A Long Rant
Everyone's Favorite Moment In The Action-Packed Rallies Briefings
Healthcare resource allocation is the easiest way to describe what I do, when I'm not speaking through the persona of a smart-assed white dog online. It involves Physical Space and infrastructure capabilities; Resources (human beings), Durable and Disposable Medical Equipment (beds; ventilators; swabs; masks; PPE gowns and gloves), medications -- requirements versus availability. It's logistics and negotiation. The past few months have been busy, preparing additional overflow sites for the kind of New York City-level surge of CoVID-19 cases in the Bay Area.
That hasn't developed. It's a relief. But, with the demands of the bloated Child-Leader, we could see another spike in cases as America is forced back to work, the Leader determined to have his moment of fantasy validation
though many may die. Well... we could get lucky. I hope so, but it's a hope that only extends through the Summer. Then comes Fall and Winter.
I sit in multiple videoconferences; we talk about the Winter of this year. We use words like 'anticipated' 'likely probability', and when we look at potential effects to healthcare system capacity, the numbers are frightening. If the CoVID-19 virus is seasonal (and no one knows if it is), the end of 2020 could be bad. Wuhan-bad; Northern Italy-bad; New York City bad.
I don't say this to raise anyone's already elevated fears. My way of dealing with things is Whole Sight: straight on, for the most realistic appreciation of whatever comes. We need to do everything in our power, now, to prepare the System for a New York-level of shock, for months on end. As individuals, we need to plan how best to cooperate, for our collective sakes, and for the future.
There is some (relative) good news. In a presentation I saw yesterday, the data seems clear that all the effort to ramp up for a surge which never came helped develop slack capacity that will be essential going forward. Time has been made, but we need to increase capacity to continue preparing for Winter, and after. Eventually, there will be a vaccine; we just need to get through the next eleven months and be waiting in line when it's distributed.
We could be better prepared -- but the lack of coordination from the federal government is astounding (It's been detailed in the press; I don't have to repeat it here). And the politicization of whatever efforts that government does make is staggering: a CDC alert I saw just this morning started with the phrase, "The Trump administration is taking aggressive actions..." As if He were guiding, watching everything, the master of all phraseology and human destiny; the Good Daddy.
But when he is the Angry Daddy, the Bad Daddy -- He must be appeased in the smallest ways by the sycophants he gathers around him. There is an obvious requirement that medical professionals at the national level kiss Trump's ass just to stay in the room, and be allowed to offer informed opinions they hope can counter the ignorance, the bias against 'know-everything types'.
The disconnection from reality that we all brush aside with Trump, just to keep from having our heads explode; the hours-long 'briefings' replacing Trump's 'rallies'; the lying and vicious small-minded pursuit of More by himself, his family, his satraps and toadies, while people are dying -- all of it is magnified, now.
Hopefully, it will be a stain he can't wash. The portrait of Dorian Grey, failing to contain the rotten core of this person and so revealing him, failure and bully, as he does his drunkard's weaving while standing behind the podium.
Every day we waste on this sociopath's spewings, on the ranting and insane bullshit of conservative politicians and social leaders, when we could be preparing for the coming Fall, is time we will not get back. Time literally means lives, now.
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Every three days, I go into different medical centers operated by the Behemoth corporation which employs me and do things there I cannot do via Skype. I've always considered that, as jobs go, at least I could say I did things with a social benefit; now, they are one set of actions in a chain of events that matter, tangibly, to specific people.
Every time I go into a facility, the risk of contracting a disease (referred to by the younger set on Twitter as "Boomer Remover") that could kill me -- an Old with an underlying health condition -- increases by approximately 40%.
I'm in no way a hero -- my job is administrative, logistics; the real heroes are floors below, wearing full PPE garb, trying to adhere to protocols in biologically hot environments, for hours. Rarely, I see them in common spaces, outdoors, and we're well-separated. They're the kind of exhausted you get when you push your adrenaline levels to meet calls to action over and over for long periods.
I've been in situations in bad places in my long-ago; real life-and-death situations. You do things in those situations, and only in the silences afterwards does it become clear exactly how dangerous it was; that's what PTSD is about. I will tell you: it takes a special level of consciousness to go into situations with high risk -- and then do it again, and again, daily, having had moments in the times between to understand exactly what you're getting into.
This is what thousands of physicians, nurses, and support personnel are doing around the world, right now, over and over, and have been. For months.
They do the most critical caregiving tasks, and the most humble. They are there for others when they are dying, alone and isolated from everything familiar and loved, drifting away. They watch this and they perform that last connection with light and earth and all that we know, over and over and over. My respect for them is clear and unambiguous. There are few times in life when I could say I felt that, unreservedly, towards other human beings.
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Obligatory Cute Small Animal Photo In Middle Of Blog Thing
When I come home to my small apartment on a hill in The City, I leave my Outside Shoes by the door, remove and bag clothing for separate laundering; I shower, and I scrub. The other five days in the week, I only leave my building a few times to walk at dusk, to stand on the steps of Grace Cathedral with the sun going down, surrounded by the condominiums and co-ops of the Wealthy, the huge landmark hotels, the brownstone Beaux Arts Pacific-Union Club.
In the handful of times I walk every week, I'm in the street, facing oncoming traffic, but there is very little. SFMTA buses whine past with only a few riders, as they have for weeks now: no one wants to risk public transit. Other people are out, runners and walkers, none of them masked; couples in their twenties amble slowly on the sidewalks, laughing. Knowing what I know about CoVID, I stay well clear. I walk in the street.
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On my every-two-week walk to a neighborhood market, there are people lined up, waiting to enter. It isn't a tiny business: in mid-March it was packed with panic-buying, unmasked people in thick lines waiting for checkout. Since March 19, the owners instituted a policy of allowing fifteen people inside at a time -- one person leaves, one allowed in -- but until they painted lines six feet apart on the sidewalk, few people seemed in a hurry to keep social distance. For weeks, I was nearly the only person in line wearing a mask.
Today, inside, there are plenty of people without masks, even the cloth variety, or those wearing them only over an upper lip, nose fully exposed. They ignore social distancing to lean in front of you and peer at a half-empty shelf -- as if it were just another day before CoVID.
I wear an N95 mask because I've been issued them. When I ask people to watch themselves or please step back, they turn their heads to look up at me and frown. "Sorry," their voices say, but they don't move. They want you to move; they want that last can of kidney beans.
The market owners also set up plexiglass screens at the registers early on, and found enough N95 masks and nitrile gloves for their staff. Early on, they began refusing to accept cash -- paper money being a transmission vector; credit/debit only. They found a local manufacturer willing to make and provide hand sanitizer. I pass the small shopping cart I use to an employee, who immediately disinfects it.
I check out and walk home. The market's paper bags will stand by themselves for the next two or three days, untouched. When I noted the first reports in early January of a novel virus appearing in China, which appeared to be respiratory with a good probability of human-to-human transmission, I began slowly buying whatever I thought might be needed. I'm not a Prepper, and not a tinfoil hat person. But when panic buying began in early - mid March, it was one more aspect of the situation I didn't need to feel anxiety over.
Everything purchased is sanitized with wipes bought three months ago; hard to find them, now. I don't buy produce or fruits -- I take vitamins, which also seem in short supply. I have gallons of frozen milk, frozen gluten-free bread (likewise, hard to find) and GF-pizza (I refuse to give up my comfort foods). Rice and beans are a staple (with Pesto, or Tomato paste), and so is Norwegian Kippered Herring.
And the obligatory wine and Single Malt: yes, I find myself self-medicating more frequently in, as Bill Burr would say, "the current environment" (I can even 'drink at work'; bwa ha ha ha ha ha).
This is how we -- or, at least how I, live now. And have done, for forty-five days. Part of me is proud of being resourceful. The rest of me wants to weep and beat all conservatives with a shovel and launch their corpses into the sun. But, that's just me.
Current Coronavirus Cases, FLA: 25,576 Deaths: 976
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All that personal nonsense wasn't what I wanted to talk about.
Indeed, if [Nassim Nicholas] Taleb is chronically irritated, it is by those economists, officials, journalists, and executives—the “naïve empiricists”—who think that our tomorrows are likely to be pretty much like our yesterdays.
There is an assumption:
once we just get a handle on this virus, by brute force, everything will revert to some pre-CoVID default. That electing Biden will erase four years of something unprintable and degrading. That by magic, all will be as it was.
What that assumption ignores is the massive (and that isn't enough adjective to describe what's happened) disruption to the global economy which CoVID has produced, the societal and political changes already set in motion.
Recently, the Senate Intelligence Committee, chaired by Senator Robert Barr (R-Stock 'n Property),
unanimously announced it supported the combined U.S. Intelligence Community's earlier report that the Russian government, at the direction of Vladimir Putin, had intervened in the 2016 presidential election to ensure the election of Donald J. Trump.
On Twitter, some commenters assumed this was significant -- that the Old-Boy Network had delivered a message to Trump: they had finally had enough, and the 25th Amendment was waiting to be invoked. I didn't believe this was even remotely possible, but had five minutes of fantasy enjoyment thinking about it (One, really, because we would immediately have President Pence).
At almost the same time, Fat Billy Barr announced that he might prosecute governors who went against the wishes of The Leader (whose mottled ass Barr tenderly kisses), and defy his order to
Put America Back To Work! There were other assumptions, there -- about Barr's authority as Attorney General, and that threatening state Governors could make them toe the line and kiss Trump's ass, too.
But I also thought: let's play this out -- the Players in each situation acted as they did because they
assumed the structure of things -- America's government, its finances, its society (as F. Scott Fitzgerald said, a framework of "religion and years of plenty and tremendous sureties and exact relations ... between the classes") was operating exactly as it always has.
But -- what if, as Nassim Taleb noted, the structure is no longer that way? For me, the image that comes up is the old, fat Russian officer, marching new recruits to the front in
Doctor Zhivago; they encounter a mob of deserters, who entreat the recruits to defect; the old officer orders them from the saddle, "Form ranks! Get back in ranks!" He assumed his authority and everything that supported it was the 'local reality'; the soldiers pulled him off his horse and beat him to death.
Roughly 30,000,000 Americans are out of work. In my neighborhood, I overheard several managers of apartment buildings (not the wealthy co-ops, of course) saying half their residents or more couldn't pay April rent, and likely can't pay in May.
The $1,200, one-time "Donny Trump Fun Bucks" check with The Leader's heavy, spiky signature will probably be spent on food. Mortgages are going unpaid. Business rent. Insurance coverage. Car payments. Student loans. Credit Card debt. Wireless bills. Medical bills. Cable bills.
Trump and his Republican toadies are making their own assumptions -- even about something as stupid, at a time like this, as insisting The Leader's signature be on each check. The right-wing thug strategists assume people will make positive associations between 'Getting Fun Bucks', and The Leader: Free political advertising.
It's an assumption that we're still living in the world where politics as usual is the shared reality. In truth, people getting the checks will deposit them and not give Leader's EKG arrhythmia-shaped handwriting more than a moment's notice. By the time Winter comes, businesses -- who also assume we're living in a world ruled by the same ideas of obligation, debt, creditworthiness -- will expect what they're owed. So will landlords, property owners, finance companies and banks.
As someone on Twitter noted, TeeVee commercials are appearing now, showing America's big corporations as empathetic, "understanding and compassionate; they will be happy to 'discuss arrangements' for payments. There's nice piano music playing behind these images. Just don't expect soft music and compassion when they send your account for collection".
This isn't a Civ102 class, where you spend one session skimming over 1929 and its aftermath, just as a way to segue into the Second World War. The media notes this CoVID-fueled effect to the economies of the planet will be "Worse than the Great Depression of the 1930's" -- not having the least notion what that means. No one does.
If you read the article on Taleb, his main point is, the CoVID disaster exposes all the stress points, the
assumptions we've made about interconnected global finance and supply chains, our dependence on fossil fuels (not to mention the politics of oil), and just how vulnerable we are as a species.
CoVID-19 is bad enough -- but if it had been more like Ebola, we might be looking at global deaths in the millions, now, and a global heath system which could not cope with it. And, nature isn't through with us. This was just our first pandemic in 102 years. It isn't over.
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Yes, there was an immense relief bill passed, to show that the Congress "Did So Care!" about the Little People, and of course the Bundist Billionaires and Oligarchs. And, it was done to show that no one need panic: money was on the way. Only, it was trickle-down, again; same at it ever was. As
Ian Welsh notes,
Virtually all the relief money has flowed to the top, not the bottom. Landlords and tenants are in crisis. Unemployment is going over 30% and in many places higher. A vast swathe of American small business will be destroyed, and is unlikely to recover in a generation.
Firms which borrowed money to do stock buy-backs, or to give money to their private equity purchasers are slopping at the trough, but many of the actual businesses on the ground (like Nieman Marcus) will go under.
PPE can’t be found for hospital workers or logistics workers. Important pieces of the logistics hubs like meat packing plants are shutting down. Warehouse workers are protesting, truckers are scared...
America is unable to make or procure an adequate number of masks or prioritize who gets them (though, really, everyone should). The ventilators made by GM are inadequate, because Trump wanted to keep the price down. Hospitals not only don’t have enough PPE, they’re going bankrupt because they haven’t been given enough money.
All the assumptions Republican Senators, Billy Barr, Trump -- even you, and me -- are making about how things are supposed to work in America and the world doesn't address the reality of what's just happened. Its effects are so big, we can't put our arms around it and can't know how it will affect us.
We can say all our assumptions about the future will change. Not that it will be so radically different -- but just as Fitzgerald saw the old assumptions about his world before WW1 dissolve, the same will happen to us. And the domino effects of CoVID, and continuing Climate Deterioration, will drive it.
Some observers believe America is headed towards regional dissolution, food riots once transport and supply chains break down, and who knows what political structure will emerge -- maybe a semi-United States; maybe the Republic of Gilead, run by evangelical 'christians'.
But, maybe not. Maybe when the chickens finally finish coming home to roost (as they have been since Trump was granted power), our future doesn't have to be exploitation by Neoliberal politicians and rat-faced corporate leaders, or domination by christian fascists. I like to think human beings -- even Americans -- have better imaginations than that.
When we leave our assumptions behind, perhaps they'll be about fossil-fuel dependency. Or healthcare. Or ideas that lies and propaganda are just 'alternate facts'. That income inequality, and throwing children into cages at immigration stations, are just part of the fabric of our country; just one of those things. That we can't fight City Hall. Or climate change. Or even a housing crisis. Perhaps we can abandon the assumption that the fix is in, and no solutions are possible.
There's a long road with CoVID ahead -- it won't end until treatment therapies that mitigate the worst effects of this organism are proven, or an effective vaccine is created. These are months, even years, away. When we come out the other side: what kind of culture and political realities do we want for each other? Our tomorrows do not have to look like our yesterdays.
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MEHR, MIT EIN ANDERN MEINUNG: (Repeating myself, but...)
...We're living through history. When we read about events in Europe during the Interwar Years (1918 - 1939), there's a feeling of inevitability, of being slowly sucked down a drain -- the revolving-door failures of parliamentary governments in France; Britain's declining empire; the manic Totentanz of global capital leading to 1929 and the Great Depression; the rise and fall of Weimar; the apotheosis of Italian and Japanese, and finally German, fascism. Regional war and civil war.
... and we know where the story is going. ... But we always read about the years leading up to [WW2] with a mounting sense of horror precisely because we all know how it ends.
And we have the same feeling, looking at major global currents in our own time. ... America, ruled by Babbitry, greed and illusion, retreats from the world stage. Its leader is Bloated, Raving, delegating the running of a government to corrupt, car-wash dilettantes. Other nation-state players are happy to rush into the vacuum we leave behind. The balances in the old alliances we created after WWII have been squandered, all but unraveled.
A regional conflict -- between India and Pakistan; Kim Jong Fat Boy's Fun Republic Of Chuckles and South Korea; Iran and Saudi Arabia, almost seems like a sure thing -- 'of course that's where all this is going'; no one would be truly surprised if one started tomorrow. What we wouldn't be prepared for is what would happen the day after, and the day after that.
Kleiner Mann; Was Nun?
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