My Covid-19 Posts

March 13, 2020

Great quotes from American presidents on leadership:
John Quincy Adams - "If your actions inspire others to dream more, learn more, do more and become more, you are a leader"
Millard Fillmore - "An honorable defeat is better than a dishonorable victory."
James Buchanan - “The test of leadership is not to put greatness into humanity, but to elicit it, for the greatness is already there.”
Grover Cleveland - “It is better to be defeated standing for a high principle than to run by committing subterfuge.”
also - “Unswerving loyalty to duty, constant devotion to truth, and a clear conscience will overcome every discouragement and surely lead the way to usefulness and high achievement.”
Theodore Roosevelt - “If you could kick the person in the pants responsible for most of your trouble, you wouldn’t sit for a month.”
Woodrow Wilson - “The object of love is to serve, not to win.”
Warren Harding - “There's good in everybody. Boost. Don't knock.”
Herbert Hoover - “Be patient and calm; no one can catch a fish with anger.”
Harry Truman - “It is amazing what you can accomplish if you do not care who gets the credit.”
Bill Clinton - “If you live long enough, you'll make mistakes. But if you learn from them, you'll be a better person. It's how you handle adversity, not how it affects you. The main thing is never quit, never quit, never quit.”
Barack Obama - “Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change that we seek.”
Donald Trump - "I take no responsibility at all."

March 14, 2020

This is a non-political plea.
For a living, I mostly do the math. How often am I ahead, how often will I improve, how often can I get a fold, how much of a bet will be called by worse.
The Covid-19 threat in the US is a math problem.
1. While reported cases in the US are now around 2200, all the experts believe it is much higher. Likely 10x. Maybe more. We don't really know because we have done so few tests. Blame who you want, but that it irrelevant. Everyone agrees that the reported number does not represent the extent of the spread.
2. Depending on what we do to contain the spread, the infection number appears to double every 2-6 days. Assuming 20K cases now (conservative) and 4 days to double, in 4 weeks, we are looking at 2.5M cases.
3. There are 2 ways to contain. One is by massive testing and quarantine of those who test positive or have been exposed to someone who tested positive. Dr. Birx made a point of S Korea having only 3-4% positive. But that is the point. They are testing mass numbers of asymptomatic people so results will be mostly negative. But it is the only way to find infections when people are totally asymptomatic for at least 4-5 days after infection and sometimes, never showing symptoms. S Korea appears to be over the hump, with recovered patients exceeding the number of new infections. Unfortunately, mass testing is not an option. We are promised 5M tests available in 30 days, but if infections are already in the millions, it is way too little and way too late.
The 2nd option is mass self-quarantine whether you are symptomatic or not. We have to just stay at home. We are fortunate that local and state governments, many businesses and hospitals are proactively preparing, but it is up to us to avoid contact as much as possible.
3. The US rate of complications due to Covid-19 will be much higher than they are in Asia and Europe. Kaiser estimates that 40% of us are likely to suffer complications from the virus. The reason: we are overweight and out of shape. We have diabetes, high blood pressure, asthma, etc.
4. Hospital resources are limited. We have far fewer beds per capita than China and Korea. Also fewer than Italy. We have under 1M hospital beds. They are about 80% occupied. Just not a lot of capacity. And, of course, free beds in Idaho are not likely to help someone who is sick in NY.
We have about 160,000 ventilators in US hospitals. I don't know how many of them are available, but for people who are hit hard by the virus, they are literally the difference between living and dying.
So, do the math. If we get just 1/2 of that 2.5M cases and the number of complications is 20%, not 40%, we have way outstripped resources. Certainly all the cases won't need beds and ventilators at the same time, but given the back-ended rise in cases and a fairly slow recovery period, the picture is bleak.

Tony Fauci keeps talking about flattening the curve. He says there will be a lot more cases but we need to slow the spread to avoid the hellish scenario of deciding who gets help and who does not.

I am not an alarmist. I am a pragmatist. And I am staying at home as much as possible, which is almost totally. I am not hoarding TP and sanitizer. I get what I need and hope that supply catches up before I have to use newspaper. I urge you to do the same, to self-quarantine while asymptomatic and get help as quickly as you can if you show symptoms. If we get through the next 4-6 weeks and minimize the spread, we should get through this OK, together.

March 17, 2020

I expect some of this is going on, but seems like we have a pretty clear path forward: 1) Army Corps of Engineers, National Guard, military should be building out temporary hospital facilities. Use tents, prefab buildings, trailers, warehouses, unused hotels.. We need an immediate expansion of facilities. 2) All non-critical procedures should be postponed to mobilize more health care workers 3) re-tool non-essential manufacturing in select industries to produce medical supplies: masks, gowns, gloves... and figure out how to expand the supply of ventilators, again by re-tooling as needed. 4) create child care facilities near every hospital to free hospital worker time. 5) Obviously, continue the ramp up of testing and make sure that health care workers are tested regularly. 6) Nationally, close all bars, restaurants, etc except for take out and delivery 7) Use available hotel rooms to house homeless population. Some of you will say, this is not possible. We did this in WWII. This is the same deal. If we were able to land on the moon 50 years ago, we can do this today. We probably have 2-4 weeks to expand ICU capability 10x.

March 20, 2020

People are grumbling about the rich and famous (like NBA players) getting special access to tests. Wait until the rationing is for life-saving ventilators, not tests. And where are the tests? We were told there would be 1.4M tests this week, but every state is complaining about lack of access and still, the US has run only 41,000 tests total.

March 20, 2020

If our leadership was nearly as concerned about protecting the public as they were about protecting their investment accounts, how different would our situation be now? If we had done 1M tests 2 weeks ago instead of barely 100K by now, if we had aggressively isolated infected people and protected vulnerable populations, maybe we wouldn't be in lockdown now and who knows how many lives could have been saved. This is mass mortality, economic and social catastrophe at least hugely exacerbated by unbelievable and unforgivable incompetence. We do need to move forward but we also need to account for the unprecedented failure to protect the public. BTW, a week ago we were promised 1.4M tests this week. To date, we have tested barely 100,000 in total. Another failure, another lie, more deaths. Trump knows no one needing a test who cannot get one. Seems like all the rest of us know many. Start with everyone working in hospitals with infected patients.

March 25, 2020

Its hard to believe, but the first Covid-19 case in NY was just over 3 weeks ago. Florida provides the perfect storm for the disease: large elderly population, recently departed spring breakers and a lot of visitors from NY and NJ. We have the biggest ports for cruise ships in the country and huge amusement parks that attract hundreds of thousands of visitors, especially in winter months. We have many big cities spread across the state and we have many large universities where a lot of students are in close quarters. Yet, the governor refuses to follow the lead of almost all other populous states to require shelter in place. We have no time. On the current path, we will look like NY and New Orleans in just a few weeks. And, a few weeks after that, we run into hurricane season. We just cannot afford a disaster on top of a crisis. We must shelter in place, just to have a chance.

March 26, 2020

Florida is now 6th among the states in number of confirmed Covid-19 cases. We are the ONLY state in the top 10 of cases that does not have statewide shelter in place. West Virginia and New Mexico are under shelter in place. Idaho is under shelter in place. And FL has done less than 25,000 tests, about 10% of what NY has done. Forget about leadership from your governor. It won't happen. STAY HOME for all of us.

March 30, 2020

We really need to speed up the Covid-19 antigen test to see who has been infected and recovered and now has immunity. Those people can go back to work. We are using the sledgehammer of universal isolation because we don't own a scalpel. We don't know who has to be isolated (those who are positive) and those who can go about normal life because they have immunity.

On testing, I need to get something out here. Every press conference we hear about the antiquated testing system that this administration inherited that made testing impossible. The argument is that South Korea, Germany, Italy, Singapore, Hong Kong, China... were all better prepared than the US to test. Really? With the best scientific and medical systems in the world? Do you really buy that?

The restrictions were FDA imposed restrictions on controlling tests. On March 3, VP Pence said he eliminated those restrictions. This was not an act of Congress. No need to go to the courts. Just an executive decree. Why did this happen on March 3 rather than Jan 20 when the first case in the US was confirmed? Why didn't the administration in late January, or at least early February sit down with CDC and drug companies and say we need to test 1M/day within 2 weeks? Why? Because they were still busy denying the problem. We had everything under control and anyone who wanted a test could get a test. Note that the first case in South Korea was 1 day before the first case in the US and the first case in Germany was 6 days after the first US case. They were both able to begin mass testing in early February, not the last few days of March.

We now hear how we have done more tests than S. Korea. True, but even ignoring the fact that we have 6x the population and have not done anything close to 6x the tests, the point is we missed the window when testing would have allowed us to get control without isolating everyone and without accepting the grim reality of 100,000 dead.

The reason why we have the most cases in the world is not because we're doing more tests. It is because we were unable to test early, when mass testing would have enabled some control over the virus. Both the extent of the economic devastation and the extent of human suffering were greatly exacerbated by 7-8 weeks of a totally inept response, which seemed to be more focused on "our numbers" than on human suffering.

And the antiquated testing system?
We tested approximately 16,000,000 people for HIV last year.
Not saying it's the same thing, just saying mass testing is not only possible. We do it.

So what have we done right? We boldly stopped travel from China by non-US citizens. We hear about that great move that everyone else was opposed to every day. We made that move on February 4. Prior to that, United, American and Delta had already suspended flights out of China. The WHO had already recommended a halt on travel from China. And, on January 31, Italy suspended all (not just non-citizens) travel from China. So the radical non-popular move was merely an echo of what the WHO had recommended and what US airlines were already doing. And, it was later than Italy, so alone, that move is not enough to change the course of the virus.

At this point, I am all in with the president and applaud the extension of social distancing for another month. But to solve a problem, you have to first admit to the mistakes that were made. And we made horrible, deadly mistakes.

If you always open under the gun with 52 off suit, and point out that once you flopped a straight and won a big pot doing that, so there is nothing wrong with the move, you are unlikely to improve your game. Even worse would be to blame your poor strategy on something you insist you read that justified the move, but be unable to cite the reference or refute the overall negative EV.

We are totally bought in to getting through this together. We want to have confidence in our leaders and we expect honesty. Part of being honest is admitting to our own mistakes rather than blaming others.

March 31, 2020

Over the weekend Senator Ron Johnson, in arguing that the cure may be worse than the disease, said "Every premature death is a tragedy, but death is an unavoidable part of life. More than 2.8 million die each year..." OK. Cool. We have our third volunteer. He can join Glenn Beck and TX Lt Gov Dan Patrick cleaning bed pans in a Covid-19 ICU. PPE is overrated and not required.

May 7, 2020

Sorry to be a downer, but pretty clear that, as a country, we have given up. Covid-19 wins. We had 6-8 weeks in Jan-Mar to prepare like they did in New Zealand, Germany, South Korea, even Washington State. But we did nothing to step up testing and produce PPE. So we shut down for 2 months. And thanks to quick action from states and localities, we mostly avoided overrunning the health care system (with obvious exceptions in NY, LA, MI). The idea was always flattening the curve so we could buy time (again) and be prepared when we re-opened. And in the interim about 20% of workers have lost their jobs. The task force prepared criteria for opening and then left it to the states and 40 states are now opening. None of them meet the criteria. The number of new cases has not slowed, it has stabilized. If you take NYC out of the numbers, cases in the rest of the country are increasing. The CDC produced a detailed document on how to manage re-opening and the WH chose to throw it in the trash because it was too detailed. So we are still short on PPE and we still cannot test enough. We have no plan for contact tracing. In fact, it appears that testing has also plateaued. We are only testing slightly more people today than we were a month ago. So short of a miracle, July will look like March except it will be across a much broader swath of the country. Unfortunately, the economic and social pain and suffering of the last 2 months will have mostly been wasted, as for a 2nd time in 4 months we squandered the opportunity to get ahead of the virus. The hopes we have are a treatment (not that one that Trump promoted and bought 29M doses) that looks like it shortens the duration of the virus and advancement on candidate vaccines which may be less than a year away. But, for the most part, we have given up as a country because the problem is too difficult to solve. We were told to stay home and watch TV and we would be taken care of. Too bad the guy who was supposed to be taking care of us was also spending most of his time watching TV.

May 16, 2020

Since Trump clearly does not understand what "under control", "winning" and "success" mean relative to a pandemic, I want to help, with pictures. The first 2 charts reflect daily new cases and active infections in Germany. (I could replace Germany with a dozen other examples.) It appears that they, at least for now, have the virus spread under control. The second 2 charts are the same information in the US, which is a profoundly different picture. Hardly a success. Just the opposite.
To be clear, I am actually not opposing re-opening, although I think that we, as citizens, need to be extremely diligent in social distancing, wearing masks... to protect ourselves and others. The almost totally avoidable economic devastation that is a direct result of incompetence and idiocy in the executive branch is overwhelming the most vulnerable. Unfortunately, it is now obvious that if we wait for this administration to put in place the capabilities and precautions to safely re-open with testing, contact tracing and isolation, we will never re-open. They are both uninterested and incapable of making this happen.
Be safe out there.

June 8, 2020 on race

Since my FB friends are largely poker related, it is a pretty diverse group, geographically, politically, racially. You know my politics and I (mostly) respect yours although we disagree often. But for those who are posting all lives matter and look at all the shit that George Floyd did, I'm done with you. You don't get it and never will. I grew up poor, but (obviously) white. I had 3 run-ins with police, 2 in Chicago, one in southern IL in my late teens. One case they drove by when 4 of us were obviously behaving suspiciously (2 teenage couples in a park doing LSD - long story), one a slightly confrontational traffic stop with pretty nasty Chicago cops, and an arrest in Champaign for possession. The results were, being left alone, getting a 2nd ticket for questioning why I was stopped, and dropped charges after about 6 months. I know that if I was not white, it is incredibly likely that the results would have been different in one or all of these cases. Likely would have been arrest, arrest and conviction. And any one of those could have dramatically changed the course of my life, in a very negative way, like prison instead of college. While watching a man being brutally murdered on video may be what it takes to wake us up, the problem is deep and systemic. It doesn't require taking a life to destroy a life. The fact that we're talking is positive. The massive, diverse protests are encouraging. This is the time to listen, mobilize and force change. First step is to change leadership. Vote.

June 13, 2020

3 weeks ago, Gov DeSantis declared "we have succeeded" in fighting Covid-19. At the time, I suggested that he should have learned from others (Chamberlain, Bush, trump, trump, trump...) that it is foolish to declare victory in the 2nd inning of a tie game. This chart from FDOH shows the trend in new cases over the last 30 days. This includes a record high in new cases yesterday. A new record, until today's over 2500 new cases. Let's welcome a jammed mask-less trump rally followed by the packed, mask-less RNC. I also said on May 7 that we had obviously given up and accepted loss in the Covid battle. Clearly too hard a problem for trump and DeSantis to even think about anymore.

June 26, 2020

In the middle of a pandemic, trump doubles down on trying to take away health insurance from 20M Americans. This is not just ignorant, it is absolutely evil. It would be like holding a mass rally without masks in an area that is seeing Covid-19 cases spiking. Oh. He did that also.

The administration's late-night court filing makes no mention of the coronavirus.

Trump administration urges Supreme Court to overturn the Affordable Care ActThe administration's late-night court filing makes no mention of the coronavirus.

July 9, 2020

It's good we learn from our mistakes. CDC wrote guidelines for states reopening in April-May. Covid-Don didn’t like the detailed guidelines because they were too detailed so CDC held back the 60 page guidelines. They rewrote it in a few pages and then states were told to open regardless of whether they met the criteria and with no measures in place to control spread. ("Liberate Michigan, Minnesota, Virginia")
So now most of the country is in far worse shape than in March-April and CDC writes guidelines for schools reopening. Covid-Don doesn’t like them either because it is too restrictive, too difficult to implement safety measures. So the guidelines become “recommendations” and will be rewritten while Pence and Covid-Don tell states to reopen regardless, even if cases are at an all time high. Don’t worry so much about the tough safety standards which, Covid-Don says are too expensive. Need him to tell us the value of a 12 year old life so we can figure out what the relative expense is. Please explain to me why we provide relief funds to Elaine Chao's company and the Kasowitz law firm and public companies like PF Chang, but no money to protect kids.
And Betsy DeVos is very clear. The federal government will demand that schools open but leave it up to state and local governments to figure out how to do it safely and how to pay for safety measures. Once again, Covid-Don and team just throw up their arms. This is too tough a problem, so it's up to state and local governments to figure out.
Even assuming that most kids don't get sick and forgetting about transmission from kids to teachers, staff, parents..., they don’t know the long term effects of this virus, but they do know many people experience major long term health issues. Even if only a few thousand kids die, which will be ignored by Covid-Don and the VP, we could see 100’s of thousands of kids with lung, heart, brain, kidney problems in 5 years. We just don’t know.
In Florida, the Education Commissioner has demanded that all schools open "at least 5 days per week". Florida is one the the 3 sickest states in the country and is one of the worst hotspots in the world. There's no money for local governments to implement safety "recommendations" but let's just move forward because Covid-Don wants a strong stock market.
Here is the totally obvious plan for opening schools.
1. Spend the summer bringing the case curve down. Not flat, down. Do whatever it takes. We cannot safely open schools and we cannot restore the economy while the virus is rampant.
2. Provide crystal clear, medically sound criteria that must be met before schools can reopen. Criteria should be by county and by state.
3. Provide safety requirements, not recommendations, to allow for schools to operate in as safe a manner as is possible.
4. Provide federal funds, PPE, equipment, technology, personnel to local school districts to implement safety measures.
This is so obvious, it is absurd that none of this is being done. If we continue to follow Covid-Don into virus hell, there will be many, many families who will have the worst Christmas they could have ever imagined.