Tuesday, March 17, 2020

Notations On Our World (Special Tuesday Edition): On #LifeInTheAgeofCorona

These are profound challenging times.     We begin by an observations of the profound challenges being faced:

Even as U.S. cities cancelled St. Patrick’s Day parades because of the Covid-19 threat, bar crawlers simply moved their celebrations indoors. Over the weekend, they packed bars, pubs, and restaurants, ignoring pleas from public health officials to practice self-distancing.
The U.S. Centers for Disease Control and Prevention on Sunday urged Americans to cancel gatherings of 50 or more for the next eight weeks. But the lack of broader direction from the Trump administration has prompted states and cities to take drastic measures. California’s governor called for nightclubs, bars, and wineries to shut down. Other states — including Illinois, Ohio, and Washington — closed bars and limited restaurants to delivery and takeout. And on Monday, New York, New Jersey and Connecticut announced a unified effort to suppress gatherings and commerce across the huge metropolitan region. Crowds of more than 50 are banned, and bars, gyms and restaurants (except for delivery and takeout) will be shuttered.
Millions of students are also being told to stay home. Washington state was among the first to shut down schools. Since then, more than 30 states moved to shut theirs down, too. Los Angeles made the call last week, and now New York City, the nation’s largest public school system, will close at least until April 20. 
The restrictions only now proliferating across the U.S. follow those already implemented in Europe, the new epicenter of the pandemic according to the World Health Organization. Emergency decrees there have been more draconian: Movement in Italy is largely shut down, while in Denmark police are empowered to seize private property to enforce public health measures. Across the European Union, once-open borders are being sealed back up. And while the U.S. trails the EU in terms of robust response, they do have one thing in common: efforts that are “more of a loosely stitched patchwork than a single shield." -Linda Poon

Our State, California, has been at the forefront and as we went to press, a shelter and place order went into force.    We hereby present the following snapshot courtesy the team at AllAroundTheCapital on what has been the latest in California in the aftermath of Governor Gavin Newsom's Presser Sunday and his Facebook update late last night.  It is also of note that President Trump underscored the profound serious nature of the pandemic as there appears to be a Nationwide Shutdown of key industries--The Airline Industry being one that may look at a potential $ 58 Billion Dollar bailout as we also extend St. Patrick's Day Wishes to all: 

  • California confirmed cases: 572 (+151 from yesterday), with 11 deaths (+6 from yesterday). Confirmed cases in 29 counties. [h/t SFChron]
  • The outlook: The pattern around the world has been a doubling of cases every three days and that what has guided federal, state, and local elected officials. If we assume the 572 confirmed cases in California (last time I ran the numbers at 8pm today) is the entire universe which it clearly is not and the experience in other countries repeats here, The Golden State would have 292,864 by Easter. Here is what it looks like (click for bigger:

    COVID Possibility

    If you watched Governor Newsom's presser yesterday, you heard the discussion of influence-like illness (ILI), which is a patient exhibiting flu-like symptoms. The concern is this cohort of patients who have tested negative for the flu but have not been tested for COVID-19. This number may be in the thousands, some who have recovered and others who are in ICU beds across California.

    I hope that the worst does not happen and we are ahead of the European countries. I only want to show you what federal, state, adnd local officials have been looking at in their decision making. That's why the below seemingly draconian steps are being taken, with a goal of flatten the curve so as to not overwhelm the healthcare system as it has in Italy. As the White House Coronavirus Task Force and other experts have been telling us, that's the biggest threat--having a case load that exceeds the system's capacity.
  • Governor's new announced guidance and requirements:
    • Home isolation for 65+ and those with underlying medical conditions: Effective immediately, the state is issuing guidance that all Californians 65 and older and those with underlying medical conditions under CDC guidelines self-isolate in their homes. The governor said that the state is developing plans to deliver meals to the 5.3 million and others covered by the guidelines that should be available today.
    • Hospital capacity. The governor said that the state is in active discussions with multiple closed hospitals for lease or purchase to reopen to increase the state's hospital capacity. Given that negotiations are occurring, the governor did not identify which ones, although health care company Verity recently got permission from a bankruptcy judge to close St. Vincent's Medical Center in downtown Los Angeles. Some city officials have been eyeing it for a possible homeless shelter, but it may be a temporary hospital before that, or perhaps a combination of the two functions given the state's emergency powers.
    • Homeless. The governor said that the state will use the executive order issued last Thursday to commandeer private properties (hotels, medical facilities, and other facilities) that are "suitable for temporary residence or medical facilities as necessary for quarantining, isolating, or treating individuals who test positive for COVID-19 or who have had a high-risk exposure and are thought to be in the incubation period.” (03/12 executive order, provision 8)
  • Schools. Governor Mike DeWine (R-Ohio) and NYC mayor Bill DeBlasio (D) both have stated that it is very possible that schools in their jurisdictions may not reopen in this school year. Californians should likely keep that in mind as a possibility.
  • Bay Area "Shelter in Place": You likely have heard that six Bay Area counties (Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara) issued a shelter in place order for all residents today. This includes shuttering all non-essential businesses. Here is the order and I'll write more on this tomorrow.
  • Los Angeles County: This afternoon, LA County ordered that all gyms, bars, and theaters be closed and, like the Bay Area, that restaurants that remain open only provide take-out and delivery service. 
  • Statewide application: During a Facebook video tonight, Governor Newsom announced that he would follow the Bay Area and Los Angeles counties with a mandatory order of statewide application. The language of the executive order is not available yet, but he explicitly said that it will prohibit dining in at restaurants. Bars, theaters, and other places of public gathering are also likely to be mandatory. Whether he will make the 65+ and persons with underlying medical conditions mandatory is not clear, but he is not expected to order shelter in place to the extent the Bay Area, a national hot bed of COVID-19, mandatory.

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