bcl05

We are still dramatically undercounting COVID deaths. Not clear if this is intentional misleading or just incompetence.

No medical professional (myself included) advocated for shutting down simply to shut down. The entire point was to shut down to buy time, reduce the peak, and build infrastructure. We should have been spending every second of the shut down organizing a systematic, data-driven, comprehensive testing and contact tracing system. If we had that, we could reopen safely, with much greater knowledge of where the virus is, who is at risk, etc. We could have also spent that time emphasizing and educating about the critical importance of handwashing, social distancing, and mask wearing. Instead, we had a devastating economic shutdown with minimal progress and benefit. The idiots in charge did not lead, and we are going to reopen in a far less organized and far less safe way than needed to happen. The number of cases and number of deaths is far worse than it had to be, and is going to get worse again. Competence would have helped in this crisis.

That dog-birder incident hit home to me. I'm also an avid birder, and spend a ton of time alone in parks, often being quiet in the woods. I encounter idiots with off-leash dogs in areas with endangered birds nesting all. the. time. I always - always ask people to leash their dogs, in accordance to the local rules (often these are in places where dogs aren't allowed at all, leashed or not). I'm not always polite about it. I've never been threatened, and no one has ever called the police on me. I'm white, obviously.

Some more migrant warblers from the last few days...

Spring migration is well underway here. These are some of my favorite shots from the last week. All taken in southeast Minnesota.

He truly has no idea how infectious diseases work, and seems completely unable to learn. This is the biggest failure of presidential leadership in my lifetime. Truly pathetic and heartbreaking for our country.

I work at Mayo. This is exactly what happens when anyone else shows up without a mask. This fiasco is generating some discussion.

https://www.washingtonpost.com/investigations/2020/04/27/covid-19-death-toll-undercounted/?arc404=true Our "official" count of deaths is way below reality. As expected.

Another piece of data from this presentation: 19% of documented cases in the US are health care workers. Damnit.

It's certainly unusual (for comparison, SARS has peak shedding approximately 7 days AFTER symptom start). This is pretty clear in the data now, for COVID19, and is why this thing is so hard to contain. Its why we ALL need to be isolating/distancing, washing hands, wearing masks, etc, and not just the sick or vulnerable.

I'm currently watching a COVID19 grand rounds put on by our infectious disease team. Just showed good evidence that peak viral shedding is seen 24 hours BEFORE symptom onset. That's amazing, and relatively unique, and explains why containment is so difficult. Scary stuff.

Prosecutors have gone after people who intentionally spread HIV. I think whoever put that sign up should be in jail. They're killing people.

I appreciate the concern - very kind of you. I'm fine. I'm a physician at Mayo, and MDs are not being furloughed. We're all taking salary cuts, which isn't great, but compared to many others, I consider myself lucky. Lots of our ancillary staff are off work, though, and that's awfully rough. I haven't been on here as much - its too infuriating and frustrating to deal with all the BS and misinformation and stupidity out there. I'm so incredibly disappointed in our country.

Look - China is a deeply flawed, immoral state. They were faced with a complete unknown - a virus that had not been seen or reported previously. They responded in a lot of ways, some terrible (disinformation and suppression of reporting) and some reasonably OK (aggressive social distancing, widespread testing). At this point, I would have significant distrust of their numbers. Their circumstances were wildly different from ours. The US government was warned. The data from China and the WHO were clear - this was an aggressive, dangerous, highly contangious, often lethal virus that had the potential to cause widespread infection and overwhelm systems. Our government was not dealing with an unknown. They chose to treat it like one, and completely missed the early opportunity to lessen the damage. There is no universe where we, as a country, would face this coronavirus unscathed. We can't blame Trump and his minions for the fact that the virus exists. But. We absolutely should have been more prepared and had a more thoughtful and data-driven response. Pandemics respond best to proactive action, not reactive. Our government has bungled this from the start, and that has cost us thousands of lives and millions of jobs.

This is simply devastating to health care - not just in patient care, but also financially. This is where I work. Now I have to figure out how to furlough some incredibly great employees. Next week is going to be awful. https://www.mprnews.org/story/2020/04/10/mayo-clinic-announces-sweeping-pay-cuts-furloughs

Well, you see, the federal government, with its well-run, coordinated, data-driven, pandemic response team that had been planning for this for years will..... Oh wait. Goddamnit. I'm going to drink and cry.

Wisconsin is running this election worse than a banana republic. Pathetic. The GOP there should be in jail. Completely un-American and anti-democratic.

Every minute that Jared Kushner is talking to Dr. Fauci is a minute that Dr. Fauci isn't talking to someone competent, intelligent, and motivated to help. What a fiasco.

drop Pete and add Oscar Charleston for the top 6. But yes, the writing for this series has been incredible. Joe Posnanski is a treasure.

I mean, he's already demonstrated the willingness and enthusiasm to withhold life-saving military aid from an ally for purely political reasons. And he got away with it. Why would we expect his behavior to change now.

I am certain that Tony Fauci (whom I know) and Dr. Birx (whom I don't, but has a reputation of credibility) knew about this virus the same day that it was discovered. I'm sure they were raising the alarm in the first days of January. Every infectious disease doc who focuses on emerging viruses saw this coming. The fault is in the people who ignored them. Maybe if we still had a pandemic response team in the NSC we would have responded better.

THIS IS NOT FULL MITIGATION. THIS IS NOT FULL MITIGATION. THIS IS NOT FULL MITIGATION. Every time they use that phrase, my blood pressure spikes. This farce is going to drive me to drink (more).

I would do anything for any reporter to ask them "what would the number be if we instituted social distancing in every state a month (or two weeks) earlier?" The lie is that this is full mitigation. It isn't. We started late. Its a patchwork of mitigation. Not every state is taking this seriously, and we didn't all start at the same time.

I was in the grocery store the other day and there was a lady walking around with gloves on who was also holding a (dirty-looking) rag over her mouth and nose. Every time she would pick up produce or other groceries, she would put the rag down on her cart or on the shelf. Then she would pick it back up and hold it to her face. It was as if she was trying to get sick.