Numbers Gathering Misconceptions

Among the misguided  “Patriots” protesting with Matt Shea and far right religious leaders at the courthouse in Spokane last Friday was “…a group of young people holding signs claiming that COVID-19 death counts aren’t accurate and that the novel coronavirus is a hoax.” 

“Covid-19 death counts” aren’t perfectly accurate. Gathering death statistics is not just counting corpses. These young people are questioning the motivation of the numbers gathers, suspecting them of intent to deceive. In short, these sign carriers and their ilk are conspiracy theorists. They hold that in common with the conspiracy theorist in chief, Donald Trump, a man who started his run for office on the birther conspiracy, a man for whom the entire government is part of a “deep state” conspiracy against him personally.

Here is my starting place: Without quality data on the world in which we live we are lost, rudderless, unmoored (exactly the way some would like us to be). People in government and medicine tasked with assembling this data are doing their very best to get it right. What it takes to come close to the right number is an effort most of us don’t appreciate or understand. It is time to look.

Consider influenza statistics. How are they gathered? Does each corpse dead of influenza get a stamp on its forehead, “DIED OF THE FLU”? No. Most every corpse has a story of intercurrent chronic and acute illnesses, diabetes, coronary disease, alcoholism, dementia, any one of which, in the absence of positive gold-standard test for the influenza virus, might be labelled the cause of death by the individual responsible for filing out the death certificate. 

Each year good faith efforts are made by an army of honest workers in government and medicine to assemble the best estimate of deaths due to influenza. They examine a multitude of data. They hone their methods in conferences and academic arguments. Finally a number is published (typically two years later). It’s a completely non-political effort, but one that carries policy implications. (Check out this CDC website page for a glimpse at the complex methodology used to estimate “Influenza-Associated Deaths.”)

Doug Muder puts it this way (his whole article at that link is a good read):

The flu comparison is even less appropriate than the numbers make it sound. In Scientific American, Dr. Jeremy Samuel Faust concludes that the comparisons we hear about flu deaths vs. Covid-19 deaths are misguided.

When reports about the novel coronavirus SARS-CoV-2 began circulating earlier this year and questions were being raised about how the illness it causes, COVID-19, compared to the flu, it occurred to me that, in four years of emergency medicine residency and over three and a half years as an attending physician, I had almost never seen anyone die of the flu. I could only remember one tragic pediatric case.

He began asking other emergency-medicine doctors, and found that their memories match his. They remember lots of opioid deaths, gun deaths, and traffic-accident deaths — which are supposed to happen in similar numbers — but not flu deaths. Flu death totals, he came to understand, are not counted deaths — deaths of particular people whose doctors write “influenza” on their death certificates — they’re extrapolations based on models. The models assume that many people die of the flu outside of hospitals, and aren’t officially counted.

In the last six flu seasons, the CDC’s reported number of actual confirmed flu deaths—that is, counting flu deaths the way we are currently counting deaths from the coronavirus—has ranged from 3,448 to 15,620, which [is] far lower than the numbers commonly repeated by public officials and even public health experts.

In other words, (and I [Doug Muder] am commenting here, not quoting or summarizing Dr. Faust) the flu death totals we usually hear are more comparable to the Covid-19 death totals we’re starting to get from excess-death demographic models — which show much higher numbers than the 65,000+ you commonly see reported. But if we compare counted Covid-19 deaths during the second week of April to counted flu deaths during the worst week of an outbreak “we find that the novel coronavirus killed between 9.5 and 44 times more people than seasonal flu”.
The young people in last Friday’s protest, with their claims that Covid-19 death counts are inaccurate and the novel coronavirus is a hoax, need a reality re-adjustment, a window into the complexities of honest efforts to gather information intended to provide the intellectual and scientific framework to deal with the pandemic. Instead, they parrot their parents’ and right wing media memes that they are the victims of some vast government conspiracy. They are the misbegotten descendants of a long Libertarian effort to discredit and shrink government, an effort that now threatens us all.

Covid-19 is not the flu. It is both more contagious and more deadly.

And these people are not Patriots. 

Keep to the high ground,

P,S. Fox News and Trump propaganda bellowed for weeks that Covid-19 was just “mild flu,” disingenuously citing the very highest of the CDC estimates, 61,000 from 2017-18 (the average over nine years is actually 37,000) using the number as though 61,000 were accurate and usual. Note that we blew past 61,000 in Covid-19 deaths nearly a week ago–and this number is almost certainly an undercount. 

P.P.S. Correction: I am indebted to Eric Johnson, retired statistician, accountant, and curious polymath, for taking seriously my request to “check my work” at the end of last Wednesday’s post Viruses–an Orientation. After all the assumptions I made to calculate the number of average-sized atoms that might fit into the 18nm wide, 300nm long cylinder of a tobacco mosaic virus, I neglected to multiply by pi at some point. The recalculation of number of atoms yields 97 million, not 24 million.

The Local Covid Come-Back–Brace Yourself

The most-read article in the Spokesman last Friday was “Hundreds protest stay-home order at courthouse, shout down politicians hoping to reopen economy.” Click on it, have a look, scroll through the photographs. (No paywall, it’s “COVID-19” coverage.) People standing shoulder to shoulder, not a mask in sight. 

On Saturday the Spokesman published “Idaho retailers welcome customers, as state’s four-stage rebound plan gets underway.” The lead photo shows a scene in Coeur d’Alene of rejoicing shoppers, none with masks. Brad Little, the Republican governor announced “stage 1” with “90 percent of businesses in the state will be allowed to reopen. This includes retail businesses, day camps, daycare facilities and places of worship.”

The Washington-Idaho border is no barrier to the spread of a respiratory virus. What happens in Coeur d’Alene and Spokane will wash both ways. All of us are about to become unwilling subjects of an epidemiological experiment to which we have not given our consent. How many of Matt Shea’s protesters in Spokane will bring the virus back to the Redoubt? On the Idaho side Governor Brad Little is trying to walk a middle road (for a Republican). After all, he was called a “Little Hitler” by Heather Scott, ID state Rep from the northernmost Idaho legislative district, darling of the Redoubt, and ally of Washington State extremist Rep. Matt Shea (who led the protest in Spokane last Friday). Governor Brad Little’s “Stage 1” (of four stages of two weeks each) calls for safeguards, including an instruction to practice social distancing. Masks are left to the discretion of the establishment and the patrons. 

Wake up, people. This is a respiratory virus. It is spread by coughing, sneezing, talking, singing, and, maybe, even breathing. It is spread by people who don’t even know they’re infected. One infected person shouting without a mask at the Matt Shea-led protest last Friday in Spokane could seed the Covid-19 virus among dozens of other shoulder-to-shoulder protesters. How many of these know-nothings will go shopping early this week in Coeur d’Alene without a mask? How many will transmit the disease to an elderly neighbor? 

I urge you to read the Spokesman article on the Spokane protest carefully. Take notes on the names. The article is a Who’s Who of the Inland Northwest’s religious extremists, science deniers, white supremacists, conspiracy theorists, and would-be revolutionaries. Chief among them is Matt Shea, prime promoter of his theocratic “Liberty State,” featured speaker at conspiracy theorist forums, podcaster, and incumbent Washington State Representative for Legislative District 4, Spokane Valley north to Mount Spokane. He faces two challengers, Leonard Christian and Lori Feagan, in the August 4th WA State Primary. Remember that. Matt Shea is a festering cancer in our body politic. He needs to be electorally excised.

The Covid Come-Back? We’ll see. It comes down to individual behavior, morality, and the quality of our leadership, not questions of law and prosecution. Leadership from the top, from Trump and Pence on down, needs to say it is patriotic, right, respectful, and decent to wear a mask. Friday’s Matt Shea-led Spokane protest is particularly discouraging. These folk have no respect for the lives of others. Their shoulder-to-shoulder spacing, lack of masks, and the fact that they even gathered speaks volumes of their ignorance–and it does not bode well for keeping Covid-19 at bay. 

Spokane County Sheriff Knezovich (R) and several other elected officials, including Rep. Marcus Riccelli (D, LD3, Spokane) endured the boos and catcalls of protesters in order to speak. Sheriff Knezovich “made the point that no one had been ticketed or arrested in Spokane County for violating the shutdown order from the governor and didn’t think there ever would be.” That’s a key fact that puts the lie to Shea’s incitements over “tyranny” and their twisted idea of “freedom.” In fact they are “free” to act in an ignorant fashion. They should be spotlighted, recognized for what they are, shunned, and, in Shea’s case, voted out of office.

Whether we succeed at safely opening up while avoiding a resurgence of Covid-19 will depend on personal compliance with reasonable recommendations. It’s not a legal issue. It is a moral issue. The moral high ground is to practice social distancing, wash your hands, and wear a mask. 

Keep to the high ground,

P.S. The level of sheer ignorance prevalent among the speakers and protesters in the Spokane crowd at the demonstration last Friday is amply documented in the article itself. Once again, I encourage you to read it carefully and take note of the names of the speakers and the groups represented. For me, the saddest quote illustrated how this ignorance is passed on: “Emilia McGuire, a 16-year-old from Deer Park, stood with a group of young people holding signs claiming that COVID-19 death counts aren’t accurate and that the novel coronavirus is a hoax.” 

Antibody Testing, Some Basics

This post is to highlight and direct you to a superb article by Caroline Chen, a health and science writer for ProPublica. It is entitled What Antibody Studies Can Tell You — and More Importantly, What They Can’t. I encourage you to click that link and read the article itself. This is some of the clearest writing on a complex topic that I’ve seen. To whet your appetite, here are the sub-headings of article:

Antibody studies can be used to answer more questions than you might think.

Setting up a sero-survey correctly means you need to test a random population — easier said than done.

Test accuracy can skew results in some pretty surprising ways.

Forget the headlines, your city is nowhere near herd immunity.

There are two types of death rates. Most people are mixing them up.

Stop comparing this to the flu. Without a coronavirus vaccine, we are far more vulnerable.

Antibody tests aren’t ready to be used to issue “immunity passports.”

Caroline Chen deserves a prize for the clarity and readability of her explanations of complex, nuanced material. You would not be wasting your time if you read it carefully–several times. A clear understanding of this material will equip you to cut through a whole lot of muddled, and sometimes needlessly sensationalist reporting and headlines.

When you’re done absorbing the first article I encourage you to carefully read an earlier work of Ms. Chen’s from April 2: What We Need to Understand About Asymptomatic Carriers if We’re Going to Beat Coronavirus. In that article she clearly addresses how scientific data is sifted and formed into public health recommendations. 

Keep to the high ground,

P.S. A few musings on the topic of science and statistics:

People (and stock markets) crave certainty. People often rally around a leader who offers a certain future, even if, for example, the predicted future is a fixed date and description for the end of the world. In contrast, science might start with something that’s pretty certain, “Covid-19 kills some people” and then strive, by asking questions and analyzing data, to come up with the most reliable prediction of what’s going to happen. Science is messy. Watching the process science uses to seek truth can be confusing–but is a far better guide than a would-be leader blustering inanely about “bouncing back,” a “V-shaped recovery,” or touting unproven or dangerous treatments based on the last thing random thing he heard.

Scientists, and effective governments. run on numbers: gathering numbers, understanding numbers, analyzing numbers. (The Founders knew this. That’s why we have a Constitutionally mandated decadal census.) In this pandemic well-meaning (but sometimes not-so-bright) media folk bombard us with a bewildering array of statistics and ill-defined terms, e.g. case fatality ratios, infection fatality ratios, antibody prevalence, and even just the simple term “cases,” often without clarifying what the number means and how it was determined.

Questioning the importance and accuracy of any number is essential. Does the number actually represent a cross section of the population we’re trying to draw conclusions about, i.e. was enough data gathered or did the method of gathering of the sample bias the result? Questioning the data (formally that’s called “peer review”)–and then improving that data with more gathering and analysis–is an important way science works. Absolute certainty is always a little out of reach, but each step adds to what we know and the clarity with which we can look into the future. 

Read Caroline Chen’s articles. Arm yourself we a clearer understanding of the basics. Read the news with greater clarity. 

Viruses–an Orientation

One of my readers asked if I would provide a basic orientation to the science of virology, a way of making viruses a little less mysterious than the “unseen enemy” featured on TV and in newspapers. I try to start at the beginning. I see viruses through the lens of the history of science. Seen that way, viruses are a part of story of how we see ourselves in the universe. That sounds ambitious, but bear with me.

The basic unit of life is the cell. People studying nature have seen, described, and studied cells since the mid-1600s, the early days of the light microscope (the optical instrument present in every junior high school science lab). Single-cell creatures, wee-beasties visible with the light microscope, i.e. bacteria, fungi, and protozoa, are nearly everywhere, once one looks. Bacteria, for example, are present on our skin, in our intestinal tracts, in pond water. In the 1600s the light microscope opened up a whole new world of inquiry and insight, much like early telescopes helped open up a new understanding of our place in the cosmos, and the study of fossils and atomic chemistry changed our understanding of time (for most of us). But I digress…

We tend to focus our attention on the wee-beasties that cause diseases in humans (and in our stock animals and crop plants). The single-celled organisms that cause anthrax, cholera, syphilis, malaria, tuberculosis, gonorrhea, leprosy, and african sleeping sickness (among others) were intensely studied in the 19th and early 20th century by researchers like Louis Pasteur, Robert Koch, Theobald Smith, and Walter Reed. All these people strove to find treatments or vaccines to rid humanity of these scourges. The stories of these scientists made news at the time, but today most of us barely recognize their names. Many physicians in “developed” countries like ours have never seen a patient suffering from leprosy, tuberculosis, malaria, or any of the diseases these researchers fought, diseases that had been part of life and literature for much of human history, 

Every disease mentioned above is caused by a single-cell creature that can be seen with the light microscope, but the light microscope, because of the physics of light itself, allows us to see organisms only as small as about 1 micrometer (µm). Contemplate that. Think of a millimeter (mm), the distance between two of the thinnest lines on the metric side of a modern ruler. Within that millimeter there are a thousand micrometers (µm) (aka “microns”). The world messured in micrometers (µm) is the domain of cellular life. For example, one phase of the malarial parasite, the “trophozoite phase”, is 1-2 micrometers (µm) in diameter. On the other end of the micrometer range are some free-living single-cell organisms like certain paramecia and amoebae whose size is between 250 and 750 micrometers (µm), one quarter to three quarters of a millimeter, a size visible to a young, healthy, naked human eye.

Cellular organisms, tiny as they are as members of the micrometer world, are still structurally complex. There is huge variation, but even the simplest bacteria contain genetic material (DNA, deoxyribonucleic acid), lipids (molecules of the material we generally call “fat”), and a variety of proteins. All of these organic molecules are organized in structures that provide cells the means to use chemical energy, energy to function and reproduce themselves, energy almost always ultimately traceable to the sun.

But what of the agents that cause smallpox, chickenpox, measles, mumps, polio or rabies? Scientists knew these disease organisms were smaller than known bacteria by running what now look like fairly simple experiments, but which, at the time, were revolutionary. By the early 1700s the word “virus” (originally “potent juice” in Latin) was applied broadly to any fluid from a diseased person that could infect another person. (At the time such fluid might have contained both viruses and bacteria.) In 1892 a Russian biologist, Dmitri Ivanovsky, used a filter developed by French scientists to filter out all the cells and bacteria from a fluid that could pass mosaic disease between tobacco plants. He went on to demonstrate that the remaining fluid was still infective. The filter removed everything which could be seen with the light microscope, the only tool then available at the time. 

A few researchers used the term “virus” to designate only the infective agent that passed through the filter, but through the first half of the 20th century the word was in common circulation to mean any infective fluid. (See P.S. below)

A new tool was needed before we could understand what the infective agent in this filtered fluid looked like. The first images of viral particles were made using early versions of the electron microscope in the 1930s. They were images of tobacco mosaic virus (TMV), the infective agent causing the mosaic disease mentioned above. A whole new sub-light-microscopic world opened up, a world measured in units of nanometers (nm), thousandths of a micrometer (µm). (Remember that micrometers, thousandths of millimeters, are used to measure the world of single cells, including bacteria.) Images of TMV particles obtained with the electron microscope show cylinders 300 nm in length and only 18 nm in diameter. Viruses are no longer “unseen.” SARS-CoV-2 particles are spheres measuring between 50 and 200 nanometers, i.e. a twentieth to a fifth of a micrometer. (The mammalian cells they infect and destroy range between 10 and 100 micrometers, 50-200 times the diameter of the virus.) 

In contrast to bacteria, which contain their own metabolic machinery, a virus is basically a protein and (sometimes) a lipid-encased blueprint for its own replication. (Coronavirus blueprints are encased in a lipid bilayer, think “fat”, hence their sensitivity to soap and alcohol.) Viral blueprints can be either RNA (ribonucleic acid) or DNA (deoxyribonucleic acid). (Coronaviruses are “RNA viruses.”) The details of the viral proteins that accompany the viral blueprint in a viral particle are essential for gaining access to the cells the viruses infect. Once inside the cell membrane or cell wall of the victim cell, the viral RNA (or viral DNA) hijacks the machinery of the cell to make countless copies of itself, weakening or destroying the infected cell in the process. (Netflix has a great verbal and visual explanation of this process, Coronavirus, Explained, you might find worth watching.)

I hope you find this as interesting to read as I have found it to review. For me, knowing some of the history of the scientific endeavor helps me understand how we know what we think we know (epistemology). It takes away some of the mystery with which some people seem to view science in general. Science is firmly rooted in observation and experimentation in the natural world. It consists of ideas that are testable and accretive. Understanding the basics upon which modern science rests is proof against those who see fit to make dangerous pronouncements based in deplorable ignorance as in a recent infamous example.

I give credit for this presentation to my parents and a long line of teachers, professors, and authors and to the volunteer editors of Wikipedia, front which much of what I present here was gleaned and suitably checked and cross-checked through its references.

Keep to the high ground,

P.S. What a word means changes over time. In doing the research for this article I wondered if the use of the word virus is different now from what it was when Paul de Kruif wrote the original Microbe Hunters in 1926, the book that engaged my mind with medical science as a youth. Sure enough. The original text of the book is available here. Searching the text for “virus” using CMD-F yields forty-three instances of the use of the word “virus” in de Kruif’s book. The very first use of the term–for the contagious material that causes cholera (a bacterium)–means that de Kruif used the word virus in the broad sense, i.e. any infective material, not just the nanometer-sized particles we label viruses today. No wonder I was confused in my youth. (Contemplate for a moment what this means for the interpretation of ancient texts that have gone through multiple translations…)

P.P.S. Among the many millions of viruses that co-inhabit our planet are a whole class of viruses called bacteriophages that infect bacteria. Think of that. Some bacteria that make us ill have their own viruses that infect them.

P.P.P.S. Note on Viruses and Atoms: The next “zone” smaller than nanometers (nm) are picometers (pm), one thousandth of a nanometer. This is the realm of atoms and parts of atoms. A typical atom is in the range of 100 picometers = one tenth of a nanometer. Think of the 18 nm diameter of the tobacco mosaic virus. Strung out along that 18 nm diameter line you might put roughly 180 atoms. In a 100 pm cross-sectional layer of that 18 nm diameter cylinder you might sandwich in 8085 atoms. (Think area of circle = π times r squared.It follows that in the entire 300 nm long cylinder of the tobacco mosaic virus you might fit around 8085 atoms/layer X 3000 .1nm thick layers = about 97 million atoms. Check my work. My math skills are rusty 🙂

Covid-19 Stories from the Front

I come to writing this today from an peculiar place. I am profoundly angry at our nominal “leader” and profoundly ashamed of the stain he puts on our country. Our “leader” is a man who finds it appropriate to claim that his rambling delivery of “disinfectant” and “strong light” Corvid-19 treatment options was merely sarcasm. I imagine his intent was to bait the press, sarcasm cynically delivered with a straight face to a suffering country. We are left to choose between crippling ignorance and mean-spirited inhumanity. I encourage you to read Heather Cox Richardson as she dissects this event.

From that angry place I read a series of medical articles that appeared over the last few days. I offer them to you sequentially. They all come from places where the pandemic is in full rage. I hope we avoid these scenes, but if we do not, understanding them a little better will serve us well. This in not the flu.

The first is an opinion piece entitled “The Infection That’s Silently Killing Coronavirus Patients; This is what I learned during 10 days of treating Covid pneumonia at Bellevue Hospital.” that appeared in the New York Times. The title does not do the contents proper justice.

This was my take-away: Covid pneumonia somehow selectively impairs the lung’s ability to transfer oxygen to the blood while, relatively speaking, it does not so much impair the ability of the lung to blow off carbon dioxide. Key concept: at the altitudes at which most of us live what drives us to take a breath is the build up of CO2, not lack of oxygen. What Dr. Levitan is suggesting is that many Covid-19 patients don’t know they are getting short of oxygen (decrease in “O2 saturation”) until they are really in trouble, until their brains start to malfunction and they are about to lose consciousness. (For more, see the P.S. below) It may be good insurance to order a pulse oximeter, a device to measure the oxygen saturation of the blood in your nail beds in the event of illness.

The second article, entitled Why Some People Get Sicker Than Others appeared in The Atlantic. It discusses the interaction of our immune systems with this new threat. After all, the outcome of the sometimes mortal battle with this viral intruder depends on how our immune systems react. I do not think this article offers an action item. Rather, it offers some insight into what some of us might face. 

Finally, 32 Days on a Ventilator: One Covid Patient’s Fight to Breathe Again that appeared in the Sunday NYTimes, left me in tears. I know this hospital. I trained next door. I am familiar with each of the treatments described. Some of the devices used in this cases are not widely available, nor is the expertise with which to reasonably apply them. I know the lengths to which the physicians and staff who practice at this hospital may go in pursuit of a cure. I’ve been there. I have watched. This story hit home with me.

And, finally, the very thought that some callous supporters of the current President might label me a “snowflake” for shedding tears as read this account, that thought brings me back to the anger with which I started this piece.

Keep to the high ground,

P.S. The physiology recounted in the first article reminds me of stories I’ve heard of swimmers who drown (or nearly drown) competing to swim the furthest under water. Typically, one intentionally hyperventilates before diving in. That hyperventilation blows off more CO2 from the system than what the CO2 level is asking for. That removes the drive to breathe, the sense of air hunger, that would otherwise (as a secondary effect) keep one from using up the oxygen stored in the blood and lungs. In this hypocarbic, hyperventilated state swimming under water the first sign that you’re in trouble may be that you black out for lack of oxygen—and drown. My mother, probably not understanding the why of this phenomenon, warned me about hyperventilation. Her story very much impressed me, but I didn’t understand the physiology until many years later.]

Covid-19–It Gets Real

We humans are story-tellers and story-learners. It is one thing to read about numbers of Covid-19 cases and deaths; it is something different to hear the story of a fellow Spokanite. A friend of a friend of mine had been feeling crummy for a couple of weeks. She obtained one of original tests for Covid-19. A week and a half later It came back negative –certainly not a “rapid” test–or very useful one from the standpoint of case management. The crummies persisted, spurring a second test–and that second test came back positive. She is still convalescing. Another contact, a funeral director in his fifties described his test positive case of Covid-19 as feeling the worst he has ever felt for seventeen days straight, constantly wondering if he would die. A few weeks later he reports being back to “about 85%” of normal. This is not the flu, no matter what they say on Fox. 

We hear a lot about the need for testing. Early on, tests for Covid-19 took more than a week to come back. Such a tests may help for gathering statistics, but it is nearly useless for identifying people who need to be quarantined because they’re shedding virus. 

Abbott Laboratories announced FDA approval of its new ID NOW COVID-19 testing device March 27. The device tests one sample at a time. It requires about five minutes to detect the virus and offers a negative result in fifteen minutes. The devices shipped to laboratories, but only with very limited available test kits (in spite of the unrealistic Presidential hype). Last Wednesday, April 22, a hitch appeared. Testing by the Cleveland Clinic revealed that ID NOW COVID-19 accurately reports negative results if the nasal swab goes directly from the nose into the machine, but if the sample is placed in a “viral transport medium” (the typical method of getting a sample to a lab, even a lab just down the street), the test produces about 15% false negatives, offering false reassurance safety. 

Of course, at one critical place there is no lack of test kits–and swabs go directly from the nose into the machine. Visitors to the White House have been screened with that Abbott Laboratories’ rapid test since early April. With this level of testing Mr. Trump can safely declare that “wearing a mask is optional” and the he won’t wear one. When you function in a protected bubble it costs you nothing to recommend that others expose themselves.

Speaking from his bubble, Mr. Trump feels free to exhort his followers to go out and make a display of their patriotic bravery (irony alert), threatening Democratic governors and grabbing media attention with demands for the “liberty” to gather and ignore public health recommendations. 

Closer to home, Stacey Cowles, in an Editorial in the Spokesman on April 19, argued for the urgency of re-opening of Spokane’s economy. He, somewhat breezily, cited a Spokesman article to indicate “good progress” in testing availability. 

Let’s examine that. According to the article, rapid testing would be available in Spokane through Providence Express Care starting last Friday, April 16. That was great news, but the fine print told a more nuanced story: a “pilot program will target health care workers, first responders and high-risk patients who can access rapid testing by referral and appointment only.”

There is a disconnect between these scenarios.

In Trump’s virus-free bubble, everyone who sees him, asymptomatic or not, has been proven minutes earlier to be free of viral shedding. Presumably, if the same person visits again in a week, that person will again be tested before coming into his presence. 

In Spokane, where Mr. Cowles is arguing to start opening up for business, there is zero chance (as an asymptomatic person-on-the-street) of my obtaining a rapid test for SARS-CoV-2 before I go out to a re-opened factory, restaurant, or shop. It offers me no reassurance that the guy next to me at the gym isn’t spewing virus after protesting with Heather Scott last weekend or attending a church gathering. 

No matter how much Mr. Trump, the talking heads on Fox News, and Mr. Cowles want the economy to re-open, the reality is that we still lack anything close to the testing (and contact-tracing ability) to make it safe to do so. Letting up on social distancing now in anything but a very careful and measured way will guarantee a body count that will make the flu look tame.

Keep to the high ground,

Liberty v. Virus, Liberty for Me, Virus for You

Their credo: My liberty is more valuable than the lives of others.

The title in the April 16 Spokesman read: “Idaho Rep. Heather Scott calls governor ‘Little Hitler,’ compares nonessential workers to Holocaust victims.” The previous day eastern Washington’s very own legislative pariah, Rep. Matt Shea (LD4, Spokane Valley north to Mt. Spokane), was the lead subject of another article: “Far-right politicians denounce government’s COVID-19 response in Washington, Idaho” (Both articles are free to read on the internet as part of the Spokesman’s Covid-19 coverage.)

In times of national crisis we have a history of pulling together for the common good. When the threat is clear, people pitch in and help. During the time of threat they may grumble about personal hardship and perceived injustices, but intelligent people understand the threat, unite, and deal with it. Ask your parents or grandparents (or if you’re over 80, just think back) about the federally mandated rationing of gasoline and many food items during World War II

We cut our leaders some slack in dealing with an immediate threat (at least insofar as their leadership is reasonable and skillful). Not allowed to go fishing? Hmmm. I can comply with that for a while as things get adjusted. I don’t like it and I don’t quite see the logic to it, but I won’t squawk for now. It is patriotic and humane to have some patience.

Times such as these show the baseline stuff of which people are made, especially people in public office, and for some of them, like Shea and Scott, their stuff does not show well.

We must pay attention. These are their true colors. Elections are coming. 

Matt Shea and Heather Scott value their “liberty” to do as they wish, they value it over the lives of others.  Here’s where they’re coming from: “Government regulation of where I go and what I do is UNCONSTITUTIONAL under all circumstances! You say gatherings where one asymptomatic person might spread virus to a hundred others? No problem! On April 25 in Franklin Park (across from the Northtown Mall in Spokane) at 1:30PM we’ll hold a Liberty or Death Rally for our candidate for Washington State governor, Loren Culp(current Police Chief of Republic, WA)! We’ll carry our AR-15s and demonstrate our claim to the liberty to threaten your life by aiding the spread of virus!” (If you have the stomach for it, I recommend a visit to these folks’ common website, Redoubt News, to sample the crazy trash they put on display.)

So where does liberty stop and the common good start in a lethal pandemic? When does it become immoral, plainly disgusting?  A friend put it this way: “This is like the careless pickup driver whose boards fly out of the back of his truck killing you as they fly through your windshield. But HE ignorantly drives on with no idea that his carelessness has caused multiple causalities in the multi-car pileup behind him.”

Elections are coming. We need to pay close attention and get ready to remove people like Shea and Scott from elected office. We’ll have closer looks at upcoming races in later emails.

And what is our cretinous divider-in-chief doing by way of crisis management? Instead of leading and uniting, organizing and managing the response to the threat, Donald Trump is tweeting out encouragement to these crazies, “LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!” “LIBERATE MINNESOTA” and “LIBERATE MICHIGAN” soon followed, all states with Democratic Governors that might be in play in the November election. Take note Mr. Trump did NOT tweet out support for protesters in Idaho or Washington, with similarly restrictive policies and Republican and Democratic governors, respectively. Tellingly, neither Idaho nor Washington is likely to be a swing state in November.

Governor Jay Inslee’s (WA) said Trump’s LIBERATE tweets were “unhinged.”  Inslee’s response to upcoming protests in Olympia could not have been better put (understand as you read Inslee’s words that the population of Washington State is about 7,000,000):

Inslee said they [the protesters] were “welcome to express their First Amendment rights to say what they want to say.

“I do encourage them to socially distance when they do that, try to maintain 6 feet apart. … We care about your safety as well,” he said. “But I will say, if a thousand people show up this weekend, that would mean there would be 6,999,000 Washingtonians that care enough about their families to pitch in a little bit to try to prevent our loved ones from dying.”

Keep to the high ground,

P.S. Doug Muder in his “The Weekly Sift” this week was particularly eloquent about: 

1) The Liberate protestors and identity politics:  Off the Table and 

2) Trump’s transparent gambit to take no responsibility for a bad outcome while position to take credit for any improvement: Trump’s Guidelines Aren’t What He Says They Are