Tag Archives: social distancing

Distance Learning, Disrupted Learning & Social Eruptions

On a morning walk, my mind turning to Dr. Anthony Fauci’s injunction to exercise, I daily move between the many signs posted outside houses in my neighborhood congratulating graduates of the Berkeley CA public high school my daughter attends or Oakland’s School of the Arts and Tech, ending among million dollar homes sporting yard signs congratulating graduates of elite private schools. This is America, and not uncommon. The path I take traces yawning shifting divides of public schooling across America in the most blasé of ways. The uneven distribution of different schools barely conceals the deep divisions between schools and families seems to widen in terrifying ways as the coronavirus pandemic continues to ravage the nation. While we are shocked to learn that Donald Trump delayed informing the nation about coronavirus not to panicked markets, the lack of school policies stood only to magnify existing fracture lines: for the failure to provide any overarching vision left school districts with the football as decision makers they are unequipped to assess of learning requirements in remote settings of learning, and to bear the weight of difficulties in shaping remote learning programs without training.

Ill-equipped boards are asked to struggle in high pressure situations with finding ways of engaging students increasingly removed from one another or instructional settings. Increasingly, states are offering regional guidelines, but the absence of a national policy may rupture public trust with the very schools on which the nation most depends, now treated as swimming in a laissez-faire sea without guidesposts in an already disrupted educational setting, raising questions of graduations, requirements, baselines of school performance, or even study habits and the value of coursework and requirements for diplomas or graduation, as the educational market long an unqualified good in America stands to erode.

But if this might have been an opportunity for collective response, we have no evidence of any preparation to supplement what school networks offer, as if those who can afford the private tutors, off-site education, and private educational services are alone provided with continuing education, as other scramble to make up the gaps school closures create. Unprepared with a broader educational strategy in the midsized of a global pandemic, we have all in essence “left the library” of schools, pausing education or switching the nation onto a disembodied experience, that makes the old physical globes of schoolroom study seem emblems of a far less complicated past, when global topographies lay undisturbed beside books in cozy nooks, waiting, as it were, for new fingers to turn it with curiosity, while more and more schools are compelled to remain on the remote learning platforms to which they gradually shifted en masse over the month of March, 2020.

U.S. News & World Report/Bret Zeigler

The status of education–and of school closures and now school reopening–became a sort of political football. Despite the readiness of a switch to remote learning and online platforms of education, school closures echoed a cartography of abandonment, in unforgivable ways: if closures were born of necessity, and disorientation before the pandemic’s spread. And the levels of insecurity that have been fostered in the desire for mitigation may remind us that the problem of COVID-19 has been a crisis of public education, as much as a lack of frontline workers’ protective equipment–PPE–or adequate testing.

To be sure, the many functions that schools now provide across the social spectrum of the United States–meeting nutritive needs; offering social and emotional support and providing models outside the family for structuring time; minimal levels of health services–go far beyond being quantified by educational standards: by a magic trick of tests and quantification, government may have reduced education to metrics that erased their value as sites of community from the Bush administration, and led them to be sacrificed with deeper costs than many have registered. Without metric to tally schools’ dividends to students and communities, we omit the crucial educational role of instructing about coronavirus comportments–from regular hand washing to social distancing to mask-wearing, to bridge some of the enduring divides that have endured in the nation, with coastal “elites” donning masks more than the “heartland” of an expansive non-urbanized midwest.

Mapbox from Dynata Data/Upshot, New York Times July 17, 2020 (link to interactive map)

Is not the deep and tragic failure to not “educate” the nation to mask-wearing, sustained since the first cases of the coronavirus reached our shores, suggested the only the initial hot-spots where infections ravaged communities in the New York tristate area, Seattle, the Imperial Valley and coastal California, and central Texas are sites of mask-wearing, with Chicago, Detroit, Denver, the southwestern border and coastal southern Florida and Tallahassee. Only a fifth of the time or less were all five people who might meet at a large part of the nation likely to be wearing protective masks.

Why is such a paucity of mask-wearing continuing save an absence of public health education? There is a predictable if terrifying congruence with areas that were themselves, by the proxy of underserved medical communities Mitchell Thornson mapped, also by a Mapbox distribution of commute-based health centers, rather than by counties, to suggest the sites most vulnerable to disasters such as viral infections: even if the promise of a complete count of infections recedes, the inhabitants of some 300 counties underserved by federal health services suggests fault lines of future sites of vulnerability, that may accentuate with continued school closures.

Mitchell Thorson, clinics in counties medically underserved and vulnerable to disasters. featured in USA Today, March 31, 2020

These steep inequalities of health care suggested a very broad difference in those able to weather and sustain COVID-19, to which the Trump administration seemed blind. School closures created insecurities for American families was perhaps not different from globally, but they lacked any support network: social support had withdrawn to schools in the United States more than other nations. The lack of any narrative of the sudden closures, and interruption of human contact and resources that followed, were deeply disorienting. And the lack of oversight from a government that one expected, perhaps with little grounds, to provide a sense of purpose and oversight in an unprecedented health crisis was, unbelievably, punted to the states, and from the states to local school boards, utterly unprepared to cope or plan–as admittedly, even are many medical specialists and health professionals–with the scale of a pandemic.

It seemed like a charade of government effectiveness; Secretary DeVos shifted from leniency, lack of coordination, to steadfastness concealing unprecedented circumstances. And the recent possibility that private schools and sites of instruction will be allowed to open their doors, while poorly funded public schools serving adjoining communities, if sometimes distinct demographics: whereas public schools that serve up to 90% of American children–just short of 51 million (50.8) by federal projections–open for restricted hours if at all, private schools possess the needed funding for on-staff epidemiologists, thermal scanners, and additional teachers–as well as often enjoying more space.

The Emoji Icon Index tells at that on Instagram, the story of a skyrocketing use of the  ðŸ˜· emoji from early March, as the. Face-with-Medical-Mask rose in use in parallel to the icon of the virus, but a plan for schools, quickly shuttered in China, was not imagined, as wishful thinking prevailed.

While our nation is prepared to react to the novel coronavirus by high-level cabinet meetings to bail out airlines after summoning executives or the bail out of banks, school are evidently far lower down the list. If Donald Trump prioritized cabinet-level meetings on bailing out the airline industries to ensure the Dept. of Treasury provided passenger airlines $25 billion, cargo haulers $4 billion, airports $10 billion and airline contractors $3 billion as industry lobbyists demanded to recognize a 95% reduction of passengers in response to the epidemic, saw meeting with executives to work out that deal worth the time of health officers and coronavirus response team–

–while he saw no similar body of school executives with whom he might meet in one room around a glistening desk with nametags, mugs of coffee and glasses of water. A past President of the P.T.A. of an Alameda CA public elementary school was familiar with reduced funding of California’s public schools since rollbacks on property taxes, smarted at the clear contrast of inability to prioritize public schooling as part of our national infrastructure. Is it not most probable that the very corporate structure of the airline industry provides a more familiar set of faces to interact earning high incomes, unlike the leaders of the dispersed structure of public schools, or community voices, that Trump is so much more apt to dismiss and neglect?

Or is it that the nation is ready to sacrifice the public schools that are less likely to have the funding, save in wealthier districts in Durham, NC or Charlottesville, VA, echoing lines of a deep class divide? Not only were private schools prepared to devote attention and benefited from technological resources to transition to online platforms in the Spring, but are able to use larger buildings and reduced class sizes to benefit the children who attend them, while the aging ventilations systems of older buildings of public schools lie on the other side of a technological divide that plagues the nation.

To be sure, there are deep discrepancies–informing the Mapbox Upshot map, of which one might be rightly suspicious given the potentially unsound sampling practices based on the interviews conducted by Dynata, both in the United States and globally,  based on 250,000 survey responses between July 2 and July 14; the surveys administered by a firm boasting to provide businesses with a sense of global trends of consumption able to reorient businesses and advertisers to “re-opening,” but while showing vast expanses with relatively lower incidence of a group of five wearing masks–

–fails to acknowledge a rift among state governors who recommend masks, rather than require mask-wearing–or the considerable role that mayors have consistently played in advocating mask-wearing, if they often appear over-ruled by governors who have been filling the absence of federal policy: the looses of “recommendations” in Iowa, Wisconsin, Missouri, and Oklahoma, Kansas and the Nebraskas meant that only in some cities, where mayors had advised protective measures, was mask-wearing adopted, creating a terrifying prospect for the pandemic’s future.

When Fauci addressed the question of health disparities between race, he reminded the nation stoically that “we are not going to solve the issues of health disparities this month or next month . . . but what we can do now, today,” the voice of reason was probably far less reasonable for many, who had already tuned out, before he described the need for social distancing that was, in fact, a privilege for many. The mottled nature of northeastern communities the Dynata found in its interviews suggested an uneven terrain of mask-wearing policies, even in the Tristate Area, dictated by individual choice–and underscoring the lack of regional or federal policies.

The social topography of crowding, of second homes and of gardens or access to parks that was revealed in the Bay Area made us think in practical terms to egregious inequities that were perpetuated by sustained lack of investment to resolve pronounced racial disparities in health came as COVID-19–and the uneven landscape revealed as the coronavirus tore through communities where it was contracted in the United States. The revelation of inequalities was striking, as it suggested how communities experienced it quite differently, and the question of access to education–and access to remote education–cut across social divides in profoundly different ways.

The almost purposeful pronounced lack of master narrative in confronting COVID-19 was long apparent. President Trump, grasping for authority as a true authoritarian playbook, argued the situation demands force, as his removed son-in-law, the dauphin Jared Kushner, spun 60,000 deaths from COVID-19 as a “great success story,” as if to challenge the nation’s personal narratives with a monolithic storyline of a disconnect from communities which were ravaged by hospitalizations. In claiming his father-in-law created a “pathway to safely open up this great country,” Kushner radiated overconfidence as he painted a future as rosy as the marble atrium of Trump Tower, even when the figures didn’t add up. It was akin to Trump’s 1993 proclamation, after huddling with bankruptcy lawyers to obtain new lines of credit, having had “the most successful year I’ve had in business!”–he reprised in a compulsive act of boosterism over the next decade, and continues to rely upon in the pandemic.

The dauphin Jared had not only used a spilt infinitive, but a split reality, a divergence destined to make the Presidential Election about COVID-19, whose malevolence is hard not to say: as the growth of rates of infection by the novel coronavirus most rapidly grew in the United States, claims Trump was doing “things right” with coronavirus testing plummeting to 30% percent, over twenty-five million unemployed and further furloughs coming, and one million infected by the coronavirus and 60,000 dead in a month, hardly fit narratives that suggest “great success,” even as the rates of infection from the coronavirus may have by mid-March grown greater in the United States than any place in the world, as escalating infection rates would continue to elevate the United States far beyond other nations. The manifestation of symptoms of COVID-19 grew two weeks after contracted, and by late March through late June, they had risen above all other nations.

Yet no clear plan for school closures had emerged on a national level in the United States, and denial at the danger of the infection’s growth dominated. Vice President Pence adopted similar talking points, in a few months, taking it upon himself to bestow premature congratulations that “we slowed the spread, we flattened the curve, we saved lives,” in a mismatch evident to any map in news media, but to the actuality on the ground.

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Filed under Coronavirus, COVID-19, education policies, remote learning, school closures

Shelter-in-Place?

If elites have long harangued lower classes for continuing behavior that continued to spread disease, interpretation of the spread of illness has rarely divided so strikingly along separate interpretations. It is as if life or death matters were open to public debate: rarely have reactions to an infection been able to be received so clearly along partisan lines. While reaction to COVID-19 were long cast in partisan terms by the President, our Fearless Leader of Little Empathy, as far overblown, the surprise was perhaps that even as the data grew, and the exponential growth of infections in American cities began, the decision to announce Shelter-In-Place directives in hopes to “flatten the curve” shuttering non-essential businesses with increased fears of overloading public health facilities.

Faced by drastically uneven hospital bed capacities in individual states, reflecting existing fears of hospital bed capacities for intensive care units or floor beds, and deepening fears of needs to add increased beds across the nation, to confront a major public health emergency. Using different scenarios of increased needs for beds based on infection rates, a relatively moderate need for beds: infection of a fifth of the population in six months would compel expanding existing capacity for beds in multiple western states already hard-hit form infections, like Washington and California, east coast states, including Massachusetts and New York, and Midwest’s like Ohio, Michigan, and Minnesota, and many pockets of other states, including Louisiana. Actual fears of such an impending emergency of public health emergency —

The Upshot/New York Times/March 17, 2020

–grows even sharper if one allows oneself to imagine an expansion of infection rates to 40%–not unheard of for the highly infectious novel coronavirus–over the same six month period:

.The Upshot/Interactive Version/March 17, 2020

1. Even as “Shelter-in-Place” measures sought to staunch the spread of infections across the nation, the uneven nature of the measures adopted by state governors, mayors, and counties suggested a fragmenting of the nation, as the governors of many states reacted to the issuance of shelter-in-place orders or stay-at-home directives by declaring their separate rule of law, in the words of Alabama’s Governor, “we are not New York state, we are not California–right now is not the time to shelter in place.”

Shelter in Place Measures Confined to Bay Area/Washington Post, March 15

Yet if the confirmed infections of the novel coronavirus seemed concentrated in preponderance in Louisiana, California, and New York, the virulence of its transmission was far more widely distributed, Philip Bump created a simple overlay to show, and the readiness of imposing measures of restriction were often resistant to accept school closures, or shuttering bars and restaurants as a means to restrain the virus’ spread.

httpsPhilip Bump, Washington Post, March 17 2020

Such choropleths are poor indicator of concentration and dispersion of infection, or of the “hot-spots” early watchers of the novel coronavirus hoped to isolate, folks commuting from counties of identifiable outbreaks created an immediately far more complicated map of viral dispersal, often crossing state lines and state jurisdictions at the very start of March, as work commuting alone bled from 34 counties into 1,356–even into Mississippi!

County-to-County Commutes from Confirmed Cases of Coronavirus COVID-19/March 3
BRENNEJM, r/dataisbeautiful/

Despite some a lone call the President impose a national shelter-in-place order, but the response of asking for a collective sacrifice would be hard to imagine. But the animosity that Trump revealed to any governors who tried to impose a policy of social distancing has intensified a new sense of federalism, as the increasing opposition that President Trump has directed toward Governors who have responded with attempts to enforce social distancing led, mutatis mutandis, to a new call for “liberating” states from social distancing requirements, President Trump announced April 21 that “We are opening up America again,” with great content, heralding an “opening” across twenty states comprising two-fifths of the nation’s population, if partial reopening are only slated in eighteen states.

But how could one say that the need for social distancing was not increasingly important, in a nation where health care is not only not accessible to many, but that hospital bed capacity is uneven–and would need to be ramped up to serve the communities–

–but that many areas are distant from ready testing, diagnosis, or indeed the ability for easily accessible health care? What is COVID-19, if not a major wake-up call for disparities in public health and medical access?

New York Times

–and many regions suffer severe health care professional shortages, that have been obscured in the deep shortages of health professionals, according to Rural Health Info, who have revealed these gaps in the following infographic, but many towns in each county remain difficult to get to hospitals in time in cases of emergency or need.

2. The legitimacy offered to “re-opening” states for business channeled a rousing sense of false populism across the nation, courting possible onset of a second wave of infections by easing llocal restrictions on social distancing–although testing is at a third of the level to warrant safe a transition, several governors claim “favorable data” to justify opening shuttered businesses. But when @RealDonaldTrump retweeted an attack on public safety measures against COVID-19 that were enacted in California and other states to slow airborne viral infection that labeled the closures of bars, restaurants, and theaters as revealing local states’ “totalitarian impulses” in the face of COVID-19, as having effectively “impaired the fundamental rights of tens of millions of persons” and flagrantly abrogating constitutional rights and natural liberties: the endorsing of a tweet of former judge, Andrew Napolitano, of an open “assault our freedom in violation of Constitution” demeaning sheltering policies as”nanny-state rules . . . unlawful and unworthy of respect or compliance,” inviting the sort of social disobedience, encouraging the stress-test on our nation that the pandemic poses be generalized?

COVID-19 Infection Rates in United States/New York Times/March 27, 2020

While the calls to prevent violations of the U.S. Constitution have grown in recent weeks from March to April, it makes sense to question the validity of an eighteenth-century document to a public health emergency–or to abilities to respond to a zoonotic disease of the twenty-first century. Never mind that such arguments ignore the reserving of rights of state governors in the U.S. Constitutions Tenth Amendment to protect the safety, health, and welfare of the inhabitants of their territory, is the ability to manage state health not a calculus for public health officers, rather than a partisan debate? There is a despicable false populism and rabble rousing in decrying “nanny-state rules” as “unlawful and unworthy of compliance,” and covers for “assaults on freedom” as a Lockeian natural right. Yet in retweeting such charges and denigrating policies of social distancing as “subject to the whims of politicians in power,” President Trump perpetuated the notion that medical consensus was akin to an individual removed from public concerns. In doing so, Trump echoed the opinion of a member of his own Coronavirus Economic Advisory Task Force, Heritage Foundation member Stephen Moore, to protest “government injustices” echoing false populist calls to “liberate” Michigan and Minnesota from decrees of Democratic governors. As Moore called for further protests, opening a group, Save Our Country, dedicated to agitating for the reopening of states, out of concern for the “abridgment of freedom” of sheltering in place.

The call to arms over a rejection of social distancing emphasized the translation of the pandemic into purely partisan terms, and echoed the partisan resistance to the states-right discourse of a rejection of health care, using the panmdemic to divide the nation along party lines.

3. The weekend before SIP was announced in the East Bay, my daughter’s High School suspended, and I snuck out in the mask-free days for a Monday morning coffee at my favorite café, where my friend Mike caused some consternation in line by ordering through his black 3M facemask. The mood was survivalist and grim, but we stopped outside our local Safeway, as if to provisions before an impending lockdown, looking for half-and-half. Staring me in the eyes, Mike said with some resignation that the massive mortalities in northern Italy were our future in a week at most, as the spreading waves of infections migrated crosscountry, approaching in something like a delayed real time; the question was only when “It’s gonna happen here.

What was happening across the Atlantic Ocean was trending not only on social media, but was being attentively followed by epidemiologists like Dr. Cody, apprehensive of the state of development of pubic health across the entire East Bay.

The Public Health Officers in the region had been haunted by the vision, alerted by the tangible fears of the Santa Clara Public Health Officer, Dr. Sara Cody. That very day, Cody was convening the coming early Monday morning, gripped by a sense of panic for a need for action, as the public drinking festivities of St. Patrick’s Day loomed, and as Chinese health authorities curbed travel and cancelled New Years celebration, even if its airborne communication was doubted, in hopes to contain an outbreak that still seemed centered in its largest numbers in Wuhan province–

Quartz, January 22, 2020

4. It was if we were watching in real-time image the global ballooning of COVID-19 infections in the Bay Area feared was on its way to Silicon Valley, or the entire Bay Area, as the virus traveled overseas. The lockdown that had begun in northern Italian towns in a very localized manner from late February when a hundred and fifty two cases were found in Turin, Milan, and the Veneto, had, after all, only recently expanded to the peninsula, filling Intensive Care Units of hospitals or transforming them to morgues. Although elegant graphics provided a compelling narrative, with the benefit of retrospect, that “Italy’s Virus Shutdown Came Too Late,” the interactive story of a “delayed” shutdown after the February 24 shutdown of sites of outbreak within days of the first identification of an infection in Milan, across two “red zones” around Italian cities, and the March 3 cordoning of larger areas.

February 24, 2020 Lockdowns in Northern Italy
Lockdown in Response to COVID-19, March 8 2020

The reluctance to impose a broader shutdown over the northern economy created a tension between commerce and public health that led to a late ‘shutdown’ of the movement across the peninsula by March 10 to prevent infection risks, haunted by public health disaster.

Multiplication of COVID-19 Cases in Italy, February 27-March 12, 2020 BBC

Fears of the actuality of a similar public health disaster spreading under her nose led Dr. Cody to convene a quick check-up with local public health officers to see if they registered a similar alarm, and what policy changes were available across a region whose populations are so tightly tied. And the need to convene a mini-summit of Public Health Officers to take the temperature of willingness to recommend immediate public policy changes was on the front burner, as one looked at the huge difficulty of containing the outbreak in Italy–often argued to not have been responded to immediately enough, but revealing a full public health response that the Bay Area might not be able to muster, as Italy’s hospitals were flooded by patients with infections and was on its way to become the site of the most Coronavirus deaths.

Vivid fears a growth of COVID-19 filling the hospitals and emergency rooms after St. Patrick’s Day–an event for a far larger audience contracting the aggressive virus–led Dr. Cody to arrange a group call among the Public Health Officers in San Matteo and San Francisco early Monda. Dr. Cody had broad epidemiological training was rooted in an appreciation of contagious disease–including contagious diseases outbreaks like SARS, H1N1 influenza, and salmonella, and had worked on planning for public health emergencies and completed a two yer fellowship in Epidemiolgoy and Public Health, managing E. coli outbreaks as an Epidemic Intelligence Service Officer with CDC. Fears “crystallized” quickly of a scenario of similarly exponential rise in case loads making Silicon Valley a new epicenter outbreak of an epidemic overwhelming the public health services. As she quickly contacted Public Health Officers in San Francisco and San Matteo, to contemplate a response, by March 8, a lockdown in all Lombardy and other states was declared, as COVID-19 cases multiplied, in a chilling public health disaster replicating the lockdown in China.

In contrast to the uncertain public health numbers from China, as the city’s airport, highways, and rail stations, images of massive mortality from health care disasters in Italy were haunting and suddenly far closer in space, even if cases of viral infection were already reported in each province, Macao, Hong Kong, and Taiwan–revealing a global pandemic that linked place to a global space in ways difficult for some to get their minds around. The honesty that came out of Italy was an alarm.

The Bay Area health authorities were looked with apprehension at the arrival of St. Patrick’s Day celebrations, after the exponential growth of infections from COVID-19 in the region: Dr. Mirco Nacoti had just published an eye-catching account of the catastrophic conditions of Ospedale Pap Giovanni XXIII in Bergamo that weekend, describing the levels of general contamination of caring for COVID-19 patients, for whom over two thirds of ICU beds were reserved, and filled a third of 900 rooms in thd peer-reviewed NEJM Catalyst; he described phantasmagoric scenes of a hospital near collapse as patients occupied mattresses on the grounds, intensive care beds had long waiting lines and with shortages of both masks and ventilators, and poorly sterilized hospitals became conduits for the expansion of diseases. The clinical model for private care incapacitated, as patients were left without palliative care; a surge of deaths in overcrowded wards overtook China’s community-based clinics at such higher death rates of 7,3% Italian doctors plead felt incapacitated by the surge of cases overflowing at intensive care units from March 9-11 as a model for mass infection, before COVID-19 was declared a pandemic.

The desperation of a staged re-enactment of Michelangelo’s Pietà of L’Espresso were a few weeks or so off. While the spread of infections in our region had not yet begun, ant eh below photoshoot by Fabio Buciarelli did not appear until April 5, we were still formulation the desperation of confronting the ravages of disease we lacked time to develop any reactions, processing current or impending mortality rates.

Fabrizio Bucciarelli/COVID-19 Pietà. 5 aprile 2020, L’Espresso

The danger of trusting scientific modeling, or data, and fostering deep suspicions of trusting data on confirmed infections, or modeling that suggested the danger of failing to practice social distancing.

5. Decisions to “shelter in place” promised to “slow the spread” of COVID-19 transmitted widely in group settings, and able to create a public health disaster in the Bay Area, and was quickly followed by Santa Cruz county. After the growth of cases in Santa Clara county–whose rates of infection doubled over the weekend to 138 as of Monday–the absence of a any national restraining order save a suggestion to social distance, as Seattle cases of infection had grown to 400–and some 273 cases of infection had appeared over th weekend, despite limited testing availability.

The clear eventuality of a public health disaster, after a directive closing bars, night clubs, and large gatherings, as well as many school closures in San Francisco and the East Bay–where my daughter attends Berkeley High, whose doors shuttered on March 13; Los Angeles’ mayor, Eric Garcetti, closed bars, gyms, movie theaters, bowling alleys and indoor entertainment on late Sunday night, as Gov. Newsom encourage all elderly to self-isolate immediately. The 6.7 million in the Bay Area early agreed on the need for a “shelter in place” order as a basis to control the spread of COVID-19 that had been discovered in the region on March 16, 2020, anticipating the nation by some time.

The closure of all non-essential businesses in the seven counties sprung from the epicenter of Santa Clara county–Silicon Valley–but included affected a much larger area of commuters, no doubt, across an interlinked region of commuting far across the northern state to twelve other counties.

The cases in Italy would only grow, creating a textbook case of the exponential expansion of illness that killed a terrifying number of physicians in hospitals on the front lines against its expansion, as the arrival of medical supplies and medical viral specialists from China increased the logic of the lockdown as a response to its spread.

The evident stresses on the health care system of Lombardy, where a terrifying number of physicians on the front line contracted the virus and died, in the wealthy region of Lombardy, distanced the disease whose effects were projected or distanced onto China, and provided a clear scenario that Cody understood could be repeated, with even worse consequences, in the crowded population and limited health facilities of Santa Clara County: her own close ties to public health authorities in Italy made the exponential growth of cases from February 21 across the peninsula seem a preparatory run-through for a future disaster, as China was sending increasing medical supplies and specialists to Italy in a global story as a pandemic was declared in China March 11; northern provinces were declared under lockdown March 8 quickly extended to the nation, as a spike in 1,247 cases were found on the previous day.

When Cody urgently alerted San Francisco Public Health Officer, Dr. Tomás Aragón, to discuss the fears of a new epicenter of COVID-19 spread in Silicon Valley, they did not start by contemplating their authority to issue a legally binding directive to shutter businesses in the region. But as they discussed consequences of the exponential increase in Santa Clara County and the greater danger of facing an analogous overwhelming of pubic health hospitals as in Italy, haunted by a danger of a similar scenario overwhelming public health, and Cody’s tangible fear, Aragón floated the idea of a shutdown, acknowledging their authority of acting without permission of governors.or mayors or county supervisors; the call touched on a series of calls to debate options, including the most dramatic — a lockdown order–which seemed the only certain means to enforce isolation and social distancing haunted by the image of the increased diagnosis of COVID-19 across the Italian peninsula that would indeed only be publicly released March 18. Two days later, Governor Newsom expanded the policy to the entire state; the time lag meant that by late April, almost half of all infected with the novel Coronavirus in California were found in Los Angeles County, and were facing the prospect of overloading its public health system and hospitals.

Diagnoses of COVID-19 in Italy/ Ministero di Sanitá, March 18 2020

The influence of the health care provider Kaiser Permanente was unseen, but the preventive agenda of the health provider can be seen in a sense in the shadows of this quick consensus among six Public Health Officers. But the qyuick defense of the decision–soon followed by dozens of states since–suggests the prominence of Kaiser Health Care in the dynamic of emphasizing preventive health care, and in anticipating epidemiological spread. Cody’s brave insight into the fact that northern Italy provided a rehearsal for the public health disaster, shifting from the ban on mass gatherings to a concerted effort to isolate millions, was less apparent to the nation.

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Filed under Coronavirus, COVID-19, data visualization, global pandemic, Shelter in Place

Get Me Out of Here, Fast: Escape from D.C.?

The forced monotone of Donald Trump’s public address to the nation on March 12 was a striking contrast from his most recent State of the Union address. He sought to calm the nation as it faced the pandemic of the novel coronavirus COVID-19 in what was perhaps his most important public address. On the verge of breaking beneath the gravity of circumstances that spun far out of his control, however, rather than show his customary confidence, Trump seemed a President scrambling and in panic mode trying to rehearse stale tropes, but immobilized by events.

President Trump tried to look as presidential as possible, re-inhabiting a role of authority that he had long disdained, as he was forced to address a nation whose well-being he was not in control. The national narrative, as it was begun by WHO’s declaration of a pandemic, was perhaps seen as a narrative which seemed to spin out of his control, below his eyes, as he tried to calm markets by addressing the nation in what he must have imagined to have been as reassuring tones as he could summon. With his hands grasped but thumbs flickering, as if they were a fire under which he sat, as if he were wriggling like a kid strapped in the back seat of a car where he was a passenger to God-knows-where, wrestling with the increasing urgency that his aides demanded he address the outbreak of the virus in the United States that he had long tried to deny. Serial flag-waving continued to fuel President Trump’s attacks on China and the World Health Organization, as if trying to toe the line of adherence to America First policies of nationalism before a global catastrophe, that did not compute. If America First as a doctrine allows little room for empathy, affirming national greatness and the importance of a logic of border closures was all he could offer, and would be predictably lacking reassurance or empathy as he attempted to create a connection at a defining moment of his Presidency, but looked particularly pained.

March 11, 2020

If Trump rarely trusted himself to make hand gestures as he plighted through the speech, thumbs flickering, hands clasped, he every so often seemed distinctly out of synch with his austere surroundings, gold curtains drawn to reveal two flags, barely aware, perhaps, that the eyes of the world were very much on his performance in this new sound studio to which he was not fully accustomed, trying to explain that he had undertaken measures that had made us safe, even if he must have been worrying that the lack of worry he had been projecting and urging in previous weeks had risen across the nation, and his performance was not calming them at all. He was tasked with describing the vulnerability of the nation to the novel coronavirus whose effects he had downplayed repeatedly, but was no longer able to dismiss, and no longer able to concede posed a far greater threat to the American economy than the danger of “illegal” migrants he had so often pointed to as a cause of national decline: the virus that had already crossed our borders repeatedly, since the first cases of COVID-19 were diagnosed in San Jose and Seattle, would potentially bring down his presidency, and he lacked any ability to explain the scale of the effects of the virus that he had effectively helped release by ignoring warning signs.

Oval Office address of Wednesday, March, 11, 2020. Doug Mills / The New York Times)

The link of America to the world defined in his America First candidacy–even made the very identification of a pandemic difficult to process. And he did so in the starkest national backdrop possible, vaunting his closing of borders, suspension of “flights” from China, and ties to Europe–even as he encouraged Americans to return from abroad, and had allowed unmonitored entrance of Europeans and world travelers into New York that would make it the site of the entrance of the disease to the majority of American cities where the viral load arrived, with over 900 people entering America through New York daily for months after China suspended travel from Wuhan on January 23–after China called the outbreak “controllable” on New Year’s Eve. The declaration that echoed the concerns of the World Health Organization may have been buried in global celebrations, even as Trump blamed it for starting a sense of false complacence before undeniably “real” news that he feared would come to define his Presidency.

Trump was unable to accept declarations of the World Health Organization had just called the coronavirus outbreak–an outbreak which, we now know, he had in fact been hearing alerts from American intelligence as early as November 17, about the outbreak of cases of the novel coronavirus in Hubei province, rather than January, when initial infections in the United States were reported. As much as Trump found it difficult to admit the vulnerability of the United States to a global pandemic–or to the recommendations issued by WHO–who set the caduceus that symbolized medical ethics authority over the North American continent–at which he bristled at the notion of a global scope of edicts across boundaries, as if a map where national divides were erased as if it compromised national authority for a disease the President has been uncannily persistent in localizing in China, even before an increasing preponderance of evidence of its global circulation and transmission over a series of months.

Fabric Coffrini, AFP

As cascading fears grew in markets across the world, Trump was perhaps forced to realize his new relation to the world, even as the German stock exchanges plummeted as the measures he announced seem either difficult to process, or failing to address the importance of maintaining trade ties–or of taking adequately prudent steps of public health.

Slumping in his seat at the Resolute Desk, perhaps contemplating how no predecessor had ever delivered on air unprepared remarks from the desk, and visibly discomfited in doing so. He must have hoped to make up for his televised performance by sending surrogates scrambling to social media, issuing clarifications for misstatements–as the exemption offered U.S. citizens to return from China, or the exemption of Ireland, as well as England, and an assurance that trade would “in no way be affected” by the ban, as markets had reacted poorly to his performance. While it seemed that Trump was cognitively unable to process the possibility of a crumbling American economy–and a decline of America’s place in a global economy–under his watch, a prospect faced since he had met with airline executives with whom he discussed the effects of stopping flights of foreign nationals from China in a March 4 meeting, offering them a bailout that limited the impact economic effects of heightened travel advisories, is it possible he had no sense of the massive fallout on the national economy?

March 11 Address/Ralph Orlowski/Reuters

As Trump spoke, global markets not only failed to register confidence–but plummeted, as he revealed no clear plans to to call for social distancing to contain the spread of the virus, and revealed that lack of national preparation for confronting an infectious disease that had no vaccine. He may have remembered that he had outright fired a former cabinet member, barely remembered in the rogue’s gallery of administration, Tom Bossert, who had demanded preparedness “against pandemics” and a “comprehensive biodefence strategy” of the sort the previous administration of Pres. Barack Obama had tried to institute, or that a simulation of a pandemic that could devastate the American economy and kill up to half a million revealed in October 2019 “just how underfunded, underprepared and uncoordinated the federal government would be for a life-or-death battle with a virus for which no treatment existed.”

It seems likely he was rather trying to conceal the massive scale of lying to the nation about the effects of an economic downturn unprecedented in scale, but which the increased lines at Wuhan’s Tianyou Hospital the previous November had already indicated had a problem of infectious diseases on their hands that would have a potentially global consequence. Trump tried to spin the consequences as purely local, in an unprecedented wishful thinking whose scale of deception far exceeded the pathological deceits he had long taken to perpetrate on investors, business partners, and even on family members–from hiding his older brother’s treasured trucks that were a Christmas gift and then admonishing him not to cry, or he would destroy them before his eyes. Even as satellite imagery showed a clear rush to hospital emergency rooms in Wuhan in November, as clusters of cars marked in red crowded the emergency rooms that revealed “a steep increase in volume starting in August 2019 and culminating in a peak in December 2019,” when China began epidemiological investigations that led to identifying and sequence of the novel coronavirus by January 12, ten days before the city went on lockdown to contain its spread.

Annotated Satellite Photographs of Wuhan’s Tianyou Hospital in September 2019

While Trump registered no alarm at the arrival of the very pandemic whose global impact American simulations feared would cripple the national economy, he tried to offer spin on having closed borders to the virus, as if it were not already diffused within the country, in a mind over matter sort of exercise that suggested limits purchase on reality, as if he was able to recognize the risk earlier administrations had identified as a national priority.

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