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Mr. Trump has promoted hydroxychloroquine as a game-changing drug in the treatment of Covid-19 ever since mid-March when he first acknowledged the threat of the disease. Detractors of Mr. Trump looked for a personal financial interest in Plaquenil, the brand name version of the drug, but he holds only a minor interest (around $1500 of Sanofi stock held by a mutual fund). The truth, as I see it, is more worrisome. The president and many of his followers, some of them otherwise well-educated, simply fail to understand the nature of scientific inquiry. Mr. Trump has faith in what he “hears from a lot of people,” people he trusts. At the same time he is deeply distrustful of the motives of “experts,” defined as all those who question the truth of the statements he makes.  Hydroxychloroquine was approved for medical use in 1955. Its multiple side-effects are known, manageable, and less serious than the conditions it treats, primarily rheumatoid arthritis, systemic lupus, and malaria. Previously approved and relatively safe drugs are often considered for treatment of emerging diseases. So it was with chloroquine (the parent drug of hydroxychloroquine) during the original SARS epidemic (2002-2004). A group of scientists (mainly at the CDC) tested chloroquine in a culture of monkey kidney cells (what we think of as “in a test tube” or “in the laboratory”). They found that chloroquine inhibited the spread of the original SARS virus from cell to cell. Their findings were published in 2005, a year and a half after the last cases of the original SARS were reported (in January 2004) by the World Health Organization. On account of the timing, chloroquine and hydroxychloroquine for treatment of the SARS-1 understandably gained little attention.  Fourteen years later Covid-19 appeared. Prof. Didier Raoult, a flamboyant, outspoken, iconoclastic French researcher in Marseilles was ready. In early March, Raoult and his institute tried hydroxychloroquine against Covid-19 in a tiny, open-label, non-randomized human trial (36 virus-positive patients divided into three groups), comparing viral shedding in treated versus untreated groups. On the basis of six-day results of this tiny trial, Raoult announced, “We know how to cure the disease.” Is this science or self-promotion? It is certainly not an adequate human trial to justify treating hundreds of thousands of patients. Raoult’s story was covered in a lengthy article in the May 12, New York Times Magazine, “He Was a Science Star. Then He Promoted a Questionable Cure for Covid-19.”  A cure offered by a medical researcher? That’s headline material. “Lots of people” talking about it, especially reporters on Fox News? That’s proof enough for Mr. Trump, reason enough for his enthusiastic, headline-grabbing endorsement.  But that’s not how actual scientific progress happens. (See P.S. below) Raoult’s study, with only thirty-six patients, raises far more questions than it answers. How does a reduction in viral shedding relate to the disease process? How old were these patients and in what state of health? Most importantly: were Raoult’s results any better than chance?  In Fox News and Trump world, the world of science illiteracy, none of that mattered, nor has it much mattered that a number of much larger studies since Raoult’s have looked at chloroquine and hydroxychloroquine, and failed to demonstrate any benefit. More alarming, several studies suggested that more treated than untreated Covid-19 patients died–of cardiac complications known to associated with these drugs. In a sane world with a president whose background included more science than reality TV, hydroxychloroquine would have been mentioned as one treatment being tested, not as a wonder drug. If we don’t rid ourselves of this man in November along with many of the elected officials that prop him up, our country is doomed to slide back to a time when policy was determined not by progress of scientific understanding but by whatever bright and shiny idea is whispered in the king’s ear. Keep to the high ground, Jerry P.S. The general story of excitement over a new drug or the new use of an old drug is familiar to every physician and scientist. A physician tries a drug that is already on the market as treatment of a few patients with a different disease. (That’s ethical, as long as the drug has only well understood and manageable side effects.) The patients’ condition improves (See P.S. below). The news media, sensing an eye-catching story, hype the new “discovery.” Sober medical researchers then invest time and effort running blinded, placebo-controlled studies of the new use of the drug, testing it in much larger groups of patients. Often these studies prove the initial enthusiasm was overblown. Either the drug shows some benefit (often rather minor and statistical) and becomes an accepted treatment OR the large studies demonstrate the drug to be no more effective than a sugar pill OR, worse, the frequency of nasty side effects is greater than the marginal benefit. Finally, the news media barely cover the more sober assessment of the new use of the drug and the whole episode drains out of the public consciousness.   P.P.S. Scientific illiteracy is distressingly common–and it is used by some for political advantage. One of the confirmatory voices Mr. Trump heard in support of his faith in hydroxychloroquine came from this April 7 article in the right-leaning New York Post: “Michigan Democratic lawmaker says hydroxychloroquine saved her life.” The article is an inspiring and sincere testimonial to humanity’s overwhelming desire to “connect the dots.” We naturally tend to credit the next thing that happens to the last thing we did, especially if the thing that happens is dramatic and apparently life-saving. No one will ever convince this Democratic legislator that her dramatic improvement after taking hydroxychloroquine might have been pure coincidence–or that proof of the cause and effect relationship she perceives depends on further study. (I am certain Mr. Trump referred to this legislator’s testimonial in one of his press conferences, but I cannot put my finger on the reference at this moment.) P.S.P.S. For those who enjoy podcasts, a May 13th Fresh Air on NPR, Doctor With Rare Disease Decides To Find His Own Cure, is not only a fascinating story about a rare disease, but a window into how real medical science is trying to test for drugs useful in the treatment of Covid-19. It stands in stark contrast with Trump’s headline grabbing.

Last Wednesday, May 27, the Spokesman published an article entitled, “Restrictions loosened on religious services in Spokane, other Phase 2 counties,” in which the Phase 2 guidelines for such gatherings were laid out: 

“The numbers in the limitations [no more than 50 people or 25% the buildings’ capacity, whichever is smaller] do not include the staff from the religious organization, who should wear personal protective equipment when appropriate. The facilities should be cleaned and sanitized frequently.

Participants must follow social distancing rules, so no physical contact between participants and no communal sharing of food or beverages is allowed. They must wear face masks, even when singing, and no choirs can perform.”

(Note that most or all of these guidelines have been pointedly ignored by Pastor Ken Peters’ of the Covenant Church for the last four Sundays.)

In view of our improving understanding of the spread of Covid-19, these Phase 2 guidelines are entirely reasonable. Pushback against these guidelines seems at best ill-informed, at worst. profoundly stupid.

Jim Camden, author of the Spokesman article, quotes comments from a number of faith leaders, all of who expressed support for the guidelines and judged the guidelines reasonable and prudent. Then Mr. Camden adds:

But Mark Miloscia, executive director of the Family Policy Institute, called the limitations disappointing after churches have been closed for more than two months.

“Tribal casinos, big box stores, even pot shops have less regulations,” Miloscia, a former state legislator, said during a video on Facebook. “We still have the First Amendment.”

First off, people sing, hug, shake hands, and gather in clusters in churches, not in casinos, big box stores, or pot shops. Mr. Miloscia’s comparison is thoroughly off-base. And what gives this man and this “Institute” standing to be quoted as representative of the faith community? Why isn’t his opinion relegated to the Letters to the Editor page?–monetary backing, a divisive political agenda, and the internet.

The Institute has a professional looking website, The Family Policy Institute of Washington. (But professional-looking websites may be had for a few hundred dollars investment.) The Institute’s featured “Team” consists of just two people. Mike Miloscia is the “Executive Director” (over a staff of one?). His bio details experience as a state legislator, politician, and lobbyist, not as a faith leader. Among five of the group’s “Issues” on the website are “religious freedom, parental rights, and marriage,” all hot-button topics routinely exploited for political gain.

To merit quotation as an authority one might reasonably expect the commenter to be supported by prominent institutions and people of the community for which the commenter claims to speak. The Family Policy Institute’s listed endorsements consist of written statements by 22 people with a smattering of titles, one “Rep.,” one “Dr.,” and three pastors. Of the pastors two are associated with west side Assembly of God congregations and one with the West Seattle “Calvary Chapel” (based on web searches of their names). 

The website gives no indication of the Family Policy Institute’s funding sources and no explicit endorsements by any religious institutions (apart from personal endorsements by the three fundamentalist pastors noted above). The money comes from an unspecified source. The Family Policy Institute is also a “lobbyist employer” listed with the WA State Public Disclosure Commission as “Family Policy Action,” at the same address in Lynnwood WA as the institute itself. 

Mr. Camden responded to an email inquiry about his inclusion of comments by Mark Miloscia, writing, “The Family Policy Institute is a very active organization that lobbies for certain issues that would generally be described as conservative Christian: they are opposed to abortion, same-sex marriage and assisted suicide and recently have been vocal in their opposition to the comprehensive sex education legislation. They have some strong supporters among the evangelical Christian communities…His comments were part of the story as a way of offering different voices of reaction to the new rules.”

I understand Mr. Camden’s wanting to offer different voices, but the leap from the opinions of faith leaders who are actually responsible for the details of opening houses of worship in phase 2 to the opinion of a political operative responsible only to unspecified funding sources is a jarring shift. That Mr. Miloscia does not speak for all Evangelical faith leaders is already evident in Spokane from the contrasting comments and actions of Pastor Ken Peters of Covenant Christian and the Reverends Wittwer of the Life Center here in Spokane on the re-opening of in-person services

As we try to re-open during the Covid-19 pandemic (and at other times as well) it is important to sort out who is given standing to rile us against one another. The Family Policy Institute of Washington ought not be allowed a voice without better scrutiny of whom–and whose money–it represents. Setting up with a  name and a fancy website seems to be the Family Policy Institute’s prime claim to legitimacy. The broader religious community does not subscribe to Mr. Milosocia’s political belligerence. He should send in a letter to the editor, not be offered standing as an authority on how the Evangelical Community feels about Phase 2 regulations.

Keep to the high ground,
Jerry

The German state of Hesse relaxed restrictions on worship as of May 1, provided that parishioners maintain 5 foot social distancing and hand sanitizer made available. The Evangelical Christian Baptist Church in Frankfurt held in-person services on Sunday, May 10. Church officials said they followed the rules. Thirteen days later on May 23 the BBC reported there were “over 40 cases” of Covid-19 traced to that one church service. By the next day there were numerous media reports (led by the Wall Street Journal) that German authorities had traced “over 100” cases of Covid-19 back to that single church service–and contact tracers were still working on the case.  This is entirely parallel to the now infamous Skagit Chorale case in Mt. Vernon, Washington, in March where more fifty-two out of sixty participants became infected and two died over several weeks following a socially distanced choir practice.  Mr. Trump, apparently oblivious to the detailed report of the Skagit Choral case presented on the CDC website, threatened to “override” governors who refused to allow reopening of churches.  Neither of the state governments of Washington or Idaho loosened regulations on in-person large gatherings in response to Trump’s pandering to his base, but his grandstanding stirred up defiance of regulations on both sides of the border among his far right supporters. Here we have a “leader” stirring up rebellion against legitimate government. In Spokane the spotlight shown once again on Matt Shea and his prime ally, the Reverend Ken Peters of the Covenant Christian Church (3506 W Princeton Ave in near north Spokane). Peters and his flock held in-person church services without any attempt at social distancing on May 3rd, 10th, 17th, and 24th in self-righteous open defiance of state health regulations. The Spokesman article from May 24th is worth reading. The cast of characters and the organization are familiar: Ken Peters, pastor at Covenant and leader of “The Church at Planned Parenthood”; Matt Shea (State Rep, LD4), according to Peters “in the audience” and “fighting for the Constitution.” Pastor Gabe Blomgren, another fixture at Covenant, was one of the speakers at Shea’s May 1st stay-home protest.  Meanwhile, next door in north Idaho, Matt Shea’s right wing ally, ID Rep Heather Scott, was busy holding a crowded meeting in a church in Bonners Ferry three days earlier:

Another meeting was advertised for last evening, May 28, at the Priest River Community Church in Priest River, ID, entitled “The Virus that tried to kill our Constitution and What You Can do about it” in open defiance of Idaho health regulations. Many local churches besides those mentioned in the Spokesman article chose not to hold in-person services on May 24th, in deference to the health of their members, their members families, and the community at large.  The gatherings of unmasked, shoulder-to-shoulder, singing worshipers seem mostly confined to churches allied to certain far right politicians in our region, particularly Matt Shea, whose ties to Ken Peters, Gabe Blomgren, and the Covenant Church were manifest at Shea’s May 1 protest of the stay-home order. Ken Peters’ and his Covenant Church’s open defiance of state Covid-19 public health guidance serves primarily as political nose-thumbing, a denial of the common interest of disease prevention. Ken Peters and his Covenant Church apparently believe that their political/religious faith exempts them from epidemiology. Will they “get away” with their defiance? They might. but just one unwittingly infected and still asymptomatic, bare-faced, singing parishioner could convert a Covenant Church service into a case study worse than the Skagit Chorale or the Frankfurt Baptist Church. (In both of those outbreaks at least social distancing and hand-washing were practiced,) Should Peter’s and Shea’s and Scott’s risky defiance result in an outbreak, contacts in the wider community would be infected and some eventually die before contact tracers are even aware of the origin of the outbreak. For the time being the odds are not high of such an event and, sadly, lack of a Covenant Church-associated outbreak of Covid-19 will be cited by Peters, Shea, and Scott as evidence of their political and religious righteousness. No law enforcement challenge of Covenant in-person services will occur, in spite of their whining about violation of their “constitutional rights.” Compliance with public health regulations in these United States is largely dependent on community opinion.  To that end we all should recognize, separate out, and shun pastors, parishioners, and politicians who flaunt public health regulations. Familiarize yourself with these people, their names and their ideologies. Then thank your church and the churches of your neighbors and friends for sensibly following regulations meant to protect us all.  Keep to the high ground, Jerry

On May 1st, a Friday, several hundred protestors led by soon-to-be-former State Rep. Matt Shea marched through Spokane to the County Courthouse. They were protesting Governor Inslee’s stay-home order as “unconstitutional.” Their motto: “Freedom is the Cure.” Spacing was shoulder-to-shoulder, masks were rare and MAGA hats aplenty. Speakers were mostly familiar members of the Matt Shea circle: Gabe Blomgren of Covenant Church; Joey Gibson, founder of the Portland-based, far-right group Patriot Prayer; Caleb Collier, former City of Spokane Valley city councilman; and the Rev. Matthew Cummings, a right-wing pastor associated with the Marble Community Fellowship in Stevens County. 

Buried in that May 2 Spokesman article (linked above) was a photo of a speaker who was otherwise unmentioned in that first article: Jason Kinley, a doctor of naturopathy. Dr. Kinley, speaking to the closely packed crowd at the courthouse, “launched into a minuteslong polemic deriding stay-home orders and widely accepted public health guidelines offered at the state, local and national level.” That was according to the Spokesman’s followup article on May 17th. Speaking without a mask to mostly unmasked protesters, Dr. Kinley expressed doubts about the effectiveness of masks in reducing the spread of Covid-19. 

He told the crowd that there exists “no widely accepted treatment” for viruses. That is false. There are thoroughly tested, proven, and useful drug treatments for AIDS, herpes, and influenza, all diseases caused by viruses. 

His statements in support of the use of hydroxychloroquine and high-dose vitamin C for Covid-19 launched him into the realm of quackery. There is scant evidence, much less a series of double-blind, controlled studies, that supports the efficacy of either treatment. Hydroxychloroquine use in Covid-19 patients is associated with an excess risk of death from cardiac arrhythmia while showing no conclusive benefit. Dr. Kinley has not read, does not comprehend, and/or simply dismisses multiple studies presenting clear evidence. 

Dr. Kinley’s counterfactual presentation of medical science was his to make, except for this: Jason Kinley spoke as a “medical professional” from an appointed position on the Spokane Regional Health District’s Board of Health (SRHD BOH).

The Spokane Regional Health District Board of Health is an intergovernmental group encompassing Spokane County (the territory of the “Regional Health District”). The Board of Health holds a monthly meeting that is open to the public. The mission statement of the Board reads, “As a leader and partner in public health, we protect, improve and promote the health and well-being of all people through evidence-based practices.” Jason Kinley rejected evidence-based practice and directly undermined the mission statement of the Board on which he sits. How did Jason Kinley come to sit on the Board of Health? 

The only members of the twelve member Board of Health with any training in a health profession are Dr. Kinley, with a 2016 degree in naturopathy and Andrea Frostad, with a degree in Dental Hygiene. Both are appointed “members-at-large.”

To meet the Board, click here. Of the twelve members, nine are elected officials from Spokane county, city, and village governments. Three members are “members-at-large.” The Board appoints an Administrator, aka the Director of the Health District, and a District Health Officer, who reports to the Administrator. The District Health Officer, currently Dr. Bob Lutz, is the only person associated with Board who, according to the Bylaws, “shall be a qualified physician trained and experienced in Public Health. 

Each of the three members-at-large sits on the Board as an appointee put forward by one of the three County Commissioners, each from that Commissioner’s District within Spokane County. (map of the districts). Jason Kinley was appointed to the Board by Spokane County Commissioner Josh Kerns. Commissioner Kerns hails from District 1, the northeast part of the County. 

According to Kerns, Jason Kinley was the only applicant for the District 1 member-at-large position that opened up this year with the resignation of Donald Condon, M.D., a local family physician with 40 years experience in medicine. What does having only one applicant say about the advertising of the position and about community awareness and willingness to participate? One must suppose that those paying enough attention to know to apply might have a political agenda. (The Board of Health has been the target of the local and vocal anti-vaccination community for the last several years, a group also with allies in Shea circles.)

While the rest of the citizenry is paying little attention, a small, but growing, group of motivated folk, many of them allied with Matt Shea are organizing, paying attention, and joining local government. 

It is time for the rest of us to pay attention. The Spokane Regional Health District Board of Health holds an electronic meeting tomorrow, Thursday, May 28, at 12:30PM. You can watch the live proceedings at https://www.youtube.com/watch?v=nKT9hLJM5J0&feature=youtu.be  Visit the SRHD BOH website at https://srhd.org/programs-and-services/board-of-health/bohabout. Learn about and recognize the members and administrators. This is your city, county, and village collaborative government at work. 

Have an opinion about current goings-on after reading the Spokesman article? Written comment received prior to tomorrow, Thursday, May 28 at 10:00 a.m. will be included in the agenda packet and will become part of the official meeting record. Submit written comments at public_comment@srhd.org.

Keep to the high ground,
Jerry

P.S. Bylaws of an organization, any organization, tend to be checked only when a problem or a crisis arises. Then the Bylaws take on significance. The Bylaws of the SRHD BOH can be read here. I am unable to find a specified procedure for removing a member-at-large from the Board. Article III, 3. specifies a four year term for these non-elected members-at-large. It does not specify the details of geographic distribution or details of the appointment process. The Bylaws only state that the three at-large citizen members are “appointed by Board of County Commissioners.” Perhaps that Board has rules governing the at-large BOH appointment procedures. If not, then the District and Commissioner specific appointment process is a matter of custom.

P.P.S. It will be interesting to see what happens when the election and make-up of the Spokane County Commissioners is reorganized by Washington State law in the next year or two (pending the result of a court challenge to the re-organization filed by the Spokane County Commissioners themselves).

P.P.P.S. It takes some sleuthing to figure this out, but the “Regional Health District” of the Spokane “Regional Health District” is, geographically, simply Spokane County. It is one of 34 local public health agencies serving Washington State’s 39 counties. The confusing name is probably meant to avoid suggesting that the governance is purely through the three Spokane County Commissioners, when, in fact, the Board is made up of elected officials from cities and towns within the County in addition to the County Commissioners.

P.P.P.P.S It turns out there are a number of Boards in Spokane County that are formed by an amalgam of elected officials from various local governments. The Spokane Transit Authority, which I wrote about, is a governing board of similar (but different) composition to the SRHD BOH. More of your government at work–mostly unnoticed by the citizenry.

Pause and contemplate what we have lost and are still losing. 

Keep to the high ground,
Jerry

P.S. Back on Wednesday

The names on this poster are a who’s who of far right in the Inland Northwest. When I was young my mother often warned me, “You will be judged by the company you keep.” I’m not sure that is entirely just, but I think it behooves voters to be aware of the company that candidates and office-holders keep.  Soon-to-be former WA State Representative Matt Shea (LD4, Spokane Valley and points north and east) is near top billing, as is ID State Representative Heather Scott (LD1A, Canadian border to south of Sandpoint). Once a person has attained a government position, it offers the person an aura of legitimacy. (We see this in another Shea acolyte, Jason Kinley, a naturopathic physician recently appointed to the Spokane Regional Health District’s Board of Health, who spouted fringe medical ideas at the May 1 Shea-promoted stay-home protest.)  Take note of the name Rob Chase, former Treasurer of Spokane County and recently declared candidate in the shuffle for one the LD4 Representative seats in Washington State. What is he doing speaking at a “Liberate America” gathering in North Idaho? Chase is also on record as “seeing nothing wrong” with Shea’s “Biblical Basis for War” document. Chase is a frequent attendee at Greenbluff’s Northwest Grassroots gatherings, infamous for hosting James Allsup. Allsup is the young eastern Washingtonian white supremacist whose contorted face appeared among the marchers at Charlottesville. Among “birds of a feather” Chase’s plumage is clear. The updated “Guest Speaker” listing above (found on Redoubt News), rightly gives Ammon Bundy, son of Cliven Bundy of Bundyville, Nevada, top billing. Ammon, with his father, was pivotal in the armed standoff at the Bundy Ranch in Nevada in 2014. Ammon gained further notoriety leading the deadly occupation of the Malheur Wildlife Refuge in Oregon in 2016. LeVoy Finicum achieved what these people characterize as martyrdom in that incident (Finicum was shot dead after pulling a gun on state troopers). Both Matt Shea and Heather Scott traveled to the Malheur occupation in solidarity, perhaps in the hope the occupation might be the right spark to touch off the national conflict they stoke. Ammon Bundy apparently recognized friends and fertile ground for his ideas. He now resides in Emmet, Idaho, from which he peddles his ideas in the Inland Northwest. Joey Gibson is founder of “Patriot Prayer,” a small group notable for violent clashes in demonstrations in Portland OR. Patriot Prayer attracts white supremacists and the alt-right, including the “Proud Boys.” The “Proud Boys” recently made local news for vandalizing a memorial display for Covid-19 victims at Spokane City Hall. Joey Gibson demonstrated his lack of broad-based electoral appeal in WA State in 2018 by running against WA State’s U.S. Senator Maria Cantwell. He garnered 2.3% of the vote. Even so, he carries on as a political agitator, as this “Liberate America” billing shows. John Jacob Schmidt (the alias of Jack Robertson) spreads the word by hosting a weekly podcast on Radio Free Redoubt.  Rene Holladay, aka “Lady Liberty” of the theocratic Liberty State movement (and former Shea aide), is also the author of a book, “The Perils of Sustainable Development.”  Tom Deweese, new to me with this poster, is a national figure, founder of the right wing 501(c)(4), the American Policy Center, and prominent promoter of conspiracy theories around Agenda 21.  Agenda 21 is a non-binding UN resolution around sustainability alleged to be “the linchpin in a plot to subjugate humanity under an eco-totalitarian regime.” Pastor Afshin Yaghtin leads the small fundamentalist and activist New Covenant Baptist Church at 5109 N Adams St in Spokane. He is a close ally of Pastor Ken Peters of the Covenant Church at 3506 W Princeton Ave, Spokane, where Matt Shea sometimes preaches and holds forth as a supposed persecuted patriot. Both pastors and Matt Shea have been involved in “The Church at Planned Parenthood,” yet another idealogical means of rallying political support. Ingri Cassel and Jaclyn Gallion are active local leaders in the anti-vaccination movement.  Pay attention. These people are not benign, to which Matt Shea is testament. They aim to be elected or appointed to public office and thus gain influence and a whiff of legitimacy. Knowing their backgrounds and associations is key to knowing where they would like to take us–and I, for one, don’t want to go there.  What does it mean when every one of the folks listed as a Guest Speaker for “Liberate America” is part of a known subculture laced with 1) white supremacy, 2) armed intimidation and rebellion, 3) the theocratic Liberty State, 4) the anti-vaccination movement, or 5) weird conspiracy theories around non-binding United Nations resolutions, Covid-19, and sustainable development?   Follow the links to familiarize yourself with these people. You will be rewarded by recognizing their associations each time you see their names in print. It’s a useful exercise.  Keep to the high ground, Jerry P.S. The Economist (rated “least biased” by mediabiasfactcheck.com) on May 17th published an article that puts some of what the Kootenai Fairgrounds’ “Liberate America” likely represents into a national perspective:  “America’s far right is energised by covid-19 lockdowns” It is an interesting read–and there is no paywall for this article. The Inland Northwest has long been a center for some of these movements.

Thanks to the work of epidemiologists the world over we know how not to spread this virus, or, better said, those who are paying attention know how not to spread this virus. This is a virus spread primarily by respiratory means, mostly respiration in relatively closed spaces. All the studied case clusters here and abroad have two ingredients: an enclosed space, a bus, a room, a restaurant, AND the addition of one individual who does not know (yet, at least) that they are infected and shedding virus with every breath, shout, song, cough, or sneeze. In those cases the spread is, well, viral, and each newly infected individual goes out and potentially spreads the disease in wavelets. 

Six foot social distancing is only a useful for being easy to remember. There is no magical barrier at the six foot limit, especially indoors. I highly recommend the following two articles (the first of which I highlighted last week) to inform your understanding of what we know of the transmission of this disease:

From a Dr. Erin Bromage, professor of biology at UMass: https://www.erinbromage.com/post/the-risks-know-them-avoid-them?fbclid=IwAR0pFNF7i8Rf_LVRLSZhyFNfDe8KvjbO8zdhMxhq9mogDuHlyCzYiYFQeZo

Here’s Dr. Bromage in a 7 minute video: https://www.youtube.com/watch?v=uqqPY8N2d-8

From Dr. Atul Gawande, renowned physician and communicator, based in the hospital system in which I trained: https://www.newyorker.com/science/medical-dispatch/amid-the-coronavirus-crisis-a-regimen-for-reentry

For my part, sadly, it is going to be a long time before I am comfortable sitting in an indoor restaurant or, even more sadly, attending any sort of energetic dance venue (indoor or out), or exercising with others in a gym, or traveling in a commercial airplane. Masks in those situations would help but they’re problematic, either practically (eating) or aesthetically (dancing). Obviously, all this gets more risky next fall when we try to come back indoors. 

The culture factor is paramount. Our abysmal, science-and-reality-denying national leadership, with its encouragement of protests against Democratic governors in swing states, is making mask-wearing yet another badge of partisan division, when that leadership should be touting mask-wearing as a patriotic duty, a public health courtesy, and a nod to the reality that we’re all in this together. National guidance is blocked (from the CDC) or misused for partisan advantage. That leadership failure is already killing us on a per capita basis [the bold is mine]:

Australia, China, Japan, South Korea, New Zealand, and Taiwan, among others, all have kept deaths below 10 per million population, compared with 271 per million in the United States.

The contrast of the culture fostered by the man in the White House compared that of more successful countries is pointedly detailed in this three and a half minute video [worth your time to watch and share]: https://www.youtube.com/watch?v=VYQvWuiXC8c

Instead of uniting us against the risks, uniting us in our universal desire to get back to some semblance of normal life with honest, scientifically based guidance and preparation we find ourselves in a culture with people who flaunt their “liberty” to put us all at risk. 

Ironically, as long as enough of us are careful enough, the odds of an asymptomatic virus-spreader appearing at and infecting a church full of people in, say, Stevens County, will be small, and the attendees will increasingly be convinced of the rectitude of their resistance to any call for unity. It is a  paradox that will only resolve as travel restrictions ease and people become more lax. The culture that flaunts bare faces and heedless attendance at large indoor social gatherings will eventually spread the virus. The only question is when. If it is going to happen we can hope it does so before the late fall.

Keep to the high ground,
Jerry