Saturday, June 20, 2020

Weekend Reading: The Little Bit Ranty at the Start Edition

I started a post on Tuesday about whether we "wasted" the time we bought with stay at home orders. It was going to be a list of the good things we did (lots of clinical trials, for instance) and of the the things I wish we'd done (e.g., make better plans for providing people who live in crowded housing a way to isolate if they get sick).

Then I got an email from our school district about their plans for reopening for the 2020-21 school year, which begins at the end of August here. The info they provided wasn't bad, but it wasn't anything close to an actual plan. There will be three options for next year: fully on campus, fully online, and online with a small number of on campus activities. We have no details about what those options will look like, except that our school district says they only have enough money as of right now to offer in person schooling for half of the school year. If additional funds don't come through, we'll be back to everyone going to school online mid-year. Wheee!

The next step is for us all to fill out a questionnaire about which option we prefer and then our school will put together a plan. Then later this summer, we enroll in one of the options.

OK, fine, I thought. The questionnaire will allow them to gather data to help them craft a good plan. But no, we received the questionnaire on Thursday and it literally just has a question to select your preferred option and a comments field.

Petunia really, really, really wants to go back in person. She hated online school and says she'll do whatever she has to do to go back in person. Pumpkin says she wouldn't mind the online option if all the subjects were taught as well as her history class was in the stay at home period this year. The district says the online option will be "high quality" with more engagement than we got this spring. That makes sense - they've had more time to prepare.

Meanwhile, San Diego county hit one of its triggers for slowing down reopening: We had seven community outbreaks in a seven day period. In fact, we hit it twice - after announcing we'd hit it on Thursday, we had two more community outbreaks on Friday. A "community outbreak" is a cluster of three or more cases in different households, all caught in the same place.

Three of the community outbreaks reported in the last week started in gatherings in private homes. Others were in a restaurant, a campground, a business, and a "social club" that wasn't supposed to be open. Our health director has said the ban on gatherings in homes will likely stay in place until there is herd immunity, either via a vaccine or accumulation of cases. I think this is terribly misguided. That is at least a year away. You cannot expect that people will not see their friends and family for a year. I think our health authorities need to offer guidance on how to safely have gatherings, i.e., keep them small, distant, and outside.  San Francisco has it figured out and so do many other places. Meanwhile, here in San Diego we're still entirely focused on getting as many businesses open as possible. I predict we'll see a lot more outbreaks from private gatherings, because they are impossible to monitor and prevent and people miss seeing the people they care about.

So anyway, what are we going to do about the school questionnaire? I think we will fill it out saying we prefer the on campus option, and then write some comments about wanting the school to take advantage of our lovely San Diego climate and move as much as they can outdoors. I had been worried by mixed messages about whether masks would be required, but our governor took care of that for me this week. We've been working on finding mask options that work for the kids, and so we're set for all day masking.

But I am also going to accelerate my efforts to teach my kids how to do more cooking. I think that we need to be ready for the scenario in which both adults in the house are sick and the kids have to feed themselves. Luckily, our kids are old enough to do this (they are 10 and 13). Honestly, I should have been pushing more cooking skills already, but they both have a fear of the stove that we'll need to overcome and I've been lazily waiting for them to just outgrow that.

I am just so angry about how we could not find a way as a society to prioritize making it safe for kids to go back to school. My kids have the best possible "learn at home" scenario - their own spaces, their own devices, and two parents with flexible jobs and the educational background to be able to help explain things. And it still sucked for them. My kids will be OK whatever happens in the 2020-21 school year. A lot of kids won't be, for a variety of heartbreaking reasons. Read this Buzzfeed article about how much the stay at home orders sucked for kids, and how unevenly that impact is felt. It just breaks my heart that risking a repeat of this because we can't get our collective act together.

In other news....

Read Jamil Smith's essay on Juneteenth and the difference between emancipation and freedom.

Derek Lowe summarizes what that dexamethasone trial means. My take is that this is good news, but that a lot of doctors were probably already using steroids for the same reason that the trial was done - you would expect a steroid like this might help in a cytokine storm situation. But it is always good to get clinical trial results and I think usage of the drug will probably go up. But I wish we had a more robust public health messaging environment right now, because this is absolutely NOT a drug to take as a prophylactic. It depresses the immune response, which is why it helps the very sick COVID-19 patients. Taking it early in an infection or in an attempt to prevent infection may do harm. As any asthma patient on long-term steroid treatment knows, steroids increase the risk of a respiratory infection. (But they are what we're given if we're having a hard time getting our lung function back to normal after recovering from an infection.)

Anyway, as Derek says, this may reduce the fatality rate (which is good news) but will do nothing to change the course of the epidemic. Right now, our best interventions for changing the course of the epidemic are distancing and masks.

Here's a devastating look at how much our poor response to this epidemic has hurt us.

And we continue to have a poor response, so we'll continue to have more deaths that could have been avoided.  The scenes out of Tulsa as people prepare for the Trump rally are so depressing. People crowding together, joyfully flaunting not wearing masks.

I mean:

I think that even after we bungled the early response, we had a moment in late March/early April when we could have been convinced to rally together and have a better response if we'd had better leadership. But we had Trump and so here we are.

I am mostly done arguing with people about masks. The people who don't think they are necessary now are not really evaluating the evidence and making a rational choice, they are cherry-picking things to post hoc rationalize a choice they are making for other reasons. But Bad Mom, Good Mom has a nice write up on why we wear masks if you or someone you know is in that tiny sliver of people who genuinely aren't sure if the evidence supports mask wearing.

The next time someone asks me for definitive evidence that masks work, I will ask them for definitive evidence that masks don't work and be done with it. Arguing with these people is a waste of time and energy.

Here is a good thread on a recently reported study of asymptomatic SARS-CoV-2 infections in Wuhan. The fact that they see evidence of potential lung damage in some members of this group is pretty sobering.

Even before the pandemic, I'd been thinking a lot about how to balance my love of travel with the impact of travel. This essay captures that ambivalence really well.

In other travel news: authorities in Alaska removed the bus made famous in "Into the Wild" because people wouldn't stop risking (and occasionally losing) their lives to go see it.

This is a really interesting interview with one Romney to Johnson to Bloomberg voter who was participating in Black Lives Matter protests in DC.

A perfect response:

And here are some fun things:

I looked up the YouTube channel of the two actors mentioned in this story out of Singapore and it was delightful.

This thread made me smile:

Here's a beautiful bird:

Here's your bunny for the week:

Have a good weekend, everyone!


  1. Anonymous5:08 PM

    “My friend died, but...”
    I try to understand people’s thinking. First, there is a set of people whose main source of information for actual decisions is personal associations. So: his friend died, but the other friends, who claim to be concerned, didn’t wear masks. Second, consider the possibility of false analogies in mental models. Eg., my friend died of prostate cancer, and I’m a middle aged male, but that only means I get a PSA test, not that I avoid the movies. Or, my friend had a heart attack, but it doesn’t follow that I stop eating beef. Or, my friend died in a construction accident, but I still go to work there. What mental models of severe widespread infectious diseases do present day Americans have? Really none since mid twentieth century. Third, he feels “played.” Yeah he is, but it’s pretty hard to see, as you said above, start with cherry picking.
    Just trying to be compassionate here, for what we view as problem reasoning.

  2. Socal dendrite9:52 PM

    "I am just so angry about how we could not find a way as a society to prioritize making it safe for kids to go back to school." Yes, this. I just heard our district's tentative plan for my incoming 2nd grader and kindergartener and it involves split days on campus (Tu/Wed or Thur/Fr) plus about 1 hr of synchronous online schooling on each of the days they are not on campus. To allow for the online component, the on-campus days are only scheduled to be 3 hr 45 min long, with kids grabbing a lunch bag and then departing. I was expecting the split days aspect, but not that those split days would be so much shorter than a regular school day. I understand they are trying to be careful (and the plan may yet change) but I - somewhat selfishly - feel like this is going to just kill my career. I freelance so I feel very very lucky that we have a lot of flexibility, but I can't keep on squeezing my work into the evenings indefinitely. And what about the families with two full-time working parents? But I am sure the district are in a "damned if they do and damned if they don't" situation.

  3. Socal dendrite9:53 PM

    PS That indigo bunting cheered me up :)


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