We Are Failing Teachers and Working Families Right Now and Forever

What are we doing? No, seriously, what the fuck are we doing? I saw this meme (not sure who made it, or I would ascribe credit), but it perfectly encapsulates the bind our country's anemic response to the pandemic and its fallout has put working families, parents, and teachers into this fall.

We are in the midst of a global pandemic that is many months--perhaps a year or more--from resolving in any meaningful way, by which I mean widespread testing and a vaccine. Scientists and researchers are working feverishly on both, and I think these solutions will eventually materialize. But until then, we are going to have to do better than simply tell parents, teachers, and working parents to just figure everything out on their own.

That is essentially what has happened. 

Trump's edict to "reopen schools this fall!" is just another vacuous, self-serving directive from a clinical sociopath who has never cared for another human being--in any way--in his life. It's just like "build the wall," "make America great again," "law and order!" or any of his other meaningless, bumper sticker lies. And he's issuing it amid soaring cases in many states--including here in Alaska.

I personally witnessed this on a Zoom call for a school board meeting here in Juneau. It was apparent that district officials and teachers had put an enormous amount of work, thought, and effort into developing a re-opening plan, engaging parents in feedback, answering questions, and trying to offer solutions and comfort. 

It was also obvious they had no idea what they were doing, and that's because they are not supposed to know. They are not supposed to be in the position of having to figure this out on their own, and our country has truly failed teachers and parents in asking them to.

I wish someone would just say out loud, "look, the United States is failing miserably to manage this pandemic. We are not prepared for it--not politically, not medically, not economically, and certainly not scholastically. It's obvious that teachers and parents are doing the best they can, but everyone is making it up as we go along and it's a total shit show."

This dilemma--and our government's neglect of it--is not a coincidence. It is the natural outgrowth of decades of a particular model of economics: one where parents--mostly mothers--are told to work eight or more hours a day, five or more days a week, send their kids to school for five or six of those hours, and figure out what to do with their kids the rest of the time.

Now, while Trump and his cronies siphon off federal corporate welfare for themselves, working parents and teachers are left to their own devices. What is more, we are being divided and conquered in precisely the manner described in this meme below:

"Teachers are underpaid and underfunded" (an intentional societal choice). 

"Parents are not prepared to homeschool their children" (Why would they be? Teaching is a profession that not everyone has trained for). 

"Parents need to work and can't be home all day" (another patriarchal choice to value a person's time at work over their home life). 

"Children and teachers need to be safe" (which they can't be with a highly contagious virus no one fully understands, but who cares because "the economy" comes first. And for some kids, of course, school is the only safe place they can be). 

"Teachers cannot teach online and in person simultaneously" (of course that is completely impractical, and not everyone has food or running water, much less internet access). 

"Anyone in contact with COVID should be quarantined" (science suggests this is true, but what does that do to us, and how impractical is that, given the above demands on our time)? 

"Kids won't be able to stay in masks and social distance all day" (not even for five minutes--anyone who has spent more than ten seconds with a child of any age knows that). 

"Distance learning is difficult and socialization is important" (again, how are kids with working parents, food insecurity, no running water, no internet, and no ability to see their friends supposed to distance learn or socialize at all)?

"We don't know the long-term effects of COVID" (another troubling aspect of this disease is that, like polio, COVID may beget long-term physical and neurological impacts).

"It is not an educator's job to risk their lives for other people's children" (which goes back to the main conceit here that the Trump administration is more or less telling teachers to drop dead this fall).

It did not (and does not) have to be this way. We need to move the Overton window to a place where we value teachers and working families at least enough to provide them with the basic infrastructure and tools they need to get through this thing. 

They deserve that, at a bare minimum, don't they? 

Other countries are doing it; there are good ideas about ways to do it in the United States. But we don't feel like we can pull it off, because people can't even be trusted to put on a mask for ten minutes at Costco without dissolving into an insane temper tantrum, and the President of the United States thinks that's a beautiful thing.

Again, this is not a coincidence and it is not inevitable. It is a direct result of choices we have made as a society to elect sadistic leaders who value money over lives. Now, as a result, parents, teachers, and working families are being asked to figure out how to navigate something it is not their place to navigate, and made to fight amongst themselves to accomplish the impossible, all while the one percent abscond with the lion's share of federal resources that are supposed to be helping us. 

Disregard for mothers in the workplace, for children and teachers at school, for a struggling workforce that can't pay its bills no matter how hard it works--has been woven into every policy choice our government has made since at least the 1980s. Leave aside, even, the mass shootings: COVID has exposed the indifference and the "fuck off and die" attitude toward school children and working parents that has long been the fulcrum of American public policy.

We need to keep voting and advocating to make sure we are never--ever--put in this position again.

I Rewrote Ice Ice Baby for Vanilla Ice’s Corona Show

Yo, RNA, let's kick it!

ICU baby

ICU baby

All right stop
Collaborate and listen
Ice is back without COVID prevention
Virus, grabs a hold of us tightly
Stay in your bedroom, daily and nightly
Will it ever stop?
Yo, we don't know
Take off the masks, at this show
To the extreme, he spreads the virus like butter
Light up the swab and drop a lung for this nutter

Cough

Rush the emergency room
It's killin' your brain like bar mitzvahs on Zoom
It’s deadly, when it gets in your airway
Down for the count, you can't walk up a stairway
Love it or leave it
You best stay away
You better stay home
Cuz this shit don't play
Rona is a problem
Trump can't solve it
Check out the stats while his spin docs revolve it

ICU baby Vanilla
ICU baby Vanilla
ICU baby Vanilla
ICU baby Vanilla

Now that the cases are jumping
With the bars poppin' off, and the beaches bumpin'
Quick to the point, to the point no faking
Infecting Gen-Z's, they remain unshaken
Burning 'em, laid up on the couchie
I go crazy when I hear Doc Fauci
MAGAs, with their guns and their ammo
Rona's on a roll and it's time to go solo
Rollin' at 103 point O
With my temp up high cuz of bat guano
The doctors on standby
Ain't here just to say hi
Did you stop?
No, I just drove by
Kept on, pursuing to the next state
I busted south and I'm trying not to tempt fate
That state was dead

Yo so I continued to A1A AUSTIN TEXAS!
Girls were out, they were not quarantining
Rona lovers, driving Lamborghinis
Jealous, 'cause I'm out getting mine
Grab that Purrell, it’s malignant not benign 
Ready, for the chumps on the wall
The chumps are acting ill ‘cuz they're all outta Tylenol
Sirens, ranged out like a bell
Grabbed my N95
And my white blood cell count was
Rising, in my bloodwork real fast
Jumped in my car, slammed on the gas
Bumper to bumper the avenue's packed
No social distance, viral load is jacked 
Medics on the scene
You know what I mean?
They passed me up, I didn’t even get screened 
Rona is a problem
Trump won’t solve it
Don’t have a vax, watch his spin docs revolve it

ICU baby Vanilla
ICU baby Vanilla
ICU baby Vanilla
ICU baby Vanilla

Take heed, I ain’t washing my hands
COVID’s on the scene and I’m packing in the stands 
In Austin, with the aerosol droplets 
Enough to super-spread from Miami to Charlotte 
'Cause my stupid, is like a chemical spill
Feasible dumb you can vision and feel
Conducted and formed
It’s a hell of a concept
We infecting the masses, you don’t wanna step with this
Hydroxychloroquine, scroll past like fake news 
It’ll be some time before you go on a cruise, it’s hot 
CDC says, “Damn"
If my rhyme was a drug
They would say it was a scam
Keep my composure when it's time to get sick
Magnetized by the mic, I’m an epic dick
Rona is a problem
Trump won’t solve it
Go read a book, while the spin docs revolve it

ICU baby Vanilla
ICU baby Vanilla
ICU baby Vanilla

Yo man, let's get outta here. Go call your mother.

Big Apocalypse Energy is my New Aesthetic

Wow guys. 

It's been a long time since I've written an actual full blog post. I guess I just haven't felt very inspired to sit down and journal my thoughts; with everyone's attention span in quarantine being five seconds long--including mine--it's easier to just fume in a pithy tweet, push send, and be on my way, which when you think about it doesn't leave much time for self-reflection, and is probably even a little bit Trumpy.

But ever since mid-March, when we went into COVID-19 lockdown, I've felt a weird combination of doom-and-gloom apocalypse mixed with a new inspired energy to get shit done in this world. Sometimes I feel like a keyboard warrior, but then I remind myself of the real things I've done this year, including working on my own world view and my place in the world.

Leveraging Privilege: A guiding theme for me since last December has been both recognizing and using my privilege--primarily my skin privilege and my education. The way I use my law degree is a big part of that. I've been involved in some cool cases: a class action lawsuit to keep the Pioneers' Home rates reasonable, which helped catalyze legislation that did just that. I worked on election reform and education reform ballot measures, both of which may be on the general election ballot this year. The election measure, in particular, will be monumental if it passes. I helped on the legal side of the recall effort. Both the recall and the election reform measure were upheld in the Alaska Supreme Court. I wrote an article on ballot measures for the election symposium issue of the Alaska Law Review and I am looking forward to publishing my first piece of legal "scholarship" since law school. I try to be responsive when people call me with legal questions or issues, listen to what they say, and guide them in a helpful direction. My new full-time job as a municipal attorney for a mid-sized rural city is rewarding and interesting, though I still miss my former colleagues at the State every day. 

Listening to Math and Science: When the pandemic first started, my cousin who is a biomedical engineer and working on the vaccine told me: "It’s going to be at least 18 months before anything is normal again. They're not really saying that because everyone would riot but that's the reality." So I've adjusted my sense of time to accept that life isn't getting back to "normal" any time soon. It's been so cool watching my brain and girl-crush, Dr. Anne Zink, who is my exact age (!) lead the state through this pandemic, despite the sad politicization of public health. I'm wearing masks in public because it's the kind and scientifically right thing to do.

Black Lives Matter: I'm choosing to engage more actively in racial justice movements because I am more conscious than ever of how my skin privilege has always infused every aspect of my life--from the microcosm of viewing police as protectors (which they always have been to me) to educating myself on the larger issues of reparations and mass incarceration, and sharing what I learn as widely as possible.

Books, Books, Books: Both in my book club and out of it, I am reading a lot more--I always have a book going, and friends and family have really opened my eyes to some great fiction and nonfiction, especially by BIPOC and on issues of race and equality. My goal in reading is to escape and keep my mind sharp but also to self-educate, listen, and attempt good ally-ship devoid of ego. Which means making mistakes, absorbing criticism, and self-correcting without self-defensiveness.

Friends & Family. I've been pretty focused, too, on trying to help friends and family through this pandemic and its fallout. I am so grateful that the beginning of COVID coincided with the start of a new job for me, and with no travel or entertainment, I've been in a better position to donate resources to friends, families, and causes I believe in. I've been trying to be more present for my children and make sure they maintain their connections, and have been incredibly indebted to their amazing dad who is with them all day while I am at work and is much better with kids than I will ever be. I've tried to be in better touch with friends, even though my daily groove is auto-pilot and I fail at this plenty of times. I extracted my parents from Zombie Land NYC and they're in Juneau for the summer thanks to a generous house-sitting gig offered by some dear friends.

Exercise. I've had a fucked up relationship with exercise ever since I was a teenager. I looked at it as a way to excel at sports and lose weight and nothing more. But I've been exercising almost every day since the pandemic started, and even though I still hate every second of it, I have to admit I feel good afterwards and it's helping my mental health a lot more than I thought it would. I still eat garbage, however.

Time and Voice Preservation: I've always said that our time and voices are our two most valuable assets. The way we use our time and the way we use our voices are also the things we can most control. OHM self-promotion has a purpose beyond narcissism, which is authentic humor and advocacy. We all have control over how we use our time. I choose to use it writing, reading, and doing real work in the world that tries to further the things I think are important both in my intimate sphere and in the world at large. I try to use my voice to do the same--litigating free speech claims as a plaintiff with the ACLU to hopefully gain broader speech protections to government workers and minimize fear and corruption in government. And, knowing that silence is not now and never will be an option, saying what I think needs to be said out loud without arguing about it and trying to convince anyone else of my rectitude. I don't get mired down in "the comments" for that reason. I try not to look outward at what others are doing or not doing. I try to be inner-directed as much as possible, though it's always a challenge.

Faith. I'm not religious, though I am ethnically Jewish and fully recognize that the Nazis would have come hard for me 80 years ago. That also drives my actions. I am spiritual, though, and I do have faith that the world can and will be better. I always come back to my favorite line from the Talmud:

Do not be daunted by the enormity of the world's grief.

Do justly, now.

Love mercy, now.

You are not obligated to complete the work.

But neither are you free to abandon it.

The Quickening

It’s sometimes called the quickening, that first flutter of life you feel inside your belly when you’re pregnant. I remember clearly that first quickening, with my first baby, lying in bed on my back one July afternoon in 2007.

I was just starting to feel human again; that month I finally wanted to eat something besides lemons. It was a small but distinct & perceptible jump, definitely not indigestion. It was new—the unique sensation of life and otherness. And it was surprising in an odd and almost distressing way, like a swallow bouncing off a window in mid-flight. 

As she grew it was so strange, I remember, to feel this other body rolling around inside of mine. Stretching her arms, her head down and firm like a bowling ball in my pelvis, her feet stretching up against my diaphragm, already a person with her own agenda of movement.

Everything since has felt like an extension of that quickening. An unspooling of this human being over whose life I like to believe I have agency and control, while actually having neither. I am agog at how I put this person into the world and, knowing that so much of who she is is already encoded by DNA, all I can do is help her maximize her best traits and minimize her challenges and obstacles.

She will be 13 at the end of this year; a year already marred in its own infancy by a pandemic, natural disasters, and a fractious and battered national psyche. She is handling these "unprecedented times" with aplomb: converting to virtual learning; accepting with circumspect resignation the cancellation of long-awaited trips and plans; finding new ways to interact with friends; going for morning walks; cooking and baking; cleaning her room; reading; making tea.

So we decided at last to dive headlong into that 21st century parenting murder hornet’s nest and get her a phone. It was precisely because she wasn’t nagging for a phone that it felt okay to get her one.

Especially in quarantine, I was growing weary of being her recreational and academic intermediary, and I knew she was missing out on some much-needed peer interaction. The independence and executive streak that had made her a difficult toddler now matched her abilities, and she was occupying herself with (mostly) helpful activities and good clean fun. Her instinct for self-care and her tendency to tattle on her little brother for the slightest infraction, I knew, meant she could handle the responsibility and rules of a cell phone.

But as always with these things, it wasn’t the thing itself, so much as what it signified. 

“I don’t even want a phone anymore,” she wailed as we tried to navigate some frustrating technical issues. Upon probing further, though, it was clear she was crying simply because she did not want to get older. 

If she got this phone, she knew, suddenly she was a big girl (already taller than her mom anyway) with real responsibilities. A girl who made her own plans and exercised her own judgment. And although I knew she was ready for it, she didn't want to be.

As her mom, I felt both ready and not ready for this little milestone that came upon us a bit unexpectedly. If quarantine has given me anything, it’s more time to think. I’ve been thinking about the kind of girl my daughter is, and the many ways I hope she will be “better” than me, and already is.

I was so maladjusted at her age. I was consumed with what other people thought about me. I tried to win the friendship of toxic, broken girls. I had a bad relationship to food and exercise. I constantly sought validation from boys. I was alone a lot of the time. I put enormous pressure on myself to succeed academically and athletically. I felt inferior to my own mother. I was afraid of everything. 

My daughter, fortunately, is mostly none of these things.

And as an adult, I’m not much better to be honest. I’m still a validation junkie (obvs). I say and do so many of the wrong things, so much of the time. I often chase the rush of my own brazen self-destructiveness, which masquerades as courage or fearlessness. I shudder to think of the damage I would have brought on myself with a cell phone at her age, considering the amount of damage I’ve managed to do with it as a grownup.

I wouldn’t have thought a simple device like this would feel like some major landmark moment in parenting, but yet it’s served as a reminder that my daughter is ready to handle a lot more than even she realizes.

Scylla and Charybdis

In the Greek myth of Scylla and Charybdis, two deadly hazards loomed before sailors navigating the Strait of Messina between Sicily and Calabria. 

On the Calabrian side towered Scylla, a rocky shoal mythologized as a six-headed monster. On the Sicilian side churned Charybdis, a broiling whirlpool said to swallow unfortunate boats whole and drag them to the bottom of the Mediterranean Sea. 

According to Homer, Odysseus was advised to pass closer to Scylla and sacrifice a few sailors, rather than tempt the yawning maw of Charybdis with his entire ship.

This myth was a childhood favorite of mine: I had a book with beautiful illustrations that depicted an old wooden boat being tossed about on white-capped seas, in a narrow passageway between a black-tentacled monster and a huge, frothy whirlpool. 

I thought of this myth tonight as I watched Dr. Anne Zink sail what I believe was a similar strait during her press briefing, which she has been giving with her bosses, Governor Dunleavy and State Health and Social Services Commissioner Adam Crum, nearly every day since the beginning of the COVID-19 pandemic. 

During these conferences, Dr. Zink has been holding a master class in crisis management, thereby earning well-deserved praise for her leadership. 

She is calm. She is empathic. She is deeply knowledgeable. She is a numbers person. She studies data as well as health care infrastructure and the availability of personal protective equipment (PPE) in a state with limited quantities of both. She is an assiduous student of this disease. She gives meaning to her direction. She bases her recommendations on science and data. She takes seriously her Hippocratic Oath that all physicians swear to "do no harm." She works tirelessly night and day to mitigate and contain the impact of this disease on the public. She sounds--and probably is--ten times smarter than anyone in the room.

Yet she faced legitimate criticism--and questions--from both reporters and legislators yesterday as to why one particular procedure was singled out in the latest State Department of Health COVID guidance. 

Naturally, that procedure was abortion. As Rasha McChesney at KTOO reported:

Alaska joined at least five other states in banning elective abortions during the coronavirus outbreak. That procedure, along with dozens of others, is listed as an elective surgery — state officials suspended those in mid-March. But on Tuesday, Dunleavy issued clarification about exactly which surgeries to stop. Health and Social Services Commissioner Adam Crum said the state followed guidance from the American College of Surgeons about which procedures should be delayed. However, the guidance the state refers to doesn’t recommend delaying pregnancy terminations at all — either for medical reasons or if a patient requests it. According to the guidance, pregnancy termination is a procedure that “if significantly delayed, could cause significant harm.”

Here's another report on this, describing how certain states--Ohio, Texas, Oklahoma, Alabama, and Louisiana--have chosen to specifically call out abortion as a procedure that should be avoided if possible during the COVID pandemic in order to conserve PPE. Both Dunleavy and Zink tonight dodged questions from reporters as to WHY the state guidance--otherwise verbatim to the federal guidance--differed in this conspicuous regard.

The answer is politics, notwithstanding Dunleavy's forceful denials to the contrary. 

His disgraced former Chief of Staff, Tuckerman Babcock, posted on his public Facebook page last month that closing Planned Parenthood for two weeks would save more lives than the virus would ever take. 

This administration vindictively and unconstitutionally vetoed $350,000 from the court system for interpreting Alaskans' reproductive rights in a way that did not sit well with Dunleavy and his base. 

And just months ago, before the pandemic, the governor fired and replaced the entire abortion-issue-plagued State Medical Board.

Some anti-choice folks are asking why abortions should get "special treatment" when every other clinic is being "asked to sacrifice" PPE, but that is not the question. 

No one is arguing against universal preservation of PPE or asking some providers to sacrifice PPE while others won’t have to do the same. What reporters, legislators, and the public want to know is WHY Alaska has joined a minority of (not coincidentally, very red) states in issuing guidance specific to abortion that is at odds with its national counterpart.

There is no answer to this question, or at least none that can be said aloud.

For over a decade, I worked for and defended five administrations of Republican governors. My goal was always to uphold my oath to support and defend the constitution of the United States and the State of Alaska. Before being unconstitutionally fired (along with two doctors and two other lawyers) for speaking out against the misdeeds of the Trump administration and other illegal and unconstitutional activity, none of these prior governors had ever put me in a position of having to sign my name to something I thought violated my professional oath.

I expect Dr. Zink is in a similar position. She just doesn't have time to fight with her bosses about this. She's simply counting on doctors—including abortion providers—to do what's best for their patients in adhering to their own oaths. 

Her focus, as she has said, is to save as many lives in Alaska as possible by emphasizing social distancing and conserving as many resources as we can. I imagine that her calculus is to pick her battles: to focus on understanding the disease every day, increase the supply chain of PPE, and flatten the curve of the virus, rather than try to convince her bosses to quit throwing red meat at their base. 

Like Odysseus, she is choosing Scylla.

I agree with the Governor that Dr. Zink is a treasure and asset to the state, and that she is performing beautifully and unflappably under unspeakable pressure. That her boss has put her in the awkward position of having to defend his political peccadilloes in the midst of a global pandemic says a lot about him and nothing about her.

Understand that mediocre hacks like Dunleavy don't run for office because they care about the public health and welfare. They run on blind ambition and to redistribute wealth to their corporate and religious backers. They simply do not view their duty to the public the way people like Dr. Zink do.

So when Governor Dunleavy claims he isn't playing politics with a pandemic, you can bet he is lying, and that Dr. Zink is doing everything in her power to ignore him and save lives. 

In other words, she is choosing the Scylla of her superiors' petty political side-projects over the Charybdis of a disease scientists do not yet fully understand, and that left unchecked, will surely bring what the doctor has described as a "significant loss of life."

Alaska needs her, and she is making the right choice.

We Didn't Start the Rona (Billy Joel Parody)

Bats and lizards, 14-Days, Wuhan China, Chest X-Ray
Ventilators, Teleworking, Andrew Cuomo
Trump Twitter, Tony Fauci, Eating cookies on your couchie
North Korea, South Korea, streaming those shows

Coughing, fever, pounding heart
Can you stay six feet apart
Silkwood shower, wash your paws, human boogers are the cause
There is not a vaccine, you will have to quarantine
Viral truthers, CDC, Boris Johnson Goodbye!

We didn't start the Rona
It’s been replicating
And it’s devastating
We didn't start the Rona
We don’t understand it
And we didn’t plan it

Idris Elba, Tom Hanks, Steph Curry, crashing banks
Laid-off workers, unemployment, plummeting stock
Toilet paper, panic-buying, zombie preppers testifying
Hashtag Flatten The Curve, Trump is a cock.

Pandemic, hunker down, health care workers, ghost town
Zoom meetings, PPE, social distance is the key
Health insurance, business loans, cancellations, hot zones
Prince Charles, "Tiger King", trouble with math.

We didn't start the Rona
It was circulating
While we’ve been debating
We didn't start the Rona
It was zoonotic
And it’s been chaotic

Drive through testing, symptomatic, socialism, democratic
Home school, soap and water, it could be your son or daughter
NYC, alcohol, there will be no baseball
Broke, bored, stuck inside, sibling fighting multiplied

Online classes, NPR, Mike Pence, shuttered bars
Italy, death tolls, travel is a no-go
Face masks, sterile gloves, masturbation self-love
New York Times, CNN, Fox n’ Friends is on again

We didn't start the Rona
It’s a bad contagion
You should not engage in
We didn't start the Rona
It is pretty frightening
But we’re out here fighting

Reagents, testing swabs, Huckabee’s corn-cob
Podcasting, Instagram, No one really gives a damn
MAGA wingnuts in denial, Libtard leftists on the pile
NBA, NHL, concerts, churches gone to hell
Vatican, bouncing checks, doggie style corona sex
RNA, DNA, what else do I have to say

We didn't start the Rona
It was always spreading
Cellular imbedding
We didn't start the Rona
It is inconvenient
But we can’t be lenient

Mental health for the win, when can we go out again
Not by Easter, Fake News, inside-trading, drinking booze
Stay indoors, cut your hair, no Pilates, it ain’t fair.
YouTube, ICU, our President is huffing glue
Frozen pizza, microwaves, trying not to hibernate,
Netflix, making memes, shelter-in place.
These talking heads are a bore, China’s under martial law
Alex Jones, info wars, I can't take it anymore

We didn't start the Rona
It’s a novel virus
Just like Miley Cyrus
We didn't start the Rona
But when we’re gone
Will it still go on, and on, and on, and on

Ask Science: Ending Social Distancing Now is a Deadly Idea

Below is an illuminating Twitter thread from yesterday that I copied and pasted here from Tom Inglesby, Director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health. Dr. Inglesby has an MD from Columbia University and completed his internal medicine and infectious disease training at Johns Hopkins. He sees patients in a weekly infectious disease clinic. I’ve lightly edited this only for non-Twitter clarity.

In last 24 hours there've been prominent US voices calling for a stop to social distancing, citing rationale that they're worse than impact of COVID itself. It’s worth looking very closely at that claim, where we are in the US COVID epidemic, and what happens if we stop.

COVID has been spreading with exponential growth in the US for some time, and we're just beginning to get an understanding of how extensively. There are nearly 40,000 cases recognized in the US as of today, with about 100 deaths today. A few weeks ago, we had recognized 70 cases total.

Some hospitals have said publicly that within a week they will not have ventilators to treat everyone with COVID anymore.

There continue to be big diagnostic limitations.  Shortages in reagents, swabs. We don’t have rapid diagnostics in many hospitals yet, so it can be days before doctors and nurses can find out if a patient in front of them has COVID.

We don’t have capacity to diagnose many of the COVID cases that are not sick enough to be in the hospital, so those numbers aren’t counted in our national totals.

There continue to be terrible shortages in the masks that health care workers need to keep from getting sick with this disease.

How do we gain time to let hospitals get more supplies and prepare for high number of patients? How do we lower the speed of spread of COVID in the US?  How do we lower the odds that ICUs will run out of ventilators and hospitals will run out of space?  

The answer for now is large scale social distancing.

In Asia, we've seen these interventions work to lower

the pace of the epidemic, lower numbers of critically ill, lower the number of people who get COVID. In

Asia where big social distancing measures have been in place for two months, they have had very strong impact. 

In Asia they've slowed the disease by slowing social interaction. Left to its own, this disease spreads from 1 person to about 2.5 people, and then they do the same, and so on. For this disease to stop, we need to make it so that the average person spreads it to <1 other person. 

These big social distancing measures take time to work. The impact of big interventions in Wuhan China took about three weeks to start to reverse things. And then everyday after the situation got better. In the US, we're about 7 to 10 days into this, depending on the state.

To drop all these measures now would be to accept that COVID patients will get sick in extraordinary numbers all over the country, far beyond what the US health care system could bear.  

Many models report that health care systems will be completely overwhelmed or collapse by the peak of cases if major social distancing is not put in place. 

If a health care system in a given community stops working, and can no longer provide care to the ill, the case fatality rate for COVID will be far higher than 1%. We would not be able to care for some or all of the expected 5% of recognized cases that get critically ill.

Beyond that, if hospitals were completely overwhelmed, they may struggle to provide even oxygen for some or many of the 15% of recognized cases expected to be “severely ill,” let alone provide care for other life-threatening conditions.

Anyone advising the end of social distancing now needs to fully understand what the country will look like if we do that. COVID would spread widely, rapidly, terribly, and could kill potentially millions in the year ahead with huge social and economic impact across the country.

Before considering big changes to social distancing measures now, we should as quickly as possible get to the strongest possible position for COVID response – we're nowhere near that now.  We'll need rapid diagnostics in place at almost every location where a patient can be seen for care.

We'll need extraordinary quantity, reserve, and production lines of masks and PPE so that shortages at hospital and clinical sites around the country

are no longer possible. We'll need to have more ventilators on the way. We'll need capacity to provide medical care to many more that we can now.

We'll need to reduce the number of cases to such a low level that we could again do contact tracing and isolation of cases around the country (as they can in many countries in Asia now).

We will need a system of screening at airports

so that no person comes into the country with the disease without being diagnosed and isolated.

We'll need a serology test that can be used to identify those that have been infected and recovered already, and to know how prevalent the disease is in the US.  We would hopefully have therapies developed and in a quantity that we can treat at least the sickest patients with COVID.

Once we have those things in place, it would be a far less risky time to take stock of social distancing measures in place and consider what might gradually be reduced with trial and error. We would have learned more about the experience in Asia as they try to do that.

For now we need to keep production running, doctors offices working, groceries, pharmacies, and banks open. It is ok to have science-informed dialogue about which businesses need to be closed versus what can stay open in some way if social distancing can be put in place in them.

But we need to press ahead for now with closed schools, mass telecommuting, no gatherings, strong advisory to stay home unless you need to go out – all are needed to slow this epidemic.

We also need to put every conceivable economic program in place to help those being hurt by these social distancing measures. And move ahead rapidly to get our country far better prepared to cope with COVID before people recommend we abandon our efforts to slow this virus.