“..in case they’re needed..”

If you’re looking for more cybersecurity/NERC CIP posts in the near future, I’m afraid you’ll have to wait. The seriousness of the pandemic is becoming more and more apparent every day, and – even though I keep thinking I’ll write a NERC CIP post the next day – I don’t get to do it because I can only write one post (remember, I feed myself and my wife with my day job, not my blog) and I have to write a pandemic post. Frankly, this subject is far more important now – to every American, but especially to people in the power industry, since you are more crucial than ever, with people confined at home and only communicating through electronic devices. There will be time enough for CIP again, hopefully soon. The first thing is keeping as many of you as possible healthy and…well, alive.

I started writing these posts on the pandemic last Saturday. Every day since then, I've gone through the same cycle:

1. Wake up in the early morning thinking about the various pieces of information I’ve read or heard about the pandemic the previous day – and start pondering something that seems particularly important.
2. Read the Wall Street Journal in print and the NY Times online, as well as other online sources. Discover more disturbing information (also some relatively good news, but right now the great preponderance of news isn’t good).
3. Sit down to write a post about this.
4. Update the post later in the day as the bad news gets worse.
5. Rinse and repeat the next day.

So right now I’m at step 3. This morning, I woke up thinking mostly about two things: a) the fact that new Covid-19 cases in the US yesterday were up 5,000 from the previous day, to about 14,500 (let's keep perspective: There were only 3,100 cases in total on Monday. At 11 AM ET today, there were about 22,000 cases, so the increase from yesterday was 7,500. Remember: exponential growth); and b) after president Trump had made a big statement last Friday (I think) about invoking the Defense Production Act from WWII to produce medical equipment needed to treat coronavirus patients, he admitted a couple days ago that he actually hadn’t done anything yet to produce more respirators, which will be a HUGE problem very soon (like in two weeks at most). He said he wanted the authority in place “in case it’s needed”.

It should be clear by now that I don’t exactly think Trump has done a good job with coronavirus. In fact, when you compare other countries like South Korea, Taiwan, and Singapore, who had no more information about the threat than he did when he had it but will have death tolls in the low hundreds at most – whereas some very distinguished epidemiologists are saying now that they don’t think we can get by with fewer than a million deaths - if this comes out anywhere as bad as it could, he will be vilified throughout American history.

Of course the biggest debacle so far has been the lack of testing, since that means two things: First, it means that planners in Federal and state governments (although the term “Federal government planner” seems to be an oxymoron now) don’t have any good idea what is the true number of cases in the US. I heard yesterday that the consensus is the true number is over 10 times what’s reported

Second, it means that lots of people who know they’ve been in contact with infected people, but who are themselves asymptomatic, are still going about infecting other people, because nobody ever contacted them to be tested.

But, as you probably remember, Trump and Pence have been assuring us for a couple weeks that the tests are getting rolled out now and everyone who needs the test is getting one – when in reality it’s quite different, as we all know from the news reports. I heard on Thursday from a good friend of mine who had recently been in California, but was now at home (actually work) in a Midwestern state. He was in contact in California with someone who was later reported to be infected, so he had been happy to be able to be tested in his home city – I think it was last Monday. However, he still hadn’t received any result, and the hospital had just told him it would be another five days before he did! He was faced with the really difficult decision of whether to stay in his house with his wife, who is undergoing chemotherapy and thus has a weakened immune system, or to abandon her and live in a hotel. He doesn't have any symptoms now, but he knows he could be carrying the disease.

But, since what’s done is done and the government is obviously scrambling now to get tests out, I haven’t wanted to advocate that Trump and Pence should be removed from being in charge of the coronavirus response. Things are moving very fast on the ground. The growth rate in identified cases – remember, that’s around a tenth of the actual ones – between Friday the 13^th and yesterday was 866 percent. Assuming this continues – and that rate is down from previous weeks, although then the absolute numbers were so low that nobody, including me, was paying attention – we’ll have 125,000 cases next Friday and 1.1 million the following Friday. Keep in mind that China has had 86,000 total cases, and since they now have a zero growth rate in new cases, they’re unlikely to go much higher than that). 

So it seemed to me, before early this morning, that Trump and Pence should remain in charge of the coronavirus response, just because it would be too disruptive to try to bring someone else in at this point.

However, think about Trump’s statement that he wanted the power to produce ventilators “in case they’re needed.” And keep in mind that nobody dies just due to the coronavirus itself. The problem is the virus attacks the lungs, and the people can’t breathe on their own – i.e. they need a ventilator. It seems there are fewer than 100,000 ventilators in the US, and that’s probably a high estimate – it includes the 4,000 or so that the government has in a big warehouse somewhere. And keep in mind also that ventilators are at least 50 percent spoken for now, since they’re needed for other diseases, like simple pneumonia. This means there are no more than 50,000 available (and they’re often not in the right places, of course. For example, New York is going to need more in 1-2 weeks without doubt. But Trump just told the governors that they’ll have to find ventilators for themselves).

Further, keep in mind that the number of patients needing ventilators just because of coronavirus will increase inexorably behind the caseload. I don’t know what percent that is, but let’s say five percent of cases end up requiring them (it could be higher). As I just said, there will be 1.1 million cases by April 3 (two weeks from yesterday), and the cases on April 10 will be 9.4 million.

Does that number seem high? How does 81 million on April 17 sound? I won’t even tell you what the next number is. And these estimates are just from applying the 866 percent growth rate in reported cases (which as I mentioned earlier, are probably about a tenth of the actual cases) measured between March 13 and 20. Of course, the state-by-state shelter-in-place edicts will start to lower that figure, but they’ll have zero impact on total cases for at least a couple weeks, and they definitely aren't going to get anywhere near doing the job that needs to be done - eliminating the virus from the US, period.

5 percent of the April 10 case number of 9.4 million is 470,000. This means that, even if we stop the virus in its tracks on April 10 – which requires ordering a nationwide lockdown (with certain exceptions, of course) next Friday – we’ll still need 420,000 ventilators. And we’ll have to produce them all in the US, since the European countries (the other main source) have the same problem and need as many for themselves as they can get.

Of course, we won’t need 420,000 ventilators on April 10. The number needed will keep building, but by May there will be a huge crisis in the health care system and there will be rationing, based on age and who-knows-what-else (BTW, that’s one element of pandemic planning that is still possible to do on time – decide who will live and who will die. And this doesn’t apply just to coronavirus patients, since so many other diseases can require respirators as well. Can you think of the politics that will come out when that policy is debated? Another element is laying in a huge store of coffins, although funerals will have to be forbidden except for 2-3 people, as is the case now in northern Italy. A lot of people there are leaving their relatives unburied, because they want to wait until they can have all family and friends present).

Yet Trump said he’s prepared “if they’re needed”. Well, they’re needed – in fact, can he get them tomorrow? And a lot of people need to be trained to operate them. It’s evidently not quite as simple as hitting a button. Those people will be needed the day after tomorrow. Can he do that? In fact, it’s hugely unlikely that this Administration will be able to produce more than a fraction of the needed ventilators in the next couple months, even if they were busting a__ today to get this going. There will have to be an extremely competent person who can plan this all very quickly (and the fact that this planning obviously hasn’t even been done yet is…well, extremely disappointing). Frankly, even that person is unlikely to produce a lot of what’s needed in time to make a big difference in the death rate (it’s not like the hospital can just send someone home and expect them to somehow stay alive for a few months, until they get enough ventilators). And lack of ventilators is just one of the many problems hospitals will face very shortly.

Of course, this is just one of the major areas in which Trump has failed spectacularly in this pandemic. And it’s why it’s becoming more and more unlikely that we’ll even hold total deaths to the level of twice the people who died in the 1918 Spanish flu pandemic, which was 675,000. What bothered me most about Trump’s ventilator comment is that it showed how clearly he’s learned absolutely nothing from the testing debacle. And why should he, since he is positive he handled it “perfectly”? The man is literally doing infinitely more harm than good, and if he doesn’t get pushed aside now, hundreds of thousands or even a million or two will die – on top of the ones who already will die (To repeat, I think 2,500 deaths will be a near-certainty after this Friday, with no further action taken to lock down the country. That's close to the 9/11 total. After next Friday, 22,000 deaths will be certain. After the following Friday - April 10 - it will be 188,000 deaths. And after Friday April 17, the total deaths expected will be above 1 million). 

I said early this week that I thought there would be lots of pressure – from Republicans and Democrats – for “change at the top” by the end of next week, and I continue to believe that. The fact that we’ll blow by China’s total case number of 86,000 on Wednesday or so, with no end in sight to exponential growth, may finally get people’s attention. And if that doesn’t, it will happen the following Friday (April 3) - when we will very possibly have 1.1 million cases.

But why wait for that? I calculated in yesterday’s post that if the decision to shelter in place nationwide were put in place next Friday (and it probably won’t, with Trump still in charge), it would cost 188,000 lives compared to if it had happened yesterday. Even that is twice all US military deaths – combat and non-combat - in all wars since WWII. But if we wait another week and the order goes out on April 3, the additional cost in lives will be 1.6 million.[i] Doesn’t that lend some urgency to the matter? We can't wait any longer to get somebody in charge who really understands the problem, and doesn't consider his own ego and re-election prospects to be his top priorities (and by the way, Trump won't get re-elected, period. I really don't think he'll even be president a month from now. A million deaths has a way of focusing attention).

Let’s do it now. I’m not saying Trump or Pence should be removed from office now, but someone should be brought in from outside – since if there were one competent person still left in the Administration, they would already be jumping up and down about this. And they should be given total control over the whole coronavirus response - with no veto from Trump allowed. I heard Bill Gates’ name mentioned (I think his employer will give him time off from work), but I’m sure there are others as well. Whoever it is, it needs to be someone very smart and very efficient, and someone who doesn’t ignore any fact that disagrees with their worldview, or worse try to hide it (as someone in the Labor Dept. – I doubt acting on her own – did this week, when she contacted state unemployment insurance commissioners to tell them to hide their numbers for new claims until the national number is released next week, as if Wall Street could be fooled anymore by games like that. The markets have been falling in large part because investors realize they’re being lied to, and nobody in DC seems to have a clue how to deal with the pandemic. Of course, the order was disobeyed, as it certainly should have been).

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[i] I know a lot of people won’t believe this number. My calculations are all in the post and they’re all based on numbers that are reasonable – in fact low estimates. If someone wants to discuss this and prove I'm wrong, I’d be as happy as a clam to be proved wrong!