- The Wuhan Virus (COVID-19) and the New York State Quarantine : March 28th, 2020
There has been a lot of politics that continues to move New York and Brooklyn culture over the last few years. Most of it has been bad. We have a Mayor who essentially no concern for the families and middle class Brooklynites that live and work here. His obsession with his one version of social justice has been a clear signal to those of use who have been life long stewards of the variety of communities in the Borough have been told flatly that we are no longer welcome here. The Borough is increasingly monolithic, with community after community under pressure from wealthy hipsters turning our City into a larger and large beer crawl. What was cute and interesting in Williamsburg has become saturated in Bushwick, Cobblehill, Prospect Heights, Crown Heights, Bedford Stuyvesant, Bay Ridge, Bensonhurst, Sunset Park.
There are still ethnic holdouts, but not only are there much fewer of them, but they are also more monolithic and larger. Largely we have an established Russian community that has spread through south Brooklyn, a large Muslim community, anchored by Pakistani's and Bangadeshi's about the center of the Borough below prospect part, spreading south threw to Kings Highway, and a large Chinese community centered about Bensonhurst through parts of South Brooklyn. You still have an enclave of Orthodox Jews in Boro Park Brooklyn. But elsewhere, all the ethnic communities are shrinking and leaving. Particularly, the White Catholic communities Italians and Irish are remnants. Norwegians, West Indians, American African Americans, Italians, Jews, Germans, Jamaicans, Haitians, are being pushed out by a city policy that flatly opposed to the grown and building of families. The attack on the automobile cripples multi generational living for families with children and grandparents, together. The largely conservative political base within the Borough has been stamped out. The coalition of communities that enabled the Guilliani revolution is not here any more. And we can see the results. Homelessness is everywhere now as a direct result of city administrative decisions to dump homeless and emotionally unstable individuals on to the streets from mental institutions and from Rikers Island's psych ward were many were being treated.
Traffic is brought to a stop because a bicyclist is stupid enough to try to sneak between a large truck and parked cars, and getting themselves killed. This justifies reworking large backbones of traffic and business avenues until there are just not usable. Coney Island Avenue, Ocean Avenue, Kings Highway, Jay Street, Utica, Avenue, Ocean Avenue, Atlantic Avenue, Livingston Street, Court, Schermahorn, Bedford Avenue, 86th street, 13th Avenue, 65th Street, Ralph Avenue, etc etc are being unusable and shunting traffic to otherwise tranquil side streets. The SBS Buses, totally a waste of public money, made Bus lanes through our central business districts and have destroyed our shopping districts. The attack on the middle class of Brooklyn just goes on and on.
Now we come to face a pan-epidemic in the Wuhan Virus ( Covid-19) and the city and state are faced with important decisions. These decisions are being made by politicians who care nothing for the economy or the personal freedom of the citizens of New York. And the response to the virus has been neither constructive, that is it can not reach its stated goals, nor is it healthy for the people of New York City, especially families living in the Brooklyn. It is a historically unprecedented response to disease epidemics. There is no justification for the response, and in doing what they are, they are destroying the economic foundation of the city, if not the region, if not the entire country. It starts with a hypothesis as stated by our Governor that is false. The hypothesis is that if we can save a single life by a radical action, then we are justified and have a moral obligation to do so. This is fundamentally wrong, and an impossible means of treating patients or preventing epidemics. Medicine is ALWAYS a balance between acts that measure and impact morbidity and mortality. We, in the healthcare field, do this every day, and it is very personal. We restrict anti-biotic use from patients to preserve susceptibility for the population as a whole. We sit in rounds and debate if an activity has a chance to work or if it is just using nursing resources without likely outcomes. We deal with women that are pregnant who are sick, HIV patients with resistant Tuberculosis, drug shortage of heparin, the cost of drugs to be used in a variety of cases. These all have not only dollar amounts attached to them, but equally important is they all consume resources that are not infinite. So the Governor is just wrong, and the Mayor is not even responding rationally and it is not worthy to even consider his rants at this point
Before we even discuss and statistical analysis of the epidemic and the virus itself, lets just look at some of the actions that the government has in place, and the likelihood that is might be effective. I am going to pass by the entire and laughable argument about shelter in place, and the percent of allowable non-essential workers, which went from 100% to zero in 3 days, and let us just focus on what actions are taken and how they can or can not lead to the containment of disease.
On the surface of it, the Governor and the Mayor has locked down all of society. They are begging for the population at large, the entire population, the elderly, adults, children and infants, to remain locked in there houses, with no end to this in site. People have largely cooperated with this under the assumption of it being a temporary condition which will last a week or two. But that is a lie perpetrated by the government and the department of Health, and CDC. There is no statistical model or prediction about this virus and its spread which includes that we can remain indoors for 2 weeks, and come out and it will be over, no more threat. So in order to be effective, even at "flattening the curve", this complete societal shutdown would need to take place for at least 4 months... and that is ridiculously optimistic. Realistically we are looking at an epidemic that will come in multiple waves and last more than a year before herd immunity develops. Herd immunity is just a fancy way of saying that the virus will have killed off as many people as it is destined to, leaving the rest behind with immunity, unless we can intervene with a vaccination, or fight it off and reduce mortality through anti-viral therapy. That means that we will be locked into our houses for a year. And that is BULLSHIT. You can't lock down 8.5 million New Yorkers and a region of 24 million people for a year! This, conceptually, can not work. It can not flatten the curve. People will not comply. For 2 weeks they can be convinced to comply and law enforcement can support take care of those that won't, but they can not do this indefinitely.
Now, lets not assume Andrew Cuomo and Warren Wilheim are idiots. They know this can't work, and they know that not even the national guard can sweep up hipsters in mass out of Madison Park and put them all in lock ups. So they spring this on the public gradually, creating more and more hysteria about the virus and the situation and we move forward. But most importantly, they have there constituencies and priorities that have to take care of. And with these intact, we have NO CHANCE to contain this.
The first priority is that no one is to starve. So grocery stores and supermarkets need to remain open and well stocked. That wasn't immediately apparent to our government, but after the run on toilet paper, condoms, thermometers, rubbing alcohol, masks and hand sanitizers, it finally occurred to our government bodies that the hysteria the Mayor was creating was causing hording, price gauging, and real panic. So truckers and supermarkets are "essential" businesses, along with (and here come the constituencies) illegal workers in the restaurants trade, grubhub, electric bicycles, and bicycle shops. Good, problem solved! Accept it is not.
So instead of going to supermarkets we are asked to call for delivery, and so we have non-monitored and untrained trained, delivery people trying to scrape out a buck in this catastrophe that the Government created, bringing deliveries, door to door. You see, it is nearly impossible to put 8 million city-dwellers in isolated bubbles. Instead of directly contacting each other, they contact through this wholly unregulated and unsupervised delivery system. They will delivery your Chinese food (a racist comment about food if ever there was one), your pizza, sushi, your groceries and coffee. And if that is not enough, there is no stopping us from our "Virtual Life". And we shop at Amazon for socks, and shampoo, and condoms, and fishing gear, and computers, and cellphones, and summer dresses. And all that stuff is also delivered because it is delivered since it is all essential businesses, by people who are touching your stuff, and packaging it, and shipping into the city, and put it on the truck, and drive the truck and drop it at your door, these are all invisible people, and according to our government, these people are also superheros who can never get this virus, or transmit, right to your door, with your sushi and pizza.
This is a huge failure of basic logic and the results are predictable. There is no flattening of the curve because this model can not work. The President is now talking of placing the entire region on enforcible quarantine. Wholly cow. We are totally screwed.
Now, lets return to the essential part of public health and the practice of medicine. No too long ago New York had a large healthcare network largely created by non-profit agencies based on ethnic and religious organizations, to provide broad care across the City of New York. Many of them were funded by state programs designed to promote healthcare for needy and no so needy New Yorkers with the help of state funding. The grand daddy of them all was Long Island College Hospital that was closed in recent memory for a real estate swindle involving both the Mayor and the Governor. They included such stalwart institutions of Brooklyn Jewish in Bedford Stuyvesant, Bushwick Hosptial, Caledonian, Baptist Medical Center, Hamilton and Harbor Hospitals, Lutheran Hospital, St Johns Episcopal, St Mary's, Sister Elizabeth. There are almost 70 hospitals named in Wikipedia from Brooklyn that have closed on consolidated representing dozens of needs and thousands of beds, many built and facilitated when battling epidemics and fatalities was common, and beds were needed.
By the mid-1970s the discussion about hospital in New York took an ugly turn. Increasingly the 1199 Nursing union came to present minority workers and the founding communities for many of these institutions moved to the suburbs. Our medicaid system became increasingly expansive and the entire conversation about healthcare, with no help from Denis Rivera, or Andrew and Mario Cuomo, took and increasingly racist tone. Nursing had become an economic refuge for West Indian women, and other minorities, allowing them to earn a living and raise children, despite the high numbers of single parents within those communities. Couched in the battles over healthcare was conflicts over ethnic strife. Like many discussions over city policy, rational decision making was overwhelmed by intransigent positions fueled by mutual ethic hatred. Some how it got lost that we were all living in the same geological location and with epidemics largely conquered, the government lost focus of what was important. Hospitals and medicaid became stand ins for disgust with drug abuse and high crime. Governmet began to decide to close down facilities across the city. And it has turned into a disaster.
Despite that we have known that this epidemic has been coming for over twenty years, and we have known that it was going to come from China, we have failed to account for what it would cost us as a society to face such an epidemic, even a mild epidemic like the Wuhan Virus (covid-19). And now we don't have enough beds, or ventilators, to locations to care for even a virus with a 3% death rate, which is only a moderately deadly disease in the overall history of epidemics. This is not like Typhoid, small pox, or Cholera or the days of yer, or even the Spanish Flu. And yet, in those days, society faced these diseases without completely self-destructing, and that is largely because it understood how to quarantine effectively, and we had a surplus of beds available, and even institutions to separate out individuals from general society, so that the garbage could continue to be picked up. Closing down society broadly was never a consideration. Major League Baseball never lost a single game to an epidemic, not in 160 years of the sport.
The problem here isn't that this disease is particularly deadly. The problem here is that our government is particularly fucked up that is no longer can deal with inevitable public health events. They are affraid of ending up with stockpiles of dead bodies on youtube because we don't have enough ventilators and our government is too stupid to make an effective vaccine in less than a year and a half. Think about this. We have an epidemic that is shutting down the world economy to the cost of 100s of trillions of dollars, and suffering of billions of people, and the best vaccine candidate can't be released because they are waiting for 45 volunteers, for over six week for just a single stage. You can't make stuff like this up. We are being lead blindly by experts so singularly focused on there They need 45 volunteers and SIX WEEKS while we are all made political prisoners in our homes. Here is a rundown of vaccine candiates listed in the Jerusalem Post 
This is not the behavior of a Government that feels pressed by an emergency. For all the press and yelling, and media drama, and propaganda, this is not how the government would react if it truly felt threatened. Evidently, it hasn't yet reached that point yet. But when they get done destroying the economy, they might well be ready is a strange application of the Peter Principle.
- The first dose of the mRNA-1273 coronavirus vaccine, developed by the US National Institutes of Health (NIH) and Moderna’s infectious disease research team, was given to the first participant in their Phase 1 study on March 16. The trial of the vaccine, built on previous studies of SARS and MERS, is intended to provide data on the safety and immunogenicity of the vaccine, and is expected to enroll 45 healthy adult volunteers over six weeks. The Cambridge, Massachusetts-based drug discovery company emphasized that it is "still early in the story," with no approved drugs to date emerging from its vaccine program and no previous human trials. The current trials are being carried out at the Kaiser Permanente Washington Health Research Institute in Seattle. Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, described the study as "an important first step toward" finding a safe and effective vaccine.
- CanSino Biologics
- Authorities in China granted approval last week for Phase 1 clinical trials of a coronavirus vaccine developed by researchers at Tianjin-based CanSino Biologics and the Academy of Military Medical Sciences. Tests of Ad5-nCoV in animals, researchers said, showed that the vaccine candidate can induce strong immune response and demonstrated a good safety profile. Prescreening for the first human study has already begun, and is expected to enroll 108 healthy participants at Wuhan's Tongji Hospital. “Having committed to provide unconditional support to fight against the global epidemic, CanSinoBIO is determined to launch our vaccine product candidate as soon as possible with no compromise on quality and safety," said CanSino chairman and CEO Xuefeng Yu.
- Located in Kiryat Shmona, the MIGAL - Galilee Research Institute is working to adapt a vaccine initially developed to prevent the Infectious Bronchitis Virus (IBV) in poultry. Funded by the government, the institute hailed a “scientific breakthrough that will lead to the rapid creation of a vaccine against coronavirus" in late February, based on the genetic similarity between the avian coronavirus and the novel coronavirus. Human testing of the oral vaccine, the institute said, is expected to begin within eight to 10 weeks, and safety approval is expected within 90 days. "We are currently in intensive discussions with potential partners that can help accelerate the in-human trials phase and expedite the completion of final product development and regulatory activities," said MIGAL CEO David Zigdon.
- INOVIO Pharmaceuticals
- Pennsylvania-based INOVIO announced the receipt of a new $5 million grant from the Bill & Melinda Gates Foundation on March 12 to accelerate the testing of its novel DNA vaccine for COVID-19, known as INO-4800. Currently in preclinical studies, INOVIO plans to advance into US Phase 1 clinical trials next month, backed by up to $9m. in funding from the Coalition for Epidemic Preparedness Innovations. The company says it aims to deliver one million doses of INO-4900 and handheld intradermal delivery devices to administer them by the end of 2020. "Our team of vaccine experts are working around the clock to advance INO-4800 and we look forward to attracting additional partnerships to expedite its development to meet this urgent global health need," said INOVIO president and CEO Dr. J. Joseph Kim.
- Reportedly the target of an acquisition attempt by US President Donald Trump, German biopharmaceutical company CureVac announced that it is leveraging its mRNA-based drug platform to produce a vaccine against the novel coronavirus. The European Commission has offered up to €80 million of financial support to CureVac, which plans to launch clinical tests in June 2020. If proven, the commission said, millions of vaccine doses could be produced at low costs in the company's existing production facilities. "The combination of mRNA science, disease understanding, formulation and production expertise make CureVac a unique player to fight against any infectious disease, no matter whether they are seasonal or pandemic," said CureVac CTO Mariola Fotin-Mleczek.
- German immunotherapy company BioNTech and American pharma giant Pfizer signed a letter of intent last week to codevelop and distribute an mRNA-based vaccine against the novel coronavirus. The partnership, originally formed in 2018 to develop flu vaccines, will accelerate BioNTech's COVID-19 vaccine program BNT162, which is expected to enter the clinic by the end of April. Just one day earlier, the Mainz-based company announced a strategic development and commercialization collaboration with Fosun Pharma to advance its mRNA vaccine in China. Fosun Pharma will pay BioNTech up to $135m. in upfront and potential future investment and milestone payments. "We feel a duty to exploit our full technology and immunotherapy expertise to help address the COVID-19 pandemic emergency," said BioNTech founder and CEO Prof. Ugur Sahin, adding that the company is also working on a novel therapeutics approach for patients who have already been infected. Details, he said, will be disclosed "in the coming weeks."
So why is there not more panic? Well, the truth is, aside from overwhelming the hospitals, the mortality rate of the Wuhan virus, while very serious, is just not the kind of disease to destroy a civilization. Only we seem to be able to do do that. On March 4th, 2020, Slate Magazine, a more serious and reliable internet publication on many issues, publish an article with the title "COVID-19’s Mortality Rate Isn’t As High As We Think". It is a fairly sensible article with a subtitle of "Don’t hoard masks and food. Figure out how to help seniors and the immunosuppressed stay healthy." This would actually be solid public policy. It looks at the example of the cruise line the Diamond Princess, where the entire boat was exposed to the virus and isolated. In this case, six deaths have occurred among the passengers, constituting a case fatality rate of 0.85 percent. Other mortality rates data disagree, but here are the hard facts. The vast majority of people that get this disease will suffer from cold like symptoms, and never skip a beat of there regular life, except they are locked up in there homes getting piazza delivery. But it is the luck of the draw. Some people will die from this. Lots of people, actually, will die from this, and they will piled up at the local hospital. But the terror that we have generated about this disease is flatly a creation of the internet age and twitter feeds and a government which thinks it can control everything, and is attempting to. Our problem here, aside from not moving faster on vaccination testing and usage, is the unreasonable expectations we have created that we can control everything, we can fix everything, and nobody will ever die of a disease. But we die of disease all the time, and nothing in our science or our culture is going to change about this in our lifetimes. But this is NOT a biblical level plague and we must calm ourselves before we truly jeopardize our civilization.
We need to be released from our prison. This is not because we defeated this virus, but despite that. This policy of locking everyone up is not maintainable. People can't do this. It is cruel. And they won't. We can't even get people with cancer to stop smoking, They sneak out the back of the hospital and smoke. We could not stop people from drinking during prohibition. We can't get them to stop shooting heroin into there arms. And we sure as hell can't lock up the entire population for much longer, even with piazza delivery. And the economy is collapsing. It is not on temporary hold. The economy is a living thing and as we bankrupt every non-essential business, the foundations for the essential businesses are also being undermined. If air traffic, as an example, continues to die, airplanes that require huge maintenance and a steady flow of spare parts, will be inoperable and the parts manufacturers go bankrupt. Employees get layed off. Before you know it, you can't get cheese into New York City for the essential Piazza, and people will starve. Communist economies don't work. Despite Mayor Warren Wilhelm Jr demanding that Trump snap his fingers and make Ventilators just appear, it just can't be done. If can be done even LESS because we are dependent on China for parts and materials. We are totally screwed. But most of us, hopefully me as well, will live. The only question is what kind of life will we have going forward. I don't want the one that they have planned for me, living alone in my apartment living on sparse government controlled rations, fearful of disease after disease, wasting my life on facebook, rather than the ballpark, learning Torah with my friends, and fishing.