Unsanitized: COVID-19 as a Bucket on a Swivel

Abdul El-Sayed talks about the crisis moment. Plus, more on the PPP witch hunt. This is The COVID-19 Daily Report for July 8, 2020.

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First Response

I wasn’t familiar with the analogy but I understood the point. El-Sayed, a former director of the health department in Detroit, candidate for governor of Michigan, and prominent Bernie Sanders supporter, was describing a bucket slowly filling with water, drop by drop. “The bucket’s on a swivel and the drops come into the bucket until it tips one way, or another,” El-Sayed said. “We need to make sure it tips the right way.”

He was specifically talking about the political moment, but the analogy held for most of our interview. El-Sayed, author of the new book Healing Politics: A Doctor's Journey into the Heart of Our Political Epidemic, reinforced over and over that we’re on a knife’s edge, that success or failure is up for grabs, whether in the coronavirus crisis or how we respond.

El-Sayed is a medical doctor, and actually an epidemiologist, making him one of the more knowledgeable political figures with whom to discuss the public health aspects of the crisis. I asked him if the medical community has gotten any better at handling the disease since its inception. “We know a lot more about the biology of the disease,” he said. “Think about physicians in Houston or Florida being able to call colleagues in New York.”

But he added that this comes at a cost for properly communicating the seriousness of the situation. We have talked on Unsanitized about why deaths may not be spiking yet (here are some other discussions of that phenomenon), and this has mostly held. Yesterday’s higher number of deaths made up for the lack of reporting over the July 4th holiday; week over week deaths are still down, and we are a month out from when cases really took off in key states.

However, as survivability grows, more people may put themselves into situations to contract the disease. They’ll think of masks as a force field that allows them to enter any environment. “There’s a fallacy in epidemiology called lead time bias,” El-Sayed explained. “When you ascertain the disease earlier in the course, it looks like the outcome is not as bad. The ultimate truth is this is a very dangerous situation.”  

Read all of our Unsanitized reports

In the long term, we don’t know the significance of millions of survivors, and we won’t know until things develop. El-Sayed noted how the understanding of the disease as respiratory has morphed into something vascular, which can stretch beyond the lungs and to all parts of the body. “My father-in-law is a nephrologist, he’s seeing kidney disease everywhere,” he said. “Look at COVID toe, it’s stretching to the capillaries in the furthest extremities.” These consequences of unknown length could linger in the younger people infected and become a lifetime ailment added on to our array of long-term health consequences. It’s why I’ve discussed having an option like we do with dialysis for permanently putting COVID sufferers on Medicare.

The theme of El-Sayed’s book is insecurity, an epidemic of insecurity actually, where the systems expected to provide prosperity and dignity have all been “sold off to the highest bidder.” In the pandemic that manifests itself in the hollowing out of public health departments at the state and federal levels, producing a lack of basic infrastructure when we needed it the most and a distortion of what we value in health. “The healthcare system is kind of like a jail,” El-Sayed said. “You want to prevent people from getting sick in the first place. Healthcare should be a function of your public health policy. But hey, we have the best atriums in the world.”

El-Sayed is a single payer healthcare supporter, and that need has shone more brightly during the crisis. He’s part of the healthcare task force set up jointly by the Biden and Sanders campaigns to work on policy concepts. “I think the Biden team recognizes this critical moment, and the need to approach it with a broad-shouldered agenda,” he said. “He’s not Bernie and never going to be, but I think there are some real concessions to this moment and the need to stand up to corporations that have dominated for too long.”

That brings us back to the bucket on the swivel. The faults in the system are recognizable, and the renewed spotlight could allow a better way forward. “The problem is it could tip the other way,” El-Sayed warned. “There are demagogues on the other side of the gate trying to leverage the moment to divide us further. There’s a version of this history where we do not succeed.”

It’s why El-Sayed joined the Biden/Sanders task force, and will try to work with Biden, he told me. “I spent part of my childhood in Egypt, I know of a place where there’s no democracy. Donald Trump is a threat to democracy. We as progressives have to recognize, we’d rather be kicking field goals than playing defense.” 

PPP Witch Hunt Update

We now return you to America’s favorite pastime, or at least bored American reporters: posting contextless “accountability” stories about who got (Dr. Evil face) ONE MILLION DOLLARS in PPP loans. The banks who “processed” the loans, in scare quotes because they did nothing but input applications to the Small Business Administration server for approvals, as all the certifications were on the applicants and there was no underwriting, made $24 billion, but that’s not important right now.

Anyway, it’s odd that more attention hasn’t been paid to the fact that the list of loan recipients handed out by SBA, the only source material for a kajillion “investigative” reports, appears to have an indefinite amount of demonstrable errors. Several companies came forward to say they never applied for or received loans but were listed on the spreadsheets anyway. Somehow that hasn’t been investigated by these intrepid investigators (maybe because they don’t want to face the fact that the only data they used for their stories was corrupted).

I’d read those investigations. SBA merely had to provide a list and couldn’t get that right? How many names on the list are wrong? Were they included in SBA’s running tally of funds used? Did the first round close prematurely because of SBA errors in attributing loans to companies that didn’t get them? I guess journalism in context is too much to ask.

Happily though we won’t have this problem again, because the “look Ma Kanye West got a loan” reporting tendency has probably doomed any further relief for the small business sector. Democrats and Republicans in Congress are using the reports as an excuse to limit further stimulus, lest it fall into the wrong hands. I agree that firms who were supposed to be barred from receiving PPP funds and got them anyway is a bad outcome. But splitting the atom to ensure “responsible” recipients only will assuredly make it ineffective, especially if still run through self-interested banks. It’s HAMP all over again, and the media has become willing collaborators in the induced austerity. Fortunately we have the virus completely under control, so this won’t be a catastrophic mistake.

Days Without a Bailout Oversight Chair

103. In actual reporting, we learned that three airline companies receiving $338 million (about 100 or so Kanye West PPP loans, for those scoring at home) from the Treasury Department’s slush fund laid off thousands of workers, circumventing rules supposed to prevent that outcome by waiting to sign the funding agreement and executing the layoffs in the space between applying and accepting. A bailout oversight chair would have jurisdiction over the Treasury Payroll Support Program, and could haul in executives at Gate Gourmet and the other firms and ask about this. We don’t have an oversight chair.

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