and lower food-safety standards among them -- but the important thing is that it does.  It's one item of a hundred in the morning briefing and it's not unusual.

     Time passes and the news out of China's not looking good, but the Chinese government swears they've got a handle on it. By SHOT Show, Tam and I were speculating about the unfortunate confluence of SHOT and the Chinese New Year, which brings a huge influx of Chinese tourists to Vegas and throughout the world.  I warned her to carry hand sanitizer while attending and to not lick any strange door handles.  And we laughed.  --Politicians in the U. S. were not much more worried.

     And it is at this point that I'd like to mention a handy tool for understand how people deal with huge and tragic changes in their world.  It's really just a list of general tendencies in a certain chronological order, but it's a useful to understanding how people react to things like, oh, the Hindenberg disaster, 9/11, WW II, or the coronavirus pandemic: The Five Stages Of Grief. 

     They run like this:
     1.  Denial -- "This isn't happening."
     2.  Anger -- "We're gonna get the people who did this to us!"
     3.  Bargaining -- Can we do only a little, and make this happen less?  What about...?
     4.  Depression -- "Game over.  We're doomed!"
     5.  Acceptance -- "This is happening, and here's what we can do to deal with it."

     You can take, for the easiest possible example, President Trump's public reactions to the pandemic, and map them right into this (with a quick skip over "depression;" he's not really the depressive type).  From what I was seeing from FEMA, they went through much the same process -- as an agency, a few days or even a week ahead of the President; but worrying about disaster response is their only job, so they would be leading.

     This is why we got the official response we got, why the UK had the response they had, and so on around the world: it took time to grasp what what was going on and to accept it.  There was a sudden change in plans in the UK as news came out of Italy.  The UK had hoped to isolate the elderly and let the remainder of the population develop immunity by exposure. Italy had attempted a somewhat relaxed version of that and it failed dramatically.

     About that failure -- people keep mentioning the death rate from this virus as if that was the only effect.  Well, it is bad, worse than a typical flu season, but yeah, it's not so bad -- unless  it happens over a very short period of time.  Flu season runs all winter and a bit longer at start and end.  The other problem is for every death, figure ten or more afflicted who need ventilators to survive; figure 20 - 25 who need hospital care.  If it all comes at once, it adds up to far more patients than we have beds available.  This is the problem; this is why there is such a big effort to slow the spread, to flatten the curve.  The death rate won't change; the number of people who need hospital care and breathing support won't change -- but they won't all need it at once.

     The other complaint I see,  even from the press, is about the shortage of PPE.  Why don't we have enough masks, gloves and gowns?  And that comes right back to the scale of the pandemic; we have enough of those for normal times; State and Federal-level stockpiles have enough to deal with a "normal" disaster -- hurricane, tornado, flood, earthquake, even an outbreak of anthrax or smallpox.  A nationwide pandemic is a whole order of magnitude greater.  Maybe two.

     A related issue is the recent restriction in testing to people being admitted to hospitals (and a few exceptions).  Why would they do that?  Here's why: The supply of tests isn't the problem.  The supply of PPE is the problem: the only sure way to keep the test sites from becoming disease vectors is to discard PPEs after every sample is taken.  Line up five hundred people to get a Q-tip up the nose and you've burned through a thousand gloves and possibly five hundred masks and gowns.  Those are needed for people working with the known-infected.  There may be shortcuts; maybe the testers can slather on sanitizing gel between every sample -- but they don't dare get any on the sample!

     So here we are.  The country reacted pretty quickly, in a series of drastic-feeling steps.  Maybe it wasn't as quick as you would have preferred.  It was as quick as the ordinary people in government could manage.  Maybe it was quick enough. 

     Ask me in another week.  Ask me in another month.

Saturday, March 21, 2020

Ground Rules; Looking At Dead Men

     Last first: whatever you think of Mr. Trump and his team at the so-far daily press briefings (Mike Pence and Dr. Fauci have impressed me a lot), remember that these guys are short on sleep, long on stress and nearly every one of them is in the range of ages most likely to die of COVID-19 if they contract it -- and the virus seems to be going around the movers and shakers in Washington and other world capitols.

     If there are six guys on stage there at the briefing room, all bunched up?  At least one of them is a dead man.  Or at least gravely ill -- yes, they will get the best of care, just as they do any other time.  The odds are still not in their favor.  And those guys know it.  They're still on the job every day.

     They're all rolling Death's dice.  Most of them could probably head for the hills and wait it out.  They haven't.

*  *  *

     These are unusual times and I've instituted some rules for comments here and on my Facebook wall (do they even still call it a "wall" these days?  Page, then).

     1. Medical advice: it's not a link to a verified authority's page, like the Center for Disease Control, Johns Hopkins, a state Health Department page  or a real university,  then I will not publish it.  If you are not yourself verifably a doctor (M.D. or D.O.) or Nurse-Practitioner, then I will not publish your link or comment.  Set up your own web page if you have something you must share.

     2. Conspiracy theories of any kind will not get published.  They are demonstrable nonsense.  If you really believe the Democrats and the media colluded to crash the economy and consider over ten thousand dead in Europe and China so far an acceptable price to accomplish it, you are either gullible or insane.  (You also cannot account for how they got the Administration to play along.)

     If you can come up with anything other than a dire threat to the entire country that could get Donald Trump, The Mouth That Won't Stop, to speak well of Gavin Newsom and Andrew Cuomo, you are remarkably inventive.  And wrong.

     The only thing I have seen with a scrap of believability are the Congressthings that sold off stock after a briefing on the crisis and ahead of the bad news about the coronavirus hitting Wall Street, and let's face it, their asses are grass -- no matter how innocent they make it look on paper.

     Seriously, knock off the stupid.  We are looking at the possibility of deaths in the same numbers as the U. S. Civil War Between The States and if we are careful and lucky, we may be able to get that figure way down -- but not by spreading mental poison spun from a Bond movie.

Friday, March 20, 2020

Hang Together -- Or Hang, Separately.

     If you're still banging a drum about partisan politics, give it a rest, willya?  Just for a while?  I'm not saying you need to learn to love Nancy Pelosi or Donald Trump; I want you to be around to vote on the matter in November.

     A summary of the report that made the UK rethink their strategy is here, and the report itself, including predictions for the U. S., can be downloaded here.  It's grim.

     Chart seven at this link compares infection-rate curves for various countries, aligned for the 100th reported case from each country.  The U.S. looks like Europe's average, lagging the EU by about two weeks.  What they are experiencing, we likely will; not as bad as Italy, I hope, but bad.

     Don't tell yourself conspiratorial fairy tales about this thing.  Sure, keep your eyes open and your powder dry; that's always wise.  But take this virus and the response to it seriously.

Thursday, March 19, 2020

Set The Tinfoil Hat Down For Now

     Your elected officials aren't trying to stage a coup; they're scared. They're scared in a very politician-specific way about not being able to do a good enough job of slowing down the spread of this virus.

      If it hits hard and fast, as it did in Italy, who gets hit the worst? The most vulnerable; and the largest group among them is the elderly.

      Now when Grandma, Grandpa or Great-Aunt Whoever takes sick and doesn't get treatment because hospitals are overflowing, who do you suppose their sons, daughters, grandchildren, great-grand-children and all their kin are going to blame?

     I'll tell you. They'll blame their Mayor. They'll blame the Governor of their State. They'll blame the President and his administration. And it's not going to be any nice, simple red/blue divide, either. No, whoever is in office and seems most blameable when Grandpa dies will never get a vote from the surviving family, ever.

     Cross that with the public-health experts and epidemiologists who point out, correctly, that in a pandemic like this, the actual spread is well ahead of the data we have about it, and you get cities where everyone is told to shelter in place; you get a country where all citizens are being asked to work from home and limit their travel and contact with others.

      The politicians know people will die from this. They want to make sure it's as few as possible -- and for once, what they want and what we the citizens want is perfectly aligned, regardless of party, creed or philosophy.

     Paranoid speculation does not help, and can do a lot of harm. The loons and fools and yes, those fine, fine public-spirited people (there must be one or two in all that crowd!) that you, I and our neighbors voted into office are not up to anything right now but trying to get through this -- and we're all in it together.

     We can fight later. Let's get through this first.

Wednesday, March 18, 2020

Please Don't Share Garbage

     Someone on Facebook was pushing an unsourced rumor that breathing hot, dry air would kill the SARS-CoV-2 virus.  It doesn't.  It could be dangerous if tried with very hot air.  Don't do it.

     I keep seeing absolutely bogus talk, things that do more harm than good, that encourage misuse of essential supplies -- it's all just trash.  If CDC or your state or city Board of Heath (or equivalent) didn't say it, it's probably nonsense.  Whatever you think about inducements to innovative thinking in modern Red China, with 11 million sick and/or gravely worried people in Wuhan and more in the rest of China (not to mention South Korea), if there was a way to MacGyver this virus to a standstill, someone would have done it already and they'd be getting awards from a grateful planet right now.

     Politicizing this illness doesn't help, either.  The politicians are going to do so anyway.  They've been busy sniping at one another, especially if they were already campaigning.  We don't need to play along.  We can play red flag/blue flag later, once we get through the worst of this.

     TV and online news from reputable outfits is not lying to you about the virus.  Yes, CNN loathes the current Administration, but even they -- and all the other ABC/CBS/NBC/etc. a little to the right of them and major newspapers on either side -- are working hard to get the facts out.  Some of them can't help but snipe and snap (New Yorker is still so consumed by Presidential Derangement Syndrome that they're just about useless) but the majority are working past that.

     And your local news, TV and what's left of radio and newspapers, look, they're not paid well enough to put up a wall of lies even if they wanted to, which they do not.  These are earnest strivers, some of them a bit wet behind the ears but working hard.  I have an inside view of this.  They're knocking themselves out to gather, assemble and present the news about this crisis and how people can deal with it.  They're just as much at the mercy of experts as any of us -- but at present, they have good access to large body of genuine expertise and they are doing whatever they can to share it with you.

     Pay attention and survive.  Don't share whacky, unsourced nattering and misinformation.  Be kind to others.  Get through this. 

Tuesday, March 17, 2020

Working From...Away

     I have been sent off to the North Campus, unstaffed for many decades, with some Official Letters and IDs authorizing me to travel even if there's a ban (which we don't have yet, just a lot of strongly-worded suggestions).

     The place is to be put into shape for emergency use if need be, as a bare-bones nerve center for the entire operation.  We might not need it; and it's Plan B to a Plan A.  Plan B will be followed-up by a much larger-scope Plan C of widely-dispersed locations for our various functions if implemented.

     This is the real deal.  If you're a prepper, this is the thing you have been prepping for.*  If you're not, right now would be a real good time to take inventory, maybe dig out those cans from the back of the cupboards that are approaching the "best by" date and enjoy them.  No need to panic -- it looks like a zillion ijits have already done that for us, especially in the paper-goods aisle -- but a nice time to be judicious and opportunistic in what you buy.
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* What, it doesn't look like you expected?  Well, it never does.

Monday, March 16, 2020

Pascal's Wager Applied

     It's a simple grid, a logic chart, two sets of two-value inputs and the outcomes when they are combined.  Let's apply it to SARS-CoV-2 and see how it works out:

1. You stay home if you can, and take precautions if you cannot.  No unnecessary contact.
     A. If the coronavirus is over-hyped, you'll be a little bored.
     B. If the coronavirus is as bad as CDC and WHO say it is, you will not get sick, or at least if you do, the hospitals won't be overloaded.  You won't spread the virus.

2. You live life as usual, 'cos you're tough and brave.
     A. If the coronavirus is over-hyped, you'll do fine.  And hey, no crowds at the bar!
     B. If the coronavirus is as bad as CDC and WHO say it is, you will get sick and you will spread the disease.  Possibly to elderly or otherwise vulnerable family members, who have a much higher chance of death.  If you're over 60, the odds are distressingly high that you may die.

     Choice one or choice two: which one has the worst downside?  I don't know about you, but I'm going to treat this sickness as real.  You can't bluff a virus.  The Johns Hopkins data is convincing.

Sunday, March 15, 2020

Still Out There Mingling Unncessarily?

     Why not?  After all, you're young and healthy and for you, if the (best guesstimate) one-in-ten chance hits and you do get a nice dose of the current coronavirus, so what?  In your slice of the demographic, it'll be no worse than a bad cold about 999 times out of a thousand and you like those odds.

     Here's why you shouldn't:
Most cases of COVID-19 are not severe enough to require mechanical ventilation (artificial assistance to support breathing), but a percentage of cases do. This is most common in older adults (those older than 60 years and especially those older than 80 years). This component of treatment is the biggest rate-limiter of health system capacity that drives the need to flatten the curve (to keep the speed at which new cases occur and thus the number of people sick at one point in time lower). This is why social distancing is so important to saving the lives of others, not just to preserving one's own. This fact falsifies the argument that a young healthy adult can ignore the need for social distancing, accept a mild flu-like illness, recover, and move on. The burden on the healthcare system will also limit the availability of other types of health care, such as that required after a motor vehicle collision. 
     Didja get that?  You're a disease vector.  We all are, all the time, and every cold and flu season is a reminder of it. The grandparent you save may be your own -- or maybe they're a doctor, nurse or delivery driver.

     The Wikipedia article includes some nice little animated GIFs that show a number of possible responses and their effects.  Go have a look -- and consider their implications.
*  *  *
     Here's something the geekier biomedical types are already thinking of, I'll bet: just how much of a ventilator does it take to get someone through a really bad lung inflammation, and how can that be improvised?

     Before the polio vaccine, Australia had a problem with the high price of imported iron lungs -- so they started building their own, out of plywood and vacuum-cleaner parts, at a tenth of the cost.  These days, assisted-pressure help machines for sleep apnea are darned near consumer goods -- but do they move enough air?  Can they safely be made to help someone struggling for their next breath?  Can you use them to handle the slightly less-severe cases?

     Pray we don't have to find out, but remember, too, that we're a nation of tinkerers with a lot of useful junk to hand.

Saturday, March 14, 2020

Social Distancing, Or, Let's Visit On The Internet

     Here's a good, short piece from a medical professional about the why and how of social distancing.  "Going turtle" will save lives.  If you can, do so.  If you can't, read the article anyway; there are still things you can do.

     At least one of the widely-memed sets of recommendations being shared on social media is sheer and utter nonsense.  Not every "uncle with a Master's degree" is worth listening to.  Snopes has a whole coronavius page, and no matter what you think about their politics, they're doing a good job sorting out fact from fancy on this subject.  Don't buy into conspiracy theories, don't be sold a bill of goods.  And wash your hands! 

Friday, March 13, 2020

The Wrong Science-Fiction Future

     I was hoping to grow up to spend my adulthood in the science-fictional future in which we had commercial space travel, permanent space space stations, Lunar settlements and were expanding to mine the asteroids and build outposts on Mars and the larger moons of the gas giants.  Watching 200l: A Space Odyssey along about 1971, it all seemed very likely.

     Surprise!  Instead, we all got the future where we're facing a global pandemic that's hammering the economy and travel restrictions are in place all over the planet.   Those were never my favorite books.

     (We're screamin' close to the future of John Brunner's Stand On Zanzibar.  An interesting place to visit but nowhere I'd have chosen to live.)
*  *  *
     Also, the most recent Windows update seems to have put the knife in Firefox.  Thanks, Microsoft.  I'm back on the Raspberry Pi.  It isn't the fastest or fanciest, but at least I can count on it.  --No, wait, Firefox just popped up on the big board, seven long minutes after the double-click.  Wow, these modern computers are so fast!

Thursday, March 12, 2020

Stop Playing Around. Don't Be A Fool.

     COVID-19 is well and truly here.  It's not hype, it's not fake and it is not -- as I have pointed out before -- a weapon or a crowd-control tool.  It's too uncontainable.

     If you live in a major city, it's already there.  And spreading out.

     If you're getting your coronavirus "news" from a gray-to-black propaganda site, like "Zero Hedge"* or a nutjob conspiracy site shilling dodgy products like "Natural News," stop taking them seriously.  They're clueless and serving other interests.  They're not out to help.

     Get real information.  Johns Hopkins has a good dashboard that includes an interactive map and the Feds have an extensive set of pages run by the CDC.  These are factual sources.

     We don't know how bad this thing might get.  The only way through it is forward and the best way forward is not to spread panic or invidious rumor.  This is the kind of health issue our parents or grandparents or, for some of you, great-grandparents lived through and feared before antibiotics and the widespread availability of vaccines.  They got through them.  Society got through them.  We can, too.  
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* Almost certainly a Russian government operation intended to sow chaos.  Anything you read there is not to be trusted; if they gave the sunrise time at my location, I'd wonder what was in it for them and go check another source.

Wednesday, March 11, 2020

Stop Biting

     He'll stop biting if I stop trying to brush him, I hope.  Holden has a couple of spots of badly-matted fur and (because I'm not as clever as I think) I have made four attempts to sneak up on them with a special cat-detangler brush.  None have ended well for me.

     He's not having any of it.  Brush the nice, untangled fur along his spine?  He's generally okay with it.  Veer even a little to one side with the brush?  As  I have written earlier, he'll seize the nearest hand in his teeth.  He's not out to hurt, but he means for me to stop and right now.  He's not going to be lulled into accepting it, not even a little.

     Yesterday, I asked our vet about his matted fur and their advice is to wait until he's in shape to be lightly sedated, at which point they'll give him a trim.  The result may be something of an affront to his dignity, but it's the best way to take care of the problem.  In the meantime, I won't try to brush him at all; once he's had his haircut, Tam and I can start over with a different brush, when it won't be painful for the poor guy.  If it all works out, he'll have his thick coat back before autumn and we'll be able to keep him brushed.

Tuesday, March 10, 2020

Bookstores

     There aren't as many bookstores as there used to be.  There been some growth in small independents, and even a few used bookstores have shown up, but the big chains have dwindled; I think Books A Million is still around (but not widespread) and Barnes and Noble has been an trouble for many years.

     It's Amazon.  I feel a little disloyal writing it -- Amazon has long been both a major beneficiary of and an enabler of online culture -- but it's true.  As much as I love shopping at Amazon and the convenience of my Kindle, there's a lot be be said for going to an actual bookstore and looking, picking up and reading actual books before deciding to buy them or not. (But maybe not just right now.)

     Barnes and Noble is owned by a hedge fund these days.  The people running it have decided they'd better get some expert help.  I dislike throwing a link to that rat Bloomberg, but the new guy at the top of Barnes and Noble may be a good thing.

     We'll see.  In the meantime, visit your local bookstore -- new or used, chain or independent.  Get out there and buy a book!

Monday, March 09, 2020

Cat Update

     The house remains divided between the two tomcats, as it will until Holden completes his probationary period and finishes his medicine.  It may continue a few days past that, since he's due to be fixed as soon as his respiratory infection is over.  (Meanwhile, we have to make an extra effort with the litter boxes; an un-neutered tomcat can be a bit whiffy.)

     Saturday afternoon, I crawled under my desk and coaxed and hauled Holden out from under the bottom section of the corner shelves.  The 1920s baseboards in Roseholme Cottage are seven inches tall and I routinely build shelves so the bottom shelf is just above baseboard level.  This leaves a void, closed at the front to help stabilize the shelves. (The wall side of the verticals is coped to clear the baseboard and quarter-round.)

     The vertical support for deeper side of my corner shelves is made of two posts with a gap between them that turned out to be just big enough for a large tomcat to get through.  A space seven inches high, a foot deep and thirty inches long makes a nice hiding spot if you're a cat.

     It's difficult to get to; my big oak desk is in the way.  With just one tiny entrance, you can't remove a cat that isn't a little willing to come along.  Lured by treats after nearly twenty-four hours of hiding out, Holden was reluctant but not angry.  Once he was out and the entrance blocked off, he made his peace with the situation rapidly and was smoothing on hands and being fussed over within half an hour.

     So far, Huck has been as good as gold about the new guy.  I have taken over the living room couch to sleep on and Huck sleeps on me, as he prefers.  Holden hangs out in the office and hallway.

     The two cats do each spend some time on opposite sides of the door between the hall and the dining room, "talking" a little.  But there's no growling and neither one is camping out at the door, hoping for a fight.  They aren't greatly interested in getting through the door, either.  That's a good thing -- a combined 28 pounds of tomcat could probably made a credible effort if they were  determined to.

     Holden is long-haired and he has some matting.  He does not want his tangles messed with, and will a deliver a firm but not aggressive bite by way of saying no.  He's careful not to bite too hard; he just takes hold of my hand or wrist without breaking the skin but the message is clear.  He may have to get a haircut once the weather has warmed up.

     Holden is very talkative, at least a much so as Rannie was.  If you make eye contact, you'll almost certainly get an inquiring "Prrrr-witt?" and anything that might involve feeding receives a one-cat chorus of plaintive calls and cat and food are brought together.  After three days, Huck doesn't seem to mind hearing this; he was a bit worried the first day but he seems to have decided it's okay.

     Fingers crossed! 

Sunday, March 08, 2020

Writer's Group

     We had one of our gatherings this evening and I think it went well.  Lots of good discussion and much to learn from the manuscript we were critiquing.

     "Critique" isn't the right word -- much too fancy, for one thing.  You go through and look for narrative inconsistency, plot holes, shifting characterization, formatting issues, and so on.

     Some things are stylistic choices, but more are mistakes, overlooked loose ends and so on.  The idea is to learn how to look at writing analytically -- how to edit.  "Editors" at publishing houses, professional websites and magazines aren't going to dig through the basics for you; they don't have time.  You have to turn in finished work.  And that's what we are trying to teach one another to produce.

     These meetings had been difficult for me because I was so tired, just fatigued all the time.  The new medication appears to be working; I was never even close to nodding off.

Saturday, March 07, 2020

Paranoid Nonsense

     It's popped up on Facebook, in comments (unpublished) at this blog, in conversations at work and overheard in restaurants, any place the COVID-19 corornavirus is discussed for more than a few sentences:

     "It's Chinese biological weapon."

     This is easily shown to be ignorance or lunacy, for one simple reason: it's a lousy weapon.

     Noodling around, one of the best descriptions I found was at Wikipedia; I could give you some long, dry dull stuff from declassified DoD reports, but the language is mind-numbing to plow through and comes to the same thing:

     "Ideal characteristics of a biological agent to be used as a weapon against humans are high infectivity, high virulence, non-availability of vaccines, and availability of an effective and efficient delivery system. Stability of the weaponized agent (ability of the agent to retain its infectivity and virulence after a prolonged period of storage) may also be desirable, particularly for military applications, and the ease of creating one is often considered. Control of the spread of the agent may be another desired characteristic."

     I'll take it point by point:

     COVID-19 does look to have fairly high infectivity: you can get it about as easily as you can catch the flu.  There are lots of illnesses that spread more quickly and readily.

     On virulence -- how sick it makes you, what percentage of the targeted population (and we'll get back to that phrase by and by) it affects badly enough to take them out of action for very long -- it's poor.  Two percent mortality is militarily useless, even against a civilian population, and it's all the more useless when you look at demographics: the elderly are at greatest risk, and yet they are not soldiers, workers, officers or managers.  It doesn't appear to significantly incapacitate most others for any length of time, especially young adults and the middle-aged.  Those are exactly the groups you'd want a bioweapon to affect most. 

     Delivery system?  Coughs and sneezes are impossible to aim. COVID-19 is apparently not naturally  airborne. It doesn't seem to spread really well in affected populations if they keep their distance and wash their hands.  We'll know more as it develops, but it's not looking like something that wafts on the breeze, crawls under doors or lingers on toilet seats.  It doesn't appear that you could spread it from an airplane or even via parcel post.

     Stability/storability, it's hard to say but it doesn't look great that way; word so far is that it doesn't last long on surfaces, so it probably won't keep well in jars, either.  Anthrax spores, it's not.

     Control of the spread: Yeah, no.  At this point, if they had a way to control it, China would be quietly doing so while bragging about the effectiveness of their rapid medical response and very harsh crackdown on person-to-person contact in the affected area.  That hasn't happened, so the odds are good they've got nothing.  For this to be a good weapon, you'd need a vaccine for your own troops or a drug that would treat it effectively.  Given that all of Europe, the U. S., India, Canada and the Commonwealth is looking into a treatment or vaccine and has been since the thing started, and that's a whole lot of biomedical horsepower that will save the researcher's own parents and grandparents, not to mention spouses, offspring and their precious selves, if it's findable, we'll have it soon.  Not exactly weapons-grade performance.

     China's losing money hand over fist as long as the pandemic and their response (and world-wide worry) has so much of their industry shut down.  And their shutdown is rippling across the planet.  Does it make any sense that they have idled everybody in the hopes of, I don't know, establishing dominance over the South China Sea, tramping down hard on Hong Kong and/or seizing Taiwan while we're griping about a slowdown at the Toyota plant for lack of Chinese-made grommetage?  COVID-19 moves too slow (fast though it is) and does too little harm to most persons infected, too long after exposure, to be a useful weapon; the people who are paid to get paranoid about this have been poring over spy satellite output and comms traffic since halfway through Day One.  (And count on it, some of 'em bunkered up about supper time that day and they're still sealed up, but by now even they've got to be starting to say that it looks like just the planet trying to kill us as usual.)

     The Red Chinese government may indeed be plotting to kill us all and take over, Han Lords of the Wasteland for the Greater Good, but they've been getting rich selling us suspicious electronics and building roads, office towers, influence and totally not military bases, no sir, all over the third world.  It's working a treat so far; why would they poison a cow that's still giving milk?

     Poison gas is a much better weapon than this virus -- and it's a pretty poor weapon, especially when the wind suddenly shifts.

     If anything, this pandemic may result in some rethinking of supply chains and supply-chain resiliency.  It's unlikely to increase China's influence and will probably do just the reverse.

     Stop spreading panic.  Stop spreading misinformation.  Wash your hands.  Cover your mouth when you cough or sneeze.

It's Never The Cat You Expect

     I managed to talk Tam into interviewing some possible new members of the household.  I'd found three likely prospects at Hamilton County's no-kill shelter, all torties: Croissant, Monkey and Kigs.

     Miss Croissant was very shy.  She was hiding under a blanket in her bed (which the shelter carried out to the visiting room with her inside) and while she looked out a little and didn't object to being petted, she preferred to stay hidden.  She was anxious.  Her foster family had reported that she was very cautious but would eventually relax.  I didn't think she'd like Huck much.

     Monkey was not even interested in leaving her multilevel enclosure.  Ears flattened and all forted up in her bed.  She wasn't likely to be happy with our tiger, either.

     Kigs was as friendly as can be.  A nice cat -- but she's got limited vision.  She doesn't appear to be able to move her eyes.  I was worried a bouncy tomcat was not going to be good for her.

     I met a pretty, tiny black cat with a white tummy and white-tipped tail.  She was friendly and lovey, but so small and at a year old, likely as big as she'd ever be.  I was concerned she'd be intimidated.

     Tam was looking at a young fellow almost Huck's size, brown and gold and sable, with long hair.  We spent some time with him and he was friendly and nice.  After a lot of discussion, we decided to give him a try.  Because he needs some medicine, we're just fostering for now and he won't be meeting the Head Cat In Charge for a while.  His name is Holden.

     Holden was as good as gold on the long drive home.  Once the house was divided -- we've done this before, since Tommy refused to believe any creature except his immediate family was really a cat -- Holden emerged from his carrier, found the single most inaccessible spot in the back part of the house, and has remained there ever since.

     This may take some time.

Wednesday, March 04, 2020

Doctor, Brunch, Nap, Drugstore, Grocery

     It's the darned "nap" part I don't like.  I had a good sleep last night, woke up fine and went to the doctor.  Then Tam and I walked over to a nice place for brunch -- and darned if I wasn't worn out once we got back home.  I thought I'd just relax a bit but I was out like a light within minutes of laying down.

     Tam decided I wasn't going to wake up any time soon and made a run to the big-box store, a jumped-up five and dime.  I woke up about the time she returned, just in time to make a run to the drugstore for some new prescriptions.

     I am hopeful one of them will help with this sleepiness.  Tests suggested it might: my thyroid's about half-asleep at the switch, despite being yelled at by other parts of the endocrine system.  Been there before, got better, and now it's back.  There are drugs for that.

     Got ambitious and made a big pot of Hoppin' John for dinner -- with an Irish Banger sausage, a big ham steak cut up in cubes (I haven't seen real "seasoning ham" for years now; I need to get over to the fancy butcher and find out if they've got it), some nice mirepoix (celery, onion and carrots, cut up and ready to go -- tolja I was sleepy), fresh mushrooms, canned crushed tomatoes, canned green chilies and a can of blackeyed peas.  Cooked up the meat (sausage first), added vegetables and mushrooms, and once that was done enough, added the canned stuff and a little this and that in the way of spices.  Ten minutes of simmering and it's about as good a quick home-made dinner as you could hope for.  I had mine over rice; Tam didn't.  Hot sauce to individual taste.

     Starting the new drugs tomorrow morning.  It'd be nice to be able to stay awake.

Tuesday, March 03, 2020

I'm Off This Week

     It's a good thing I am off this week, because I am just worn out.  We walked to a neighborhood eatery for a late lunch yesterday and once we were back home, I had to lay down.  Once I laid down, I realized I needed to sleep.  So I did.

     Woke up about ten p.m. and had some supper while looking at television and at midnight, I was back in bed.  Got up at six to feed my cat, and went right back to bed until ten a.m..

     Since then I have made a pot of coffee and a little breakfast, ordered some new jeans, run a load of laundry and I can hardly keep my eyes open.

     Doctor's appointment is at eight tomorrow. 

     Also, I want a new Wu.  There's no replacing Miss Rannie but Huck and I are lonely already.

Monday, March 02, 2020

Sunday, March 01, 2020

     From 20 June, 2017:

Singing To Tam's Cat

Rannie, Rannie, Underfoot Wu,
How do you say "I love you?"
With winks and blinks and sometimes nods,
Which no one thinks is even odd.

You purr and beg for table scraps,
Or mice we've caught in humane traps.
You'll let no one tell you what to do,
Rannie, Rannie, Underfoot Wu.

     1 March 2020:

Oh dear Rannie, Underfoot Wu,
This life became much too much for you.
Slept curled at my elbow, night after night,
Wheezing and sneezing in the dim light.

Went warm to the register when the furnace ran,
Huddled there comfy and dreamed as cats can.
You left purring and smoothing while we sobbed and held you,
Rannie, Rannie, Underfoot Wu.