Tuesday, Mar. 3 - If You Fail to Plan, You Plan to Fail

Day 39. COVID-19 is now in 70 countries, and more than 92,000 people are infected. It's been raining heavily for days, and the air feels fresh. I pick up two packages: five pounds of bean sprout seeds and some organic apple cider vinegar. I had asked Xiaolin to order the ACV, and she gave me a 5-minute spiel about how my weird food is weird, but then she ordered it anyway.

Although I can't be sure from inside my little home, it seems like things in China are getting under control. On Monday, the World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said, "In the last 24 hours there were almost nine times more cases reported outside China than inside China." This shift shows quarantines work to reduce the rate of infection (ROI or R0).

I want to go to the mall soon, walk around, watch a movie, then have a coffee on the scenic cliffs of Hongyadong and watch the sunset over the river. I will do this again soon. Chongqing is waiting to be rediscovered.

We make delicious pancakes. I watch the news with a strong pot of coffee. At 2 PM, I do a tutoring class. Eight-year-old Kim is so funny, "Hi fishy, nice to eat you!" I laugh a lot, it's a good class.

Afterward, I consider shopping online. Do I want to get more immunity boosters or a P100 respirator or super anti-fog goggles? The "Hail Mary" vitamins Andrea wants to help me get are coming from the USA and may or may not arrive at all.

Xiaolin and I relax, and we video chat with the family, including our grandson, baby Ethan. Ethan loves to say my name, "Kai Kai," and smile and clap when we sing.

In other countries, the experts are disagreeing. The most concerning argument comes from the central health Czars saying one thing, and their experts painting a different story. The French government says COVID is not passed asymptomatically. In contrast, our brightest minds say that COVID-19 exists on a continuum between respiratory droplets and full-on aerosol/airborne.

This means you should be making changes in your area before the clusters become an outbreak. Practice social distancing, avoid crowds, especially poorly ventilated areas. Stop shaking hands, elbow bumps are in. Cough and sneeze in your sleeve, avoid people who don't respect or don't have good hygiene. Avoid touching buttons and shared screens: use gloves, or a tissue, and hand sanitizer, and regular hand washing. I suggest a scratching fork for itchy noses and keep your hands off your face in public.

With more than 850 new cases in South Korea today, they are changing tactics from containment to triage. The most severe cases that need oxygen and life support will be treated first. As the number of cases blooms in other countries, you will have to make similar changes.

Say comorbidities 5 times really fast...mor-dibities-dibities-dibites.. ugh. I get tongue-tied easily these days, but my studies in Pathology, thanks to MIT and Pathoma are coming along.

I have this crazy dream of commentating the horse race of global infection spread, with my burlesque host circus old-timey announcer voice - cabin fever?

If you listen to your health department briefing, they will tell you they are ready. Ask them two questions and watch their poker face crumble: on a given day of the week, what % of beds are free? Could they accommodate 1000 new patients? 10,000? 100,000?

Harvard epidemiologists modeled 40-70% of the world will get COVID-19 this year. If 20% need hospitalization, fuggedaboutit.

Don't panic. But we need to be aware. This scenario is the most persuasive argument that China did not overreact. The 'draconian' quarantine measures are what all countries may soon impose.

A recent study shows the phylogeny of the cases in Washington state. Over 6 weeks, the RNA strand of the COVID-19 virus hadn't changed significantly from the first case of a person who traveled back from Wuhan to the most recent case of a teenage boy. This shows the virus is fairly stable, which is good. It also means it's been circulating in the area under the radar for 6 weeks. Washington State appears to have community spread. Judging by the empty shelves and visible paranoia in the streets, this makes Vancouver pretty nervous.

That's how it happens, a case, a case, and a briefing warning the public to wash their hands, then a few more cases, a cluster, another cluster, and then an outbreak. What level is it where you are?

I make myself a peanut butter, honey, and banana taco (one piece of bread, unsliced banana).

Sixty percent of Americans live paycheque to paycheque, and 20% are uninsured. Half a million people go bankrupt every year for medical bills. We can't expect people to self-isolate or pay $1500 (10,000 RMB) for a possibly faulty test.

If this scares you, realize only Bernie Sanders and his medicare for all will make these tests free, and treatment in hospitals free. The Democrats Abroad primary is happening this week for Americans around the world, and you're allowed to vote online. Don't sleep!

After dinner, we relax for a couple of hours, and then I set up my computer to play some Dungeons & Dragons on WeChat. It's wild to video chat with a half dozen friends after 40 days of solitude. We're all excited to socialize with someone that's not been locked with us in our homes for over a month. We laugh, we make lame jokes, then we play and roll dice, and it's glorious. We try not to split the party and take it slow at first. It's good to have a plan. 

Despite the overwhelmingly calm and downplayed demeanor from many developed countries health organizations, many doctors and experts are crying out on social media. They say a dangerous amount of incompetence and misinformation is circulating from their highest sources. In the Netherlands, for example, they are saying washing hands works best, not to use masks, goggles, or gloves. The German CDC says you disinfectant in ineffective! The inference that can be drawn is that since they did not source these goods in advance, they don't want to be competing with the general public for the scraps that remain.

There’s a new study today, that seems to show equatorial and very hot countries are having a lower rate of spread than other countries that have colder weather. This is a hope we should keep an eye on.

In America, two California health care workers have tested positive for COVID-19 after using proper respiratory droplet protocol with an infected patient at an airbase. Four days later, they were told they should have used airborne/aerosol protocol. One hundred and eighteen more doctors and nurses are in quarantine. If you fail to plan, you plan to fail.