The Lit City Blues Plague Days List

Howdy y'all-- so, I'm going to start keeping a running list of thoughts/links/initiatives that I've come across to kind of help get knowledge moving around out there. I'm not in Public Health. I have no secret sources of knowledge. All thoughts and opinions are entirely my own...  if you know of something that I should add to my list or have some comments/thoughts you want to get out there, let me know and I'll throw 'em on the list...

1. In general, I am taking the attitude of "it's already here" and acting accordingly. Plan. Plan. Plan. Don't wait for confirmed cases or for the government to tell you what to do. Educate yourselves, make informed decisions for yourselves and make a plan for yourselves. We've cleared the decks for the rest of the month in terms of non-essential appointments for the kiddos and we got an extra thing of TP, 200 bucks of groceries and are preparing to hunker down and get into "work or home" mode for the Missus and I. (Neither of us gets to telecommute, unfortunately.)

2. More and more states are canceling schools into early April- so far, only Des Moines here in Iowa is totally out until April. A lot of Eastern Iowa districts are on Spring Break next week (a nice bit of 'good timing' if anything about this can be good) so I think they're playing for time to see what develops. (For various laudable reasons such as 1. Some kids only get to eat when they're at school and 2. Health care staffing is kind of important right now and not completely fucking them over with a childcare nightmare is kind of a good thing to do.) But I cannot stress this enough: plan for an extended school closure now. If the school districts are right and we're back on post-Spring Break by March 23rd- wonderful. But I'm not banking on it and neither should anyone else.

3. It's with a keen sense of irony that I proclaim that I am fucking sick of politics about this. And this isn't a Trump thing or a Hashtag Resistance thing. All y'all need to stop it and get to fucking work already. This is getting ridiculous. They should have had an aid package done by now, but the President wants to mouth off on Twitter and make the stock market go all bipolar and the Democrats are trying to slip shit about abortion into this. Seriously. Stop it. I don't want to hear about it. Fix the problem and get people help to get through this and when we're through the worst of it the National Shouting Match can recommence. (Update: naturally, as soon as I posted this it appears they've got a deal on something. Excellent 👍 Here's what the House passed- seems pretty decent.)

4. Similarly, I don't care about Capitalism or Socialism at this time and neither should you. I'm not convinced that Medicare For All would save the day in these circumstances because the Federal Bureaucracy and the Federal Government are very much 19th Century Institutions and as we can see, it's moving like one as well. European countries have smaller populations to serve and smaller areas to cover- it's like comparing apples to oranges- and by the way, Italy isn't doing all that great at this, y'all. Do I think the American healthcare system as it stands now is going to do any better? I don't know yet- there's plenty of legitimate reasons to think: "Doubtful." BUT, the fact that we have fifty states and public health infrastructure at local/state/Federal level gives us a certain amount of flexibility that might prove advantageous to handling this. (The opposite could also be true.) Again, see the end of point #3. Let's get through this and then the National Shouting Match can recommence.

5. Inform yourselves! Johns Hopkins has a pretty good data map I've been using. Joe Rogan had an infectious disease guy on for a frankly terrifying but oddly comforting interview. (If you believe that 'knowledge is power' it's actually a good interview. If you're anxious AF about this and ready to go full Doomsday Prepper, perhaps skip it.)

6. For folks in my immediate area, I'm going to give this a signal boost. God bless the College Kids, man. Seriously good work to get this going.

7. Books I'm Reading: I'm a 'pick my way through four or five books at a time' kind of a person, but I've cracked Antonia Fraser's biography of Oliver Cromwell and am breaking into my first ever Tolstoy- War and Peace is underway. (In addition, I'm working on the Personal Memoirs of Ulysses S. Grant- I found a free edition on Kindle, so that was a no brainer and I'm working on finishing Robert Jordan's The Wheel of Time-- I'm on volume 13 of 14.)

8. Movies We've Watched:

Legend of The Guardians: The Owls of Gahoole- I've low key always wanted to make the kids watch this movie and finally, last night, I cornered them and made the executive decision to have us watch it. Beautiful animation. Great story. Features warrior Owls and of course, at least one song by Owl city on the soundtrack. It feels very much like a kids movie of my youth: great adventure with some decently scary parts mixed in. Now if I can just find Warriors of Destiny somewhere online...

Hook- The kids only half paid attention to this at first, but by the end the Eldest Spawn was getting pretty into it.  I have heard tell on the internet that Dustin Hoffman and Bob Hoskins decided to play Hook and Smee as an old gay married couple and that pissed off Speilburg when he found out-- but I have no idea if that's true, but you can't unsee that thought when you watch the movie. Plus, I know Dustin Hoffman has been in some of the greatest movies ever made, but low key: this is his greatest role. Absolutely incredible and for a movie made in 1991- Hook holds up.

Teenage Mutant Ninja Turtles II: The Secret of The Ooze- The kids are a bit more familiar with Ninja Turtles and were thus more engaged overall. Great flashback to our youth for the Missus and I with a New York that includes the WTC (always weird to see that) and feels a lot more gritty than you see it portrayed today. Vanilla Ice was very 90s, plus, its weird to think about, but none of the turtles are wearing pants.

Ant-Man- Perhaps the most underrated of the MCU movies? Maybe? I think we can stipulate that. I'm Paul Rudd is just about perfect for this and when things started shrinking and getting bigger, the kiddos all started paying attention.

Cars 2: I tried for 'Around The World In 80 Days' but they weren't having it, so we pivoted to a cartoon instead. As sequels go, it's not bad- but does it measure up the original? Not really.

The Good Dinosaur: We'd seen it before- and it's considered one of Pixar's few 'misses' but it's actually pretty damn good. Plus, there was a bonus drug trip scene that I totally forgot about and it was unsubtle about it- which surprised me for a kid's movie.

9. Another signal boost for my immediate area--- It's out there pretty widely now, but on the off chance someone hasn't seen it: UIHC Visitor Screenings/Limited Entrances

10. Got an email from Wellmark Blue Cross Blue Shield this morning-- the highlights:
  • Waiving prior authorization processes. Wellmark will waive prior authorization processes for covered services related to COVID-19 to ensure patients receive the right care at the right time and location.
  • Covering diagnostic tests for COVID-19. Members will have no cost-share for appropriate testing to establish the diagnosis of COVID-19.
  • Increasing access to prescription medications. Wellmark prescription drug benefit plans allow for early refill (up to 30 days of medication). We encourage the use of your 90-day retail and mail order benefits for maintenance drugs. We also will ensure formulary flexibility if there are medication shortages or other access issues. Members will not be liable for any additional charges if they receive a non-formulary medication as a result of a shortage of their current medication.
  • Offering virtual health care visits and 24/7 help. We encourage our members to take advantage of virtual visits — a covered benefit for most Wellmark members when they use an in-network health care provider or Doctor On Demand®— to avoid the spread of germs. Members also have access to Wellmark’s BeWell 24/7SM service that connects them to real people who can help with a variety of health-related concerns 24/7.
11.  If you've ever wondered what goes on at Integrated DNA Technologies over by the Coralville Wal-Mart, well it turns out something pretty awesome. I have a feeling the lag in widespread testing is going to start to close in the next week or so- at least I hope so.

12. For Parents! Guidance on playdates from the NY Times... 

13. First case of community spread has been reported in Iowa. They want us to avoid gatherings over over 250+, but no school closures yet- but it's gotta be coming. Same for sit down dining and bars and restaurants.  Plan. Plan. Plan, if you haven't already. (Seriously: we went for groceries and there was no flour left. None.)

14. More for Parents--- now that school is officially done for a month at minimum, we've started to try some of the options that are out there- and there are plenty being shared on Facebook and social media if you need resources-- so far, our faves include:

Lunchtime Doodles with Mo Willems

Cosmic Kids Yoga 

If you've got a Lego fanatic in the house, this is proving to be a brilliant tool for creative exercises:

(Highly recommend this one-- Eldest Spawn has been asking for his daily challenge as soon as he gets up in the morning.)

15. Given the shortage of basic goods in the grocery stores, we doubled down on making our own and chunked out five loaves of bread yesterday.

If you've got flour, yeast, salt and some time on your hands this is a pretty good recipe. (Don't need to go to the grocery store to get bread if you can make your own!)

16. Because of Spring Break I was anticipating having a week off from work anyway and maybe going on a trip or two, but this shit blew up and I've been doing my damndest to practice social distancing and really hunker down and get into a 'work and home' type of mode. However... wife goes back to work tomorrow. (She's a nurse.) I follow on Friday. (I'm a Dispatcher). My extended family is all in the UK. My sister is on sabbatical in France (a well-timed one, to be sure). My parents are nudging into the danger zone for this shit. Her Mom isn't doing that well to begin with and is FOR SURE in the danger zone for this shit as are her grandparents.

Starting to feel like everyone I know and love is in the firing line for this shit, so needless to say my anxiety is spiking even higher than it already is. I randomly found one- ONE, N-95 mask for the wife to use and I know y'all aren't all nurses- but if you know a nurse, if you're married to a nurse please take a minute to sign this petition. Frontline workers desperately need PPE to get through this.

17. Tylenol not Ibuprofen for this stuff...  per WHO. (Well, now they've changed their minds.)

18. So, ABC Mouse is giving everyone a free month's subscription, however, turns out their founder is a Scientologist and gives them tons of money. Free is free, but if you're not comfortable even supporting them, however indirectly, do your research and check it out. (This is a pretty decent article, even if it is from The Sun.)

19. There's an interesting data discussion that's floating around out there:

This looks at the Case Fatality Rates globally.

This suggests that perhaps it's not as bad as we think it is. (Seems a little optimistic to me, but the narrative of "are all these quarantines doing more harm to the economy and not being as effective at mitigating the virus" is only going to grow.)

Testing is growing, but either reporting of testing is spotty or not uniform across the board, so it's really hard to make any inference from any of this, but-- data from one of the cruise ships where they tested everyone found that over 50% of the people who tested positive were asymptomatic. Data from South Korea kind of backs that up a little bit- they found large percentages of 20-29 year olds that were asymptomatic as well. I also saw something float by that 99% of fatalities in Italy so far involved people with underlying health conditions as well-- which, combined with Italy's status as one of the oldest countries is Europe is probably contributing to the dreadful death toll there as well.

I don't know about all this- it's fascinating data to sift through, but I don't know if you can hang your hat on this notion just yet. It still feels pretty early in all this, you know?

20. Maybe not so good news on the chlroquine front- must read thread here:

21. I'm spinning off more specific thoughts into their own posts-- 10 Things About This Mess

22: Add this to list of 'something worth reading.'  Also, this:

All right- that link above to 'something worth reading' was actually taken down by Medium and is being fairly heavily criticized. I read it. Didn't think it was too bad, but toward the end it kind of veered off into somewhat dubious territory, I thought- which should have been a signal to me that perhaps something was amiss, but this is a pretty good breakdown of what's wrong with it:

There is an emerging narrative right now that's kicking around out there that ranges from, "this is a statist plot to wreck the economy and make us all more dependent on the government" to "at some point, the cost to the economy is going to be higher than the cost of all these lockdowns, so we need to plan on how to crawl back out from behind the bushes sooner rather than later." The latter I find to be a more persuasive narrative than the former, which is pushing into crazy town territory. But, I also think it's way too soon to jump to conclusions about the latter narrative either. Testing is ramping up- but nowhere near to the point where we can draw big, national conclusions about how this is going. Not yet anyway.

23. There's mounting evidence that hydroxychloroquine in combination with Z-Park/Zinc seems to be an effective treatment. France followed up the initial studies with a wider one and now France and Italy are both using it as a treatment option. The FDA has approved it for emergency use and multiple pharma companies are donating significant amounts to the national stockpile. The media still seems to be downplaying it, but I'm willing to upgrade this from 'anecdotal' to 'quite possibly a thing' at this point. It'll be intersting to see if this changes the admittedly grim numbers from New York at all. Also, I don't know if I'd classify this as a 'hope' yet, but it's a twinkle of something.

Update: Well, it's the Daily Mail so grab your salt shakers, but this seems to be add to mounting evidence that chloroquine is a thing.

24. MILD RANT ALERT: I am disgusted by the national media straight up gaslighting us on this. Has the President done everything right? No, he hasn't. But local and state leaders haven't exactly covered themselves in glory either. Don't trot out the Mayor of New Orleans or DeBlasio to bitch about Trump when calling off Mardi Gras and shutting shit down was entirely within their purview and had Trump done anything, people would have lost their goddamn minds.

I get it. The President isn't everyone's cup of tea. But this was a nationwide fuck up at multiple levels. Can't be laid at the feet of one person, no matter how much the national media might want to pretend otherwise.

25. Let's talk models...  Iowa still hasn't ordered a shelter-in-place yet, despite people losing their minds with every day that goes by we don't have one. Everyone's talking about this model-- which has Iowa's peak hitting on May 1st, 2020 with hospital/ICU bed shortages. But here's the thing: because Governor Reynolds hasn't fully mandated- but reccommended school closures (though I think she has ordered it now)- it doesn't pick up that schools are closed. It doesn't pick up the restaurants/bars/tattoo shops and a lot of other retails places are shut down. We don't have a stay-at-home order that's true- but we are doing things that this model doesn't appear to take into account.

Because of that, I'm sort of inclined to view it as a 'worst case scenario' type of marker.

And yet...

Linn County and Polk County accelerated to 100+ cases really fast. Part of that is probably due to outbreaks in care facilities, but still-- it was really fast.

I think the whole 'steady as she goes' model seems to be working okay for Iowa- so far. But the thing is, Captain Smith probably thought 'steady as she goes' was working okay for him too- right up until the moment the Titanic hit the iceberg. I've been fairly agnostic about the whole 'shelter in place' debate, but...  I don't know. These numbers are starting to worry me a bit. And for it to have the most effect, we need to 'shelter in place' before the state's metrics are triggered. I really hope the IDPH knows what it's doing. I'm going to have faith that they do...  but...  kind of getting into squeaky bum territory here.

26. Google has something that's both creepy and slightly heartening out- COVID-19 community mobility reports. If these percentages are a good metric of where we're not or where we are, I think Iowa seems to be doing okay. Also, it's creepy AF.

Again...  this is a rolling list. Gonna keep updating as we go.


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