The State of the Union on Covid-19
Positive test rates are declining, states are opening up, and Mitch McConnell wants to absolve business’ of liability in exchange for more funding
Each Monday I try to provide a state of the union on Covid-19. Categories today: New York and rest of the US, state openings, science, Congress, and public discourse.
The state of things in New York is getting better. The trend in hospitalizations and deaths is obviously great news. New York is still adding 2,000 new cases each day — too many to effectively contact trace if they open up.
There is a lag in data, but as far as we can tell, the state of the rest of the country is headed in the right direction. Outbreaks seem concentrated around hot spots — meat processing and nursing homes. The R0 (rate of infection), once between 2 and 3 appears to be slightly under 1 — .97 from reports I’ve seen. Not enough to bring the numbers down, but still headed the right direction.
If those cases are more asymptomatic people — or people with only mild symptoms — that’s not a worst case scenario by any means. And with the positive test rates down to 5%, that appears to be the case. This of course is before changes in behavior with state openings in May. 27 US states have steadily declining case growth, 22 of which have begun some form of opening. Don’t get me wrong. I’m sure there will be mistakes and over-reaches. A few states are opening while case growth has been increasing include AR, NC, MT, ND, and TX. People must remain vigilant.
If we don’t know how states are doing and won’t know until it’s too late, what’s the one warning sign to look for? Many of the experts I talk to watch ICU capacity closely. Since the lag can be several weeks, if ICU capacity approaches 70% and growing, it’s a warning.
Which states have ICU at 70% capacity?
- Maryland 82%
- Colorado 81%
- Rhode Island 80%
- DC 78%
- Nevada 76%
- Alabama 75%*
- Mississippi 73%
- Penn 72%
- Georgia 71%
- Tennessee 72%
- Florida 70%
- Louisiana 70%*
- West Virginia 70%
Only states with * have rising case counts.
Texas and North Carolina are getting close to 70% and have pretty high case growth. North Dakota, Minnesota, Montana, and Arkansas have case growth but a little more room to reach 70%. All are reopening. All should be watched closely.
Countries around the world have experienced modest case growth upon reopening. This is to be expected here as well. The key to keeping it modest is testing and contact tracing. We are not yet where we need to be with either of those, but we are slowly getting better.
Testing — there are zero states that have hit the CDC measure for testing, but roughly 40 have hit the measure put forward by the Task Force and National Governors Association.
Contact tracing — initial efforts have begun in a number of states but we are probably less than 1/10 of the way to where we need to be.
See how your state is doing across all these measures here:
The state of science is confusing.
- European leaders stated that they must prepare for a world in which a vaccine never comes.
- Trump’s new vaccine czar — Moncef Slaoui — started.
- Oxford trial results were questioned.
- Several vaccine companies released encouraging info or expressed optimism.
The big news today was that Moderna showed data from their vaccine effort. It showed a good immune response. This is an RNA vaccine — very novel and only a few patients, but enough to get people excited. I would view these kind of results with caution.
The state of Congress is a standoff.
The House passed a $3 trillion bill — the HEROES Act — with bipartisan support. The bill contains key health provisions needed to open the economy safely. It provides a sustained level of support for the marathon of the virus. Mitch McConnell said he will not pass any more Congressional aid for Americans losing income unless he gets one thing: waivers for employer liability if you come back to work and get an infection from Covid-19. He called this his “red line” issue.
This is unusual and only happens when lobbyists have significant power. The National Rifle Association (NRA) negotiated unprecedented national liability for gun manufacturers in 2005 and it has kept them in business more than anything else they’ve won.
The reason this makes no sense is because the best way to be sure that stores and offices are ready to open, is for businesses to wait to open until they can ensure a safe environment. If they’re not ready, we should wait a month or two. Not open with all the risk on us.
This is very much the hidden story of the “opening of the economy.” It compounds a new phrase — the “voluntary quit.” Many states that declare themselves open disqualify people from collecting unemployment insurance if their employer invites them back and they don’t feel safe going.
But what if they open up without screening, testing, masks, or basic cleanliness or safety precautions yet in place? What if they let a super spreader in the office or make people work in a proximity too close to be safe?
130 million Americans have pre-existing conditions, many with vascular conditions or immune system problems. Covid-19 is highly lethal to many of them. But they have to go to put themselves in danger or they won’t have any way to put food on the table.
The US — unlike other nations like Germany, Italy, the Czech Republic, Vietnam, South Korea, New Zealand — is not opening with a low case count. And without a plan designed to contain cases when they occur.
Trump knows it. McConnell knows it. CEOs know it. And they want to open anyway.
As Beto O’Rourke so wisely put it to me in this great conversation, it’s all well and good to bravely ask someone else to die so we can have our economy.
McConnell will ask for other liability protections in this bill — for medications, for vaccines, for medical devices, ventilators, medical malpractice. This could become the greatest shift in corporate liability in generations.
I expect all of May and June to go by before this gets resolved. The 4th of July may be the backstop date, but that is too slow. I’m doing a number of bipartisan Hill briefings tomorrow on Testing and Tracing. Will report back.
The state of discourse is unkind but unrepresentative.
The White House spends its energy avoiding blame and pointing fingers. China announced today the commitment of $2 billion to fight the pandemic. Others are working together across the globe on vaccines. The US — courtesy of Tucker Carlson and Lou Dobbs — is aiming to end funding for the World Health Organization.
Discourse in the US is understandably tense: Open vs. don’t open? The economy vs. life? The election. Safety. Back to work. Health equity. Nursing home. Deaths. There’s an effort to paint us as divided. And a further effort to divide us.
Images of extremism aside, Americans are united. 92% of Americans say they don’t want to be in crowds of 10 or more. 70% think that will be the case for months. There are a set of principles and actions that the vast majority of Americans agree on. I’ve been working for several weeks to understand it, put it in writing and vet it with experts. It must inform what we do next.
The state of things since last week is better. In the midst 90,000 deaths (the actual number is probably greater) our greatest hotspot could soon be on the mend. We have adjusted our lives and our habits.
Scientists are making progress in understanding and slowing this disease. It won’t be a straight line. The politics, our diminished place in the world, the hate and indifference have not gone away with the global pandemic either. But we will get through this. And we can put two things above all else; saving lives and helping each other through the hard parts.
