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Sunday, March 29, 2020

Sunday, March 29, 2020
This prepublication paper (March 25th) uses newer data than that of the Ferguson et al. paper (March 16th) that I drilled into last week.  It also focuses on the U.S. situation, broken out by state. And the executive branch seems to be using it to design shutdown policy. The headlines:

The University of Washington paper projects 81,114 deaths, with a very large Uncertainty Interval (UI) belying the precision of those numbers (at left).  This is in the ballpark of the lower bound of Anthony Fauci's estimate of 100,000-200,000 deaths. These are high numbers.  The bottom is about  3 times typical death counts from influenza.  But they are 20 times lower than the "doing nothing" estimate in the Ferguson et al. paper. The two papers agree on the scale of reduction that suppression measures achieve.

(UPDATE: This number of total fatalities was revised to 93,765 on April 2nd. It was revised downward in the wake of sustained social distancing measures, and has stood at around 60,400 since April 9th).

The authors also modeled health care capacity, estimating demand for hospital beds peaking at 7 percent above the national bed count, and Intensive Care Unit demand peaking at 25 percent above the national ceiling.  This means that suppression measures do not eliminate the health system crisis (this looked better in the Ferguson et al's projections for the UK).

The  UW team couldn't estimate ventilator shortages because they couldn't find reliable counts for these. Bed and ICU shortfalls are expected to vary greatly by state, with "peak excess demand" for beds being particularly bad in New York, New Jersey, Connecticut, and Michigan, and excess demand for ICUs being more widely spread across the country.  California is in comparatively decent shape on both fronts, though that isn't saying much.  Excess ICU demand is figured below.



All the estimates (reduced deaths, very serious but perhaps non-catastrophic excess hospital demand) assume social distancing that approximates Ferguson et al.'s suppression regime.  I find this to be the least convincing aspect of this paper.
For states that have not implemented 3 of 4 measures (school closures, closing non-essential services, shelter-in-place, and major travel restrictions), we have assumed that they will be implemented within 7 days, given the rapid adoption of these measures in nearly all states. At this point in the epidemic, we have had to make arbitrary assumptions in our model on the equivalency between implementing 1, 2, or 3 measures – and we have implicitly assumed that implementing 3 of 4 measures will be enough to follow a trajectory similar to Wuhan – but it is plausible that it requires all 4 measures. (8) 
I see two obvious problems with this. First, we are not seeing "the rapid adoption of [suppression] measures in nearly all states."  Duringthis past week, many Republicans politicized social distancing as anti-business.  Although some Republican governors have not followed this line, Covid suppression has now been polluted by the country's toxic political discourse. POTUS is angling for ways to pin an extended shutdown (anything past Easter Sunday on April 12) on the libs, and his proposal for a NY-NJ-CT quarantine didn't have to be implemented to tar the country's leading Democrat stronghold as a disease-carrying Gommorah. Florida governor Ron de Santis has set up border checkpoints partly aimed at excluding New Yorkers; at the same time, Rhode Island's Democrat governor is proposing door-to-door searches for infected New Yorkers.  The American political system may not be good at public health, but it is world-class at finger-pointing. This does not bode well for a national suppression regime and its 20x reduction in mortality.

Second, I see no reason to assume, as the authors do, that "implementing 3 of 4 measures will be enough to follow a trajectory similar to Wuhan."  That is the best-case trajectory, in which full shutdown in  Wuhan on January 23rd led to no new cases by March 15th.  (That included a peak rate of daily deaths 27 days after that shutdown date.)  Wuhan implemented all 4 of 4 measures and then some--Wuhan authorities also instituted an app that used personal data to restrict movement for people rated "red" or "yellow," and broke disease clusters through family separations, in which some members were sent to medical dormitories for isolation.

In other words, the UW model may be way too optimistic--landing us back in a mitigation model which halves deaths (to about a million in the U.S.) while overwhelming the medical system.

This study notes but, as far as I can tell, ignores two other major differences between Wuhan (and South Korea) on the one hand and the U.S. on the other.  One is our lack of mass testing, including testing of people without Covid-19 symptoms.  Testing allows the health care system to identify people who need total isolation and/or treatment, making social distancing much more efficient.  The U.S. seems to have missed the crucial testing window (the New York Times' investigation of the serious failure of Trump's executive branch is worth reading in full). The other is China's massive mobilization of equipment and facilities--the new hospital constructed in two weeks and the like.  In stark contrast, the U.S. story is of shortages--of ventilators, of masks and gowns, of swabs, and, soon, of trained and healthy medical personnel.  All this also casts doubt on our powers of suppression. We will have to fall back on brute isolation, which is of course is the longest and the most costly mode economically--and educationally.

The paper ends on this note:
Our estimate of 81 thousand deaths in the US over the next 4 months is an alarming number, but this number could be substantially higher if excess demand for health system resources is not addressed and if social distancing policies are not vigorously implemented and enforced across all states.
We are thus encouraged to continue the most stringent version of a difficult lockdown with the clear possibility that the disease itself will be much less lethal than we have been assuming.

I do take this as encouragement.  We could start seeing a real ebbing of fatalities and infections in the Wuhan 60-day period: by mid-May in the New York region, and not too much later elsewhere. (See Bryan Alexander's Three Scenarios for other possibilities.)
Stay strong--indoors.

April  3rd.   The Washington Post has a big piece entitled, "Experts and Trump's advisers doubt White House's 240,000 coronavirus deaths estimate."  There's nothing new that we haven't covered here, but it's interesting to note the ongoing refusal of the White House "to explain how they generated the figure" of 100,000-240,000 national Covid-19 deaths, beyond the mashup of the two studies we've analyzed here - Ferguson et al. at Imperial College and the UW model discussed here, from the Institute for Health Metrics and Evaluation, with its user-friendly projections, one of which appeared in Deborah Brix's briefing.   "But what remains unclear and alarming to many modelers is whether the White House is using their data to create a coordinated, coherent long-term strategy." The answer is no they're not, for example, implementing a national stay-at-home order called for by Anthony Fauci.

April 5th Covid-19 continues to receive saturation coverage, but the single most interesting piece to me was NYT coverage of the German response to the virus. So far, Germany's case-mortality rate is 1.4 percent, nearly a tenth that of Italy and about half that of the United States. Some reasons why: the German infections "started as an epidemic of skiiers" coming back from Italy and Austria, so younger people were infected first. Second, Germany has run many more tests, so they capture a higher share of infections than Italy or the U.S. (their denominator is bigger). The piece goes through other crucial factors:"early and widespread testing and treatment, plenty of intensive care beds and a trusted government whose social distancing guidelines are widely observed."  The U.S. can't really draw on any of these.

I thought ruefully of UC Health when I read this passage:
Before the coronavirus pandemic swept across Germany, University Hospital in Giessen had 173 intensive care beds equipped with ventilators. In recent weeks, the hospital scrambled to create an additional 40 beds and increased the staff that was on standby to work in intensive care by as much as 50 percent.
“We have so much capacity now we are accepting patients from Italy, Spain and France,” said Prof. Susanne Herold, the head of infectiology and a lung specialist at the hospital who has overseen the restructuring. “We are very strong in the intensive care area.”
All across Germany, hospitals have expanded their intensive care capacities. And they started from a high level. In January, Germany had some 28,000 intensive care beds equipped with ventilators, or 34 per 100,000 people. By comparison, that rate is 12 in Italy and 7 in the Netherlands. By now, there are 40,000 intensive care beds available in Germany.
Separate item: People say the infection numbers are bad but the death counts are good.  A WaPo piece reminds us that they're bad too.  Covid-19  caused deaths are likely undercounted worldwide, perhaps by a lot.
 
April 12th

Today is Easter Sunday, which POTUS wanted to be America is Open for Business Day.  It isn't.  For example, Kansas Gov. Laura Kelly's executive order to close churches was opposed by Republican legislative leaders, but yesterday they lost before the Kansas Supreme Court.

Yesterday was also Peak Resource Use in the UW (or "Chris Murray") model I've discussed here.  Peak fatalities were to occur April 10th.  Early infection zones--Washington State, New York, and California--are all heading in the right direction.  Other areas (New Orleans, Detroit) are not yet.  The South remains a wild card.  Here in Santa Barbara County, we had 264 cases as of 5 pm on April 11th, with two deaths, a number that has held steady for a week.  Many of the new infections are in the Federal Prison in Lompoc.

Some states have released some incarcerated people in response to the pandemic (like Gov. Tom Wolf of Pennsylvania).  The Federal Bureau of Prisons is screening prisoners to release some into home confinement.

California is going to be closed at least through the end of the month, and LA County among others through mid-May.  But the debate on openings is heating up in Europe.

April 17th

STAT has an interesting overview of the criticisms of the methodology of the University of Washington model covered here.

Posted by Chris Newfield | Comments: 0

Sunday, March 22, 2020

Sunday, March 22, 2020
Shutdowns are now spreading as fast as the coronavirus. On March 19, Gov. Gavin Newsom ordered 40 million Californians to stay home, claiming that the infection rate puts the state on track for 25.5 million infections.  The order has no end date.  New York and other states and counties have since followed suit: by noon on March 21st, 75 million US residents were under some kind of lockdown.

In this post I'm going to talk about what I've learned during a sustained effort to apply analytical expertise to a topic outside of my normal subject areas, as I try to build a base for a series of citizen judgements about health policy, and also the related areas of educational and economic policy that I know more about.

This learning process has changed my mind about a number of Covid-related issues: for example, when I learned March 10th of UCSB's shutdown--at the end of my senior seminar, thanks to Jenna, multitasking on her email again!--I was a skeptic about the benefits of widespread closures. Now I'm a believer: I think that widespread social distancing is our only chance to avoid levels of infection that would overwhelm hospitals and clinics and lead to much excess death.  At the same time, I'm also more optimistic about reducing infections than I was a week ago.

The main part of this post close-reads the one published infection model that I've been able to find-Neil Ferguson et al.'s paper, from Imperial College London.  The U.S. Centers for Disease Control and Prevention (CDC) has not released its modeling, though it was discussed in a bootleg version by the New York Times.  My caveat up front is that the SARS-CoV-2 infection model I analyze does not offer any certainty about the future. But I will talk about the powers of the suppression regime we've entered into, and how the disease might be made less deadly than many of us now assume.

An overview:
  • The policy of virus suppression does appear to reduce Covid-19's spread. I'll define this and other terms below, since terminology is all over the place in media reports. (The one journalist I've found to have interviewed Neil Ferguson--Nicholas Kristof of the New York Times--conflates mitigation and suppression.)  Suppression has worked well in South Korea, Singapore, and post-lockdown Hubei in China when social distancing is combined with mass testing. 
  • The U.S. simply does not have the testing capability to do the most effective form of suppression.  (Santa Barbara County has brilliant and frequently exercised emergency services.  As of March 22nd it has 13 confirmed Covid-19 cases, a shortage of test kits, and 200 tests out whose results won't be in for awhile.) The U.S. has not been able to do contact-tracing, which would have allowed a much more efficient form of isolation than the mass version we're doing now.  In spite of some encouraging reports of new equipment coming on line, the U.S. is in the midst of what statistician John A. Ioannidis calls an "evidence fiasco," and its public health capacities have been downsized (personnel down 20 percent since 2008, according to David Himmelstein) to the point that we're likely stuck with the crudest, most disruptive, and most economically damaging form of suppression. 
  • This has implications for rebuilding social and public capabilities that I'll save for a later post on how SARS-CoV-2 is putting neoliberalism out of its misery--and how to keep that from causing further misery for diverse publics.
  • A theory point: public officials are using projections of high infection and death rates to install suppression regimes, but these suppression regimes are designed to invalidate the numbers that justify them (by producing much lower rates of infection and death).  Either you infect 81 percent of California by doing nothing, or you lockdown California and get a much lower infection percentage.  You don't do both.  I elaborate on this point because it's important for people not to think lockdown = death (regardless), but to think the opposite.  
  • A policy point: public officials must not bullshit the public with exaggerated numbers, withheld models (CDC!), and mashup policies that will encourage cheating. Newsom did the right thing, but he didn't give clear, honest reasons for it.  That has to change.
To take the last point first: Where did Newsom get the number that he used to shut down most of the state economy without an end date? We don't actually know. The LA Times reports, "the governor’s office declined to provide an explanation of the state’s projection that 25.5 million Californians will be infected with this virus. Instead, a spokesman for the governor said the state’s mitigation efforts could lower that estimate."

The last part is true (though "mitigation" is the wrong word, as I'll explain), but the public should be told the source.  In the meantime, I'll guess that Newsom's people got that number from the now-famous pandemic modeling paper I mentioned at the top, Ferguson et al. Their baseline reproduction number (Ro) for the disease is 2.4--meaning each case typically goes on to infect 2.4 other people. You can get to 25.5 million Covid-19 infections by taking California's Covid infection count when Newsom spoke--around 1000--and giving it an exponent of 2.45.  (Updated: See Akos Rona-Tas's correction of this speculation below, under March 23.)

The Ferguson paper derived that Ro in part from from the spread of the virus in Wuhan, China, before the government began its many non-pharmaceutical interventions (NPIs)--forced quarantining, widespread testing, etc.  (Wuhan's Ro was previously reported as 3.11).  The projection that 56 percent of the California population will become infected appeared as a math error in Newsom's letter to Trump requesting a hospital ship: it's actually 64 percent, or alternately, 39.56 million Californians * 0.56 = 22.15 million inflections.  The point isn't the bad math but the need to offer credible numbers and explain clearly where they come from.  People will take honest, fully disclosed estimates more seriously.  Health policy needs to be open to establish the trust that government now desperately needs, to discourage cheating, and to allow meaningful democratic judgment about overall policy. 

Public officials, including Newsom, seem to be now focused on using big numbers to stampede the masses into social distancing, RTFN. This is understandable, since, in the suppression arsenal, social distancing is pretty much all we've got.  But one major effect of their statements is to muddle the difference between mitigating and suppressing a pandemics: the former allows infection rates like 55 percent. The latter slows growth rates and can put them into reverse.  Suppression also requires a rigor that people won't pursue if they don't understand the massive difference it can make.

To put this in the form of a question, could the U.S. and the European Union (and other regions) achieve suppression and thus decline in the number of new cases?  The current tracking in California is not good.



But look at  the South Korean case pattern.



South Korea had our hockey stick and has now bent it down into slower growth of new cases.  As is now widely discussed, South Korea, Singapore, Hong Kong, Taiwan, and now Wuhan have slowed the spread.  This is the effect of suppression strategies.  There's some important news here, which is that Covid-19 infections rates can be reduced, and its case-mortality rate can be kept low (not the 3.4 percent reported by the World Health Organization, but about 1 percent in South Korea, or 0.54 percent for cases under age 60).  Germany currently has a 0.3 percent case-mortality rate. SARS-CoV-2 kills people by doing horrible damage to their lungs (see the images around 0'30" in this Santa Barbara Cottage Health grand rounds lecture).  And yet the virus does so little to so many other victims that 86 percent of cases in China were undocumented prior to travel restrictions. 

On to the model: the Ferguson et al. paper draws on previous work with influenza pandemics to compare three responses-- doing nothing, mitigation, and suppression.  Doing nothing seems to have been the preferred option of the Boris Johnson and Donald Trump governments until about March 15th-16th  (Johnson, Trump), with the Johnson government allegedly working on a trust that infection would create "herd immunity" without disrupting the economy.  At least in the UK, they seem to have taken on board the Ferguson et al. calculations that "doing nothing" will lead to infection in 81 percent of the population (at  2.4 Ro), producing 510,000 deaths in the UK, plus 2.2 million deaths in the United States, both over a 2 year period.

With doing nothing now ruled out, the alternatives that Ferguson et al. modeled are mitigation or suppression. Suppression is China after January 23rd and South Korea, among others; Britain is moving to suppression with one escalating announcement after another (which may defeat the purpose).  Some parts of the U.S. are now doing suppression, including New York and California. The Ferguson paper divides these two strategies into two groups of non-pharmaceutical interventions (NPIs).

 The most effective set of mitigation measures are:
  • Case isolation in the home (CI): symptomatic cases stay at home for 7 days.
  • Voluntary home quarantine (HQ): all members of a household with a case stay home for 14 days
  • Social distancing of those over age 70 (SDO).
Note that this falls short of "lockdown," which includes social distancing for the whole population (SD) and, in most cases, closures of schools and universities.

Mitigation is the famous "flattening the curve." The serious cases that need hospital services are pushed out over time, with the goal of relieving some of the stress on the health care system. Mitigation is "predicted to reduce peak critical care demand by two-thirds and halve the number of deaths" (8).  Assuming the ratio of infections to critical care cases is constant, and that the syntax means mitigation yields 2/3rds of the "do nothing" infection rate, this leads to 54 percent of the population being infected, and to 1.1 million deaths in the U.S.  (When Kristof quotes Ferguson saying his best case is 1.1 million deaths, I think he ran Ferguson et al.'s two regimes together: in my view, the sentence should read, "his best case for mitigation" is 1.1 million deaths.

Clearly mitigation isn't good enough.  A million deaths in the U.S. is unacceptable, and the model suggests that under mitigation health care systems will still be overwhelmed (10). Since something like Italy's hospital crisis and high fatalities are the combination everyone wants to avoid, the UK, the EU, California, and now several other U.S. states have moved into suppression.

A side note: I would normally read the quotation to mean that mitigation reduces peak care demand (and infections) by 2/3rds, down to 1/3rd of their previous level, which is a 27 percent infection rate.  I don't know if that's what Ferguson et al. meant, but it's still more than double this year's seasonal flu rate (so far this season, flu has killed 22,000 Americans). 

Much of the U.S. is now following Italy, France, Spain, and other countries into suppression. The key benefit is that it reduces the reproduction number (Ro) to close to 1 or below, which China has shown is feasible.  Here's a nice stretch goal for the West.



 In the Ferguson et al. model, suppression adds to mitigation's measures:
  • school and university closures (PC)
  • social distancing expanded to the whole population (SD)
I've reproduced the table that shows the results. I'd recommend starting in column 1 with the baseline Ro of 2.4 (510,000 "do nothing" deaths) and look at the medium case of 200 (which means that the full suppression program is suspended when ICU cases fall below 200 in Great Britain, and are re-engaged when they rise above that number). (The paper does not have a similar table for the U.S.) 
California is now doing the full suppression program.  If you look at the right-hand column under Total Deaths you can see the results.  Deaths in Great Britain drop from 510,000 to 24,000, or by a factor of around 20.  The U.S. equivalent would be 110,000 deaths, not Kristof's 1.1 million.

Note two other features of this model.  The interventions all have finite periods: mitigation is modeled over 3 months (to mid-June 2020) and suppression over 5 months (to mid-August 2020).  They don't extend to the full 18 month "vaccine" period, nor are they open-ended.

Second, they are adjusted according to thresholds of infection and hospitalization that can be selected and monitored.  Governments have a great deal of agency here.  In other words, this new coronavirus is bad, but it is not an irresistible event like a giant asteroid hitting the earth.

A big catch is that the versions of suppression in South Korea, Taiwain, Hong Kong, Singapore, and China include mass testing.  Neither the US nor the UK have done this, nor do we seen to have the capability to ramp this up.  There's been much excoriating commentary on this point.  I had been hoping that UC Health could make a big difference to California public health. A potentially exciting March 14th headline, "UC has a solution to the national shortage of coronavirus testing," didn't, with our weak public sector, mean UC is gearing up mass testing for the public, but that it has a private test for its own patients.  I've heard ambitious UC plans--in this week's board meetings, one UC regent suggested for the installation of MASH hospitals on empty land that UC owns. But because of testing and equipment shortages, UC medical centers have to focus on protecting themselves (see 0'44"-0'49" or so in this very useful UCSF infectious diseases division' grand rounds). I'll end by adding a few items to the summary list above:
  • The virus is going to be terrible for public health workers, who deserve not only massive sympathy and support but also personal protective equipment, which they may now have more hope of getting.  Mass testing also depends on cranking out PPE.
  • Public health interventions in Asia have had enough success with suppression to give  credibility to the Imperial College model--most interestingly, its suggestion that deaths can be reduced by an order of magnitude. 
  • On the other hand, hospital access remains a potential catastrophe.  Full suppression reduces ICU need to 1/3rd of "doing nothing."  In the bootlegged C.D.C.’s scenarios, "2.4 million to 21 million people in the United States could require hospitalization, potentially crushing the nation’s medical system, which has only about 925,000 staffed hospital beds. Fewer than a tenth of those are for people who are critically ill."
  • Still, suppression seems to make a big difference even if it is leaky: the Ferguson et al modeling assumed incomplete success and still got major reductions (see Table 2 on page 6).
  • The US has a weak health system (or no health "system" at all, as Robert Reich rightly observes). This is a big problem. But the US has some other advantages: a lot of really good, dedicated health personnel, lower population density than Europe's or East Asia's and, ironically, dependency on the self-isolating feature of private cars.  Our version of suppression might be more successful than we now expect.
  • Officials should give expiration dates to the current suppression regimes. They can be extended later, depending on conditions.  As I noted, the Ferguson et al. model assumes a kind of regular adjusting depending on infection numbers. (Hong Kong has reimposed quarantine and testing on arrivals after an uptick in cases.) Indefinite lockdowns are bad for both people and the economy.  Once people are scared indoors, and the infection curve is bent like South Korea's, governments should throw the lockdown into partial reverse, lest they create another Great Depression x 2.4.
I'll move on to political, economic, and university dimensions in other posts.  From the Haley Street Bunker: stay well, and keep your distance! 
Monday March 23rd

Statistical chemist Michael Levitt hammers on one of this post's key points: "The virus can grow exponentially only when it is undetected and no one is acting to control it."  The media, he says, should focus not on total number of cumulative cases but on rates of growth of new cases. 
Speaking of which,  South Korea's number dropped again, so the chart looks a bit better today.

The coming U.S. health crisis will owe much to a social system that can't anticipate non-market public needs.   That's not what this WaPo piece says in so many words, but it has all the raw material--shortages of masks, gowns, tests, ventilators.  What aren't we short of Covid-wise?

This piece, by a Mass General physician, specifies how the market power of large hospitals will mal-distribute emergency equipment: "We are currently taking an every-hospital-system-for-themselves approach, in which some hospitals will surely say “we’ll take them all” while others will lack the capital to make such large purchases in advance and therefore will be reliant on FEMA, which will be forced to ration scarce, lifesaving equipment. These already cash-strapped hospitals serving poorer populations will soon be put in even greater jeopardy.

From Akos Ronas-Tas (Prof of Sociology, UC San Diego): How Newsom got his numbers (over half of Californians being infected) is a mystery, but it is surely not by raising 1000 to the power of 2.45. I am no epidemiologist either, but the Ro produces an estimate only if you specify how many generations of infections you count. So if the base (generation 0) is 1000 and Ro is 2.4 (used by Ferguson), the first generation will be 1000*2.4=2400, the second generation 2400*2.40 = 5760 and so on. The total number infected will be by then 1000+2400+5760=9160, adding up generations 0,1 and 2. In the Ferguson paper they use a 6.5 day generation time. The key here is that Newsom made his prediction for 8 weeks out. So he is counting roughly 8 generations. The number of newly infected in the 8th generation will be 1000*2.4^8=1,100,753. You have to add to this those from the earlier generations. That will give you the total number of those infected (roughly, 1.9 million). Some of them will have recovered by then and happily immune, others would have died. I don’t see how this adds up to 25.5 million, either as the number of all people who have ever been infected, let alone all people needing care at a certain date.  You would get to a cumulative 26 million in 11 generations with 15 million new infections. That is 71.5 days, 10 weeks, still only late May.

You can make the model more complicated. Ferguson assumed a variable R in each generation and it should also vary across generation as the number of people getting immunity increases.

Here is a nice calculator that adds a few other considerations.

The real scary numbers come from the healthcare system. There are only 74,000 hospital beds in California, and 6,300 in SD  county, only 32% of which are available. This is probably similar in the state overall. But what you really need is ICU beds (only 800 available in SD county). There are about 50,000 ICU beds in the entire US and about 100,000 respirators. And you also have to add to this that beds, even ICU beds are useless unless you have trained personnel attending to them. So if we suppose only 2 million people being sick at the same time in CA, and only 10%  (100,000) needing hospital beds and only 4% (40,000) ICU beds, we have a major catastrophe. 


Tuesday, March 24

On the duration of the shutdown, Jeffrey Sachs invokes the example of China. Their ironclad version of suppression, including mass testing, suggests the spread of SARS-CoV-2 can be stopped in 60 days.  Sachs says 60-90 days.

This is not what's happening in Italy, where exasperated mayors berate their citizenry.

Buzzfeed does funniest home videos for the Covid quarantine

As India's government orders a 3-week "total lockdown,"  nearly 60 percent of the U.S. population is not under stay-at-home orders or being mass-tested.  The U.S. is therefore not, overall, doing suppression, but mitigation of SARS-CoV-2.  Note that this predicts some "flattening of the curve" of infection--reducing but not eliminating the overload on health care-- but not reversing the spread of the disease (Ro stays above 1). Some red state politicians are actively resisting social distancing (Texas, Mississippi), as is POTUS himself.

Speaking of testing, California is way behind New York, working "piecemeal."
This piecemeal approach, said Harvard epidemiologist Michael Mina, is a key problem with testing in California and nationwide.
“We have a decentralized healthcare system and we have no way to scale for government means,” Mina said. “Everything is privatized, everything is individualized in our country and it’s become our Achilles’ heel in this case.”
   
Wednesday, March 25  It's Bailout Day!

NYT summaryEssential first take by David Dayen. Trigger warning: wow will this analysis not reassure you that any economic reforms are in the offing.

Yes we have no protection: "A very American story about capitalism consuming our national preparedness and resiliency"  Painful contrast between the American scramble for the most basic equipment and Germany's highly successful health system for radically minimizing fatalities.

Half-assed LAT reporting on the coming fiscal crisis of the state of California.  No real info, and other annoying stuff. How do you find the school lobbyist who will say this will be really bad for the schools, and then add, "under current law, it is likely that schools could withstand a total statewide revenue loss of around $5 billion. But more than that and schools will face significant problems."  So your own lobbyist just told the state that a 7 percent cut is fine. 

Where's higher ed in the stimulus bill? Inside Higher Ed's summary:
Six-Month Loan Deferment in Senate Bill
March 25, Noon. Student loan borrowers would be allowed to defer making payments for six months, without interest, through Sept. 30, according to a summary of the $2 trillion stimulus package Senate leaders agreed to at 1 a.m. Wednesday morning. The full bill is still being written and hasn’t yet been released.
But according to summaries of the bill making the rounds among education advocacy groups and obtained by Inside Higher Ed, the measure will also include changes sought by advocates such as not requiring Pell Grant students to repay money to the federal government if their terms are disrupted by the coronavirus emergency.
However, the bill is expected to disappoint advocates who had embraced Democratic proposals in the House and Senate, in which the federal government would have made the payments on behalf of borrowers, reducing their balances by at least $10,000. The summary did not mention any loan cancellation.
A separate summary contains $30.75 billion in grants to “provide emergency support to local school systems and higher education institutions to continue to provide educational services to their students and support.” That amount appears be about $29 billion less than what higher education institutions could potentially get in the bill proposed by House Democrats, but $21 billion more than what Senate Republicans had initially proposed, one higher education lobbyist said.  Associations representing institutions that were disappointed with the previous proposals were still waiting for the full bill before they commented on the level of funding.
The bill requires the secretary to defer student loan payments, principal, and interest for six months, through Sept. 30, 2020.

Thursday, March 26

Covid revealing America's rear guard place in the world 

Zero Hedge's mashup of hostility to the shutdown, mixing vulnerability of SARS-CoV-2 to treatment (it isn’t a superbug) with statistical problems (extensive) with lockdown’s effect on the economy (bad but unavoidable). Playing rural roulette because lockdowns are Democrat.

Suppression works, says none other than Neil Ferguson!!
He said that expected increases in National Health Service capacity and ongoing restrictions to people’s movements make him “reasonably confident” the health service can cope when the predicted peak of the epidemic arrives in two or three weeks. UK deaths from the disease are now unlikely to exceed 20,000, he said, and could be much lower.
But don't go back outside! Because, on the other hand,
This measure of how many other people a carrier usually infects is now believed to be just over three, he said, up from 2.5. “That adds more evidence to support the more intensive social distancing measures,” he said.
Special bonus for modeling fans: Oxford now has a model too. More on this coming soon.

Hope for a UK Covid-19 home test within two weeks.

And We're Number 1 - in Covid-19 cases.
Posted by Chris Newfield | Comments: 4

Wednesday, March 18, 2020

Wednesday, March 18, 2020
Statement to the UC Board of Regents by Shane K. M. Wood, President, UC Irvine Associated Graduate Students; Department of Theater and Drama

The Pandemic we find ourselves currently enduring has shown just how precarious the lives of our students across the state are. Within days of the rolling campus closures, the student governments from each campus began receiving reports of students who would be losing their housing because of lack of work or inability to move as has been suggested for social distancing. In particular, our graduate population has been specifically impacted, many scrambling to create online classes with little to know training while being expected to also contend with all the other logistics

When speaking about the need for more funding for our graduate students, it is often mentioned that the state is cautious of another economic downturn and therefore will not contribute more money to the system. Frankly, this is an unacceptable stance to take. Our graduate students are a huge economic driver for the UC System and the state as a whole. Not only are we responsible for a large portion of undergraduate education, but also the research our system, state, and society depend on--including the continual study of the Covid-19 virus and the media, literature, and art we’re being urged to utilize during social isolation.

As the graduate students navigate the next few months, foregoing personal research, travel, and coursework as they continually adapt to the changing needs of this pandemic, the Regents must urge the state to begin investing in its graduate students, not only to support the current population doing this essential work, but to allow the UC to get back on track once this crisis is over to continue the enormous growth of the graduate population that is being asked of each campus.

A logical start is to insist that state commitment for graduate students be raised and expanded to cover the additional costs that this 20% increase in graduate numbers will represent to the state. The UC simply cannot commit to this increase without a firm commitment from the state for their increased and continued financial investment in this vital population.
Posted by Chris Newfield | Comments: 0

Sunday, March 15, 2020

Sunday, March 15, 2020

Dear UCR Senate Colleagues:

As everyone prepares for Spring Quarter “remote learning” classes, i want to offer some advice and insight that is informed by what’s been happening at other UC campuses and universities around the country.  As always, feel free to email me at my personalUCR email address if there’s anything you think i should communicate to campus administration and leadership.

  1. “Remote learning” is an emergency measure.  These teaching adjustments are temporary ones.  Treat them as such, even if the suspension of in-person classes is extended beyond April 3 to the full Spring Quarter.  We’ll be back in the classroom after we get through this crisis.  We do not need to magically transform ourselves into YouTube or TikTok stars!  We just need to get through this period as functioning teachers.

  1. Don’t pressure yourself to produce the equivalent of serial TED talks, Academy Award-winning documentaries, or high profile Netflix specials.  Instead, teach to the best of your ability, don’t worry about “production values,” and work with the tools you’re most comfortable using. Communication with our students is the most important thing, and this emergency situation doesn’t change that. Consider low tech and no tech solutions to engage students as well. The “Keep Teaching” UCR website is a one-stop resource that is constantly being updated, so please use it:  https://keepteaching.ucr.edu/

  1. Emergency remote learning is not a backdoor to coerce the faculty into permanent online teaching (or de facto strikebreaking).  Any proposed permanent online curriculum must be fully reviewed by the Academic Senate’s Committee on Courses, as well as the faculty Executive Committees at each College/School, at a minimum.

  1. Please offer concise, constructive feedback to the hard-working staff who are supporting us with daily updates of the UCR “Keep Teaching” website!  This team works out of the Center for Teaching and Learning (also known as XCITE, Exploration Center for Innovative Teaching and Engagement), and has pledged to me that they will be as responsive as possible to faculty input.  I recently learned that a total of six staff members (including the Directors) are tasked with running remote learning for the entire campus.  Campus infrastructure in this area is extremely limited.  Feel free to reach out directly to [local emails omitted].

Stay safe and healthy, everyone.

dylan

Dylan RodrĂ­guez
President-Elect, American Studies Association (2020-2021)
Chair of the Academic Senate, UC Riverside Divisio (2016-2020)
Professor, Department of Media and Cultural Studies
University of California, Riverside
Posted by Chris Newfield | Comments: 0

Friday, March 6, 2020

Friday, March 6, 2020
The labor action that began with the grade strike in Santa Cruz and has now spread throughout the university has cast a painful light on UC and on the working and learning conditions of its graduate students.  Both the national and the international press have taken notice:  the strike and the administration's response to it has been covered in the NYT, the UK Guardian, the Washington Post, Salon, and even Teen VogueBernie Sanders and the AAUP have both issued statements condemning the administration's response.  You have seen the various statements on the blog.  They all point to the crises facing graduate students and the inadequacy of the University's response to them.

But it is equally clear that too much of the discussion has gotten trapped within a constrained range of considerations:  that these are wildcat strikes against the current contract and illegal under the current system of labor law; the treatment of undergraduates as passive bystanders whose interests--depending on which side you talk with--are being threatened either by the strike or by the response to the strike; the accusations of bad faith which have led to the dueling unfair labor practice complaints filed this past week by both the UC and the UAW.   These pressing but constraining debates are themselves, like the strike itself, a symptom of a larger crisis that needs to be addressed and addressed openly--that the strike is itself the outcome of a nearly two-decade-long failure of the university leadership (starting with the Regents and OP) and the State to adequately fund graduate education and research.  The strike is a moment for reconsideration:  is the state of California remain committed to a high quality system of research universities and does the University leadership fully grasp what that would entail? This is a question that is even more pressing as the Regents move towards selecting a new president.

The best way to start this discussion is with Chris's favorite graph:


Put simply: the chart takes UC 2001 funding as a proportion of the state's per capita income and uses it as a benchmark.  The blue line indicates where UC state funding would be if the state had kept funding in line with the growth of per capita income.  The red line indicates the actual state funding UC has received (and proposed for 2020-21).  It's hard to miss the extremely large gap between the lines.

Now I understand that someone can object that there is no logical reason why UC (or higher ed funding in general) should perfectly track per capital income.  As both the Coronavirus and the homeless crisis remind us, new challenges do emerge that divert funding.  But the striking thing about the graph is both the size of the gap and its growth over time.  Moreover, by taking 2001 as a baseline (and not, say, 1970) the graph demonstrates not only that there is no economic necessity for the decline in per capita funding but it also highlights the gaps ideological nature by connecting it to the administrations of Arnold Schwarzenegger (whose ultimately broken compact with higher education included the demand that students assume more financial burden for their public education) and Jerry Brown (who refused to recognize the numerous ways that UC supports the state beyond its function as a grantor of undergraduate degrees).  The mess we face today is an ideologically-driven under-funding that has been accepted (when not encouraged) by the University's leadership.  And this says nothing about the effects of twenty years of student enrollment growth since this graph is presented in nominal dollars.

At the heart of this funding gap has been the inability of the University to show the governor and legislature the full significance of university research and of graduate education.  This is, to be sure, a difficult task.  Most of the legislators have not been graduate or professional students at UC and the greatest source of political pressure they receive is from the parents of undergraduates (or, more painfully, the parents of students who were not admitted as undergraduates).  But as the university's handling of the current labor crisis reminds us, neither UCOP nor the Regents have, for 20 years at least, been able to explain to the state exactly why they should support doctoral education.

The latest example of that inability has been the effort to set undergraduate students off against graduate students.  Instead of seizing this crisis to make the fundamental point that graduate and undergraduate education are inextricably linked, and that the conditions of life and work for graduate students are already affecting the education of undergraduates, they have sought to suggest that it is only in the withholding of grades that students suffer from the condition of graduate education.  But as everyone at the university well knows, graduate students play a central role in the support and education of undergraduates even when they are themselves being forced to work multiple jobs, live in overpriced or substandard housing, and find themselves food insecure.  If the state and public truly care for the education of undergraduates they would demand that graduate students learn and work in secure conditions.

Indeed, the size of the COLA demands is itself a sign of how deeply precarious graduate education really is.  I've seen overall cost estimates ranging from $300m to $600m, depending on how many graduate students would receive a COLA. (For a very helpful demonstration of the dimensions of the problem go HERE.) That would mean an increase of between 7.5% and 15% of the state's general fund support for the university.  The University requested an increase of approximately 7% this year (without including increases in graduate student salaries of course) (20). The Governor countered with a proposed  5% increase in continuing funds that in reality translates into a little over 1% of an increase in core funds.  Put another way, if the state and the university continue in their present trajectory the under-funding of graduate education will only get worse.

But even that picture may be too optimistic.  UC has announced its 2030 goals of increasing the number of degrees by 200,000.  The only way to meet these goals without a further decline in quality is by increasing the number of faculty and graduate students.  Otherwise, class sizes will increase, faculty and graduate student teachers will become increasingly overburdened, responses to undergraduate writing will all but disappear, all problem sets will be machine-graded, and the deep education that the university exists to provide will be made more and more shallow.  Unless there is substantially increased funding for graduate education the 2030 plan will exist only as a hollow shell of its promises.

So far, I have only been discussing teaching pressures.  But if the university has done a poor job of explaining to the state the interconnection of graduate and undergraduate education, they have done even worse in explaining graduate research.  Put simply, UC has been a world-renowned resource for research and insight across all disciplines not only because of its faculty and professional researchers but also because of its graduate students.  There is no research university without graduate education.

Moreover, there is no research university without the support of non-commercial research.  UC, like so many of its competitors in isomorphic imitation, has placed increasing emphasis on the possibilities of commercializing its research and lauding its production of startups.  But these are private gains;  UC is supposed to be a public trust and its greatest contribution to that public trust is through the knowledge that it produces and transmits not only to its students but to society.  One only needs to look at the crisis facing society today: climate change, growing economic inequality, the looming COVID-19 pandemic, the reemergence of exclusionary ethno-nationalisms based in myth, growing surveillance under the sign of techno-determinism, and a world of internet dystopias to recognize that the greatest public trust that UC stewards is the continuing production of knowledge.  And that it is needed more than ever.

To return to my starting point, the continued flow of knowledge and insight--in classrooms, labs, libraries, and creative arts venues--in teaching and research can only be maintained not by some sort of enforced labor peace but by a deep reinvestment in graduate education and research.

This is not something that UC can do on its own.  In the immediate short-term campuses can try to reduce as many of the housing burdens of their graduate students as they can; in the medium term, campuses should increase the amount of affordable graduate housing.

But the greatest task is facing the University as a whole, especially UCOP and the Regents.  The graduate student strike has made dramatically visible what any aware member of the university has long known: the university has been severely underfunded for two decades, the tactics and strategies that the university has adopted will not preserve the research university; and that students, both graduate and undergraduate have suffered. The University has for too long pretended that it can manage financially with increasing tuition, philanthropy, tech transfer, and internal privatization.  The inadequacy of those approaches are crystal clear now.  And it is up to the University leadership to recognize that and make it clear.

Regents Policy 1100 indicates it is an obligation of the Regents to:


Ensure adequate resources and their effective management. This includes serving as advocates for institutional needs with external constituencies.

It is time they begin to do that job.


Posted by Michael Meranze | Comments: 0

Thursday, March 5, 2020

Thursday, March 5, 2020
The Executive Council approved the following statement in March 2020.
The Executive Council of the Modern Language Association condemns the termination of employment for graduate student strikers at the University of California, Santa Cruz, calls for their reinstatement, and urges the university to commence negotiations with the students as soon as possible. We consider that their demands for an appropriate augmentation of salary in line with the increased costs of living are legitimate and note that they now have the full support of the UAW, with whom the university is contracted. Graduate students are indispensable workers who cannot be expected to execute their teaching duties and to pursue their own research when housing and food costs are not affordable with their current wages. The Modern Language Association maintains that graduate students should be compensated at a level that makes it possible for them to flourish on campus as research assistants, teachers, and emerging scholars. A fair wage correlated with cost of living increases is a necessary precondition for their own work, essential to fulfilling the educational mandate of their departments, and essential for the dignity of all workers at the university. To punish students for exercising their rights to demand a decent wage is, in our view, unjust and unacceptable, and all penalties should be reversed immediately.
Posted by Michael Meranze | Comments: 1

Wednesday, March 4, 2020

Wednesday, March 4, 2020

Feb. 28, 2020
Statement of Solidarity with Striking UC Graduate Workers

To: Carol Christ, Chancellor, UC Berkeley
      Lisa GarcĂ­a Bedolla, Dean of the Graduate        Division, UC Berkeley


We, the graduate students of the Department of English at the University of California, Berkeley, with the support of the undersigned faculty, lecturers, and postdoctoral fellows, stand in solidarity with the graduate student workers at the University of California, Santa Cruz (UCSC), the University of California, Santa Barbara (UCSB), and the University of California, Davis (UCD) as they strike for a Cost of Living Adjustment (COLA).

In response to the severe housing crisis in Santa Cruz, graduate students at UCSC have organized around ​an urgent demand: that the University of California (UC) provide a COLA that would bring every graduate student out of rent burden. Rent burden is defined by housing scholars as paying more than 30% of monthly income on housing costs; many Santa Cruz graduate students find themselves either rent-burdened or severely rent-burdened (paying as much as 50-70% of their monthly wages on rent). This demand was delivered to the UC Administration on November 7, 2019. On December 8, hundreds of graduate students at UCSC voted to begin a grading strike following UC Administration’s failure to act. The strike swiftly garnered the support of faculty, undergraduates, and university workers at Santa Cruz and elsewhere. In late January 2020, Santa Cruz Chancellor Larive wrote a letter addressed to the UCSC community that simultaneously offered a meager “need-based housing supplement” and threatened to begin disciplining striking students. 

On January 30, hundreds of UCSC graduate students voted to initiate an open-ended teaching strike on February 10. On February 14,  UC president Janet Napolitano, via EVC Lori Kletzer, demanded that striking graduate students release grades and stop striking by the end of the day on Friday, February 21, or face disciplinary action and dismissal from current and/or Spring TA appointments. This threat spurred a rally that shut down the UCSC campus, as well as protests and rallies at institutions throughout California. On February 27, hundreds of graduate student workers at both UC Davis and UC Santa Barbara initiated teaching strikes, which are still ongoing. On February 28, at least 82 striking graduate student workers were dismissed from or denied their Spring appointments at UC Santa Cruz. We stand in solidarity with them, and with striking graduate students across the UC system.

As students and employees of the UC, we are familiar with the dire financial straits faced by our colleagues in Santa Cruz. Living in one of the most expensive housing markets in the U.S., we know, just as intimately as they do, how near impossible it is to stretch our salaries to meet our basic expenses. Most of us face rent burden or severe rent burden; many of us have been forced to take out loans or work second and third jobs to make ends meet. And we do this knowing that tenure-track positions in our fields are diminished and that we will likely continue to face precarious employment once we graduate.

As Berkeley’s own published estimates indicate, the UC knows that our salaries are inadequate to cover the cost of living in the Bay Area. At ​current salary rates, the UC’s own ​estimatesfor graduate student housing costs in Berkeley leave Step I-III instructors with a standard (50%) appointment faced with an approximate rent burden of between 53 and 59%. We feel passionately about our work as teachers and researchers, but navigating this disparity between our wages and the cost of living has had profound effects on the time we have to write, instruct and mentor our undergraduate students, and contribute to the intellectual community of our department. For these reasons, we believe a COLA is also much needed at Berkeley. 

We commend the graduate student workers at Santa Cruz for their bravery and are grateful to them for all they have done to raise the issue. In solidarity with them and with student workers now on strike at UC Santa Barbara and UC Davis, we join our colleagues in the Faculty Association and in the Departments of Comparative Literature, Rhetoric, African American Studies, Sociology, and Geography here at UC Berkeley, in organizations and departments across the University of California, and our statewide student workers' union, UAW 2865, to demand that the UC Administration reinstate the graduate students dismissed at UC Santa Cruz, that it refrain from taking further disciplinary action against any striking student workers, that it discontinue police presence at UCSC’s picket and at any other COLA-related action, and that it finally agree to pay us all a living wage. To this last end, we call on the University to meet our demand to bargain over a statewide end to rent burden for student workers. And we urge others to join us and declare their support as well.

Signatures available on request.



Posted by Michael Meranze | Comments: 1