Health Departments & Politics (Oct 21)

I’ve been more than a bit obsessed with Covid-19 since it started. For a while it was almost a full-time gig. These days it’s calmed down to just a few hours a week: reading science papers, and spot-checking a few websites.

Among them are sites for Health Departments in some nearby counties. They vary. All have current numbers, but some break it down by towns; some give a brief description of each case; some have lists of places where infected people visited. Right after the Sturgis rally, Cattaraugus County (4 to the west) even mentioned that two cases were in people just returned from South Dakota. That’s a long motorcycle ride.

The sites are entertaining, in a geeky sort of way. I keep adding more counties, and now visit 15 of their sites. Reading between the lines, they paint a picture of what the pandemic must be like for staff in local Health Departments.

Pre-Covid, their biggest job was inspecting restaurants and other food services. Keep perishables below 45° or above 145°F, don’t put meat above salads in the fridge, control rodents and the like. They also administered WIC, and tried to keep people from catching STDs or growing too obese. Flu shots. Toxic algae blooms. Ticks and Lyme disease. Mosquitoes and West Nile. Opioids. Tobacco. Rabies.

Most of these departments are pretty small. They already had a lot on their plate. This year they’ve been in crisis mode for seven months already, and the battle has just started.

Contact tracing and quarantines are an important part of controlling a communicable disease like Covid-19. That’s mostly what they do now. I’m sure it is not an easy job. You’ve got to ask people where they’ve been, and who they were close to. Then persuade them to stay home for a couple weeks. Plenty of people resent authority or think it’s all a hoax. Even the best will be tempted to sneak out for a bit. You’ve got to deal with all that, and probably don’t have much enforcement power.

Normally I avoid talking about politics. As a business owner, I’m significantly less liberal than most folks here in Ithaca. As an Ithacan, I’m more liberal than most people using our software. It’s not worth arguing about.

Thing is, right now the US probably is headed into a major emergency. A once in a century situation. It’s right in the middle of an election for President, all of the House and 1/3 of Senators. Plus local races.

Both political parties got together in March, and signed the CARES act to support people and organizations affected by the pandemic. Since then, it’s been gridlock and antagonism.

All those local Health Departments will make the difference between a moderately bad Fall/Winter season for Covid-19, and a runaway disaster (or lock-downs and economic damage). To keep everyone safe, they need more staff to trace contacts. More tests. More resources to support folks in quarantine so they don’t wander off and infect others. Problem is, the states and counties that pay them are facing bigger expenses, and reduced revenues. They can’t print money to make up the difference. They need help.

And of course, many individual people are in the same boat. Life got a lot more complicated and generally worse in March. It’s not turning any corners, anytime soon. It will take extremely competent leadership to manage the next phase of the pandemic, and recover from the economic damage. States and counties can only do so much. Covid-19 is exactly the kind of problem that needs full attention at the Federal level. It’s not happening now.

You might say this country needs to come together to fight a common enemy: the coronavirus that causes Covid-19. And maybe come together for other stuff also. Life was already headed downhill for many people, even before March 2020.

I miss the days when there were liberal Republicans and conservative Democrats. When politicians compromised and solved problems (at least some of the time). Voting in a politician is a lot like hiring an employee or subcontractor. In the end, competence and integrity are what counts.

Dennis Kolva
Programming Director
TurtleSoft.com

Covid-19: Contact Tracing (Oct 12)

Our county had its first death from Covid-19 today. The number of active cases has gradually increased as well. Surprisingly, Cornell is not to blame. They’ve only reported 5 new cases in students and staff during the past week. The rest of the county had 30.

This is not just a local problem. Some parts of Upstate NY have even bigger increases. There currently are 226 active cases in Steuben County (2 to the west of here). 870 people are in quarantine (almost 1% of their population). It’s much worse now than in March/April. So far 60 people have died in Steuben, with 15 in the past week. Their population is similar to here.

New York State is actually doing better than most places in the US. Looking ahead, it makes me very concerned.

It’s possible to divide epidemics and pandemics into three levels of severity.

The best option is full containment. It’s what happened with SARS, MERS and Ebola (twice) in this century. There’s a local outbreak, but medical help rushes in to help the infected. Contact tracers find and quarantine everyone exposed to them. There’s public education, to help folks reduce their risk of infection. Eventually the disease stops spreading. Eventually it disappears.

With Covid-19, some countries have reached containment. China is the biggest example, but most of Eastern Asia is fully contained or close. However, until the disease is completely contained in the rest of the world, they all risk new outbreaks.

The next best option is just plain old containment. It still involves contact tracing and quarantines, to reduce the spread. Still public education to help slow things down. But for whatever reason, the growth rate stays about the same. People keep getting sick, but not at crisis levels. That’s where most of Europe is right now. Ditto for much of the US, especially New England. New York was there all summer, but it’s starting to lose it. Europe is starting to lose it too.

The worst option is out of control pandemic. Contact tracing doesn’t work then, because too many people are infected at once. You can’t keep track of everyone, nor quarantine them all. The disease pretty much runs its course exponentially. Eventually there is herd immunity, but it ain’t pretty getting there.

Influenza did that in 1918 to 1920. Plenty of other diseases did that in prior history. This year it happened for a few weeks in one Chinese province, then in Italy, Spain and New York City. Hospitals are overwhelmed. Almost everything becomes unsafe. Things can get very bad, even when a disease isn’t real deadly. It’s worse when every place is in trouble at the same time.

Steuben may be close to the edge now. They have 15 contact tracers, which means each of them is running daily checks on 18 sick people, plus 40 more who were exposed and in isolation. Things were fine there until Sept 23, then it went off a cliff.

Covid-19 has dominated lives for more than seven months. I think all of us are growing very, very fatigued. The problem is that Spring and Summer 2020 were just Covid 1.0. Best guess is that this pandemic will follow the 1918/9 curve. If so, we’re right at the leading edge of the second and bigger wave.

One big thing we have in 2020 that wasn’t common in 1918 is vaccines, plus the science to develop them rapidly. Vaccines are challenging. The immune system in general is not easy to understand. Luckily, Derek Lowe’s latest write-up on vaccine development sums up current progress. He is a writer for Science magazine, and all his posts about Covid-19 are great. UPDATE: the Chairman of Pfizer also just posted info about their vaccine development.

The short answer is that creating a safe & effective vaccine is a slow process. One probably won’t be ready in time to help with that middle bump (if it happens). But it may reduce the 3rd and 4th ones.

Dennis Kolva
Programming Director
TurtleSoft.com

Goldenseal Pro Progress (Oct 5)

Our staff has made some progress on Goldenseal Pro: text fields now fill in values, and popup fields get menus. QT is still working well, and I’m very optimistic that we’ll be successful with it.

However, our staff has mostly been busy with other things, the past couple weeks. The rest of October will be similar, before we get back on track.

First of all, TurtleSoft is moving to a less Covid-risky office. At the moment everything is boxes and disassembled shelving. The chaos will get worse before it gets better.

I also finished re-roofing my house last week. It was a big project that started in late May: removing 3 layers of ancient asphalt shingle from a 12:12 pitch, then installing new metal panels. I also added a couple of skylights in the attic. There’s still a small shed roof to finish on the rear, but that should only take a few days. It’s the first roofing project I’ve done with scaffolding rather than ladders, and the process was so much safer and more pleasant. Well worth the extra setup and take-down time.

Getting back into major construction work was satisfying. 20 to 25 hours a week of physical work seems like the sweet spot: enough to get very fit, but not enough for serious back and joint pains. So, I’m planning to finish some interior work over the next few months, then sell the place and buy another fixer-upper. Then repeat the process every five years or so.

For most of its lifetime, TurtleSoft has been a part-time operation. This really isn’t a change from how it’s always been here. Sometimes there are spurts, and sometimes gaps. Goldenseal Pro will be spurting again soon enough.

Dennis Kolva
Programming Director
TurtleSoft.com