Saturday, March 28, 2020

Stay! Sit! Shake? NO!

Those commands are ones we often give to dogs to train them and it may be necessary to eliminate the paw swipe as we re-examine what it means in the future to greet and meet strangers.  Never one to the kiss on the cheek which I find oddly faux European in origin (given what we have seen in those countries that follow that protocol a big no on that ever!) we usually shake hands and in turn use the firmness of grip as a determinate of power.  Weak shake, weak person. Trump one upped that with some bizarre see saw death grip which again given he is a germaphobe has now suddenly felt compelled to shake hands to the posse that is clustered about him during each crazy ranting conference in clear violation of social distancing protocol established as safe by the CDC.

If one thing we have learned you cannot change someone else you can only change your behavior and your response to it.

Right after I wrote my last blog post, Stress Test, I found this article in the Washington Post about the landscape of America post pandemic.   Each essay is from an individual in a given profession that is of course taking credit for seeing this in some sort of divination of what the future will hold as if we know, care and assume you are an authority on life other than your own.

This essay held the most weight as it was a based on history and of course the reality of the present in comparing this to the 1918 Flu Epidemic:

As influenza ransacked their communities, many Americans clung to the familiar, adhering to established ways of doing things. Men and women faced pressure to respond to the pandemic according to gendered norms. In letters and diaries from the time, women openly discussed their fears and their experiences of loss; because they were assumed to be innately self-sacrificing and skilled at caregiving, women were called upon to be nurses. Men, meanwhile, were expected to exhibit only strength and stoicism; they expressed guilt and shame when illness required them to take to their beds. People of color continued to face segregated health care: Philadelphia opened emergency clinics for white residents but did nothing for its African American community. Eventually, a local black physician organized their care. In Richmond, African American patients could visit the new emergency hospital, but they were relegated to the basement until the staff secured another, separate space for their treatment. 
The pandemic did not disturb the social and economic inequities it had made visible. And yet, while knowledge of the past is essential to understanding the present, history is rarely a reliable predictor of the future. We need not repeat the mistakes of those who came before.

The other that stood out is this about urban planning:

The current pestilence is likely to accelerate those shifts, which bear major ramifications for how Americans get to work. Transit ridership was doing poorly before the crisis, declining throughout the country, while telecommuting and driving alone continue to grow. With the specter of contagion, city-dwellers are told to avoid crowded subways, removing a critical element that makes ultradense cities work. In New York, subway traffic is down precipitously, as many commuters now work at home instead. Toronto is eliminating much of its downtown train service. The Washington Metro is also cutting back. 
Just as progressives and environmentalists hoped the era of automotive dominance and suburban sprawl was coming to end, a globalized world that spreads pandemics quickly will push workers back into their cars and out to the hinterlands.

Nashville with its lack of sidewalks, its lack of decent highways and its near to non-existent public transportation will find itself back to 1950 segregated neighborhoods and a city that will not offer any appeal what-so-ever as building high rises adjacent to the tourist trap that runs the city economy is hardly where anyone with money would elect to live so hello Williamson County.   For me here in Jersey City nothing will change and for that it means for me but for many of my weird fucking neighbors whom I don't speak to or even acknowledge I say - BYE! They are largely young professionals, with larger than normal families as they live multi generational and in turn have just realized that maybe living in a city with no parks, places to play and confined to a high rise might not be the best place to live as a family. I had to explain to one of the Concierge's here that he thought that might mean that families would move to Jersey City.. no unless they move into a single family brownstone then no and that still is limiting when it comes to space and yards and again if you are going to commute anyway why not further out to get more for your money.   So this will be the single occupants, the newly coupled and transplants as it is still cheaper than Manhattan but it is not a family city unless you head into the Western area of the city (which is undergoing gentrification and this will speed it up) as it is now building light rail to connect to major urban transit.  But again I suspect much of this work force will be working from home now and in the future as driving into Manhattan sucks.

But for Los Angeles, San Francisco, Seattle I think that there will be a sea change as the cost of real estate has already pushed people out and now it will further that movement in a new way that these same cities have pushed for the greening of America will be on the forefront of greening of suburbia.

And again Jersey has tried to push a narrative that is so fucked up and confusing that any of these Mayors remain in office after this will only prove me wrong that people here do vote and do care as Hoboken, Jersey City and Newark have been having a massive dick off that makes little to no sense and actually contributes to some of the problems that are about social distancing, proper self management and respecting businesses. As of today the Bakery nearby has a phone order only in place. You stand outside look in the window as to what is on offer and then call to pick it up from the door.  The ice cream store is the same and I suspect more will follow as some restaurants tried pick up and delivery and it just did not work so they are closed "indefinitely".  Here is where leadership and calm voices and rational heads would be useful.  Instead its hysterics over watching friends play soccer, how close are you and hey don't you all know each other and why would anyone sick play? Again it is as if we are all children with no sense of self regulation.  Hey if they get sick they are at least easy to track and of course if they live cite for a misdemeanor.

When my daily conversation is with a Barista who is the most annoying individual I have ever encountered, who has no social clues and is often rude to the point of unkind this is where I am at with social distancing and yet I feel immense pity for her and wish that I could model at least some type of appropriate ways to tease and riff people without the abject nastiness that she displays. I felt that way with the religious kooks in Nashville so it is just more of the same only different. And again much of what I see here comes from two different places: The urban dweller who is used to crowds and the other is a distinct cultural bend that includes a strong religious community of conservative practitioners of their faith both in Judaism and Catholicism.

So where will be when this ends, and that is not until June which puts us out 90 days, I suspect more businesses will close or some will pivot again and figure it out and some will just go on as business as usual; Which the bagel street across the street from the bakery has and it is just fine, the only behavior I change is mine, I wear gloves, a mask and cover my head and they don't treat me any differently and that is how it should be.

In the shadow of New York, New Jersey faces its own deepening crisis as virus spreads

By Richard Morgan, Ben Guarino, Tim Craig and Devlin Barrett
March 27, 2020
The Washington Post

HOBOKEN, N.J. — At New Jersey's oldest hospital, the demands of fighting a pandemic threaten to overwhelm the city's medical resources — a frightening prospect confronting more communities as coronavirus burrows deeper into the United States.

With just 333 hospital beds for a commuter city of 55,000, Hoboken University Medical Center has less than a week before “we will not have the resources to save lives,” said Ravinder Bhalla, the city’s mayor.

Sometimes mocked as “Bro-boken” for its hordes of young professionals who cross the Hudson River every day to work in Manhattan, this town is bracing for the same onslaught of critically ill people now gripping New York.

So far, Hoboken has only 59 confirmed cases, but the mayor noted that many of those people are in their 20s and 30s, and he thinks it’s only a matter of time before the figure jumps dramatically.

“In New York, in a span of two weeks, they’ve gone from about 50 cases to 25,000,” Bhalla said. “So it feels like we are looking across the river at a wave, and what I’m trying to do is hold my hand out and push that wave back.”

Like the rest of state, Hoboken’s bars and restaurants and most businesses are closed. But even in a shutdown, many of the residents still commute to New York for jobs.

“I want people to know, even though we only have about 50 cases, this feels like the calm before the storm,” Bhalla said.

John Rimmer, director of the hospital’s emergency department, has been working from home since he contracted covid-19, the potentially lethal respiratory disease caused by coronavirus.

So far, the number of patients hasn’t been overwhelming, he said, but the severity of their illness is straining resources. The hospital is using eight of its nine ventilators for critically ill patients, according to hospital officials. There is an emergency reserve of another 10 it can draw on if necessary, but those are designed for short-term emergency use, not longer-term recovery. The hospital is seeking another 13 respirators.

“We’re trained for trauma, but shooting events, train crashes — things that end in a few hours,” Rimmer said. “With this, there’s no end in sight.”

The hospital, which was founded during the Civil War, is now seeing about 130 patients a day, and 3 out of 4 of those are suspected of being infected with coronavirus.

The hospital’s CEO, Ann Logan, said her staff has been “watching this, chasing this, planning this. This is our every day now.”

As of midday Friday, New Jersey had nearly 9,000 confirmed coronavirus cases, and 108 deaths. The state is second only to neighboring New York in the number of cases, underscoring just how easily the disease leaps and spreads across state lines.

“These are not abstract numbers, these are our neighbors, our family, our friends, all of us, we are in this together and we mourn together,” said New Jersey Gov. Phil Murphy (D). “But we have expected, with a heavy heart, that this would take an increasing toll on our state.”

Unlike in New York, where Gov. Andrew M. Cuomo (D) has tried to make coronavirus tests widely available, Murphy and New Jersey health officials say they are trying to reserve their tests for only those showing flu symptoms.

“We need to know we are testing the right people, and not wasting tests,” Murphy said.

Even with the strict limits on testing, New Jersey Health Commissioner Judith M. Persichilli said it currently is taking as long as seven days for tests to be completed. The lag time has unsettled state leaders, who say they remain unsure just how bad the pandemic will become in coming weeks.

“This is a war, and we all know what the ingredients are for winning a war,” said Murphy, who noted that the most recent predictive models show the crisis may not peak until mid-April.

Amid widespread concern from hospital staff and first responders about a lack of personal protective equipment, Murphy took the extraordinary step of ordering all private businesses in the state to disclose to his office by Friday evening whether they had any stockpiles of protective supplies.

“This is not an ask, it’s an order,” the governor said.

In Lakewood Township in Ocean County, Mayor Raymond G. Coles feels as if the storm has already slammed into his community. Over the past week, the number of cases there doubled to more than 100.

Coles said the outbreak has been centered in the city’s Orthodox Jewish and Hispanic communities, both of which have tightknit family structures and frequent contact through social and religious gatherings. The virus quickly spread through the Orthodox community, which makes up about 60 percent of Lakewood’s population, before anyone even knew the contagion had made its way to the East Coast, Coles said.

“Folks just don’t understand with the Orthodox community, just how central daily life is in synagogue and with schools,” the mayor said. “People want to pray three times a day, and learning is paramount to life.”

In the Latino community, Coles noted, the virus quickly spread through some households because it’s not uncommon for more than one family to live together.

“And if one person gets it, it just spreads,” he said, adding that local and state officials are now working to try to ensure that immigrant communities understand they will receive treatment for their illness even if they do not have health insurance.

Over the past two weeks, amid warnings from state and local officials about remaining indoors, Coles said most of Lakewood’s residents now “understand” the virus and “are afraid of it and respect it.”

But he wishes he had more guidance from government leaders and health experts.

“If we had been made aware a few weeks sooner, we would have locked down a lot sooner, because once people were aware of what was happening, this town has pretty much locked down,” said Coles, noting that at least three Lakewood residents have died. “We really wish we could just push the self-isolation back in time.”

The scale of the pandemic is bigger in New York, where more than 500 have died. But New Jersey is facing the same steep hill to climb.

“New Jersey is literally right behind [New York],” said Maria Refinski, president of the New Jersey Nurses Union CWA Local 1091 and a nurse at St. Barnabas Medical Center in Livingston, N.J. “As they start to peak, we are going to be right there also. We’re behind, but not by much, in regards to timing.”

Refinski said some hospital staff working in intensive-care units are already resorting to buying their own versions of hazmat suits to try to guard against getting sick, because protective equipment is “constantly running low.”

A survey released Friday by the U.S. Conference of Mayors found that 90 percent of mayors who responded think their communities lack the necessary gear to effectively fight the spread of the virus.

Taken together, the cities reported a need for 28.5 million face masks, 24.4 million items of personal protective equipment such as gowns and gloves, 7.9 million test kits and 139,000 ventilators.

In Paterson, N.J., the mayor and other city officials became so concerned about supplies at the local hospital that they raided the city’s emergency stockpile, amassed in case of a natural disaster or terrorist attack.

On Thursday, officials went to a Passaic County warehouse and removed 15,000 surgical masks, 1,000 N95 masks, thousands of rubber gloves, 500 thermometers and 100 stethoscopes for delivery to St. Joseph’s University Medical Center.

Stanley Trooskin, the chief medical officer at Robert Wood Johnson University Hospital in New Brunswick, said his facility has spent the month of March gearing up for what they fear will be a flood of coronavirus cases. The 600-bed facility has been devoting more of its beds to intensive-care work.

In canceling family visitors and other activity, the hospital is more quiet than usual, giving it a “very eerie feeling” as staff wait for the coming storm, Trooskin said.

“I’ve never seen this level of cooperation and people putting their petty issues aside,” he said. “We think about a week ahead, five days and 10 days, this giant wave that’s going to overwhelm us — we don’t know that for sure.”

Two tents were recently set up to direct incoming emergency patients. In the first tent, a health-care worker dressed in protective equipment asks about possible covid-19 symptoms. Patients who potentially have covid-19 are directed to a second tent, where a robot awaits to allow an emergency medicine physician to perform a remote physical.

Health-care workers at the hospital have protective equipment in line with Centers for Disease Control and Prevention and New Jersey guidelines, but “optimally we’d walk around in spacesuits taking care of these patients,” Trooskin said.

******ETA**** Since posting this Trump has gone full tilt boogie crazyz-cra  with this announcement***

2:04 p.m.
Trump says he’s considering a two-week quarantine on the New York metro area

President Trump said Saturday he may announce later in the day a federally-mandated quarantine on the New York metro region, placing “enforceable” travel restrictions on people planning to leave the New York tristate area because of the coronavirus outbreak.

Trump said he spoke with New York Gov. Andrew Cuomo (D) in the morning. Asked if the quarantine pertained to limiting travel out of those areas, Trump said it was and it would be enforceable.

“I’d rather not do it, but we might need it,” he said.

Cuomo, however, said he had not spoken to Trump about a potential federal quarantine.

“I haven’t had those conversations,” Cuomo said when asked about Trump’s comments, which came as the governor was giving a news briefing. “I don’t even know what that means.”

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