The Pandemic Informer

As coronavirus-related restrictions are eased and temperatures climb, people are flocking back to the Jersey Shore. And with the July Fourth holiday weekend upon us, that’s making some people nervous, particularly given the large crowds that have surfaced at some popular shore spots recently and poor compliance with mandated measures to help slow the spread of the virus. “I am really concerned,” said Paul Kanitra, mayor of Point Pleasant Beach, a popular shore town that was unexpectedly overrun by thousands of tourists who swarmed the beach and boardwalk a few weeks ago at a “pop-up party,” paying little heed to social distancing or masks. “We’re seeing spikes across the country in states that opened up weeks ago, and while we’re doing a good job in New Jersey, there are a lot of people that are way too cavalier about social distancing,” he said. “There’s inherent risk in all of this.” Large crowds are expected at the shore for the holiday weekend: New Jersey’s casinos have reopened, along with amusement rides and water parks. Beaches are open, though at reduced occupancy levels. Restaurants can offer limited outdoor dining, and stores and shopping malls have reopened. But not everyone is following rules designed to prevent the spread of the virus, including wearing masks and keeping 6 feet apart. In late June, large crowds swarmed D’Jais, a popular oceanfront nightclub in Belmar in scenes reminiscent of pre-pandemic days. Few patrons wore face coverings, and fewer still kept their distance from others on a packed dance floor. Gov. Phil Murphy saw videos of the packed club and warned the state will not hesitate to reimpose harsher restrictions if people don’t behave. “We cannot let up on our social distancing or our responsibility just because the sun is out,” the governor said. “We can’t be lulled into complacency and think it’s OK to crowd around a bar. That is how flare-ups happen.” COVID-19 Cases Rising Among Young People in NJ Officials worry about lack of social distancing and PPE use as people flock to the shore.

Texas was one of the first states in the nation to ease social distancing mandates. In Houston, the number of patients hospitalized with COVID-19 has quadrupled since Memorial Day. “It’s time to be alarmed,” one expert said

HOUSTON — At Lyndon B. Johnson Hospital on Sunday, the medical staff ran out of both space for new coronavirus patients and a key drug needed to treat them. With no open beds at the public hospital, a dozen COVID-19 patients who were in need of intensive care were stuck in the emergency room, awaiting transfers to other Houston area hospitals, according to a note sent to the staff and shared with reporters. A day later, the top physician executive at the Houston Methodist hospital system wrote to staff members warning that its coronavirus caseload was surging: “It has become necessary to consider delaying more surgical services to create further capacity for COVID-19 patients,” Dr. Robert Phillips said in the note, an abrupt turn from three days earlier, when the hospital system sent a note to thousands of patients, inviting them to keep their surgical appointments. And at The University of Texas MD Anderson Cancer Center, staff members were alerted recently that the hospital would soon begin taking in cancer patients with COVID-19 from the city’s overburdened public hospital system, a highly unusual move for the specialty hospital. These internal messages highlight the growing strain that the coronavirus crisis is putting on hospital systems in the Houston region, where the number of patients hospitalized with COVID-19 has nearly quadrupled since Memorial Day. As of Tuesday, more than 3,000 people were hospitalized for the coronavirus in the region, including nearly 800 in intensive care. “To tell you the truth, what worries me is not this week, where we’re still kind of handling it,” said Roberta Schwartz, Houston Methodist’s chief innovation officer, who’s been helping lead the system’s efforts to expand beds for COVID-19 patents. “I’m really worried about next week.”

What’s happening in Houston draws eerie parallels to New York City in late March, when every day brought steep increases in the number of patients seeking care at overburdened hospitals — though, so far, with far fewer deaths. But as coronavirus cases surge in Texas, state officials here have not reimplemented the same lockdown measures that experts say helped bring New York’s outbreak under control, raising concern among public health officials that Houston won’t be able to flatten the curve. “The time to act and time to be alarmed is not when you’ve hit capacity, but it’s much earlier when you start to see hospitalizations increase at a very fast rate,” said Lauren Ancel Meyers, a professor of integrative biology who leads the University of Texas at Austin COVID-19 Modeling Consortium. “It is definitely time to take some kind of action. It is time to be alarmed.” “The hospitalizations you see today, they’re not just going to linearly increase in the next two weeks,” said Dr. Clay Johnston, dean of the Dell Medical School at the University of Texas at Austin. “They’re going to accelerate. When you overwhelm the hospitals, you’re in big trouble. That to me is the impossible task that the governor faces. It’s like steering a giant tanker through a tiny strait without any maps.”

Millions of American workers are suffering from economic whiplash, thinking they were finally returning to work only to be sent home again because of the coronavirus’s latest surge. Stores, restaurants, gyms and other businesses that reopened weeks ago are shuttering again, and this time Congress appears less inclined to provide additional aid. Other businesses that had banked on customers returning and restrictions lifting – such as hotel chains, construction firms and movie theaters – are seeing hours cut and reopening dates pushed back indefinitely as consumer demand stalls. And many governors, including some who had drawn scrutiny for initially playing down the virus’s risks, are issuing new safety restrictions, in some cases just weeks after the first round of guidelines had begun to lift. In recent weeks, three states – California, Florida and Texas – have implemented policies that partly restrict restaurant or bar service. Nine others – Arkansas, Delaware, Idaho, Louisiana, Michigan, Nevada, New Jersey, New Mexico and North Carolina – have postponed or slowed reopening plans. Thousands of workers are caught in these rapidly shifting seas, many of them hourly and low-wage service employees, and are now facing unemployment for a second time. They say the past few months have been jarring: navigating unemployment in March, preparing to go back to work in April or May, and now confronting the prospect of what could be another long stretch without a paycheck. This time, many say they’re on even shakier financial ground as they topple into yet another period without a job. They face what experts have begun calling a “fiscal cliff”: the July end date for the $600 in weekly supplemental aid that has helped keep so many families afloat. For many restaurant and bar owners and workers, the past few weeks have brought an onslaught of bad news. Some said they watched wearily as infections began to tick up, just as they were starting to reopen after months of being closed. Then came all the new cases. In Phoenix, more than a dozen restaurants closed in early June after customers or employees were found to have been infected with the virus. In Jacksonville, Fla., restaurants began closing after cases rose there – in one outbreak, 16 friends tested positive for the coronavirus after dining at an Irish pub, where seven employees later tested positive. In Houston, restaurant owners are warning that they may not survive the new round of closures. In California, Democratic Gov. Gavin Newsom ordered bars closed in seven counties, including Los Angeles. The food-service and bar industry – which employed more than 8 million people, or about 5% of the workforce before the pandemic – has been devastated by the virus, losing more than 6 million jobs in March and April. But a strong rebound of 1.4 million jobs in May had helped drive down the country’s unemployment rate, sending hopes soaring that an economic recovery was underway. This new round of closures points to the significant challenges that will exist until a treatment or vaccine is developed. The fresh round of closures is raising fears that the already challenged recovery could stall. The country has been processing about 1.5 million new unemployment insurance applications a week for most of June – an alarmingly high rate that remains well-above pre-pandemic records – although it has come down from a peak of more than 6 million in March. According to a preliminary study by two Harvard University researchers, limitations at restaurants, bars and nonessential businesses amounted for 4.4% to 8.5% of the significant increase in unemployment in mid-March. Public health experts said the threat of a new wave of closures is why stringent public health measures have been needed to prevent the virus’s spread. “It’s an impossible choice,” said Emily Timm, an executive director at the Texas-based Worker’s Defense Project, a nonprofit organization that helps immigrant and undocumented workers. “People don’t want to risk their family’s health. But it’s not a choice if you don’t have access to the safety net or you were living paycheck to paycheck before the coronavirus hit.” There are some indications that factors beyond the shutdowns weigh more heavily on the economy. The Federal Reserve Bank of St. Louis issued a recent report show that businesses said declining demand from consumers was the top constraint on their recovery, ahead of social distancing requirements and concerns about their workers’ health. “The pace of business reopening has to be completely in sync with the amount that demand is going up,” one of the authors, Charles Gascon, an economist at the Federal Reserve Bank in St. Louis, said in an interview. “It’s not like there’s an on or off switch in the economy that you flip and things go back to normal. Things have to get back up to whatever the new normal is.”

The government’s top experts in infectious diseases on Tuesday criticized American Airlines’ decision to pack flights full while the coronavirus outbreak continues to grow across much of the United States. “Obviously that is something that is of concern. I’m not sure what went into that decision making,” Dr. Anthony Fauci told a Senate panel. “I think in the confines of an airplane that becomes even more problematic.” Several U.S. airlines say they are limiting capacity on planes to between 60% and 67% of all seats. However, United Airlines never promised to leave seats empty, and American said last week that starting Wednesday it would drop its effort to keep half of all middle seats empty. “When they announced that the other day, obviously there was substantial disappointment,” said Dr. Robert Redfield, director of the U.S. Centers for Disease Control and Prevention. He said American was sending the wrong message to the public. Fauci, the top infectious disease expert at the National Institutes of Health, and Redfield made the comments in response to questioning by Sen. Bernie Sanders during a Senate health committee hearing. Sanders, an independent from Vermont, pressed the officials on how full flights square with the message from public health experts that people should stay six feet apart to prevent transmission of the virus that causes COVID-19. American Airlines spokesman Ross Feinstein said the airline has “multiple layers of protection in place for those who fly with us, including required face coverings, enhanced cleaning procedures, and a pre-flight COVID-19 symptom checklist.” He said American was also giving customers the option of changing their ticket if their flight might be full.

Airlines are desperate to increase revenue as they try to survive a plunge in air travel that reached 95% during April.

Many airline flights were nearly empty in the early weeks of the outbreak, with the average dipping to about 10 passengers, according to industry figures. Some days, there were fewer than 100,000 people flying in the United States, a level not seen since the 1950s, except in the days following the September 2001 terror attacks. Air travel has increased slowly since mid-April — although it’s still down 75% from normal — and some flights have been packed. American plans to increase flights by nearly 60% starting July 7 compared with June, which could help avoid full planes. Delta Air Lines, Southwest Airlines, JetBlue Airways and Alaska Airlines say they will continue to limit capacity, in some cases through September. Budget carrier Spirit Airlines does not.

Texas has emerged as one of the United States’ coronavirus hot spots in recent weeks, and data shows the recent spike doesn’t completely match up with the early days of the pandemic in terms of demographics. Back in April, when the virus first peaked, most of the patients testing positive in the Houston Methodist Hospital system were over 50, The New York Times reports. Now, the majority are reportedly relatively young. And while it’s widely believed younger, healthier people are at a lower risk of developing severe infections or dying, there are no guarantees. In the Methodist system, nearly one-third of intensive care patients are under 50, which the Times notes is higher than the previous surge. Meanwhile, The Texas Tribune and Fox4 in Dallas previously reported that people under 50 made up 50 percent of those hospitalized with the virus in June, as well as 30 percent of those in intensive care.

Of note: hospitals are seeing younger patients now in June compared to March around when coronavirus started appearing in North Texas. Seeing a sharp jump in hospital patients ages 21-40. 50% of hospitalizations are under 50, 30% critical care under 50. @FOX4 pic.twitter.com/kUqFl8a7Zt

— Lynnanne Nguyen (@LynnanneFOX4) June 22, 2020

The trend doesn’t appear to be confined to Texas, at least anecdotally. Last week, The Wall Street Journal reported that states like Arizona, Florida, and California were also seeing more patients in their 20s, 30s, and 40s testing positive and winding up in the hospital. Read more about Houston Methodist Hospital’s experience with the coronavirus at The New York Times.

The United States is in the midst of a full-blown second wave of coronavirus. According to Worldometers, Tuesday had 36,015 new cases — the highest number since May 1, and the third-highest ever. Arizona, Florida, South Carolina, California, and Texas are headed for a dire emergency fast. So far deaths have thankfully not returned to their previous highs, probably in part because the new surge appears to be hitting younger patients. But deaths are also a lagging indicator, and they are highly likely to start increasing soon. Europe, where most countries have largely contained the virus (after initial screw-ups), is looking at America with slackjawed horror. The European Union is likely to close its borders to American travelers when it restores some international travel on July 1. Canada will most likely keep its U.S. border mostly closed when the current agreement expires on July 21. Around the world, it is beginning to sink in how profoundly rotten the United States is. Unless America manages to turn things around, it will slide from the center of the international order to a peripheral, mistrusted basketcase, and it will deserve it. It is plainly obvious why the U.S. is experiencing a second wave. The point of coronavirus lockdowns, as I and dozens of others explained months ago, was to buy time for the government to set up more fine-grained containment protocols that could contain the virus more effectively. With transmission reduced to a manageable rate and a test-trace-isolate system in place, countries can return to something like normal life, and an increasing number are doing so. It’s a tricky business and renewed lockdowns may be necessary, as fresh outbreaks in China and elsewhere have shown, but it can be done. But the Trump administration did not even try this on a national level, or do anything of significance. Indeed, American politics is so broken that we couldn’t even manage the simplest common-sense containment strategy of mandating universal mask-wearing in any indoor space. American public health experts spent weeks on a bizarre and scientifically illiterate crusade against masks — a study years ago found that even cheap homemade masks significantly reduce droplet-based infection — but even after plenty of new evidence has come in, Trump and most Republicans keep insisting a mask is a matter of personal choice. Instead masks got sucked into the conservative grievance industrial complex, becoming another postmodern cultural signifier for right-wingers trying to own the libs. Trump simply cannot grasp what the pandemic is, because in his mind nobody save himself is a real person. Appearances are all that matter — he is plainly most upset about the Bad Numbers of infections and deaths, and continues to suggest in public that the U.S. should be testing less so he looks less bad. He promises there will be no more lockdowns even as cases spike, and recently held a huge indoor rally in Tulsa — perhaps the worst possible thing he could do, especially because his followers mostly refused to wear the free provided masks. Despite being poorly attended, that rally still could easily turn out to be a mega-spreader event. It is no doubt extremely alarming for people around the world coming to really grasp the fact that the world’s most powerful country is being run by an incompetent buffoon who could not be trusted with a lemonade stand yet still commands the lockstep loyalty of one of two major political parties. “I can’t imagine what it must be like having to go to work knowing it’s unsafe,” Siouxsie Wiles, a New Zealand disease scientist, told The Washington Post. “There are just going to be more and more people infected, and more and more deaths. It’s heartbreaking.” Indeed, American political reporters have struggled to grasp the reality of Trump as well, though the ongoing catastrophe seems to have finally beaten it into their heads. American politicians: blame avoidance. When faced with a problem, most top politicians in both parties think first about how they can shift blame to others or appear the victim of circumstance. Halting the epidemic in its early stages would have required a lot o Politicians would have had to exercise power in a way that upset people, and carefully communicate why they were doing so. Instead they largely let events do their work for them — once outbreaks were underway and sports seasons were being canceled, they could impose lockdowns without risking a backlash. That cowardice killed tens of thousands of people. Only a handful of state governors, like Washington’s Jay Inslee, actually listened to their scientists and got out ahead of events.Now multiple states are in the throes of accelerating outbreaks, and once again politicians are following events rather than anticipating them. Back in late May many experts warned California Governor Gavin Newsom that he was reopening the state too quickly, but under criticism from those who didn’t like lockdowns, he pushed forward. He largely left things up to county officials, many of whom are conservative goofballs who refuse to obey his authority. Now that reopening has plainly backfired — the state shattered its daily case record on both Monday and Tuesday — Newsom has belatedly threatened that counties that refuse to follow pandemic control guidelines may lose state aid. It’s a month late and a billion dollars short. In Texas, Governor Greg Abbot has twisted himself in knots trying to avoid any kind of responsibility. He quickly rescinded his own order closing businesses when conservatives got mad, and refused to allow local cities to implement mandatory mask orders. Instead, he left a loophole allowing them to mandate businesses to require masks, but told nobody about it until a local judge actually tried it. Florida governor Ron DeSantis, meanwhile, is weeks behind the times. At time of writing he has merely promised he will actually enforce pandemic rules on bars and restaurants, and still has not mandated mask-wearing in public. Arizona is also way behind the curve. But countries around the world are no doubt grappling with some unpleasant truths. A nation that could elect Donald Trump is deeply, deeply sick. We are comparatively lucky that Trump appointed Jerome Powell chair of the Federal Reserve board (who turned out to be at least in possession of his faculties), instead of, say, Jared Kushner. When a country is as gangrenous as the United States, the rot tends to spread through its entire system sooner or later.