Opinion | These Coronavirus Exposures Might Be the Most Dangerous – The New York Times

By Joshua D. Rabinowitz and 

Dr. Rabinowitz is a professor of chemistry and genomics. Dr. Bartman is a genomic researcher.

Credit…Image Point Fr – Lpn/BSIP — Universal Images Group, via Getty Images

“Li Wenliang, the doctor in China who raised early awareness of the new coronavirus, died of the virus in February at 34. His death was shocking not only because of his role in publicizing the developing epidemic but also — given that young people do not have a high risk of dying from Covid-19 — because of his age.

Is it possible that Dr. Li died because as a doctor who spent a lot of time around severely ill Covid-19 patients, he was infected with such a high dose? After all, though he was one of the first young health care workers to die after being exposed up close and frequently to the virus, he was unfortunately not the last.

The importance of viral dose is being overlooked in discussions of the coronavirus. As with any other poison, viruses are usually more dangerous in larger amounts. Small initial exposures tend to lead to mild or asymptomatic infections, while larger doses can be lethal.

From a policy perspective, we need to consider that not all exposures to the coronavirus may be the same. Stepping into an office building that once had someone with the coronavirus in it is not as dangerous as sitting next to that infected person for an hourlong train commute.”

Opinion | Why Are So Many More Men Dying from Coronavirus? – The New York Times

“. . .  What lies behind this female genetic superiority? It starts at the chromosomal level.

To review the typical basic chromosomal differences between the sexes: The cells of genetic females have two X chromosomes — one from their mothers, and one from their fathers — while those of genetic males have only the one X chromosome, from their mothers, and one Y chromosome.

This is crucial, because X chromosomes come in handy for vital functions like building and maintaining the human brain and the immune system. And biologists have long understood that XX chromosomes give females an advantage in some arenas: Having the use of a spare X in case the other is somehow defective is why females are less susceptible to disorders like color blindness, for instance.

But we’re only just now beginning to understand the full advantage that this extra X chromosome confers: It’s not just that women have a spare X chromosome to swap in. Rather, the more than 2,000 genes that, combined, make up two X chromosomes, are used by cells that actually interact and cooperate within a woman’s body. Each cell predominantly uses one X chromosome over the other — so if one X chromosome has genes that are better at recognizing invading viruses like Covid-19, for instance, immune cells using that X can focus on that task, while immune cells using the other X chromosome focus on, say, killing cells infected with Covid-19 instead, making the fight against the virus more efficient.

Typical males, by contrast, are forced to get by in life with just the one X chromosome. What if a male’s particular genes aren’t able to competently recognize or kill off cells infected with a coronavirus? In that case, his ability to fight the infection will be limited; his solitary X is the only one he’s got.

The bottom line is when it comes to dealing with the trauma and stressors of life — whether it’s avoiding a serious congenital malformation, a developmental disability, or fighting off an infection — females have genetic options. And genetic males don’t.”

Opinion | ‘I Do Fear for My Staff,’ a Doctor Said. He Lost His Job. – By Nicholas Kristof – The New York Times

By 

Opinion Columnist

Credit…Damon Winter/The New York Times

“Doctors and nurses responding to the Covid-19 pandemic are the superheroes of our age, putting themselves at risk to save the lives of others.

At least 61 doctors and nurses have died from the coronavirus in Italy so far. Already, in New York City alone, two nurses have died and more than 200 health workers are reported sick at a single major hospital.

These superheroes are at risk partly because we sometimes send them into battle without adequate personal protective equipment, or P.P.E. This should be a national scandal, and now hospitals are compounding the outrage by punishing staff members who speak up or simply try to keep themselves safe.

In Bellingham, Wash., an E.R. doctor, Ming Lin, pleaded on social media for better protections for patients and the staff at PeaceHealth St. Joseph Medical Center, where he had worked for 17 years.

“I do fear for my staff,” Dr. Lin warned. “Morally, I think when you see something wrong, you have to speak out.”

The hospital responded by terminating Dr. Lin.

Dr. Lin told me that he had no regrets, but he asked supporters not to circulate petitions on his behalf for fear that such an effort would distract from managing the pandemic.

Charles Prosper, the C.E.O. of the hospital network, wouldn’t take my call, although he said in a statement that he regretted losing “such a longstanding and talented member of our medical staff.” The PeaceHealth board should recognize that its hospital has more need for an experienced E.R. doctor than for a bungling C.E.O.”

A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients — by Lizzie Presser – ProPublica

A medical worker treats a COVID-19 patient in an intensive care unit in Italy. Across the globe, health care providers are using ventilators to treat COVID-19 patients. (Flavio Lo Scalzo/Reuters)

“As of Friday, Louisiana was reporting 479 confirmed cases of COVID-19, one of the highest numbers in the country. Ten people had died. The majority of cases are in New Orleans, which now has one confirmed case for every 1,000 residents. New Orleans had held Mardi Gras celebrations just two weeks before its first patient, with more than a million revelers on its streets.

I spoke to a respiratory therapist there, whose job is to ensure that patients are breathing well. He works in a medium-sized city hospital’s intensive care unit. (We are withholding his name and employer, as he fears retaliation.) Before the virus came to New Orleans, his days were pretty relaxed, nebulizing patients with asthma, adjusting oxygen tubes that run through the nose or, in the most severe cases, setting up and managing ventilators. His patients were usually older, with chronic health conditions and bad lungs.”

Source: A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients — ProPublica

David Lindsay:  From the ProPublica website:

Lizzie Presser

Reporter

“Lizzie Presser covers health, inequality, and how policy is experienced for ProPublica. She previously worked as a contributing writer for The California Sunday Magazine, where she wrote about labor, immigration, and how social policy is experienced. Her work has also appeared in The New Yorker, The Guardian, and This American Life, among others. She has twice been a finalist for the National Magazine Award and the Livingston Award.”

Opinion | Covid-19 Is Twisting 2020 Beyond All Recognition – By Thomas B. Edsall – The New York Times

By 

Mr. Edsall contributes a weekly column from Washington, D.C. on politics, demographics and inequality.

Credit…Al Drago for The New York Times

“Not only will the coronavirus crisis define Donald Trump’s legacy, it will determine whether or not he is a one-term president.

David Winston, a Republican pollster, summed up the situation in an email:

The country is not looking at what is occurring through a political lens. They are focused on the threat to their health and the country’s health and how that threat is being addressed.

Because of that, Winston continued, voters will judge the Trump administration by “the effectiveness of actions taken to address that threat, and get the country moving forward again,” making the question on Election Day “who does the country believe should be given the responsibility to govern.”

Crises can provoke extreme responses. The 2008-9 recession produced both Barack Obama and the Tea Party. On a grander scale, the Great Depression produced both Franklin Delano Roosevelt and Adolf Hitler.

No one is suggesting that the country is at such a point now, but, then again, no one suggested in January of 2015 that the country was on the verge of electing Donald Trump president.

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The current pandemic shows signs of reshaping the American political and social order for years to come.

March 10-15 NBC News/Commonwealth Fund poll asked 1,006 adults “How much do you trust the President Trump to provide information about the coronavirus epidemic?” A majority, 53 percent, said they either had no trust at all (40 percent) or little trust (13 percent). 30 percent said they either completely trust (16 percent) or mostly trust (14 percent) the president.

In another danger signal for Trump, the poll asked “how confident are you that the vaccine will be available to the American public at little or no cost” if a Democrat wins or if Trump is re-elected. Nearly two thirds said they were confident a low-cost vaccine would be available with a Democrat in the White House; half said they were confident with Trump in office for another four years.

Trump’s job approval ratings have risen in recent weeks, but Gary Langer, who conducts polling for ABC News, warned that the results of an ABC/Washington Post survey released on March 27 show that there are substantial risks to the president:

Trump’s overall approval rating drops among people who are more worried about catching the coronavirus, report severe local economic impacts, say their lives have been especially disrupted or know someone who’s caught the virus. He also has lower approval in states with higher per capita infection rates.

While some of those findings reflect the higher levels of infection with coronavirus in blue states, Langer wrote, “the results suggest that as the crisis deepens, the risks to views of his performance likely rise.”

On March 26, Pew Research released results of a survey that showed significant demographic and partisan differences in responses to the question “Has someone in your household lost a job or taken a pay cut as a result of Covid-19?”

Opinion | The Coronavirus Mask Fiasco – By David Leonhardt – The New York Times

By 

Opinion Columnist

Credit…Gabriela Bhaskar for The New York Times

“The message about face masks coming from American health officials has never been especially clear.

When the coronavirus began spreading, officials seemed to be promoting two contradictory ideas: First, masks would not help keep people safe; and second, masks were so important that they should be reserved for doctors and nurses. It reminded me of the line credited to Yogi Berra about a New York restaurant: “Nobody goes there anymore — it’s too crowded.”

The truth has become clearer in recent days. Masks probably do provide some protection. They’re particularly effective at keeping somebody who already has the virus from spreading it to others, and they may also make the mask’s wearer less likely to get sick. “Coronavirus appears to mostly spread when germ-containing droplets make it into a person’s mouth, nose, or eyes,” Vox’s German Lopez explains. “If you have a physical barrier in front of your mouth and nose, that’s simply less likely to happen.”

The Centers for Disease Control and Prevention is now reviewing whether to encourage Americans to wear masks. That would be a reversal and come after weeks of discouraging mask use. Many journalists, including me, previously quoted the experts who urged ordinary people not to wear masks.

The whole situation has been a fiasco.

True, public health officials were in a difficult position. Masks are indeed more important for doctors, nurses and other front line health workers than for everyone else. Health care workers are at far greater risk of being exposed not only to the virus but also to dangerous levels of it. And if they do get sick, they could spread the virus further — and would be unavailable to treat others.

So what was the right solution? Zeynep Tufekci, a University of North Carolina professor, described it well in a Times Op-Ed more than two weeks ago. “The top-down conversation around masks has become a case study in how not to communicate with the public,” she wrote. Tufekci continued:

What should the authorities have said? The full painful truth. Despite warnings from experts for decades, especially after the near miss of SARS, we still weren’t prepared for this pandemic, and we did not ramp up domestic production when we could, and now there’s a mask shortage — and that’s disastrous because our front line health care workers deserve the best protection. Besides, if they fall ill, we will all be doomed. If anything, a call for people who hoarded masks to donate some of them to their local medical workers would probably work better than telling people that they don’t need them or that they won’t manage to make them work.

Imagine that: Unvarnished truth from high government officials about coronavirus.”

Opinion | With the Coronavirus, It’s Again Trump vs. Mother Nature – by Thomas Friedman – The New York Times

“. . .  Mother Nature was not impressed by Trump or his markets. Mother Nature, alas, doesn’t “open” her workday at 9:30 a.m. or close it at 4 p.m. Monday through Friday and then take weekends off. So precisely when Trump was autographing his one-day stock chart to be touted by the knuckleheads at Fox, Mother Nature was silently, relentlessly, mercilessly and exponentially spreading the coronavirus among us.

As Rob Watson, one of my favorite environmental teachers, likes to remind people: “Mother Nature is just chemistry, biology and physics. That’s all she is.”

You cannot sweet-talk her. You cannot spin her. You cannot manipulate her. And you certainly cannot tell her, “Mother Nature, stop ruining my beautiful stock market.”

No, no, no. Mother Nature will always and only do whatever chemistry, biology and physics dictate, and “Mother Nature always bats last,” says Watson, “and she always bats 1.000.” Do not mess with Mother Nature.

But that is exactly what Trump did initially with the coronavirus — and is trying to do still with climate change. Yes, we must absolutely focus on combating this virus now. And Trump seems to have finally become properly awed by the power of Mother Nature’s Covid-19, ordering federal distancing guidelines to stay in place until April 30. That is a good thing.

But as we win this battle with the coronavirus and begin to think about the next round of stimulus that we want to inject into the economy — and there will be a next round — it is vital that we keep in mind just how much more destructive climate change could be for all of us, and make sure that we invest in long-term resilience against that as well.

Because there is one huge difference between the coronavirus and climate change: Climate change doesn’t “peak” — and then flatten out and then maybe dissipate or be permanently prevented by vaccine — so normal life resumes.

No, when the Greenland and Antarctic ice melts, it’s gone, and we humans will have to contend with the implications of sea level rise, mass movements of populations and various kinds of extreme weather — wetter wets, hotter hots and drier dries — forever.

There is no herd immunity to climate change. There are only endless impacts on the herd.”

Opinion | How South Korea Solved Its Face Mask Shortage – By E. Tammy Kim – The New York Times

By 

Contributing Opinion Writer

Credit…Ed Jones/Agence France-Presse — Getty Images

“The coronavirus erupted in South Korea in late January, six months into Yoo Yoon-sook’s new job. She had just moved from Seoul, where she spent three decades working in the same pharmacy, to open the Hankyeol (“Steadfast”) Pharmacy in the city of Incheon, near the international airport. Ms. Yoo hadn’t really gotten a sense of the neighborhood around her new pharmacy “before this all happened,” she told me. It became all coronavirus, all the time.

Incheon’s 1,100 pharmacies, including Ms. Yoo’s, began to sell out of KF-94 face masks, the equivalent of the American N95. So did corner stores and large retail chains like E-Mart. As Koreans learned of the scale and aggressiveness of Covid-19, first from Chinese reports, then from a surge of cases at home, the mask with the weave and construction that proved most effective against the virus could not be found, except at exorbitant prices online. Customers grew angry waiting outside stores. One Incheon pharmacy posted a sign saying, “Regarding masks: Threats, physical violence and insults against employees are punishable under criminal law.”

Such was the extent of the “mask crisis” when the central government decided to intervene in production and distribution. At the end of February, it announced that it would purchase 50 percent of KF-94 masks from the nation’s 130 or so manufacturers. The government began to ship these masks, at a discounted price of 1,500 won each (about $1.23), to some 23,000 pharmacies, in cooperation with the Korean Pharmaceutical Association.”

If You Have Coronavirus Symptoms, Assume You Have the Illness, Even if You Test Negative – By Harlan M. Krumholz, M.D. – The New York Times

By 

“You had some exposures that may put you at risk for coronavirus. A few days later you come down with a bad cough yourself and feel a little short of breath and really tired. You take your temperature: 101 degrees. A fever.

You suspect you might have Covid-19, the disease caused by the novel coronavirus. The days roll into each other, and your doctor urges you to stay home unless your condition worsens. You feel pretty bad, though, and finally get an appointment.

They test you for influenza by sticking a swab far up your nose, and you are told the test came back negative, you don’t have flu. They tell you they are saving the Covid-19 tests for those who are even worse off than you are. You go home with a prescription for antibiotics, possibly because they don’t know what else to do, and read about celebrities who are testing positive but don’t seem so sick.

A couple of days later, still with fevers, you go back, and the doctors relent and test you for SARS-CoV-2, the virus that causes Covid-19. They again stick something up your nose to what feels like the bottom of your eyeball.

They tell you that the results will be available in a couple of days and you go home and wait. Finally, the results come back and you are told you do not have Covid-19. Now what?

Opinion | The Coronavirus and the Conservative Mind – by Ross Douthat – The New York Times

“. . . . . .    In his novel “Foucault’s Pendulum,” a sendup of crackpot esotericism that anticipated “The Da Vinci Code” years before its publication, Umberto Eco captured this spirit by describing the way that self-conscious seekers after hermetic wisdom and gnostic mysteries approached the rise of Christianity:

… someone had just arrived and declared himself the Son of God, the Son of God made flesh, to redeem the sins of the world. Was that a run-of-the-mill mystery? And he promised salvation to all: you only had to love your neighbor. Was that a trivial secret? And he bequeathed the idea that whoever uttered the right words at the right time could turn a chunk of bread and a half-glass of wine into the body and blood of the Son of God, and be nourished by it. Was that a paltry riddle?

… And yet they, who now had salvation within their grasp — do-it-yourself salvation — turned deaf ears. Is that all there is to it? How trite. And they kept on scouring the Mediterranean in their boats, looking for a lost knowledge of which those thirty-denarii dogmas were but the superficial veil, the parable for the poor in spirit, the allusive hieroglyph, the wink of the eye at the pneumatics. The mystery of the Trinity? Too simple: there had to be more to it.

This is where the pandemic-minimizing sort of conservative has ended up. They are confronted with a world crisis tailor-made for an anti-globalization, anti-deep-state worldview — a crisis in which China lit the fuse, the World Health Organization ran interference for Beijing, the American public health bureaucracy botched its one essential job, pious anti-racism inhibited an early public-health response, and outsourcing and offshoring left our economy exposed.

And their response? Too simple: Just a feint, a false flag, another deep state plot or power grab, another hoax to take down Trump. It can’t be real unless Hillary Clinton is somehow at the bottom of it.”

David Lindsay Jr.
Hamden, CT | NYT comment:
In the beginning Ross Douthat basically lost me, but by the time he quoted Umberto Ecco, he had me eating out of the palm of his hand. My lady and I had been joking about how we could run rings around the first half of the essay, which lacked citations or hypertexts, and we quit reading it together. Then I read the second half, and had to call her back. Douthat was like Houdini, he revealed his main point with an almost perverted brilliance that only he, in the NYT crowd, is capable of or interessted in. My hat is off to Douthat.
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