Sunday School Extra Credit 4/12/20

I wanted to drop in on a couple of the other virtual classrooms, starting with Margaret Brennan' and Scott Gottlieb on Face the Nation.  Gottlieb is the former FDA commish, and I had his interview with Chuck Todd in yesterday's Sunday School if you want to compare the two.

Brennan wondered who should be responsible for testing in advance of any 'reopening' effort. Gottlieb said it would likely have to be the states, particularly the contract tracing to identify people who may have been infected. He said Wuhan had 1800 five-person teams - 9000 people - handling the process, but that CDC only has about 600 deployed across the country.

The states are supplementing that, but the states need to increase their resources now. The feds are gonna have a hard time pulsing their resources in the throes of this crisis... and a lot of it's going to be on the governors. 

Gottlieb reminded us that contact tracing is "sort of the bread and butter of public health work." He thinks that businesses will have to think about compensation, paid leave and whatnot for people who are forced to by the government to self-quarantine. And,

the government might actually want to pay those people to give them an incentive to step forward, because if it's seen as punitive, if it's seen that when you get COVID-19, you're going to be forced to self-isolate for two weeks, you're going to miss work and you're going to be out of money, then people aren't going to want to step forward and get diagnosed. 

He also said he doesn't think "anyone's optimized really right now" to handle a rolling reopening, and he acknowledged the pressure not just on the administration, but on governors as well. Gottlieb expects a "slow reopening" through May, which could include older people staying home longer, under-staffing shifts, limited face to face meetings, and so on - decisions that will likely fall to local politicians and governors.

He sees only "marginal utility and impact" from serology tests, and thinks there'll be around 2% immunity in the general population, versus the 30% or more some people are anticipating. And, he doesn't think this is a good time to defund the WHO, but he also believes that WHO accepting and sharing what China was saying, which was not truthful, slowed the global response.

I think going forward, the WHO needs to commit to an after action report that specifically examines what China did or didn't tell the world and how that stymied the global response to this.

And he called on the organization to welcome Taiwan into the fold. 

Moving over to CNN's State of the Union virtual classroom, Jake Tapper had three governors visiting: Phil Murphy (D-NJ), Asa Hutchinson (R-AR), and Michelle Lujan Griffin (D-NM). I'll take them in that order. 

Here's Murphy on the anticipated May 1st reopening: There's "a sequence here" he said, that includes "a health care recovery, a health recovery first, and then the economic recovery."

And I fear, if we open up too early, and we have not sufficiently made that health recovery and cracked the back of this virus, that we could be pouring gasoline on the fire, even inadvertently...

He also said it has to be a regional thing, agreeing with my Sonofa Gov on that.

...  in this respect, whether it's testing, contact tracing, the rules of the road such that you don't have -- you don't have unintended consequences or you get a different set of policies on one side of the Hudson vs. the other, or one side of the Delaware River in our case or the other, is, we need to do this regionally.

On whether he could have acted sooner, or if any of them could have acted sooner? There's always an urge to second guess, and it's a fair thing to do on something like this. He'd like to see a national, bipartisan commission, similar to the 9/11 Commission, as well as state-level reviews.  

The woulda, shoulda, coulda deserves a -- an important focus. Right now, again, the house is on fire. We got to put the fire in the house out, and then we got to begin to get back on our feet. And then, at that point, we have to look back and say, what could we have done differently?

Moving across the country, here's Hutchinson on whether other governors were wrong to have done statewide stay-at-home orders (Arkansas is one of the few states that didn't). 

No, not at all. It just reflects the flexibility a state needs. I applaud that New Jersey and New York, they've had to really lock down. They have a high density population. But we have less density in our population here in Arkansas. And I think we can take this targeted approach, which has proven to be effective.

He thinks they're "beating that trend line" and said there's "a lot of hope and optimism this Easter that our tough time is behind and we're going to be getting better." He also said "no such thing as a true lockdown."

You're going to have, if we put a shelter-in-place order today, tomorrow we would have 700,000 Arkansans that will be going out on the streets going to work. The most important message is that you wear your mask, you do your social distancing and the people of Arkansas have embraced that.... 

He said he assured Tony Fauci that he'd do more, if they needed to, but feels his targeted, long-term approach, is working, even when Tapper cited the data showing one case and zero deaths a month ago to over 1200 cases and at least 25 deaths now. Hutchinson said that's still more than 1000 cases short of projections, and only 80 people are in the hospital, in a state with 8000 hospital beds available. He also said some counties in neighboring states that have more cases than the entire state of Arkansas.

They talked about religious gatherings, which are OK as long as attendees practice social/physical distancing at church, even thought Hutchinson has been "discouraging" large religious gatherings. Hutchinson said there wouldn't be any action taken against people who don't follow the guidelines, but there would be a "very specific directive" and a discussion with any church where there was an outbreak.

So just virtually all of the churches in Arkansas are following the guidelines very carefully. They're just as concerned about their parishioners as I am as governor... and I expect everybody to make sure they follow those social distancing guidelines and not gather whenever you have a risk.

Finally, let's head to New Mexico, where Tapper asked the governor what she's do if the president makes the call for a May 1st reopening. Lujan Grisham said they'll make whatever decision safeguards New Mexicans, including first responders and healthcare workers. And the said there's a problem without having a national strategy.

This virus is blind to state borders. And if we had better national strategies... and universal testing and software-based contract tracing then we can really figure out when opening makes sense and we could actually start to do that in the country.

She said they're already looking at recovery options, but nothing going to happen "until that peak occurs and we're clear about not having hospitalizations and reducing the number of people that are positive every day in our surveillance and testing efforts."

Tapper asked about the tracking, using cellphone data, and about privacy concerns people might have and what kind of oversight there is. She said it's not state data or a state effort, it's whole-country aggregate data, which they're using to see where people are travelling and for how long and the data's being used to see if they need any additional social distancing guidelines. 

Next, they moved to the issue of communities of color being more impacted by the virus. Tapper noted that almost half of New Mexico's population is Hispanic; the governor added that another 6% of the population is Native American, with 23 distinct sovereign nations. She acknowledged

that the social determinants of health, poverty, lack of access to adequate shelter, food, health care, is an aspect that makes this virus and our efforts to combat it and provide productive treatment incredibly challenging.

And, in some cases, with the Native Americans populations, there are places where people don't have access to water and electricity, creating "unique challenges." And while she said the administration needs to do more, she echoed NJ's Gov Murphy on states working together

We're looking at a regional strategy to support the leadership of the Navajo nation between Utah, Arizona, and New Mexico. We're putting out field hospitals, triage centers. And I will tell you that the pueblo nations in New Mexico have really looked at containment strategies for their community, and we're supporting that... we hope this not only slows the spread but gives us better support to the individuals living in these remote areas in New Mexico. 

They closed the conversation with Lujan Grisham denying that she wanted to be veep in a Biden administration.

I want to be the governor of New Mexico. I will do whatever it takes to support a Biden administration, and I'm looking forward to a federal administration that can do a national strategy in good times and in bad times both.

Aren't we all... 

See you around the virtual campus, with smiling faces and nice clean hands. Those'll get you real extra credit.