Coronavirus Testing Shortages Force Extreme Shift In Strategy By Local Health Officials

Yves here. The admission that the US, even if it had coronavirus test results, lacked the institutional capacity to do contact tracing, is a stunner. Gee, we supposedly live in a world of AI and big data, but our Silicon Valley gearheads can’t come close to what China has done?

But we can find the resources to do VIP contact tracing, like of the politically important attendees of the CPAC conference.

In a bit of synchronicity, Lambert sent along this tweet from the WHO director general:

By Jenny Gold and Anna Maria Barry-Jester. Originally published at  California Healthline, a service of the California Health Care Foundation

Public health officials in California’s state capital region announced this week they have stopped tracing the contacts of patients diagnosed with the novel coronavirus. They’ve also ceased recommending quarantines for residents exposed to people confirmed to have the virus.

It was a grim recognition of the virus’ infiltration — and is yet another sign of the detrimental effects of a lack of capability in the U.S. to test people for the deadly coronavirus as it continues to spread.

“The reason we have to move on is because testing did not occur. We’re still able to do about 20 tests a day,” said Dr. Peter Beilenson, director of Sacramento County’s Department of Health Services. “If you really wanted to quarantine and contain the situation, you would have wanted to know who was positive and quarantine them. Because we never had the tests, it’s kind of a moot point, and the horse is out of the barn.”

Sacramento County — which as of Friday had 17 confirmed cases of COVID-19, including one death — instead has begun advising residents to use so-called social distancing measures as a primary response. That includes asking people and businesses to cancel large gatherings, warning older people and those with chronic conditions to avoid crowds, and begging the general public to practice good hygiene.

The move is part of a shift from containment — where the goal is to track every case of the disease and end its spread — to mitigation, which focuses on protecting the most vulnerable from the effects of a disease that is already widespread throughout the community. County residents with any sort of illness are being asked to self-isolate until several days after symptoms resolve.

“Our goal is to be much more surgical in our approach to prevent the spread to seniors,” Beilenson said.

Sacramento County’s difficult decision to change course comes even as the director-general of the World Health Organization has said that it’s “wrong and dangerous” for countries to shift from containment to mitigation at this point in the pandemic. “Countries that decide to give up on fundamental public health measures may end up with a larger problem, and a heavier burden on the health system that requires more severe measures to control,” said Dr. Tedros Adhanom Ghebreyesus.

The U.S. has not made that shift as a whole, but experts say it’s concerning that some areas of the country have had to move away from the basic public health protocols of contact tracing and quarantine in response to the federal government’s botched rollout of coronavirus test kits.

“Every tool should still be on the table,” said Dr. Ashish Jha, a professor of global health at Harvard University. “We should not give up on containment. It’s a very big challenge ahead, but I feel like we are starting to make progress as a country, and if we do an all-of-the-above strategy, there’s a pretty good chance we’re going to get through this without too much harm to our population.”

King County in Washington state, which has been an early epicenter for the virus in the U.S., shifted from contact tracing as well, but still requires a 14-day quarantine for people who were exposed to someone with the virus. Yolo and Placer counties in California also have shifted to a mitigation approach, though the details vary.

The nation’s response to COVID-19 has been hampered by a range of problems with the federal government’s tests. Kits designed and released by the federal Centers for Disease Control and Prevention initially didn’t work; a narrow testing protocol meant it likely took weeks for some communities to know that the virus was circulating locally; commercial labs began testing only this week, and it can take more than four days for those results to come back.

President Donald Trump promised again Friday that the U.S. is ramping up efforts to partner with private companies on test production. But access to testing remains sharply limited, and varies widely from state to state and county to county. As of Friday, the number of U.S. residents tested stood in the thousands. By contrast, South Korea has been testing 10,000 people a day for weeks.

The limited testing capacity in California is a pressing concern, Gov. Gavin Newsom said during a news conference Thursday. The number of test kits is inadequate, the state faces a shortage of reagents needed to run the tests, and many counties can’t yet run their own tests. He said the state will contract with commercial labs to deal with anticipated backlogs.

Even vulnerable people who had contact with people known to have the virus can’t get immediate testing. Two days after a resident at a Carlton Senior Living facility became Sacramento County’s first COVID-19 death, Dr. Mark Ghaly, secretary of California’s Health and Human Services Agency, said that all residents were being monitored. But they hadn’t all been tested for the virus. “We are working to make sure that those who need testing, that we have it available,” he told reporters, “and are working with the facility to determine who will get tested very soon.”

Containment requires both testing to find out who has the virus, and the manpower to follow up on the results — and state and local public health departments lack sufficient resources for both, said Dr. Cyrus Shahpar, former team lead of the global rapid response team at the CDC.

In Wuhan, China, for example, 1,800 teams of epidemiologists, each made of up of five people, traced tens of thousands of contacts each day. “We would never be able to do that. Contact tracing is very resource-intensive,” said Shahpar. “It’s not like public health departments have 50 standby teams to do this.”

The federal government last week allocated $8 billion in emergency funding for the coronavirus response, but the move came nearly two months after the threat emerged, and long after early testing would have helped contain the virus. “A lot of parts of the country have already had community transmission. It’s late,” Shahpar said.

Without the ability to test, it’s hard to know if we’re abandoning containment strategies too soon, said Alan Melnick, health officer for Clark County, Washington. During a measles outbreak in 2019, his county was able to muster the resources to monitor more than 800 people. But during that epidemic, they could pull in resources from the outside. Today, few places have resources to spare. Decades of stagnant budgets have left public health departments trying to do more with less.

“When you’re fighting a war with bubble gum and shoestrings, you’re forced to make difficult decisions,” said Alex Briscoe, a principal at California Children’s Trust and former director of the Alameda County Health Care Services Agency. “The burden we are placing on an underfunded public health infrastructure is unreasonable and unacceptable.”

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  1. The Rev Kev

    Just to underline the incompetency of neoliberalism, the Jack Ma Foundation has just donated 500,000 testing kits and 1 million masks to America. One guy on twitter said-

    ‘Many will welcome this. Some will see it as an insult. The real insult is that the richest country in the world has waged war on science and as a result is finding itself helpless..’

    The real tragedy is this. Iran has been covering up the large number of their Coronavirus deaths in the past few weeks until satellite images showed mass burial sites outside their cities. Through gross negligence, the US has also been covering up the infiltration of Coronavirus in America and trying to cover it all up in the same manner.

    So in a few months time, will the Russian and Chinese be releasing images of mass burial sites on the American mainland that the Trump government will seek to hide?

    1. Joe Well

      Waging war on science. Ha!

      Waging war on the bottom 99% and using the war on science as a distraction.

      1. political economist

        Exactly right. TheDems BS about Trump’s “war on science” has not stopped them from ignoring the science on the climate and health care to attack the GND and single payer.

    2. Ahinsa

      Many hospitals in SE Kentucky do not have a stock of N95 respirators so doctors and nurses are being forced to wear regular masks to treat patients. CDC in its infinite wisdom (?learned helplessness) has approved this measure and the hospitals are telling the nurses they will be fine! I guess they will, as will the other patients they treat, until the nurses and doctors start becoming vectors and victims!

      1. stan6565

        My family member has had “district nurses” come and change the fistula bag on her every two three days (this is U.K.). Nurses would come without any aprons or masks, and we figured some of them must be carrying, inevitably. Not a good practice for treating frail patients with open wounds.

        So we told them not to come anymore. I am now the chief nurse in the house for this particular patient, almost fatally wounded as a result of NHS negligence. I am a consulting structural engineer by the way. We have been socially distancing for a few weeks now.

        Some other commenters have tabled an idea that our government may have thought this pandemic a very handy opportunity to “sadly” and “despite best efforts”, let the elderly and very ill (ie those that are expensive to treat), slip to the other side.

        I would not be surprised at all to learn that was true. Same in the USA I think.

        1. EMtz

          Way too much suffering for way too many people because of greed, ignorance and absence of compassion by the ruling class. Best wishes to you and your family member.

        2. m-ga

          You mean UK Gov negligence, not NHS negligence.

          The distinction is important, because UK Gov likes to to deflect blame onto the NHS, which it has been deliberately defunding with predictable consequences. UK Gov has direct responsibility for the NHS (it runs it).

          Sorry to hear about your family member :-(

          1. stan6565

            Firstly thanks for the kind thoughts.

            But, who is to blame? Gov or NHS? Well yes Gov is guilty for not funding enough I suppose but NHS as provider of service shouldn’t allow the standards to fall below some decent threshold.

            We were asked to come and have tests done. Due to previous history, tests were supposed to be done by a specialist surgeon. But in the event the test was done by a nurse, who through rush and ignorance went on to perforate an internal organ. This was not spotted for several days until a septic shock set in, and a last second major op in A&E to prevent a fatal outcome.

            After that, no follow up care. No assigned consultant. Then, complications ensued, but no considered response or forward looking plan was put together. If we didn’t research the matter in house and had privately funded treatments I fear by now there would have been one less person living in the household.

            So, to me, it is definitely NHS.

      2. HotFlash

        Every time I encounter a story like this, of vital social services starved for resources and leadership in the name of markets, I think of E. F. Schumacher’s book, “Economics as if People Mattered”.

        1. Harvey

          The other book that explains the US predicament is “Phishing For Phools” by Schiller and Akerloff.

          In short, organisations start by building a good reputation through providing quality goods/services. But then they slowly substitute cheap components while still charging for high quality. At the end the quality is so poor that everyone wakes up and stops buying. Then the organisation is cooked but the owners have made a fortune and walk away.

          So it is in the US, which was once great but now has third world services for its citizens. It is well on the way to utter failure. This is why the US mega-rich are bolting to their bunkers in New Zealand and other countries. They know the real situation because they dun it.

          1. DHG

            It will not fail prior to its destruction at the hands of Gods Kingdom. Says so right in the Bible as to what is to become of the 7th world power (Anglo-American).

  2. Brooklin Bridge

    Ghebreyesus says it well

    Our message to countries continues to be: you must take a comprehensive approach to fight #COVID19.

    Not testing alone. Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all.

    China botched it in the early stages but came back with a vengeance. Overall, they have reduced the R0 to less than 1. Except in Wuhan (or is it Hubei province?), they are getting 0 new cases per day. It can be done.

    The US, crippled by neoliberal market worship, disadvantaged also in dealing with an epidemic by loose federal structure where states decide health policy, might not be able to reproduce China’s success, but it can do a lot better than it is doing in spite of Trump.

    1. Brooklin Bridge

      Yesterday in comments I pointed out that Dr. John Campbell looked like he was doing a 180 on everything he had been speaking about before over the last couple of months. Many others noted the same thing in the comments to his post.

      Today, I am relieved to find that he has clarified that by saying that what he was saying yesterday was repeating his government’s point of view (UK). I think he could have done a better job of making it clear that these were not his views, but anyway.

      In his address today, Dr. Campbell specifically brought up the WHO and in particular the exact points that Ghebreyesus makes in the Twitter thread in this post’s links, which I repeated in my comment just above this one.

      He goes over each of those items in detail; (Containment), testing, contact tracing, quarantine, social distancing and points out that ALL these, every one, are things every country should be doing; and makes clear, there is no too late to do as many of these things as possible. He pulls no punches about the United States though he makes clear he is speaking about political and policy mistakes, not the country. He also points out the WHO’s recommendations are in direct contradiction to the UK’s policy, of which he was a mouth piece yesterday, and he feels the WHO is “diplomatically” rapping the UK (and US) knuckles for their failures.

      Not only am I relieved that Dr. Campbell has made this clarification, I feel it should be put in front of our Senators and Congress critters as much as possible. Neoliberalism or not, we can be doing better. We do not have to squander so many lives. Not doing so is a ghastly prospect for any country, but for one of our size it is staggering.

    2. Matthew

      Apparently Wuhan closed their last temporary hospital yesterday, after only finding 15 cases within the last week. Encouraging news, if only we had the capacity or political will to follow their example.

      1. DHG

        Many states are locking selves down and canceling events left and right, others that dont will be in trouble

  3. Lina

    So our local school district cancelled our K-12 schools effective Monday (I had already made the decision to pull my child out the night before the announcement came out).

    In the message, the superintendent said that the decision was made on the advice of our school district’s pediatrician (who happens to be my daughter’s doctor and I know him well, having experienced 2 years of bronchitis, pneumonia and upper respiratory issues with my daughter – hence my decision to pull her from school in the midst of this). There hasn’t been any confirmed cases where we live (the closest is Boston about 60 miles away). Anyway, the doctor said that given that there are NO TESTS being done in our area, we don’t know the full extent of the situation here and thus, we need to act with extra caution. Because of this, his recommendation is to close the schools. The email went on to say: It is important to note that the Governor, Commissioner of Education, and DPH have not recommended school closure….

    She also said to practice quarantine measures during this time – no play dates, people!

    Anyway, my point is government is clueless and for the first time I am pleasantly pleased to see a decision made based on science. Maybe there is some hope?

    On a another note, I experienced 9/11 first hand (lived in the city and was at work a block away) and I thought I used up my quota of crappy situations to have to experience. I guess I was wrong!

      1. Lina

        Exactly. As my school announced this, the front page of the Boston Globe had quotes from the Governor saying, closing the schools across the state is not recommended at this time. Hours later, Boston Public Schools closed.

        In a similar vein – my company, instead of issuing a whole work from home initiative, is “rotating” employees in/out of the office. That makes no sense to me. It’s a big company in NYC. Do it or don’t do – what’s this half are measure?

        It’s a mess. Make the right decisions for you and your family. You can’t depend on “leaders” now. They are utterly incompetent (though we all knew this, didn’t we?).

      2. Sophy

        Everything the CDC has been doing has been shocking. As a health care provider I just don’t want to even look at their recommendations anymore: their information is months old and not based in science, let alone current research on COVID-19.

        Local colleges have been shutting down but forcing instructors to go to the schools – that’s not social distancing. And many are still having students in EMT, nursing, psychology, physical therapy, and other health sciences, go to their clinicals, where they will be exposed without adequate personal protection equipment. This is because of the CDC. And admin’s greed for money.

        1. Anon

          My local community college, after implementing/pleading with students to incorporate careful hygiene and social distancing into their time on campus, and seeing minimal compliance, decided to make ALL lecture classes online access for the next 3 weeks (at least). We have no known Covid-19 cases in the COUNTY. (But since testing is not extant, or common, no one knows what the true situation is.)

          The goal of moving to online class instruction is to minimize the number of students (15K total) on campus and limit contact with older instructors, counselors, and other staff. Lab classes (PE, Science) will continue under strict personal contact protocol. The solution is a compromise between health issues and the need for students to complete 80% of course curricula to get transferable college credits. We’ll see if the gamble works out.

          Closing K-12 schools is a “no win” situation. Some parents want them closed, others don’t. In Los Angeles the school district decided to close from pressure by the teachers labor union. Again, few kids understand/implement the protocols of social distancing and smaller home groups may be the better option (for some). Meals for disadvantaged students will continue at the LAUSD (~500K students), but they will be drive-thru pick-up.

          It appears the pandemic could bring even the invincible US to its knees.

      3. rd

        Their recommendations make sense if you have data you can use to make rational decisions. However, the colossal testing fail means that the school administrators are effectively in Spring 1918 with zero useful data other than the knowledge of what exponential growth of pandemics looks like. I don’t think CDC has factored that into their advice.

      4. lordkoos

        Myself, I’ve been ill for the last several days with a tenacious bug of some kind. No fever, so not sure what it is, but definitely stronger than a cold. I had a flu shot this year so perhaps it’s a weaker case of the flu. They say the milder cases of the coronavirus last for two weeks. I’m staying in.

          1. Yves Smith Post author

            45% effective in adults? That’s pretty poor. So don’t beat up on yourself too much. And the flu shots for some reason typically have very low efficacy in those over 60.

            1. kevin

              Apparently there’s such a thing as a double flue shot for seniors. Michael Osterholm mentioned it on his recent podcast with joe rogan

    1. rd

      The Chinese have the stuff to provide because they make it. The US and EU outsourced that to China.

    1. b1whois

      That’s all well and good, but I don’t think that the situation scales to the current condition

      1. The Rev Kev

        No, not unless you can wear a six-foot condom to protect your body from this particular virus!

      2. xkeyscored

        It seems like a very similar situation to me. Sex and HIV: be safe. WURS: be safe. Act like you have it.

      3. dk

        All behaviors scale, even the bad ones.

        Collect small advantages. Little things count, especially if we have a lot of them.

        Gargling with warm salt water along with hand washing. Salt water doesn’t kill viruses but contributes to a hostile environment for the organism. Hostile blood/body chemistry is a general preventive strategy (antibiotic medication for example).

        Reducing sugar intake to improve autoimmune response. Even in the case of viruses, existing low level bacterial infections add to the body’s autoimmune burden. The less extra work the system has, the more resources it can give to recognizing and fighting a specific viral threat.

        I’ve used both of these strategies for decades since I don’t use insurance. Although less obvious, I also suggest that reducing unnecessary vitamin intake is helpful. Taking 100%+ RDA multi-vitamins is a low level stress to the body; vitamins are enzymes that promote various specific metabolic functions, and they can over-drive the system (e.g., high vitamin B dosages affecting circulation and blood pressure). One such supplement a week is sufficient.

        Finally, mineral supplements (again, one a week) help metabolic stability, before during and after disease encounter, and generally support electrolytic balance.

        This is not medical advice, it’s just what I do. YMMV and rational caution always applies, and as adults one can be expected to know ones own specific needs; diabetics certainly need to manage their sugar intake for their circumstances.

          1. dk

            Yes that’s just an example. Viruses are hard to target that way. They seem to respond to hostile blood chemistry like a lot of salt, alcohol, nicotine etc. but that’s risky too. With flu virus I usually try to quick-trigger and support the immune system’s antibody response and go through a fever phase (with self-quarantine). I try to knock a yearly flu out in 1-4 days to full recovery. If I don’t do that I’m sick for weeks like everybody else.

    2. stan6565

      All those years back, I thought gays were just left out there as practice targets, but obviously, intelligent gay people figured it out and got on to self-preserving.

      That is exactly what’s happening now, except that all western MSM is spewing bulls11t in order to confuse and distract those who may have the audacity to switch their brains on.

  4. thoughtful person

    No time at the moment to read anything here, will be back, but just wanted to report what’s up testing wise here in central Virginia. Sunday I returned from a business trip to Los Angeles and the SF Bay area where community spread was likely. I contacted my doctor’s practice yesterday afternoon reporting cold symptoms, no fever, which started Monday. They said they do have tests from LabCorp and that i should call and come in if i have a high fever or trouble breathing.

    So not widespread SKorea levels of testing here yet.

    1. Dirk77

      That may be a bleed over effect from NoVA and the rest of the beltway. Having lived there, I bet that the CDC, etc., are devoting enough resources to make sure everyone there is safe. If not, then don’t expect much for the rest of the country.

  5. efschumacher

    Contact Tracing: Isn’t that what the FBI, and OPM generally do to process Clearances, Secret and Otherwise? They should be able to devote all those years of expertise to rolling it out to something socially useful.

    1. stan6565

      Or just call Facebook to help.

      They have most of the information already but not sure how much they would charge.

      Never miss a chance to make a buck, I say.

  6. Amfortas the hippie

    the “richest country in the history of the world”, rendered into a Failed State by short sighted avarice and muddle minded willful ignorance, both on such a grand scale that it baffles the senses when fully grasped.
    the evidence for our failed-state-dom has been there for everyone to see since at least 2000 A.D., but in the form of disconnected and complexified numbers, buried in the footnotes of the Official Reports, that somehow manage to maintain the fiction of Exceptionalness. Inhabitants of the various Bubble Universes blissfully unaware of the pain and hardship happening just outside the gates(“Qu’ils mangent de la brioche”).
    That the gross cruelty and neglect of a growing number of our Fellow Americans can be so easily obscured, over decades, is breathtaking.
    and now, the pathogen(!) breaks into the open…there it is!…Catholic Mass suspended in Bexar County, of all things!…and still the denial runs rampant.
    my brother, Blithe Bourgeois Spirit, just last night:”everybody’s over-reacting…it will blow over…”
    Me: “besides handwashing and not touching your face, what is the main recommendation put forth on every TV?”
    Him:” stay home if you’re sick. Work from home”.
    Me: who makes your lunch and hands it to you? who puts the shit you order on your fone into a box? who takes care of our infirm step-dad?…do you really think those people have paid sick leave…let alone access to healthcare?”
    Him: changes subject to his latest fishing trip.

    the cruel, vengeful person that lives…in spite of my best efforts…in a small corner of my mind says “let it Come!”…Collapse is what it’s gonna take to shatter the illusions.
    Mass Death and Suffering so widespread that it, finally, cannot be ignored.
    But it’s unclear if even that will work….which is it’s own testimony to our decadence and navelgazing indifference.

    the silver lining, at this point, is that our gerontocracy may be dislodged(one hopes that there is a Hell), and that…like after the Black Death…the workers may enjoy a period of having bargaining power, due to such an indiscriminate culling.
    Nemesis forever stalks Hubris…and she’s been a long time coming.
    The Masters, after having endeavored to freeze Time in the late 90’s, and snuffing out any inkling of a challenge to their privilege(TINA), may finally learn what “Pragmatism” really means.

    1. xkeyscored

      I think the Benighted States may be waking up to the extent of its failed-state-dom. Much of the rest of the world has been aware of this for a while, even if it continues to kow-tow to a nuclear-armed nation that conducts foreign policy with sanctions, bombs and starvation.

    2. notabanktoadie

      When I hear TINA, I’m reminded that there IS an alternative that, so far, Right, Left and in-between have shunned since it decreases the power of elites to lord it over others and that’s ethical finance and land reform.

      And that reminds of the Monkey Trap – all the monkey has to do to escape is to release his grasp on the bait.

      1. Ian Ollmann

        Ethical finance maybe, but land reform? We are soooo post agriculture. It is a tiny part of the US economy, around 1%, and it is far from a source of wealth in this country. Really the narrative around farming is the bankrupt family farmer. We are working on post-manufacturing, so Marxism is increasingly irrelevant. It’s a knowledge economy these days. The land reform equivalent would be free college for all.

  7. Mark

    An excellent read:

    This might have been posted already but it is WELL worth a read. It is a comprehensive analysis of the spread and the ability for the spread to be drastically reduced. Most countries are being REACTIVE rather than proactive. And despite all the information out there it doesn’t seem to be changing fast enough.

    The US has about 3 weeks or so before things get dire. Unless they get AHEAD of this rather than being two steps behind. (I’m in Australia and we doing much better than the US in halting the spread. Though our social and health infrastructure is better equipped to handle the health and employment crises.)

    1. The Rev Kev

      G’day Mark. While it is true that we are doing a better job in Oz tackling it, that is mostly because we have universal healthcare as a base to operate from whereas the States notoriously does not. This means that it is being done piecemeal over fifty States but without their CDC giving out universal, practical standards to be adopted across the country like they should be doing.

      Having said that, we are still behind the curve here due to Scotty from Marketing and his wonky government. We should be shutting down schools whereas at the moment we only shut them down when a Coronavirus schoolkid is identified. Also we should have shut down ALL audiences at all games weeks ago. Scotty was going to attend his team’s last football game this weekend before the shutdown until he pulled out at the last moment.

      Finally, we should be having the transparency that the South Koreans have but a lot of this is still for privileged eyes only. A story for NC readers here. The Home Minister returned from Washington and brought back the Caronavirus with him. He then attended meetings with the whole Cabinet in an enclosed room to discuss the crisis before he got sick. So now Scotty from Marketing and his entire Cabinet have refused to be tested for Coronavirus and have refused to go into isolation for a fortnight.

      They will be having meetings with all of the States but it will be done by open telephone, but still. So the conclusion is that Scotty from Marketing’s performance during the recent bushfire was just not him going though a rough spot. It is just him.

      1. Mark

        Hey Rev Kev,

        Oops! That sentence of mine was a typo. I meant to say that we AREN’T doing much better than the US.


        1. Mark

          Oh an my sister who is a health care worker has now been waiting for almost a week for her test results! So it would seem that we aren’t too fast on that front.

      2. campbeln

        Trump hasn’t gotten tested, either.

        Hopefully Scotty from Marketing via good ole Pete and Ivanka can take out the worst elements of both the Aussie and US regim… governments.

    2. Brooklin Bridge

      Thank you, an excellent article indeed! I think the US is and will remain in blame-A-mole mode and has completely forgotten what a war time effort by the population itself is or ever was. What -we the people- accomplished just at home in WWII was nothing short of miraculous, so there is no doubt we could do it again ( deal with a pandemic in this case) if the country, and particularly the “leader class” hadn’t been so thoroughly brain washed over the last 70+ years (TV). George Bush unwittingly nailed it when asked what “we” could do for the country after 9/11: “Spend Money“, he replied.

      There is no one in power who has even an inkling of the human suffering that’s about to explode in this country and I strongly suspect (those that aren’t jumping ship to slither around in their underground pits that is) they are in equal denial about their own vulnerability.

      1. DHG

        Oh yes those in power know, they have set it up this way, eliminate the weak, more for them. Satan is the ruler of this worldwide system and it is he calling the shots.

    3. Ian Ollmann

      The difference between proactive and reactive is timing. If the time for proactive is passed already, as it surely has, then it is by definition too late for anything else.

      Really the poor response to Covid-19 is just a symptom of the larger malice (much of) the population has for its own government. Sure the government can be a source of evil or more often inept bumbling, but why anyone would knowingly choose to destroy the institution is beyond me. It is responsible for public safety, both against internal and external threats. The contract law it provides forms the basis of trade, as does its currency. The secular principles of the founders were not bad ones. The Republicans frankly have no business in government, any more than pedophiles running a preschool.

      1. Brooklin Bridge

        You’re right about timing, but not about too late for anything elese.

        It was too late for being proactive in Wuhan, yet China changed policy on a dime and managed to get it under control by drastic measures. It’s not too late to do better and that can save lives. In China it probably saved millions of them.

  8. Vichy Chicago

    I’m at a Food 4 Less in Evanston IL and it’s jam packed. They have toilet paper but out of:
    Fresh fruit
    Frozen vegetables
    Dishwashing soap
    Laundry detergent

    1. Joe Well

      Please don’t go anywhere that is jam-packed.

      Shelves will probably re-stocked in a week or two, right? (and then once that runs out, the real shortages begin)

    2. Amfortas the hippie

      Cousin in Houston, currently in the process of escaping the Pine Curtain…loaded down, himself, with who knows what…says the ten nearest grocery stores to where he’d been staying were jam packed, as well.
      seven car line just to get into the (ample, ahem) parking lot.
      this is last night.
      I’ve been finishing up getting the Pest Cabin livable.(I’d stay there, given enough beer—so…maybe another once-through?)

      Meanwhile, back on the Farm…
      you can tell how long someone’s lived out here by the severity of their seasonal allergies. Ergo, there is Always a lot of sneezing and throat-clearing going on, just about everywhere.
      This makes it sometimes difficult to determine when to take your kid, or yourself, to the doctor….in a good year.(only remaining determinate symptom is the presence of fever)
      we have a clinic….owned by a Spanish Conglomerate…that used to be an ER…that once was a part of a county hospital(wife was born there)
      In order of sophistication, we have “real” hospitals 40+ miles away to the north, east and south.
      helicopter rides are routine, due to distance from modern medicine.
      The largest employers are, in order, the school, the city and the county.
      Many of those not employed by Socialism drive considerable distances for work, where they have lunch out and all but touch everything they come in contact with, before returning home to have dinner out, where the process is reversed.
      We enjoy a Physician’s Assistant(PA) and a Nurse Practitioner, and an actual Doctor comes by from the moderately sophisticated hospital to the east.
      there are also 2 Home Health outfits…both absorbed by the same Spanish Conglomerate that owns the Clinic.
      Because of Stepdad(paraplegic vietnam vet), I see these people all the time, and hear often what they do not even realise are Labor Problems.
      I’ve managed to determine which of them are the least rabidly righty, and queried them subtly. Bad pay, tyrannical overseers, clock-watching overscrutiny of the wrong things.
      School Nurse is a heroine of the republic, and doesn’t know it.

      (claps hands) “let the Test begin.”

  9. xkeyscored

    In Wuhan, China, for example, 1,800 teams of epidemiologists, each made of up of five people, traced tens of thousands of contacts each day. “We would never be able to do that. Contact tracing is very resource-intensive,” said Shahpar. “It’s not like public health departments have 50 standby teams to do this.”

    I don’t know for sure, but I doubt China did either. If they didn’t, then this is a totally and pathetically lame excuse. All those parasites in the ‘health’ insurance industry could be deployed to do something useful instead of hunting for reasons not to pay up, for example.

    1. You're soaking in it!

      But China did have a well coordinated organization with deep roots in every aspect of their community who know how to take orders under a war-time level of activity. Many of those people were youth during the Cultural Revolution, and know how to get the message across, if you will. Really, when has the Party not been at war? Despite the corruption, it seems like the institutional memories were there to be mobilized.

      Could the US (perhaps through various National Guards) come up with groups with the authority and discipline to carry out the kind of work required? I don’t know if the will to try is even there. Really requires a vision to enable something here, and as Leonard Cohen famously said, “a scheme is not a vision”

    2. Brooklin Bridge

      To join in the speculation, I wouldn’t be at all surprised if Trump hasn’t been seduced by Boris Johnson’s alleged program of Herd Immunity.

  10. vegeholic

    The poobahs of academia and tech startup land are full of tools and algorithms to exploit big data. What do you do in the face of big problems and no data? I think we are going to find out.

  11. Bob Hertz

    I am all in favor of concerted action to slow the virus….but regarding the public statement at the start of this article: “5,000 deaths” is not a tragic milestone of anything.

    I bet that 5,000 persons around the world are dying from all causes in the time it is taking me to make this post!

    I understand that if no action is taken, the deaths could exceed 1 million, and that is tragic.

    But I do favor accuracy.

    1. jonhoops

      Well, you might want to look up EVENT 201 on youtube. Various poobahs and think tankers ran a simulation of this very scenario just this past October. The projected deaths worldwide were 65 million. So it probably will be very tragic indeed.

      Here is a link to the short film that they produced about a possible outbreak

  12. smoker

    Speaking of California Counties and the coronavirus, in Solano County, en route and arrival at Travis in Solano County, where there’s more than 600 in quarantine, 03/14/20 Cruise ship passengers at Travis AFB talk about nightmare conditions

    After this incident, the bus sat parked for another half-hour. “No one is making an announcement or saying, ‘Here’s why we’re waiting,'” she said. “We were just sitting there, scrunched together, which was very contradictory to everything they were making us do on the ship.”

    The floors of the bathroom were “wet and sticky,” and there wasn’t a light or toilet paper.

    Sounds like an experiment in incubation. Dr. Martin Seligman, Father of Learned Forced Helplessness, would be proud.

    “I saw one of these CDC guys the first day, and asked, ‘When are we going to be tested for COVID-19?’ He said, ‘Are you feeling OK?’ He said, ‘Well, you’re not going to get tested as long as you’re feeling OK.’

    “It’s a tragedy. It’s unconscionable that they could operate like this. Not a single person gets tested unless you are sick.”

    1. MichaelSF

      “I saw one of these CDC guys the first day, and asked, ‘When are we going to be tested for COVID-19?’ He said, ‘Are you feeling OK?’ He said, ‘Well, you’re not going to get tested as long as you’re feeling OK.’

      Catch-22 at work. That didn’t take long.

      1. smoker

        The piece was particularly frightening, when one considers that the first US and California case of community transmission, who was (is still being?) treated in Sacramento County, was likely in close range of someone in and out of that Travis Air Force Base in Solano County. February 28, 2020, emphasis mine:

        …. The first likely case of community transmission, in California as well as the U.S., was a woman in Solano County who is being treated at UC Davis Medical Center in Sacramento County.

        The California Department of Public Health says there are now eight public health labs in the state that can test for COVID-19. The labs are located in Alameda, Contra Costa, Santa Clara, Tulare, Ventura, Los Angeles, Orange and San Diego counties.

        Another Case in Solano

        Also Friday afternoon, a new case of COVID-19 has been confirmed in a Solano County resident by the Centers for Disease Control and Prevention, the county’s health department said. The infected individual was a passenger on the Diamond Princess cruise ship, where an outbreak infected dozens of people. Yet another patient, who had tested positive in Japan, is pending confirmation of infection from the CDC.

        Both patients had been evacuated to Travis Air Force Base, near Fairfield, and have now been transferred to mandatory home isolation, the department said.

        (sorry if duplicate, I think my first response vaporized hours ago)

  13. skk

    What a mess – again !
    Its not too early to start banging on about holding people in the executive, in the federal agencies accountable. With jail time. I saw how the incompetent and the corrupt got away scot-free after the 2008 mess.

    Never again.

    1. doug

      Sorry Skk, it will be again. And bigger! and bolder!
      they got away scot free in 08, and will again…

  14. Eustache de Saint Pierre

    This is printed as part of a long thread & the original wont translate for me from Italian, so will take up some space here in it’s entirety which I hope is OK.

    Italy – Dr. Daniele Macchini, a doctor from Humanitas Gavazzeni, talks about his life on the front lines to combat coronavirus.
    March 10th, 2020, 01:39 AM
    «With our actions we influence
    the life and death of many people»

    With a long post on Facebook, Dr. Daniele Macchini, a doctor from Humanitas Gavazzeni, talks about his life on the front lines to combat coronavirus. It is a creepy testimony, to be read from the first to the last line.
    Here is the post

    In one of the constant emails that I receive from my health management on a more than daily basis now these days, there was also a paragraph entitled “doing social responsibly”, with some recommendations that can only be supported. After thinking for a long time if and what to write about what is happening to us, I felt that the silence was not at all responsible. I will therefore try to convey to people “not involved in the work” and more distant from our reality, what we are experiencing in Bergamo during these pandemic days from Covid-19. I understand the need not to panic,

    I also understand the economic damage and I am also worried about that. After the epidemic, the tragedy will start again. However, apart from the fact that we are literally also devastating our NHS from an economic point of view, I allow myself to raise the importance of the health damage that is likely throughout the country and I find it nothing short of “chilling” for example that a red zone already requested by the region has not yet been established for the municipalities of Alzano Lombardo and Nembro (I would like to clarify that this is pure personal opinion).

    I myself looked with some amazement at the reorganizations of the entire hospital in the previous week, when our current enemy was still in the shadows: the wards slowly “emptied”, the elective activities interrupted, the intensive therapies freed to create as many beds as possible. Containers arriving in front of the emergency room to create diversified routes and avoid any infections. All this rapid transformation brought in the corridors of the hospital an atmosphere of surreal silence and emptiness that we still did not understand, waiting for a war that had yet to begin and that many (including me) were not so sure would never come with such ferocity . (I open a parenthesis: all this in silence and without publicity,

    I still remember my night guard a week ago passed unnecessarily without turning a blind eye, waiting for a call from the microbiology of the Sack. I was waiting for the outcome of a swab on the first suspect patient in our hospital, thinking about what consequences it would have for us and the clinic. If I think about it, my agitation for one possible case seems almost ridiculous and unjustified, now that I have seen what is happening.

    Well, the situation is now nothing short of dramatic. No other words come to mind. The war has literally exploded and the battles are uninterrupted day and night. One after the other the unfortunate poor people come to the emergency room. They have far from the complications of a flu. Let’s stop saying it’s a bad flu. In these 2 years I have learned that the people of Bergamo do not come to the emergency room at all. They did well this time too. They followed all the indications given: a week or ten days at home with a fever without going out and risking contagion, but now they can’t take it anymore. They don’t breathe enough, they need oxygen.

    Drug therapies for this virus are few. The course mainly depends on our organism. We can only support it when it can’t take it anymore. It is mainly hoped that our body will eradicate the virus on its own, let’s face it. Antiviral therapies are experimental on this virus and we learn its behavior day after day. Staying at home until the symptoms worsen does not change the prognosis of the disease.

    Now, however, that need for beds in all its drama has arrived. One after another, the departments that had been emptied are filling up at an impressive rate. The display boards with the names of the sick, of different colors depending on the operating unit they belong to, are now all red and instead of the surgical operation there is the diagnosis, which is always the same cursed: bilateral interstitial pneumonia.

    Now, tell me which flu virus causes such a rapid tragedy. Because that’s the difference (now I’m going down a bit in the technical field): in the classical flu, apart from infecting much less population over several months, cases can be complicated less frequently, only when the VIRUS destroying the protective barriers of the Our respiratory tract allows BACTERIA normally resident in the upper tract to invade the bronchi and lungs, causing more serious cases. Covid 19 causes a banal influence in many young people, but in many elderly people (and not only) a real SARS because it arrives directly in the alveoli of the lungs and infects them making them unable to perform their function.

    Sorry, but to me as a doctor it doesn’t reassure you that the most serious are mainly elderly people with other pathologies. The elderly population is the most represented in our country and it is difficult to find someone who, above 65 years of age, does not take at least the tablet for pressure or diabetes. I also assure you that when you see young people who end up in intubated intensive care, pronated or worse in ECMO (a machine for the worst cases, which extracts the blood, re-oxygenates it and returns it to the body, waiting for the organism, hopefully, heal your lungs), all this tranquility for your young age passes.

    And while there are still people on social networks who pride themselves on not being afraid by ignoring the indications, protesting that their normal lifestyle habits are “temporarily” in crisis, the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us. The cases multiply, we arrive at the rate of 15-20 hospitalizations a day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the emergency room is collapsing.

    Emergency provisions are issued: help is needed in the emergency room. A quick meeting to learn how the first aid management software works and a few minutes later they are already downstairs, next to the warriors on the war front. The screen of the PC with the reasons for the access is always the same: fever and respiratory difficulty, fever and cough, respiratory insufficiency etc … Exams, radiology always with the same sentence: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized. Someone already to intubate and go to intensive care. For others it is late …

    Intensive care becomes saturated, and where intensive care ends, more are created. Each fan becomes like gold: those of the operating rooms that have now suspended their non-urgent activity become places for intensive care that did not exist before. I found it incredible, or at least I can speak for Humanitas Gavazzeni (where I work) how it was possible to put in place in such a short time a deployment and a reorganization of resources so finely designed to prepare for a disaster of this magnitude. And every reorganization of beds, wards, staff, work shifts and tasks is constantly reviewed day after day to try to give everything and even more.

    Those wards that previously looked like ghosts are now saturated, ready to try to give their best for the sick, but exhausted. The staff is exhausted. I saw fatigue on faces that didn’t know what it was despite the already grueling workloads they had. I have seen people still stop beyond the times they used to stop already, for overtime that was now habitual. I saw solidarity from all of us, who never failed to go to our internist colleagues to ask “what can I do for you now?” or “leave that hospitalization alone.” Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we are unable to save everyone and the vital signs of several patients at the same time reveal an already marked destiny.

    There are no more shifts, schedules. Social life is suspended for us. I have been separated for a few months, and I assure you that I have always done everything possible to constantly see my son even on the days of taking the night off, without sleeping and postponing sleep until when I am without him, but for almost 2 weeks I have not voluntarily I see neither my son nor my family members for fear of infecting them and in turn infecting an elderly grandmother or relatives with other health problems. I am satisfied with some photos of my son that I regard between tears and a few video calls.

    So have patience, too, that you cannot go to the theater, museums or gym. Try to have mercy on that myriad of older people you could exterminate. It is not your fault, I know, but of those who put it in your head that you are exaggerating and even this testimony may seem like an exaggeration for those who are far from the epidemic, but please, listen to us, try to leave the house only to indispensable things. Do not go en masse to stock up in supermarkets: it is the worst thing because you concentrate and the risk of contacts with infected people who do not know they are higher. You can go there as you usually do. Maybe if you have a normal mask (even those that are used to do certain manual work) put it on. Don’t look for ffp2 or ffp3. Those should serve us and we are beginning to struggle to find them. By now we have had to optimize their use only in certain circumstances, as recently suggested by WHO in view of their almost ubiquitous impoverishment.

    Oh yes, thanks to the shortage of certain devices, I and many other colleagues are certainly exposed despite all the means of protection we have. Some of us have already become infected despite the protocols. Some infected colleagues have in turn infected family members and some of their family members already struggle between life and death. We are where your fears could make you stay away. Try to make sure you stay away. Tell your elderly or other family members to stay indoors. Bring him the groceries please.

    We have no alternative. It’s our job. Indeed what I do these days is not really the job I’m used to, but I do it anyway and I will like it as long as it responds to the same principles: try to make some sick people feel better and heal, or even just alleviate the suffering and the pain to those who unfortunately cannot heal.

    On the other hand, I don’t spend many words about the people who define us heroes these days and who until yesterday were ready to insult and report us. Both will return to insult and report as soon as everything is over. People forget everything quickly. And we’re not even heroes these days. It’s our job. We risked something bad every day before: when we put our hands in a belly full of someone’s blood we don’t even know if he has HIV or hepatitis C; when we do it even though we know it has HIV or hepatitis C; when we sting with the one with HIV and take the drugs that make us vomit from morning to night for a month. When we open with the usual anguish the results of the tests at the various checks after an accidental puncture hoping not to be infected. We simply earn our living with something that gives us emotions. It doesn’t matter if they are beautiful or ugly, just take them home.

    In the end we only try to make ourselves useful for everyone. Now try to do it too though: with our actions we influence the life and death of a few dozen people. You with yours, many more. Please share and share the message. We must spread the word to prevent what is happening here in Italy.…ne_1344030_11/

      1. Eustache de Saint Pierre

        I checked the 3 vignettes of which the Lombardy part was similar but not the same, if it was elsewhere & I missed it as I have to spend a couple of days each week as a carer & work very long hours the rest of the time, I apologise.

  15. Cat Burglar

    The Governor of Oregon, Kate Brown, held a press conference the day before yesterday on the pandemic. The State has only a tiny ability to test, and she said we are dependent on the capacity of commercial labs to provide test processing. Otherwise, we are dependent on Federal action. The accounts of the press conference read like an admission of inability to handle the crisis, and laying the responsibility for this at the feet of the Feds.

    There was a powerful sense of deja vu when I read it: histories of The Great Hunger in Ireland. The merchants would import food to Ireland in response to the rising prices, and the population without a red cent could buy it to ease their hunger. It looks like they are really going to just let this happen. There may be only the night sky above us.

  16. rd

    There are two parts to doing the testing. You need to extract the virus RNA from the sample and then you can actually do the test.

    Providing the CDC test kit is useless if the organization doesn’t have the capability to extract the RNA. Many hospitals and public health agencies can’t do the extraction, so they can’t do the testing even if they had a thousand test kits sitting on the shelf.

    This is a massive, massive testing fail throughout the US. Even if they didn’t have the test kits in hand, they could have been setting up the infrastructure to figure out how to do the extractions quickly and locally so that when the test kits were available, they could swing into action. That would require organization, cooperation, information etc. all of which are in shorter supply than the test kits.

    Public health has been gutted in the US despite having the most expensive healthcare system in the world by far. The system is largely structured to generate profits for insurance companies, hospitals, and private equity, not keep the population safe and healthy. Americans don’t understand that yet, but it will likely become evident over the next several months.

    1. Which is worse - bankers or terrorists

      Who can presumed to be liable for the lack of reagent to do the tests?

      One thing not discussed much is who is accountable for this.

    2. Yves Smith Post author

      A reader on Links said any semi competent lab can run these tests. This isn’t a matter of infrastructure in the normal sense:

      I’m a scientist at a biotech company who feels the need to clarify a few points on the Corona test itself. qRT-PCR is not an exotic assay sitting on the cutting edge of medical science. It’s very basic, routine and a cornerstone of basic research through drug development. The key requirements are the selection of specific primers and probe sets, and the inclusion of appropriate reference material. The primer/probe set sequences do not need to be created out of thin air, but can be transferred, wait for it, by email from anyone in the world who has already sorted it out. The synthesis can be performed in bulk, on the cheap and rapidly (a day for something urgent, I think we’d agree this rises to that bar).

      The assay itself can be scaled into high throughput plate formats, and run with automation by a marginally trained technician. It does not take 2-days. It takes a few hours. Yesterday we received an email from a local world famous teaching hospital requesting RNA extraction kits so they could start picking up the slack for state run laboratories that are apparently incapable of performing this basic function (which of course we provided). It’s endearing to see post-docs snap into action, but alarming that our institutions are caught with their pants down and incapable of performing this function as though they are being asked to crack some new brain teasing mathematical theorem.

      1. Jabbawocky

        I can confirm this. I could turn my lab over to Coronavirus testing in the time it takes for primers and positive controls to arrive (<1 week). I with two people I could process say 3000 per day. Indeed any university in the US has several such labs.

  17. Tim

    In San Diego County, the County just stepped in yesterday and said we’ve got a couple of known cases, so we will assume it is in the community and initiated all recommendations and protocols appropriate for such. So schools have shut down for at least 3 weeks, all forms of voluntary quarantine and social distancing is recommended. The highways are as clost to empty as I’ve seen since early 2009.

    The goal is explicitly stated to lower the rate of the spread to keep the Health Care system from being overloaded. That’s the plan and we are sticking to it. The CDC is assumed impotent and we are acting accordingly.

    It’s going to fine for a few weeks, but after that I will start to worry about how much longer this level of economic stagnation can continue. When you spread the infection rate out, this may take months like the 2018 spanish flu did in St. Louis.

    1. Anon

      The “Spanish Flu” occurred in 1918. Covid-19 (2019) is likely to play out much different. Today, science can tell us more about the Covid-19 virus and its implications for pandemic infection than was known about the flu in 1918. (The Spanish flu was initially claimed to be caused by bacterium (like the Plague) and not definitively identified as a virus until the 1930’s.)

      Unfortunately, in 2020 virus transmission around the world is jet-aged. Schools are larger and social/economic interaction more complex. And while science can track Covid-19 permutations, implementing solutions based on science is now the weakness (See: Le Orange in the WH.)

      1. Claudia

        We may know more, but too many are afraid or otherwise unable to act. Might as well be the 19th century.

  18. Matthew

    Well unfortunately it seems that Washington doesn’t actually have the ability to enforce quarantine by state law. At least that’s what the mayor of Kent, in south King County, said after one of the people in quarantine there walked out and hopped on a bus.

  19. endurance

    “In Wuhan, China, for example, 1,800 teams of epidemiologists, each made of up of five people, traced tens of thousands of contacts each day. “We would never be able to do that. Contact tracing is very resource-intensive,” said Shahpar [ former team lead of the global rapid response team at the CDC.] “It’s not like public health departments have 50 standby teams to do this.””

    But we have plenty of federal, academic, and company scientists who are now home bound, many of whom would likely be willing and eager to help, from home, acquire even the basic contact tracing data or assist in the processing of it. Public health agencies including the CDC shouldn’t ignore that large home-bound scientific resource.

  20. CarlH

    If our leaders keep up this spectacular level of incompetence there might be a real revolution soon. They have failed us on almost every level, and in such a public and obvious way that once this really starts rolling here in the US that I think the potential for eruptive revolt is becoming more and more a possibility. Interesting times indeed.

    1. Yves Smith Post author

      I am so sorry. I wish you luck. But I am 62 with a 92 year old mother I am caring for, so similarly situated. But aside from some badly injured joints, I’m in excellent general health, so I am worried about infecting my mother.

  21. Saylor

    Fun factoid (which you all probably know) the flu showed up, killed a bunch of people, died off and then came back even nastier.

    1. Eustache de Saint Pierre

      All the more poignant due to the fact that although blurry it includes photos of the deceased, which gives them a reality that just listing names does not.

  22. Synoia

    I’m thinking dreadful thoughts:

    From a financial, or Neo-Liberal, perspective it is not economical the flatten the CoronaVirus infection curve.

    Much money must be spent in ICU beds, test, and policing the public. It is much less expensive, and quicker to let the disease take its toll.

    As horrific as this is, it resembles the US’ policy.

    In a Neo-Liberal world the Rich will purchase their ICU beds, and the remainder perish as they may. The US economy will rebound more quickly because of the smaller expense, and the people at the top benefit from the quick rebound.

    Ironically the elders who are more susceptible to infection and death, form a political target. Because the elderly are more inclined to vote for Trump, it would be prudent for a political operative to fund keeping the elderly in Democratic Areas alive to swing the vote to Trump, at the expense of Republican districts, where the elderly can be sacrificed.

    In the confusion over this plague, concealing such action would be quite possible, especially in it were only a small cadres who were driving the plan. It would be very difficult to discern the difference between incompetence, chaos and panic, and deliberate action.

    I’m glad where we live in a world where such actions are inconceivable.

    1. ambrit

      Sorry, but describing neo-liberal cogitation as “dreadful thoughts” is a moral judgement.
      Our Neo-liberal Overlords have abandoned morality in favour of Power.
      I would love to title a history of the 2020 American Presidential Election: “Inconceivable Actions.”
      Stay safe.

    2. Yves Smith Post author

      Do not attribute to malice that which can be explained by incompetence.

      Rich people need doctors. They have heart attacks and strokes just like normal people. Having the medical system collapse is not in their interest.

  23. VietnamVet

    If there is no contact tracking, lab testing, or enforced quarantine of the infected; it is all over. Half of the population or more will become infected, millions will die and hospital care will collapse.

    A plague of death like Iran and Italy will cover all of the Western Empire. Shelter in place if you can. Avoid social contact. Stockpile to have food in the months ahead.

    I must repeat this. This need not have happened! The Russian Federation on China’s northern border has only 56 cases. They have a functional government that closed their border. The West is too corrupt and incompetent to protect its people. Each and every death is on the billionaires and their bought politicians who destroyed their national governments to cut taxes, end regulations, and let a plague engulf the world.

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