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Sunday, March 29, 2020

Canary in a Coal Mine? Hardly.

A letter of gratitude arrived from a friend today, who works as an EMT in Norther New England. She wrote, "Most of the patients [I visit] can stay home but people are freaking out. I would be too if not for your educational efforts. Honestly I can't thank you enough. Our govt did shit but there you were educating for all who would listen. Our govt totally sucks." While I will take the compliment, I think it is important to distinguish between different levels of government and different levels of response. (By most accounts, America's Governor, as I have started to call Andrew Cuomo, is doing a great job.)



While the US was better prepared than almost every other country, according to both WHO and Johns Hopkins, we were not prepared in some very important ways. Ed Yong says it better than I could in The Atlantic:

Perhaps the nation will learn that preparedness isn’t just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose America’s social immune system, and that this system has been suppressed.

When some of you read the pieces in the Concord Monitor, the Boston Globe, or the Charleston Post and Courier, your response was disgust that I would be so public about what I was doing and about my private life. One friend's spouse said to me that my efforts were little more than an effort to garner attention for myself and hold myself out as an expert. She went further to say that I was being over-sensitive for defending myself against her charges of corrupt purposes. The host of my AirBNB, who was one of the wonderful humans I have ever met, was so angry that I had taken a picture with his woodstove, unbeknownst to him, for The Globe that he wrote me, "This might be an interesting publicity stunt for you, but it's how I pay my bills." (At that point, I was for the duration of my two-week stay, the only one in his county in quarantine or isolation because of the novel coronavirus. I understand his concerns.) Another spouse of a dear friend wrote some of the most hurtful words that I have ever read, "I hope you are well. I also contacted the Boston Globe and Concord, NH paper to let them know how you played them! Publicity on top of your cowardice actions. Sure you made the Lee legacy proud." (I can forgive and excuse this comment, because he is not well, but, people, please be not cruel to those in quarantine or isolation. This is not an easy time for anybody.)

Little did you all know, that in less than a month, you would be unable to read or listen to any news that was not related to COVID-19. Little did you know that alcoholism and domestic violence, not to mention anxiety, would skyrocket, as your friends and neighbors are trapped at home in a society that relies on trappings for its sanity. Since I had been locked down since January 23, I knew what was coming and it broke my heart. My heart still breaks everyday as I watch what is happening. 

It is hard to admit that the country to which I returned, China, whose government so many of my friends and family despise, has done a much better job than our own. It is an existential crisis for me, who agrees with so many of you that the doctor in Wuhan who blew the whistle is a martyr. However, the Rep. Seth Moulton approach was wrong and I am glad that he saw the errors of his ways. (Softball interview with Moulton about his experience with the disease begins at 2 minutes in video below. The part where he talks about the resolution starts at 12 minutes and 50 seconds. Sympathy to him and his wife as they recover from what they have to guess is "the disease"; he takes VA health benefits instead of Congressional benefits...and VA won't test a virile middle-aged man. There are not enough tests, as Science Friday explains, and the results sometimes take a long time.)

 

Here in Guangzhou, in my second fortnight long quarantine, this is what I am doing. I am reaching out to groups that are working to deliver quality supplies of test kits, PPE, and other equipment to the United States. It is hard to figure out who is a "carpetbagger" and who is really involved in this effort because they want to save lives. Luckily, my partner is an extremely well-connected businesswoman and we have been able to identify reputable factories that make test kits and personal protective equipment (PPE). We will be working over the next weeks to send out as much as we can, but, sadly, Trump's tariffs, his "Wuhan virus" rhetoric, and stories of bad test kits from China in Europe and elsewhere in Asia are making it hard to send these supplies to the United States, where we both most want to send them. Chinese testing kit exports have soared as COVID-19 spreads, but the cancellation of most China Airlines flights and the failure of American airlines to resume cargo flights to China are additional challenges.

The NMPA will clamp down on the bad products and I would guess eventually people will go to jail.  Yesterday, NMPA gave emergency approvals to COVID-19 test kits. Sadly, the bigger problem, which we have known for over a month, is that there are not enough US FDA workers here to do their job. Claims that the FDA is taking further steps to help mitigate supply interruptions of food and medical products should be taken with a grain of salt. This is an agency that answers to a protectionist President who would, in the words of one of my friends, "rather die than be conciliatory with China." This press release does offer hopeful words:
The [FDA] is taking steps to facilitate importation of PPE into the U.S. and we are ready and available to engage with importers to minimize disruptions during the importing process. This means that when products come in from overseas, their authorization via our EUA authority allows them to quickly enter the country. These products aren’t hindered from entry and we’ve already determined, among other criteria, that the known and potential benefits of these products being used in health care settings outweigh the known and potential risks.

Will keep you posted as things develop.

I have had my second free COVID-19 test and when the results come back, I may be free to go outside. Rumor has it that we may return to physical school in April, but as Dr. Anthony Fauci says, "You don't make the timeline, the virus makes the timeline."  There will be a knock at the door and they will remove the camera monitor from the outer door when I am done with quarantine. I am excited to see 丫丫 and the kids, as well as take a hike. I am feeling very healthy, having lost about 10 kg from my plant-based diet. Have even watched a few movies during this second quarantine--notably, "Dirty Money"!

Back to the trenches...and first breakfast. Eat well, sleep well, wash your hands, and take care of each other. May God bless America!

Alexander Lee
Guangzhou, China

Thursday, March 26, 2020

"Made in China": Provision of PPE and Test Kits Stat!

Trump and his lot seem to think that taking supplies from China would threaten American safety so they are relying on 3M to come through in a matter of weeks, which he mentioned in his press conference today.  Weeks, when we could have what we need in days! A decent President would repair relations with China and ask that this nation, which makes about 50% of the PPE in the world, get them on planes to New York, New Orleans, and New England tomorrow. I believe that we could have masks that would save the lives of health professionals and others on hand in a matter of days, if we could get them out of China....but we cannot. I have an Indian friend who has crates of FDA-approved N95 masks ready to go, but he cannot find an airplane to get them out.

A friend of mine who usually knows what's going on told me, "There were some disparaging reports out of China about faulty supplies so it might be difficult to expedite anything or get traction [for your effort to send test kits and personal protective equipment (PPE)]." Meanwhile, the US is trying to get test kits from Korea. I cannot speak to a few bad apples or masks that seem to have poisoned the pot, but the people that I am working with have a high level of professional integrity and quality control. They make test kits to be used in China so it would be a baseless accusation to say that they had a side operation of making sub-standard kits for sale in other countries where China might want the disease to spread. China does not want the disease to spread. Our economy and theirs are in a symbiotic relationship. The crippling economic blow of the last couple months of lock-down which looks like it is about to be repeated in the US and Europe is good for nobody, especially the low-paid essential workers who deliver our mail and check us out at the grocery store.

There are reasons to be worried about greedy capitalists in both countries, but the vast majority of folks want to save lives and do good in a time of incredible need. 

Hatemongers, such as Senator Tom Cotton, who does not even realize that Advil is iubprofen, continue to spew their bile. There are also propaganda efforts, for sure, in China, which Axios has detailed in their newsletter; however, the vast majority of regular folks in both countries do not want nurses and doctors, grandmas and grandpas to die, because we do not have enough masks on hand. Of course, lots of young people are dying, too, and masks won't save them all.

What we, in our group, are struggling with as we try to decide where to send supplies is whether FEMA will do a good job at speedy and just distribution. They have such a poor record in Puerto Rico and elsewhere. In fact, FEMA's clumsy form does not bode well. (In the last 24 hours, they changed the URL so we had to look it up again and the old URL-- does not redirect.) On the other hand, the prospect of sending PPE and test-kits to the points on this map below is daunting. We should be able to trust FEMA to send supplies where they are needed most.

https://getusppe.org/about/


There are exciting efforts afoot in places like Australia, where a young man named Milton Zhou founded a not for profit called RapidWard.com. They are trying to get rapid test kits and other in demand critical medical supplies to the people in need around the world, but there are so many challenges. Will Americans donate to an Australian nonprofit? I am pushing to find an American organization that is licensed to operate in China--such as the American Friends Service Committee or the American Red Cross--which could help us get these test kits and masks to the US as fast as possible. There are so many challenges, but I know that it will be faster than waiting for 3M--makers of your sticky notes and PFAS.