I was interviewed by WCBN on Covid-19

Among other things. Check out the full interview here:

How many workers are testing positive for Covid 19?

To date, there has been no data on incidence of Covid 19 cases in the workplace in Michigan.

The State of Michigan, as part of Executive Order 2020-114 requires that businesses immediately notify the local public health department and any co-workers, contractors, or suppliers who may have come into contact with the person with a confirmed case of COVID-19 within 24 hours. Businesses must also shut down operations when any person is found to show symptoms of Covid 19 in the establishment and has a positive test.

But anecdotal reports are suggesting that compliance with the directive is spotty. No doubt, businesses will be hesitant to shut down operations with little notice or to draw undue attention to themselves. However, after one local business (so far the only one to do so) issued a public statement that one of their employees tested positive for the disease, the public is becoming skeptical of the private sector’s commitment to responding to potential exposures.

Rumors are flying through service workers that businesses are slow to respond or are actively covering up information on cases that have appeared in their workplaces. Of course, these are rumors and anecdotes, but even if the incidents are wholly unsubstantiated, public skepticism on social media is not. The public does not trust businesses, and particularly service businesses to adhere to the guidelines spelled out in the executive order.

Clearly, we are in real trouble. Cases have spiked in the past week, hospitalizations are up, and many states have lost or are about to lose the gains they have made. Hospitals in Texas are overflowing. Even the US military has extended bans on movement or personnel into specific states, most notably, my own while lifting them for other states.

We need businesses to adhere to the guidelines for reporting in the executive order, but we also need to use that data to inform the public on risks for infection when visiting businesses. While businesses are required to report to local health authorities, there is no indication that the data will be made public and very little indication that the data will be disseminated in a manner that will facilitate research on specific risks in different types of businesses.

Supposedly, you can call your local health department and they will tell you if you if you might have been exposed when you went to Place X. That requires a lot of work on the part of the consumer, and how are they going to know to ask about a specific business without having an alarm raised anyway? I can’t see how that can work.

Public health authorities and the private sector MUST work together to implement systems and information sharing that protects the public health. While businesses are right to be concerned about their survival, becoming the center of a superspreader event will be a public relations disaster as we saw in Lansing, MI over the weekend.

Bars and restaurants need to develop systems to inform customers when a staff member tests positive for Covid 19

Fauci noted that “Bars are bad news” during a Senate hearing on covid 19 today, and he’s right. No one should be going to a bar right now. No one should be playing music in a bar. No one should be working in a bar right now. Just a terrible idea all around.

But people are doing it anyway, and, though the risks are very high, there have to be systems in place to minimize that risk and help insure the safety of customers and workers.

At least two bars in Ann Arbor, MI have had staff members test positive for Covid 19 within the past week. One did the right thing. They shut down operations and had their entire staff tested immediately. A couple of days later, they issued a statement informing the public of what happened and what they did. The other has yet to do anything at all, unfortunately.

Closures and public statements are good things, but maybe there’s another step that businesses can take to inform customers in a timely manner. I suggest collected phone or email contact information from customers each night.

Businesses would send out a text or an email message informing the customer a staff member tested positive and it is possible that they may have been exposed to covid19 and should get tested and isolate as soon as possible.

As this system would be voluntary, no privacy would be violated. It is likely that most patrons would consent to receiving such notices. Personally, I would like to know. I would also like to receive that information sooner rather than later.

A QR code app based system such as that being implement in South Korea would be preferable, but it is unlikely that such a system would be acceptable in the US, aside from issues of cost. A simple email list might be an easy, low cost method of informing the public when they might have been at risk for infection.

The public has a right to know when service employees test positive for Covid 19

But so far, that’s not happening.

In the past week employees at a handful of business in the tiny college town of Ann Arbor have tested positive for Covid 19. I won’t name names because I think that each businesses needs to be afforded an opportunity to make create a response and write a formal announcement.

Responses, however, should be immediate. Any delay in messaging puts the public at unnecessary risk. Businesses should be required by law to immediately make it public when an employee has tested positive.

When an employee tests positive for Covid 19, operations should be shut down, and every employee of that business should be tested without fail. Once everyone has been cleared, people can return to work and operations might commence.

Every single person who entered those businesses or had contact with employees needs to be immediately informed that they might have been exposed to Covid 19. Businesses must do this so that patrons can be tested if possible and isolate themselves if necessary.

Businesses who fail to do these things should be shut down.

One business is currently still open. I have it on good knowledge that an employee tested positive for Covid 19 there, yet there has been no announcement and business moved forward as usual (at the time of my walking past it yesterday.)

Covid 19 is no joke. People should be staying at home. They should not be eating out. Restaurants, bars and entertainment venues should not be open, but they are. If we are going to reopen these places, we need to do so under strict regulation that keeps the public informed and protected.

Michigan, you are in trouble.

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We went from 74 new cases of Covid 19 on June 15 to 389 cases on June 26, a five fold increase after several weeks of people partying like it is 2019.

Assuming that nothing changes between now and then, we will exceed the peak of new cases found (1,953) in Michigan back on April 3rd…. by the middle of July.

Certainly, case fatality rates are down, but if disease is not, this leaves us with even larger numbers of people suffering debilitating disease. Some will suffer for years and some of them might die earlier than they would otherwise.

Local bars, restaurants and music venues are opening up and trying to get people to come out like they did before, albeit under new rules. Some places are making a greater effort to protect workers and customers than others.

A local bar discovered that one of their staff tested positive for Covid 19 and, to their credit, shut down operations and tested the entire staff. But the infected staff member could have been infected up to two weeks ago and could have infected other staff, who could have infected customers. Every single person who stepped into that building needs to be informed. Is there a mechanism to do this? Obviously not, but there should be.

Moreover, the public needs to know which establishments have positive cases and when so that people can judge the relative safety of businesses and can act accordingly when they believe that they might have been at risk. This is also not happening but it should be.

People will inevitably say “it is worse everywhere else.” That doesn’t do anything to help a person on a vent. We are in real trouble, we need to act like it.

What will the State of Michigan do about this? Will we have another shut down? What does this bode for the future? Whatever it is, it isn’t good.

So… wear your damn mask. Stay the fuck home. Get carry out. Ignore all these people trying to get you to go out and act like life is the same as before, because it just isn’t.

Covid19 report cards for businesses: it is time.

The risks of covid19 are well known at this point. While we all need to be sympathetic to the need for people to earn a livelihood, a living should not come at the expense of public health and worker safety. This should be a given.

I have seen some businesses who are doing quite well right now. While my sample size is certainly small and my observations subject to my own biases, it is easy to tell apart the businesses who make an effort and the ones who do not.

We should support businesses who 1) require masks without fail, 2) offer masks and gloves to both workers and customers, 3) limit the number of customers in the store at any given time and 4) build plexiglass shields to separate customers and workers.

We should not support businesses who take a lax approach to masks, do not offer masks to customers who don’t have them, allow large numbers of people in the store proportional to size and do not have plexiglass shields in front of the register.

All of these modifications are easy and cheap to implement. There are few occasions where there is any valid excuse for not doing all of them in normal retail and food service industries.

Which bring me to the the point of this post. How can customers know how seriously businesses are taking covid19? Certainly, online review sites like Yelp or Google are going to be helpful, but these do not provide any indication of progress that businesses might make (“evolution”) or provide standards so that we can easily compare one business with another.

Many municipalities provide public record of compliance with health regulations. The New York City Health Department performs unannounced inspections of all restaurants in the five boroughs at least once an year and makes the data public. The public can search for any food provider in the city for any type of violation and even has a grading system. The Washtenaw County Health Department and the Michigan Department of Agriculture and Rural Development conduct regular inspections of food service establishments within their jurisdictions and publish the results online. The worst offenders often make the papers.

We need such a system for all businesses to make sure that they comply with efforts to contain the spread of covid19. Consumers have a right to know whether a business is compliant or not BEFORE they make the decision to visit that business. While the logistics of such a system are complicated and likely expensive, they are necessary.

Will this be on our legislature’s agenda? Do local health departments already have the authority to implement such a system? Would businesses push back against cheap masks and plexi? Certainly, there are challenges to implementation, but it isn’t impossible.

Movie of the Week: Tehran Taboo (dir: Ali Soozandeh, 2017)

A friend suggested recently that I revive my blog, though I seem to notice that my last 20 posts all say something to the effect of reviving my blog… which sort of begs the question of whether this endless revival contradicts the idea that it was ever dead.

Regardless, I used to have a feature called “Movie of the Week” where I would write some sentences about some film that I found particularly impressive. I still watch an inordinate amount of movies, so much so, that the streaming services are almost dead to me; there’s not much left to watch that I haven’t seen that at least *looks* interesting. Open to suggestions though!

MUBI, however, is an endless trove of cinematic gems, adding and taking away films from its catalogue almost daily. Michigan Theater members got three months free during the Covid-19 lockdown, which has been a real life saver right now. So far, I have caught up on some recent Japanese productions that I missed (that I won’t even mention since it just isn’t polite to speak ill of the dead), got to see the Ryuichi Sakamoto doc “Coda” from 2017 (which was superb) and a number of oddball Russian productions that I would have missed otherwise (Beanpole from 2019 is highly recommended).

A standout, however, was “Tehran Taboo,” a German-Austrian production by Iranian born German director Ali Soozandeh. Tehran Taboo is the story of three women and one man, navigating the complex dissonance between strict rules on sex and economic, human and social realities.

Shot in Germany and Austria using Persian speaking actors, the film is rotoscoped. That is, the visuals are traced over live actors, in the same vein as Bakshi’s 1978 production of Lord of the Rings. Rotoscoping for Tehran Taboo availed the director of having to film sensitive material in Iran. He could shoot in Germany and then simply draw over the action to create settings that at least “look” like Iran without fear of having the religious police (who are central to the film) arrest everyone involved. Aside from the practical issues the film just looks great and the animated approach brings out the immediacy of the subject matter.

Alrighty, then, there’s my blog post. I win.

Tom Friedman knows nothing, please fire him

Referring to an opinion piece in the NYT from Tom Friedman:

“Either we let many of us get the coronavirus, recover and get back to work — while doing our utmost to protect those most vulnerable to being killed by it. Or, we shut down for months to try to save everyone everywhere from this virus — no matter their risk profile — and kill many people by other means, kill our economy and maybe kill our future.”

I mean, really? Does Mr. Friedman not understand that most deaths from Covid19 will occur because the health care system just does not have the capacity to see the high number of patients with serious disease that will appear if we do nothing?

The goal is not to “save everyone, everywhere.” People are going to die. Actually, they already have. The goal is to bring the rate that people with serious disease appear at hospitals to a manageable level and to buy us time to come up with effective treatments and, possibly, an effective vaccine.  We need to slow down transmission because a lack of ICU beds, ventilators and people to work them will be a major determinant of mortality in people with severe symptoms of disease.

“That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.”

This is just ridiculous. There is a vaccine for influenza and most people have at least partial immunity to it, so that fewer people become infected. 99.99999% of humanity has exactly zero immunity to Covid19 so that even if the case fatality rate is the same as influenza, there will be potentially more infections. Small percentages of big numbers are still big numbers.

The article he refers to even tries to make a bizarre argument that because there are other coronviruses out there that also cause death, then we should not be overly concerned with this one. Again, the other coronaviruses out there (many of which cause the common cold) have been around for quite some time. Many people have developed some level of immunity to many of them (correct me if I am wrong here) which reduces the total number of people who become infected yearly.

We certainly have to weigh out the costs and benefits of any intervention. In this case, many people will lose their livelihoods, people will turn to alcohol and drugs, there will be financial meltdowns and suicides. This must be discussed.

However, we can’t blind ourselves to the incredible human cost of a new pathogen that humanity has no immunity to, that, even if that pathogen has characteristics of pathogens we are commonly faced with. We can’t say, “saving lives is too expensive” when the financial cost of breaking our health care system is also incredibly expensive.

What if your ancestors suck?

Ancestor worship is a common theme in African lore, particulary in the traditional arts. So while people are singing the praises of their dead relatives, I always wanted to ask what to do if my ancestors were horrible people?

I was recently speaking with some people whose parents were refugees from Romania, ostensibly people who were fleeing life under the dictator Nicolae Ceaușescu, a forgotten piece of Stalinist work who made the lives of Romanians miserable for decades. While Ceaușescu and his government were vile, the people who came to the US were refugees and likely middle class families decended from peasants back home.

The contrast with my and many Americans’ heritage is stark. I am decended from a family of Mitchells, a distinguished Scottish family of wealthy means who decided to take a gamble and invest in agricultural ventures in the Southern United States. The first to come was a man named Thomas Mitchell, my maternal great x 10 grandfather, who arrived in US, fought in the Revolutionary War and set subsequently set up shop for the family business in Georgia.

Thomas, like many Scots who came to the Southern United States, came to profit not only off land and agricultural products that could be exported to Europe, but also off the promise of cheap, forced labor from Africa. Thomas Mitchell was a slaver.

From slave based agriculature, the Mitchell family became extremely wealthy in the South, producing numerous politicians, lawyers, administrators and academics. There is still a county named for the Mitchell family in Georgia.

In 1836, the Mitchell family expanded their land holdings by assembling a militia of 75 men and committing a genocide against the Native American residents of their land “in which all the Indians except five were killed, their arms, campage, etc. falling into the hands of the whites.”

There are others, but the point is, does it make sense to venerate one’s ancestors when they were clearly committing crimes against humanity? The Romanians I spoke with probably have terrible members of their family, but likely have not had their lives shaped by a horrible past.

I am not unique. Just about any white person in the South whose family was their during the 18th and 19th centuries was involved in the buying, selling and use of humans. If they have money now, it is a direct result of slavery and the ethnic cleansing of Native Americans in the South. We should never forget, because that’s how we got here, the past that shapes our present. Our current lives were made possible by terrible people doing reprehensible things to other people.

So no, not going to sing any praise songs to my ancestors any time soon. Maybe I’ll do the opposite instead.

My intro malaria/tropical medicine course at Colby College… is done!

A friend of mine hooked me up with a short gig teaching a course in malaria and tropical medicine for Colby College’s JanPlan. Every January, students have the opportunity to study a subject in depth, often with teaching faculty not based at Colby College.

I have long wanted to design an undergrad level course in tropical medicine so took it as an opportunity to do so. We focused mostly on malaria, covering the basics of malaria epidemiology, pathogen and vector biology, prevention and treatment, diagnostics, vector control, health care delivery, international funding for malaria programs, drug and insecticide resistance and elimination/eradication. We even had lectures on basic concepts of epidemiology and infectious disease and talked at length about public health, public health practice and medical ethics. It has been a fairly intense month.

At first, I was a bit concerned that the subject matter would be too broad, particularly for science people, but quickly learned that much of the class were non-science majors, and most were freshmen.  This gave me a great opportunity to bring in a wide range of topics that could appeal to just about everyone in the class.

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