A Citizen's Guide to Indiana

I don’t pretend to know how to evaluate the COVID-19 projections provided by the Institute for Health Metrics and Evaluation, but it seems reasonably legitimate (affiliated with the University of Washington and Gates Foundation), and it seems to acknowledge a lot of room for error.  For Indiana, it projects a peak on April 14 with a need on that date for 10,458 beds; 1,582 ICU beds; and 854 ventilators. Right now, we’d be short 1,973 beds and 706 ICU beds. (The 706 ICU beds represents a 44% shortage!) It projects 110 deaths per day in Indiana at that point. Projected out to August 4, we’d be looking at 2,440 deaths in the state total.

I’m not sure if you can do a simple pro rata calculation to see what it will look like locally, but figuring Tippecanoe County as 190,000 of Indiana’s 6.7 million, that would be about 2.8% of the total. If that’s correct, on April 14, we’ll need 293 hospital beds,  44 ICU beds, and 24 ventilators, and we’ll experience 3 deaths. Through August 4, our share of the total deaths would be 68.

For my part, we’ve got our office mostly working remotely. I’ve commandeered the basement storage room and am incredibly comfortable churning out legal work from the bowels of my house. I think the kids are hanging in there, though this amount of screen time probably isn’t the best thing in the world. We’ve made them come along for family dog walks which has actually been quite nice for me. They’re funny kids! Amy has worked from home for years. Having us around probably cramps her style a little bit, but all-in-all we’re incredibly fortunate compared to what many others are going through.

Nothing to do but keep grinding through this – keep kicking at the darkness ’til it bleeds daylight.

(Updated March 31, 2020: Maybe our efforts are having an effect, maybe the model changed for other reasons, but as of March 31, 2020, the model is showing peak resource use on April 18, 2020. The need has been lowered to 3,024 beds (8,485 available), 460 ICU beds (706 available), and 30 deaths on that date. Projected out to August 4, 2020, it shows 906 deaths. That’s a substantial improvement.)

Today’s numbers for Indiana from the State Board of Health are 39 positive with 193 tested. (Update – those were numbers for 3/17/2020, the newly released 3/18/2020 numbers are 56 positives, 2 deaths, and 380 tested. So they doubled the testing and yielded an additional 17 positive cases, an increase of 43%. Update 2: For 3/19/2020, the numbers are 79 positive, 554 tested, and 2 dead: that means for the day we had an additional 23 positives and an additional 174 tested. Also a second positive case in Tippecanoe County – someone who had traveled to Paris). My friend Kate from Spain is providing daily reports from our future. They identified 3,000 new cases in the last day. They are on lock down. Reports are that Tippecanoe County had its first case — someone who was asymptomatic but flew to Florida a few days ago and is now in the hospital in Orange County, Florida. Given the timing, I wouldn’t be at all surprised if I knew the person — it sounds a lot like it could be someone from West Lafayette who headed to Orlando for Spring Break. But that’s speculation.

I feel like the social pressure is shifting such that there is a lot of opprobrium developing toward people who aren’t taking this seriously. A few days ago, it felt like maybe things were a little up in the air about how serious this was or, to the extent it wasn’t,  there was some live-and-let-live as to how long it was going to take people to appreciate the threat. Now there’s less patience. There were some people who went ahead with their Spring Break plans 5 days ago. Things are probably changing rapidly where they are too, so it probably won’t be that drastic, but in some ways, I feel like they might as well be coming back from the moon. Today was the first day I’d been to a store in over a week. I picked up carry-out from the Black Sparrow – they had some classical type music playing (I’ll call it Gothic, but I really don’t have the vocabulary) – the dining room was, of course, empty, and the lights were pretty dim. It was a little surreal. Then I went to CVS to pick up a couple of things. Other than people standing pretty far apart in line, it was pretty standard.

County government is adjusting. The Governor entered an executive order modifying the open door law such that more meetings can be conducted remotely. County facilities are mostly closed to walk-in traffic. The Courts are trying to operate, but they’re trying to postpone non-critical cases and handle more things by telephone, cancelling jury trials, and that sort of thing.

Guess that’s all I have for today.

Things are moving very rapidly with the coronavirus. Last week and this week, I think, are going to be the watershed period for this pandemic going from an abstraction to a reality. I guess I’m writing this to keep track of how things are developing. It’s already a little hard to remember what my perspective was two weeks ago. I do recall that maybe two or three weeks ago, I was doing some legal research on local government’s options for dealing with disease. At the time, I was mainly focused on the procedures for requiring an individual to remain in quarantine. I also looked a little bit at how things would work for dealing with a more community-wide epidemic. That seemed a little drastic. Today it seems more on point than an individualized approach. (Generally speaking, the local health officer and board of health has the most specific powers to deal with epidemics. The local department’s authority is trumped by the state department of health’s authority.)

Today, the Governor announced that bars and restaurants would be closed to in-person dining. Take out and delivery are still permitted. Indiana had its first reported COVID-19 death. The ISDH is also reporting 24 confirmed cases out of 139 people tested. Tippecanoe County has made the decision that walk-in traffic from the public won’t be allowed in most of its buildings. The courts have to remain open to a greater extent, but they are attempting to postpone cases, continue jury trials, allow telephonic appearances, and generally limit the amount of personal contact. The Indiana Supreme Court issued an order giving the trial courts more flexibility to manage their dockets.

I gave my friend in Australia some static about Tom Hanks getting infected in his area. Turns out, this friend is like two people removed from Tom Hanks who tested positive, and he reported that Australia’s 4th death was out of Noosa, Queensland where he works. I have another friend in Spain who is giving daily reports where things are far more advanced. Their movement is very restricted, only allowed out of their houses for very specific reasons. In Madrid, drones are broadcasting the restrictions. She reports that grocery stores are limiting the number of people who can enter at once and aren’t accepting cash. The number of positive cases rose by 2,000 up to 9,800. Right now, the U.S. (with a bigger population and landmass) is at 4,587 confirmed cases with 85 deaths. One source I saw suggested we were tracking 10 days behind Italy which is showing 28,000 reported cases and 2,158 deaths.

So, people locally are starting to take this seriously at varying speeds. Some are ready to live in a bubble. Others still think it’s much ado about not very much. Most people are between those extremes but moving in the direction of the bubble people. Also, the stock market has tanked. I think that’s all I have for tonight.

Obviously I couldn’t think of a title. I just felt like I should write about this pandemic in which we find ourselves. As a history major who studied World War I a fair amount, I’ve long had some familiarity with the flu of 1918. (The “Spanish” flu — mainly gaining this title because the WWI combatants kept their flu outbreaks secret for awhile as part of the war effort, so there was more publicity about the Spanish outbreak.) This isn’t that, exactly. Currently, this doesn’t look to be as lethal as the 1918 flu (which killed more people than the War.) But, God willing and the creek don’t rise, this will be as close as we come to that experience. On the other hand, the 1918 flu and other epidemics and pandemics should inform our response. And COVID-19 does seem to be more contagious and deadly than modern flu outbreaks and other diseases we’ve seen lately.

I’m usually one to reflexively dismiss “kids these days” type grousing about how we’re getting soft. But, in terms of disease, we truly do not appreciate how good we have it. The fact that anti-vaxxers are a thing really underscores that point. Reading histories and reports from before 1918, the disease situation was an absolute horror show. Smallpox, scarlet fever, measles, mumps, polio, tuberculosis, and typhoid are all diseases which loomed large the fears of our forefathers but have largely disappeared from our public consciousness. This monthly bulletin for April 1912 from the Indiana State Department of Health is metal as hell.

There are stories about a syphilitic attorney from Shoals; a fly who is born in manure, graduates with all of his maggot buddies, spreads typhoid, lays eggs, and gets into a ladies breast milk; the image featured to the right; and an evaluation of “Dr. Lindley’s Golden Remedy” among quite a bit more.

But the most rapidly spreading and deadly of the communicable diseases have been largely contained in recent generations, so we have sort of lost the muscle memory of how to deal with them. This inexperience has been exacerbated by the 24 hour news cycle. I know it’s popular to blame “the media,” but in this case, I think it’s appropriate to some extent. I see this news cycle as causing problems in two respects – first, it has cried wolf over the years. Anxiety about disease is a reliable way to draw eyeballs, so any time something new and different is spreading around to any extent, it gets intense media coverage. When those hyped diseases don’t materialize locally in any noticeable way, the media reporting takes on a “boy who cried wolf” quality. Secondly, any issue with a vaguely political angle is reliably hyped as a crisis or dismissed as a hoax. So, even reasonably well adjusted people don’t know how to calibrate their responses. People who reflexively catastrophize or minimize everything obviously aren’t going to get it right.

That’s why we rely on experts. It’s fashionable to glorify “street smarts” and to ridicule “book smarts,” but sometimes we really do need book smarts. And, our national leadership doesn’t have them. We have to allow some leeway for making mistakes during a rapidly evolving and uncertain situation, but even so, the federal government has not been making good decisions. I’m not blaming Trump for the virus or the fact that got to the U.S. That was probably inevitable. The travel restrictions to and from China probably did some good. However, the delays in testing and the decisions about making our own tests have left us blind and behind the curve. Many of the decisions seemed designed to limit the available data so as to control a media narrative and allow the White House to deny that there was much of a problem. I don’t care much for Ayn Rand in general, but there was a passage from John Galt’s rant that stuck with me where he talks about how “A” = “A.” At some point, no matter what you say about reality, certain aspects of reality can’t be talked away and are indifferent to anyone’s wishes, whims, or feelings. You don’t have to believe in a pandemic for it to hurt you and your family.  To the horror of the reality-based community, Trump’s approach was to wish it away. Also, he put Mike Pence in charge which, given his inadequate response to the HIV epidemic in Scott County while governor, was a poor choice.

The state level response has been a little slow maybe but not necessarily bad. Much of that can probably be attributed to difficulty getting coronavirus tests. As I write this at 10:22 on Saturday, March 14, the ISDH website is reporting a total of 89 people being tested. That has to be insufficient. South Korea is testing something like 10,000 people per day. They can just drive up. South Korea has a little less than 10x the population of Indiana. A proportional response on our end would be testing 1,000 people per day. Sounds like we’re doing maybe 10 per day. Our county health officials are busting their collective asses and doing the best they can with the resources they have. They’ve been communicating with the public and issuing advisories about how the public can slow the spread.

One driving sentiment is that we don’t want to become like Italy. This disease is quite a bit more serious than the flu, but our health system seems to have the ability to treat the people who do become seriously ill if we are able to “flatten the curve.” In other words, if everyone gets sick all at once, the sheer numbers will overwhelm the capacity of our medical system in terms of available beds, ventilators, and health professionals. If we can slow the spread such that people get sick at different times, the health care system is better able to care for people as they get sick. This idea of flattening the curve is probably the critical piece of information being missed by people who regard our current response as a media-driven overreaction. There are some who just simply don’t understand exponential math, but there are others who understand the math but regard the deaths that are coming as sad but inevitable — such that we’re disrupting lives and the economy with no proportional payoff for the sacrifice. Ultimately, it will be difficult for decision makers to win. Do too little, and they will get hammered for inaction. Do enough or too much and people will complain that the pandemic wasn’t such a big deal after all.

On a personal level, my main hope is that my friends and family come through unharmed. Beyond that, this does provide an opportunity to look at people and the workings of society from a slightly different angle. In terms of business functions, many of us will have to take a hard look at what we do, why we do it, and whether it provides short term, medium term, long term, or no value. We’ll get a better idea of who among us really rely on direct, person-to-person contact and being constantly in motion versus those of us who are better suited to less in-person social contact and are more tolerant of a slower pace. Who is enjoying the break and who is climbing the walls? We’ll get a better idea of how people deal with stress and anxiety. Does having a problem calm you down and allow you to focus? Or does the stress make you manic and your thoughts chaotic?

When Isaac Newton was sheltering from the plague, he invented calculus and discovered gravity. No pressure.

So, 10 or 11 years ago, there was an especially showy Indianapolis business guy by the name of Tim Durham with connections to folks like Burt Servaas and Carl Brizzi. In a story reminiscent of the movie “Wall Street,” Durham bought a long-established company called “Fair Finance” that had been a going concern since the 30s and used it as a personal piggy bank. Investors and depositors in Fair Finance lost about $200 million. Greg Andrews, writing for the IBJ, reports that the bankruptcy trustee has been trying to get some of that money back from various sources but has suffered a major set back after a jury trial against a company called Textron who provided financing to Fair. I couldn’t quite make out the exact legal claims from the article (maybe I didn’t read closely enough), but I gather that Textron got a lot of its money back in one way or another while ordinary investors got stiffed. The bankruptcy trustee was likely trying to claw that money back from Textron to distribute to the regular investors. The trial hinged on whether the debt owed to Textron was secured or unsecured. The jury apparently decided it was secured and the bankruptcy trustee won’t recover those funds.

To date, the bankruptcy trustee has recovered something like $0.11 on the dollar for Durham’s victims. Durham was convicted in 2012 and currently has an earliest possible release date of 2056. (That assumes Trump doesn’t pardon him.)