“IT’S A CLUSTER. GET YOUR CRAP TOGETHER.” – A Ballad Health Hospitalist Speaks Out

Governor Lee has spent the past few weeks telling us “the storm is passing”, but the virus doesn’t appear to be listening. It continues to spread at a rapid pace, including here in Tennessee. Even our rural communities are far from immune, with massive outbreaks in Sumner County and then just two days ago at a nursing home in Cookeville.

After 10+ days of urging from thousands of Tennessee doctors and nurses Lee finally issued a stay-at-home mandate Thursday, citing traffic data from Unacast showing movements in Tennessee starting to tick up again as his reason, particularly in rural Tennessee. (Unacast gives TN a “D-” for social distancing and an “F” to over half our counties)

Lee believes the Unacast data means rural TN is still not taking the threat of the virus seriously enough. The data does show an uptick recently, but it’s not the first uptick in recent days, so it seems a convenient reason to justify doing something he really didn’t want to do.

He was the 40th governor to issue a stay-at-home mandate.

Waiting nearly 2 weeks to do what he should’ve done a long time ago likely means many more will be infected, particularly because this disease is largely spread by folks who don’t show any symptoms, and who don’t even know they have it.

The people most at risk are our frontline health care workers. They’ve been getting standing ovations from their neighbors all around the world for good reason, and they deserve to be the “TIME MAGAZINE PERSON OF THE YEAR” this year with no close second.

The problem is, despite Governor Lee’s assurances, we’re not properly protecting them. While health care workers in China appear to have Hazmat suits to go to battle with, our health care workers here in America are being given sports ponchos and garbage bags, and even being told to strap diapers on their faces in Tennessee – despite Governor Lee telling us otherwise.

As recently as yesterday Lee said “we’re staying ahead of the need” here, but those whose lives are on the line tell a different story. We spoke to a hospitalist in the Northeast Tennessee Ballad Health Care system about the lack of preparedness and communication there.

She spoke to us on a condition of anonymity to express her concern about the way things are being handled at Ballad hospitals – and it seems fair to wonder if this isn’t how it is in many hospitals around our state. (The anonymity comes because she’s certain Ballad would fire her if her identity got out. Not only are our health care workers not being protected throughout the country, they’re also being pressured to stay silent)

For context, Ballad is a state-sanctioned health care monopoly in Northeast Tennessee with over a dozen hospitals. They have come under fire recently for suing thousands of poor folks for not being able to pay their hospitals bills,

They were also the target of over 200 days of protest in Kingsport, and CEO Alan Levine was the mouthpiece for a company that was found guilty of Medicare fraud and forced to pay $260 MILLION in fines. (He was also recently tapped by Governor Lee for his statewide charter school approval board, which is in place to override local rulings on charter schools, and he has been known to insult people on twitter from time to time.)

But Levine’s transgressions aside, the Ballad Hospitalist tells us the reaction by Ballad has been “A CLUSTER”, citing a lack of protective equipment and testing and poor communication and education of frontline health care workers.

To be fair, these don’t seem to be entirely uncommon issues throughout the country, but the picture she paints is much different from the rosier one Governor Lee is painting for us at his press conferences, which still seem to lack the needed wartime urgency.

The Ballad Hospitalist started out by talking about masks, saying frontline health care workers at Ballad Health weren’t even wearing surgical masks throughout the day until recently:

“We didn’t even get surgical masks until 3 days ago (March 31st). Even when we knew it could be present. I had started wearing a surgical mask because it’s all I could get. It was frowned upon, but I didn’t care. I couldn’t find an N-95, but I do wear a surgical mask. We get ONE for the entire day, that’s it.”

She said nurses whose masks break or get misplaced are afraid to go ask for another one, and tells a story of having to go to bat for a nurse who couldn’t find theirs.
About the fact that supplies are so short, she has no patience for it:

“We don’t have enough supplies? GET THEM. This is your people. This is going to kill people. Maybe they didn’t think it was going to come to podunk Tennessee. But it’s here. At least 20 cases at Ballad that I know of. We’ve had 3 deaths, and at least 3 health care workers are now sick.

Governor Lee and the Tennessee Department of Health continue to brag about how many people Tennessee is testing as a way to deflect criticism being leveled at them in comparison to neighboring states like Kentucky, which took stronger, quicker action against the spread, has seen its numbers climb far more slowly, and recently told their citizens not to travel to Tennessee.

But despite the claim that there are no-to-few barriers to testing in Tennessee, tests are taking up to 10 days to turn around, and many are still being denied tests throughout the state and country. Some sites in TN are even charging up to $200 per test, which destroys the idea that “whoever wants a test can get one”.

The Ballad Hospitalist still has serious concerns:

“We really weren’t even testing for it. Nobody really knows who’s supposed to be testing or what the hell they’re doing. The Director of the ER has been complaining how the testing works, do we or don’t we?  They don’t want to test in the ER. We just now got the rapid testing which can be turned around in 6 hours. Here in the USA we should be testing everybody.”

One of her biggest concerns at Ballad was communication, which she said is all over the place, and has led to a lot of confusion among health care workers that interact with sick patients on a daily basis:

“They’re just not communicating well. Nobody really knows what to do. Education is lacking. I watch these nurses, they have no idea how to put on or take off protective equipment. The nurse has a Covid patient, then has a full patient load and has to go deal with other patients. They’ve been putting nurses at the door to take our temperature as we come in, but I’ve been having to tell nurses to take my temperature. They just ask “you don’t have a temperature do you”? 

I do think there’s going to be a huge surge of problems.”

As for what happens when a health care worker is concerned they might have been exposed or feel symptoms, she says nurses are being forced to use their paid time off, and they’ve started laying off staff – something many hospitals have been doing now that elective procedures, which are reimbursed by insurance companies at a higher rate, have stopped – the perils of an entirely for-profit health care system.

As for her message to Ballad, it’s simple really: “Get your crap together.”

“Ballad needs to GET THEIR CRAP TOGETHER. I think Ballad historically does a good job with things. A lot of people have complained since Ballad combined two systems into one, and some jobs were cut and pay was reduced – but when it comes to health care I think they’ve done a pretty good job. BUT THIS HAS BEEN A CLUSTER. 

It’s sad to me because I see such a mix of people that still don’t think it’s a big deal. Even doctors I’ve heard say this is being blown out of proportion. Sadly I think that’s because they live here. READ THE NEWS. Look what’s going on in other places. They say it’s because the numbers are skewed. No. This is real.”

As for what made her start to take it seriously, she points to a Washington hospitalist who spoke her language about what patients are going through.

“A hospitalist in Washington speaking about a patient’s progression is what really spoke to me. I was like – okay, this is a big deal. This thing is ugly. She was talking about her co-workers dropping like flies, speaking about it in a medical language that I could understand, from medical people that have seen it. Not news speak. “
Unfortunately, The Ballad Hospitalist has to stay anonymous because she says it’s clear that if you speak out Ballad will fire you – their emails say “CONFIDENTIAL NOT TO BE SHARED WITH MEDIA” – and they’re really the only employer in the area for what she does.
We appreciate her, and that she was willing to talk to us. Frontline health care workers are heroes, and they deserve to be protected.

The bottom line is in the richest country in the world we’ve lacked a uniform, comprehensive reaction to this problem, and we have been caught unprepared in large part because of a reluctance by Trump (and Fox News) to take the problem seriously until it was too late. (also, cutting the CDC budget and firing the Pandemic response team didn’t help)

Our numbers have skyrocketed. Our outbreak is the worst in the world. Our for-profit health care system system has been exposed on many levels, and we can only hope now our state doesn’t suffer even more because of a slow response and lack of seriousness by our local officials, state government, and hospital management here at home.

If you want to tell Governor Lee to hurry up and get the needed testing and gear for workers like her, holler at him HERE.

WE ASKED, YOU ANSWERED: “ESSENTIAL BUSINESSES” STILL OPEN? (FOLLERER RESPONSES)

Governor Lee has NOT issued a shelter-in-place order despite the pleas of medical professionals. Instead he is “urging” folks to stay home while ordering “essential businesses” closed.

The catch? His order includes a laundry list of “essential businesses” that basically lets everyone off the hook.

Lee also believes enforcement isn’t necessary because he’s sure everyone will just comply.

We asked y’all to tell us which local businesses that clearly are not “essential” are still open. Below are some of your responses.

FOLLERER RESPONSES:

Pollock Printing in NASHVILLE

Lowe’s in CLARKSVILLE has remained open with ineffective disinfection material and continue to schedule a woman who has cancer! I’m immunocompromised so everytime my roommate goes home from work, I’m in danger.

American Greetings – Greeting cards are not essential

Hobby Lobby in GREENEVILLE is open. Not sure if other locations are or not.

The damn Bass Pro Shop in East Ridge, TN (part of CHATTANOOGA) is still open. Why are decoys, guns, or deer bait necessities right now??!

Hobby Lobby Kingsport TN

Just about everything in Sevierville, PF, and Gatlinburg. The amount of people out still doing the tourist thing is staggering.

Jostens in CLARKSVILLE. They are forcing the entire plant to work 6 days a week and you get points even if you are sick. Around 400 employees. They make yearbooks. Not essential at all.

Whirlpool in CLEVELAND is still operating on full shifts. They employ over 1000 people who all work in close quarters. That plant manufactures stoves and microwaves. I seriously doubt that those particular items are ‘essential’ during this health crisis.

US SMOKELESS TOBACCO Closed down, forcing folks back April 1st, Located At 800 Harrison St NASHVILLE, Be The Judge Of The Necessity,Have A Great Day…!!!!

Knoxville Wholesale Furniture is still operating.

(Also: Knoxville Wholesale Furniture is still open. The owner had a fund raiser at his home on February 23 for Moscow Mitch. $10,000 donors. Marsha Blackburn attended. Owner says they are essential because they do deliveries.)

Books-a-Million in MT. JULIET and MURFREESBORO are still somehow open! I don’t get it. Friends that work there are flabbergasted. I mean, it’s a BOOKSTORE in a PANDEMIC!

grooming shop in CHURCH HILL. Groomers corner. The husband of the owner just called the county mayor of hawkins county and they told them they can stay open Also I called my regional health department in Sullivan county bc there is one I know for sure is open in BLUFF CITY and the man I spoke to told me that (paraphrasing here) since they don’t provide vet services they are considered non-essential but since there is no official mandate they are leaving it to the goodwill of the people to shut down.

RESOLUTE FOREST PRODUCTS, formerly Bowater in CALHOUN

The Whistle Stop in GREENEVILLE still had dine-in as of last week. I haven’t checked this week. It is across the street from Tusculum University where 5 students tested positive.

Also, John Deere in GREENEVILLE, they only make lawn mowers at that plant, so I don’t really understand what makes them essential. I could see it if they were making tractors here. Most of the drive through employees I’ve seen do not have gloves, mask (understandable with the shortage I guess).

Also, in Pal’s GREENEVILLE which is my kids favorite place is too small for the employees to work 6 feet apart. Most of this town is just acting like everything is normal.

The Hookah Hookup has still remained open (it is closed the next few days for inventory and the owner considers it an essential business because we carry snacks. I’ve called the health department and mayors office multiple times and no one can do anything! A smoke shop is not an essential business

Bedrugs factory on Myatt Drive in Davidson Co. — They are open, making Bedrugs for pick up trucks…. Owned BY Truck Hero in Michigan

Tmobile Call Center on 695 Grassmere Park NASHVILLE is still open

I live in GREENE COUNTY. Most if not all factories are refusing to shut down. They’re claiming to be an essential business. That they make something used by hospitals, which IMO, isn’t true for most if not all of them. We’re up to 14 confirmed cases of the virus. It’s climbing every day. They are putting their employees and their families at risk. I’m afraid it could already be too late, but hopefully I’m wrong. Thank you for all that you do to keep us informed. It is very appreciated.

hey, both Simply Mac locations are still operating and they’re absolutely not essential businesses. I have 2 friends who work there who are both high risk for COVID-19. Simply Mac is just trying to slide under the radar and actually laid off most of their employees. Ive tried calling the mayor’s office but I doubt that did anything. there are two locations in NASHVILLE. One in the same plaza as the Vanderbilt Barnes & Noble, and one in the Wedgewood Houston area. the store manager for those locations is NOT responsible for the call to stay open, she’s tried very hard to push for them to close. The corporate offices for Simply Mac are located in Salt Lake City, Utah

Bass Pro is not essential. They had someone that worked there that tested positive and closed per the mayor’s order to shut down businesses. They found a loophole and reopened three days later stating that no one can shut down a place that sells guns other than the federal government. They are not requiring customers stay 6 ft apart. No extra cleaning. Essential employees can only take off if they get the virus or they can quit. Complete disregard for their employees or the public. Only concerned about money.

Here were some twitter responses:

And then this… man’s got a point!
Here’s what a real order looks like:

IF YOU HAVE ANYONE YOU WANT TO ADD TO (OR SUBTRACT FROM)  THIS LIST, Holler at us: thetnholler@gmail.com

Or on Twitter & Facebook

Stay safe, and stay home.

GOV. LEE: “NON-ESSENTIAL SERVICES MUST CLOSE” (But Pretty Much Everything is “Essential”)

Yesterday Governor Bill Lee held a press conference during which he seemed like he was going to finally declare a shelter-in-place order one day after Sumner County was especially hard hit, sending 59 people from a senior center to the hospital and lurching to 179 cases total.

Instead, he made it clear it was NOT that order, but was instead an “urging” for people to stay home and simply an order to close “non-essential businesses”.

Reporters were a bit confused, and rightly wondered why he expected anyone would start listening to him now.

You can watch the weak display here:

Lee says this orders “non-essential businesses” close. But what are “essential” businesses, you may wonder? The answer is PRETTY MUCH EVERYTHING.

The order comes with a laundry list, and it seems pretty much any business could find a way to qualify. Lee also said NOTHING about what the consequences would be for staying open. Just more “urging” and “suggesting”, despite all the evidence showing us real mandates and strong action is working around the country.

9 of the 10 states that saw the fastest growth last week were in Republican states like ours. TN cases have more than doubled over the last 5 days. Over 2000 doctors have asked him to issue a shelter-in-place order.

This will likely do nothing to stem the tide, even though Lee insists “The Storm Is Passing”.

Meanwhile people are getting sick and dying.

From the order:

For purposes of Executive Order No. 22, Essential Services include:

1. Personnel identified on pages 5-15 of the Memorandum on Identification of Essential Critical Infrastructure Workers During COVID-19 Response issued by the Cybersecurity and Infrastructure Security Agency (CISA) of the United States Department of Homeland Security, available at: https://www.cisa.gov/sites/default/files/publications/CISA Guidance on the Essenti al Critical Infrastructure Workforce Ver i n 2.0 Updated.pd[

2. Health Care and Public Health Operations. This includes, but is not limited to: hospitals; clinics; medical practices and services; mental health and substance abuse services; dental offices; pharmacies; public health entities, including those that compile, model, analyze, and communicate public health information; pharmaceutical, pharmacy, medical device and equipment, and biotechnology companies (including operations, research and development, manufacture, and supply chain components); organizations collecting blood, platelets, plasma, and other necessary materials; obstetricians and gynecologists; eye care centers, including those that sell glasses and contact lenses; home health care services providers; mental health and substance use providers; other health care facilities and suppliers; providers of any related and/or ancillary health care services; entities that transport and dispose of medical materials and remains; manufacturers, technicians, logistics, and warehouse operators, and distributors of medical equipment, personal protective equipment (PPE), medical gases, pharmaceuticals, blood, platelets, and plasma products, vaccines, testing materials, laboratory supplies, cleaning, sanitizing, disinfecting or sterilization supplies, and tissue and paper towel products; veterinary care and all health care services provided to animals. This also includes any medical or administrative personnel necessary to operate those functions in this paragraph. Health Care and Public Health Operations shall be construed broadly to avoid any impacts to the delivery of health care, broadly defined. Health Care and Public Health Operations does not include any procedures that would violate Executive Order No. 18, which remains in effect;

3. Human Services Operations. This includes, but is not limited to: government or government-funded human services to the public through state-operated, institutional, or community-based settings; long-term care facilities; day care centers, day care homes, or group day care homes; residential settings and shelters for adults, seniors, children, or people with developmental disabilities, intellectual disabilities, substance use disorders, or mental illness; transitional facilities; home-based settings to provide services to individuals with physical, intellectual, or developmental disabilities, seniors, adults, or children; field offices that provide and help to determine eligibility for basic needs including food, cash assistance, medical coverage, child care, vocational services, rehabilitation services; developmental centers; adoption agencies; businesses that provide food, shelter, social services, and other necessities of life for economically disadvantaged individuals, individuals with physical, intellectual, and/or developmental disabilities, or individuals otherwise in need. Human Services Operations shall be construed broadly to avoid any impacts to the delivery of human services, broadly defined;

4. Essential Infrastructure Operations. This includes, but is not limited to: food production, distribution, and sale; construction-related services, including, but not limited to, construction required in response to this public health emergency, hospital construction, construction of long-term care facilities, public works construction, school construction, construction related to Essential Activity or Essential Services, and housing construction; building management and maintenance; landscape management; airport operations; operation and maintenance of utilities, including water, sewer, and gas; electrical services, including power generation, distribution, and production of raw materials; distribution centers; oil and biofuel refining; services related to roads, highways, railroads, ports, and public transportation; cybersecurity operations; flood control; solid waste and recycling collection, removal, and processing; and internet, video, and telecommunications systems and services, including the provision of essential global, national, and local infrastructure for computing services, business infrastructure, communications, and web-based services. Essential Infrastructure Operations shall be construed broadly to avoid any impacts to essential infrastructure, broadly defined;

5. Essential Government Functions. This includes, but is not limited to: first responders, emergency management personnel, emergency dispatchers, and those supporting 911 and emergency services; legislators and legislative branch officials and employees, as determined by the Legislative Branch; judges, judicial branch employees, court personnel, jurors, and grand jurors, as determined by the Judicial Branch; law enforcement personnel; corrections and community supervision personnel; hazardous materials responders; election officials and operations; child protection and child welfare personnel; housing and shelter personnel; park personnel that provide admission, maintenance, and operation of park facilities that provide outdoor recreation; military; and other governmental employees working for or to support Essential Activity or Essential Services. Essential Government Functions also means all services provided by the State, the political subdivisions of the State, and boards, commissions, or agencies of government needed to ensure the continuing operation of the government agencies or to provide for or support the health, safety, and welfare of the public. Essential Government Functions also includes contractors performing or supporting such functions. Each branch of government and government entity shall determine its Essential Government Functions and ensure a plan is in place for the performance of these functions. This paragraph does not apply to the United States government; provided, however, that any employee, official, or contractor ofthe United States government shall not be restricted from performing their functions under law;

6. Food and Medicine Stores. This includes, but is not limited to: stores that sell groceries and medicine; grocery stores; pharmacies; certified farmers’ markets; farm and produce stands; supermarkets; convenience stores; and other establishments engaged in the retail sale o f groceries, canned food, dry goods, frozen foods, fresh fruits and vegetables, pet supplies, fresh meats, fish, and poultry, prepared food, alcoholic and non-alcoholic beverages, and any other household consumer products (such as cleaning and personal care products); and the supply chain and administrative support operations for Food and Medicine Stores. Food and Medicine Stores also includes stores that sell groceries or medicine, including medication not requiring a medical prescription, and also that sell other non-grocery products and products necessary to maintaining the safety, sanitation, and essential operation of residences, Essential Activity, and Essential Services;

7. Food and Beverage Production and Agriculture. This includes, but is not limited to: food and beverage manufacturing, production, processing, and cultivation, including farming, livestock, fishing, baking, and other agricultural production, including cultivation, marketing, production, and distribution of animals and goods for consumption; and businesses that provide food, shelter, and other necessities of life for animals, including animal shelters, rescues, shelters, kennels, and adoption facilities;

8. Organizations that Provide Charitable and Social Services. This includes, but is not limited to: businesses and religious and secular nonprofit organizations, including food banks, when providing food, shelter, social services, and other necessities of life for economically disadvantaged or individuals otherwise in need, individuals who need assistance as a result of this emergency, or persons with disabilities;

9. Religious and Ceremonial Functions. This includes, but is not limited to: religious facilities, entities, groups, personnel, services, rites, and gatherings, including weddings and funerals, provided that the Health Guidelines set forth in Executive Order No. 22 are followed to the greatest extent practicable;

10. Media. This includes, but is not limited to: newspapers, books, television, radio, publishing, and other media services and related supply chain operations;

11. Gas Stations and Businesses Needed for Transportation. This includes, but is not limited to: gas stations, travel centers, and truck stops; automotive suppliers, manufacturers, repair services, and related facilities; roadside assistance operations; farm and construction equipment related services; boat repair services; bicycle shops; and related facilities;

12. Financial Institutions and Insurance Entities. This includes, but is not limited to: banks, currency exchanges, consumer lenders, including but not limited to payday lenders, pawnbrokers, consumer installment lenders, sales finance lenders, credit unions, appraisers, title companies, financial markets, trading and futures exchanges, affiliates o f financial institutions, entities that issue bonds, related financial institutions, institutions selling financial products, insurance companies, underwriters, insurance agents, insurance brokers, and related insurance claims and agency services;

13. Hardware and Supply Stores. This includes, but is not limited to: Hardware stores and businesses that sell electrical, plumbing, and heating materials;

14.Critical Trades. This includes, but is not limited to: building and construction tradesmen and tradeswomen and other trades, including, but not limited to, plumbers, electricians, exterminators and pest control, cleaning and janitorial staff for commercial and governmental properties, security staff, operating engineers, HVAC, painting, moving and relocation services, and other manufacturing, distribution, retail or service providers who provide services that are necessary to maintaining the safety, sanitation, and essential operation of residences, Essential Activity, and Essential Services, including electronic security and life safety services to assist with fire prevention and response, security, and emergency management and response;

Mail, Post, Shipping, Logistics, Delivery, and Pick-up Services. This includes, but is not limited to: post offices and other businesses that provide shipping and delivery services and businesses that ship or deliver groceries, food, alcoholic or non-alcoholic beverages, goods, vehicles, or services to end users or through commercial channels;

Educational Institutions. This includes, but is not limited to: public and private pre- K schools, K-12 schools, colleges, and universities for purposes of facilitating distance learning, providing food or shelter, performing critical research, or performing essential functions, provided that the Health Guidelines set forth in Executive Order No. 22 are followed to the greatest extent practicable. Schools providing food services to students or members of the public shall provide the food on a carry-out basis only and shall not permit the food to be eaten at the site where it is provided, consistent with Executive Order Nos. 17 and 21;

15.

16.

17. Laundry Services. This includes, but is not limited to: laundromats, dry cleaners, industrial laundry services, and laundry service providers;

18. Restaurants for Off-Premises Consumption. This includes, but is not limited to: restaurants, bars, or other similar food or drink establishments that prepare and serve food, but only for consumption off-premises, consistent with Executive Order Nos. 17 and 21. Entities providing food services to members of the public shall provide the food on a carry-out basis only and shall not permit the food to be eaten at the site where it is provided or at any other gathering site. This paragraph is consistent with and does not supersede Executive Order Nos. 17 and 21;

19. Supplies to Work from Home. This includes, but is not limited to: businesses that sell, manufacture, or supply products necessary for persons to work from home or engage in distance learning;

20. Supplies for Essential Businesses and Operations. This includes, but is not limited to: businesses that sell, manufacture, or supply other Essential Services with the support or materials necessary to operate, including computers; audio and video electronics; household appliances; IT and telecommunication equipment; hardware; paint; flat glass; electrical, plumbing, and heating material; sanitary equipment; personal hygiene products; food and food additives, ingredients, and components; medical and orthopedic equipment; optics and photography equipment; diagnostics, food, andbeverages, chemicals, soaps, and detergent; and firearm and ammunition suppliers and retailers for purposes of safety and security;

Transportation. This includes, but is not limited to: airlines, taxis, transportation network providers (such as Uber and Lyft), vehicle rental services, paratransit, marinas, docks, boat storage, and other private, public, and commercial transportation and logistics providers necessary for Essential Activity or Essential Services under Executive Order No. 22;

Home-based Care and Services. This includes, but is not limited to: home-based care for adults, seniors, children, or persons with developmental disabilities, intellectual disabilities, substance use disorders, or mental illness; and caregivers, including nannies, who may travel to a home to provide care or other in-home services, including meal delivery;

Residential Facilities and Shelters. This includes, but is not limited to: Residential facilities and shelters for adults, seniors, children, pets, or persons with developmental disabilities, intellectual disabilities, substance use disorders, or mental illness;

Professional Services. This includes, but is not limited to: legal services, accounting services, msurance services, or real estate services (including appraisal and title services);

Manufacturing, Distribution and Supply Chain for Critical Products and Industries. This includes, but is not limited to: manufacturing companies, distributors, and supply chain companies producing and supplying essential products and services in and for industries such as pharmaceutical, technology, biotechnology, health care, chemicals, sanitization, waste pickup and disposal, agriculture and agricultural products, food and beverage, household consumer products, transportation, energy, steel and steel products, petroleum and fuel, mining, construction, defense and national defense, and communications, as well as products used by or component parts of other Essential Services;

26. Hotels and Motels. This includes, but is not limited to: hotels, motels, lodges, dormitories, and short-term rentals, to the extent used for lodging and delivery or carry- out food and beverage services;

27. Funeral Services. This includes, but is not limited to: funeral, mortuary, cremation, burial, cemetery, and related services;

28. Any business related to Essential Activity, as defined in Executive Order No. 22, including any outdoor recreation area, park, site, or trail that provides opportunities for outdoor recreation while maintaining adherence to the Health Guidelines;

29. Any other business or organization that operates at all times with ten (10) or fewer persons accessing the premises of the business or organization at a time, including

employees, customers, and other visitors; provided, that the premises allows for operation within the Health Guidelines and that such Health Guidelines are followed at all times; or

30. The minimum necessary activities required to maintain any business or organization, whether otherwise essential or not, including:

  1. Maintaining the value of the business’s or organization’s inventory;
  2. Preserving the condition of the business’s or organization’s physical plant andequipment, livestock, or other assets;
  3. Ensuring the security ofthe business or organization;
  4. Processing the business’s or organization’s mail, payroll, and employeebenefits;
  5. Facilitating employees o f the business or organization being able to continue towork remotely from their residences; or
  6. Conducting any functions related to these activities.

GOVERNOR LEE WANTS “DATA AND EVIDENCE”? HERE’S SOME, GUV.

Governor Bill Lee has said he’s waiting for “DATA AND EVIDENCE” before issuing a stay-at-home order for Tennessee, which many states have done, and which doctors and mayors and the Tennessee Medical Association are asking him to do.

Instead he’s writing op-eds saying “The Storm Is Passing” despite all evidence to the contrary.

MARC LORE is an entrepreneur who works at one of the biggest companies on the planet. He has crunched the numbers, and his findings are somewhat reassuring… but require swift, immediate action.

Read what he wrote below — HIS CONCLUSION, for the Too Long Didn’t Read Folks:

“If we stay locked down and don’t spread the virus there won’t be many people who are still infected by May 1st. That’s why I believe we will be in a position to open up. But we need to remain vigilant. I feel great about NYC, but am concerned about what I am seeing elsewhere in the country. In order to keep deaths in the US below 20,000 we need to lock down the country like we did NYC immediately.”

This is “DATA AND EVIDENCE” Marc sent to family and friends in full. Hopefully someone can show this to Governor Lee before it’s too late.

—-

March 26

 

Dear friends,

 

 

I’m here in NYC on March 26th, day 10 of sheltering in place at the epicenter of COVID-19 with many of the symptoms and no way to get tested. NY represents almost half of the cases in the country and 1/3 of the deaths. Many of my friends and colleagues have symptoms as well, ranging from mild to hospitalization and they are all under 50. Coronavirus is no joke.

 

 

I’ve been reading everything I can, but it is difficult to make sense of all of the contradicting facts and figures. I find myself contemplating: How bad is this going to get? When will it be over? How does Coronavirus compare to the flu? What is the true death rate? What is the real risk for young people?

 

 

I’ve read the articles and analyzed the stats and found there to be so much bad info out there, so I decided to try and make some sense of the facts and thought I would share what I’ve learned.

 

 

In summary, this is not just a little more dangerous than the flu, but it is also not 20-40x as deadly as others claim.The Coronavirus, by my estimate, has a death rate of around .42%, on average. In a normal year the flu has a death rate of approximately .10% and in the bad flu season of 2016/2017 it was .14%. This implies Coronavirus is about 3x as deadly as the flu in a bad season. However, I’ll share some stats later that will show that the virus might actually infect older people at a higher rate than younger people. If this is true, this fact, combined with higher death rates among those 70+, explains how COVID-19 can overall be 3x as deadly as the flu, but only 1.2 – 2.5x as deadly for any specific age group. The heavier concentration of older people in the sample raises the overall death rate.

 

 

INFECTIOUS RATE

 

 

In addition to the higher death rate, Coronavirus is also more contagious. In the tough flu season of 2016/2017, 14.5 percent of the entire population was infected and there were 61,000 deaths. It is hard to know what percentage of the population would be infected if we didn’t lock things down and were business as usual. We do know that COVID-19 is more infectious and spreads more quickly than the flu. Someone with the flu infects, on average, 1.4 people, while COVID-19 infects 2.3. On the Princess Diamond cruise ship almost 20 percent of the entire population was infected within days. Granted it is a confined space, but it multiplied fast.

 

 

Even if we use 14.5% (% of population infected by the flu) at the low end and 80% of the population at the high-end we get a range of between 200k – 1 million deaths in the US.  Based on what I’ve learned I would take the midpoint and estimate 600k deaths. That implies, COVID-19, if left unchecked, would kill 1 in every 545 people (.18%) in America.

 

 

This is not a worse case. This is very likely what would happen if we did nothing. We absolutely needed to move quickly and lock things down. But now we need to be much more aggressive with testing. We are behind.

 

 

Based on my analysis, however, if the rest of the country can learn from NYC and lock everything down now (NYC waited too long and is paying the price), we can keep US deaths under 20,000 with rigorous testing and quarantine. And I believe we will be in a position to open small businesses in NYC by May 1st.

 

 

COVID-19 DEATH RATE

 

 

I said Coronavirus has a death rate of .42%. That is a lot lower than what you read. Basic math would suggest a death rate of more like 4.3% since there are currently 491,253 Coronavirus cases worldwide as of March 25 and 22,165 deaths (22,165 / 491,253 = 4.5%). This implies that Coronavirus is over 30x as deadly as the flu. That is just wrong.

 

 

The primary reason why the death rate isn’t 4.3% is simply because people with mild or no symptoms aren’t getting tested, so we have a denominator problem. I believe the true number of infected cases is about 10-11x higher than what’s being reported, which translates to a death rate of .42% vs 4.5%. That might sound like a big difference but keep in mind about half of the people with COVID-19 don’t even exhibit any symptoms at all. Let me share how I arrive at .42%.

 

 

COVID-19 DEATH RATE RATIONALE

 

 

In order to know the true number of cases you need to test everyone. Fortunately, we do have a couple of places where we’ve done that. Although it is a small data set, it tells us a lot.

 

 

Let’s start with South Korea. They have the most advanced Coronavirus testing program in the world. They have tested around 350,000 people and have 9,241 cases. That means they tested 38x the number of people who had it. This is the best proxy we have for calculating a death rate when everyone with symptoms is tested. In South Korea there are currently 131 deaths for a death rate of 1.4 percent (131/9,241). Since they are seeing less than 100 new cases a day I don’t expect the death rate to change very much although it will creep up.

 

 

Although they have a rigorous testing program they likely didn’t test those without symptoms and they definitely missed people earlier on before they started testing. They have a population of 51 million people and tested just 320,000 people. So the question is: What percentage of people have the virus and show no symptoms? We actually have two data points. On the Diamond Princess cruise they tested everyone and found 47 percent of those that tested positive didn’t show any symptoms. Also, in the city of Vo, Italy they tested all of the residents and found that 70 percent showed no symptoms.

 

 

If we take the South Korea death rate of 1.4% and adjust for 50 percent of people with Corona who have no symptoms that calculates to a .7% death rate (1.4% *  50%).  Since it took a while before Korea started testing I tried to figure out how many cases there likely were before they started testing based on the number of deaths and reverse engineering how many cases there should have been. I estimate there were another 13,000 or so cases that weren’t accounted for, making the true number of cases more like 31,000. Divide by 131 deaths and you get a death rate of .42%, which is 3x as deadly as the flu in the 2016/2017 season where we saw a death rate of .14%. Now let’s look at a few other examples to pressure test this estimate.

 

 

On the Diamond Princess cruise there were 3711 passengers and crew aboard. Everyone was tested and 697 had COVID-19 (18.7% of the population – a good example of how fast this could spread in a closed area), and 47 percent showed no symptoms at all. Nine people died for a death rate of just over 1.3% (9/697) which is higher than the .42% I estimated earlier. However, the 1.3 percent is misleading because of the heavy skew toward older people. All 9 of the people who died were over 70 years old. Since there were 288 confirmed cases for 70+ the death rate for 70+ is 3.1% (9/288). Since the flu death rate for those over 70 is about 1.2%, the Coronavirus death rate appears to be 2.5x as deadly as the flu for that age group. Let’s take a look at another example where everyone in a population was tested.

 

 

In Vo, Italy, where the entire town of 3,300 people was tested, 89 individuals had the virus and 70 percent didn’t show any symptoms. One person died for a death rate of 1.1% (1/89). But again, the population is skewed much older and the individual who died was over 70. For the 70+ age group the death rate is similar to the flu, which is approximately 1.2%. However, I admit the data sample is too small. That’s why we can’t look at any one data point. But when you start to make sense of all of the points you can begin to triangulate on a number that has statistical significance.

 

 

Another way to examine death rates is to simply focus on those of the elderly. There seems to be an interesting difference between the flu and COVID-19 regarding the likelihood of older people contracting the virus relative to younger people. For the flu, people over the age of 65 are no more likely to get it than younger people. I would have thought that the older you are the more susceptible you would be to getting the flu, but the 65+ age group represents 13.3 percent of all flu cases and 13.1 percent of the population in 2016/2017 flu season.

 

 

It appears to be different for COVID-19. On the Diamond Princess I looked at the percentage of the population that were infected by age and found an interesting trend. Here are the infection rates by age: under-50 = 6.5%, 50-60 = 7%, 60-70 = 8.2%, 70-80 = 9.4%; 80+ = 13.4%. There could be other factors at play here, but the results would suggest that an 80 year old is twice as likely to contract the virus as someone under 50, assuming equal exposure. So, not only is the death rate 3x the flu for over 80, they may also be twice as likely to contract the virus. If this were true (and I admit there may be some particular contributory circumstances that explain this) that older people are more likely to contract the virus, then it would explain why the overall Coronavirus could be 3x as deadly as the flu, but much less deadly for any specific age group.

 

 

Let’s dig in deeper on age specific death rates. If we examine the 80+ population in South Korea we see a death rate of 9.26%. Remember, we adjusted the overall death rate of 1.4% down to .42% in South Korea after adjusting for missed cases and asymptomatic people. If we apply the same multiple to the 80+ age group we get a death rate of 2.78% (9.26% / 3.3). Since the flu death rate in this population is about 1.75% this would suggest that Coronavirus is about 1.6x as deadly for this population.

 

 

Another way to analyze this is to look at the death rate for those below age 50. The reported death rate for under 50 in Korea is approximately .05%, and that is before making the correction. In fact, no one under age 30 died. If we divide .05% by 3.3 we get a death rate of .015% for under 50. Since the death rate for under 50 for the flu is .013% it implies that Coronavirus is about 1.2x as deadly as the flu for those under 50. However, it is not just the death rate for this population that needs to be considered. People under 50 are getting very sick and are being hospitalized and put on ventilators at a much higher rate than we see with the flu.

 

 

In conclusion, I believe that the true death rate on average is .42% or about 3x as deadly as a bad flu season, however for any specific age group it is between 1.2x – 2.5x as deadly.

 

 

US – PREDICTED CASES/DEATHS

 

 

With the exception of NY, I believe many states may have caught this in time, so the actual death rate will be a fraction of what it could have been. If you look currently at US data, there have been 68,211 cases as of March 25 and 1,027 deaths for a rate of 1.50 percent. However, the number of deaths will grow even if there were no new cases because there is a lag time between diagnosis and dying. Two days ago the percentage was 1.25% and now it is 1.5%. It will keep climbing. I took each of the daily cohorts of new cases and assigned a probability of dying by day based on what has been observed. Then I estimated how many deaths there would be if cases ceased today. With this calculation, I get a death rate in the US of 4% (on observed cases) which is much closer to the current global average of 4.5%. This gives me some comfort that the model is working. We know we haven’t done the testing, but this proves how little we have actually done because we’ve established that the actual death rate based on infection is really more like .42%. This means that the number of true infections in the US is more like 10x what is being reported. I estimate around 680,000 actual (not the reported number) cases in the US vs 68,000.

 

 

Based on the modeling I did, assuming some period of incubation, I estimate that the true number of cases (true, not reported) in the US could grow from 600k to between 2-5 million, infecting about 1 percent of the population. To put that in context, in Vo, Italy almost 3 percent of the population was infected.

 

 

With 2-5 million predicted infections in the US and a death rate of .42%, I would expect about 15k deaths in the US (range 8k – 21k). Remember that in the 2016/20117 flu season we had 61,000 deaths. I will continue to update the model as the days pass based on the new information.

 

 

NY – PROJECTED CASES/DEATHS

 

 

In NY we are now at 33,000 Coronavirus confirmed reported cases as of March 25th, but the true number of infections is more like 250,000, (the multiplier is not 10x because NY has done more testing than the rest of the country) based on the way deaths are materializing. I built a model to predict cases and deaths by modeling the daily number of new infections and applying a distribution of the incubation period before symptoms show. The data I have from NIH shows that less than 2.5% of people will see symptoms in the first 2.2 days, and 97.5% will see symptoms within 11.5 days with the average number of days being 5.1 days. We don’t know the actual number of infections, but we can reverse engineer the number if we know the number of cases and deaths.

 

 

Given the incubation period and time to get tested, we are now at a point, 10 days removed from the lockdown, where we’ll know any day if we’ve slowed the virus. Each day will give us critical info. I’ll be watching the numbers closely and will send an update. If we see the number of new reported cases in NY remain under 8,000 today after 6,618 cases yesterday I think we’ll be tracking toward about 5,000 deaths in NY, which is a lot lower than what people in NY fear. Today is a critical data point.

 

 

5,000 deaths equates to around 1.2m true infections (5,000 / .42%) and implies, based on the 19.5m population in NY, that 6.1% of NY State will become infected. Since almost half the state’s population is in NYC and most of infections are concentrated there it implies over 10% of people in NYC would become infected.

 

 

With 10% of the population infected in NYC we would need a maximum of 15,000 hospital beds. Today we are using 5,327 hospital beds up from 3,805 the day before. There is absolutely no way we will need the 140,000 hospital beds that Governor Cuomo said we will need. 140,000 beds would be required if every single person in NYC were infected at the same time. I know this because of the actual number of hospitalizations and deaths, which implies a certain number of infections.  It is mathematically impossible to get to 140,000 hospital beds being needed at one time. And 5k ventilators will be more than enough to handle all of the cases in NY.

 

 

Let this be a lesson to the rest of the country. If we extrapolate the NYC death rate nationally we would see nearly 200,000 deaths in the US vs my current prediction of less than 20,000. All states need to take this seriously.

 

 

WHAT SHOULD WE DO NOW?

 

 

It makes sense to shut everything down so we stop the spread, but we also need to ramp up testing dramatically.We have 6.5 times the population of South Korea and they tested 350,000 people before they were able to stop it, so that means we may need over 2 million tests. The quicker we start testing and isolating people the quicker we can get back to life. I expect restaurants and small businesses in NYC to start opening before May 1st given the more aggressive stance NYC has taken on testing and the current trends. I’ll let you know if this estimate changes.

 

 

Hope this is helpful. If you have any new data points that I should include please let me know. I will update the model daily and send an update.

 

 

NY Update – March 27

 

 

I said it would be a good sign if the number of new cases were less than 8,000 yesterday and we had less than 7,000 so that is a good sign, but I’m seeing a lot of bad data relating to the number of cases. The cases are too dependent on the number of tests and the timing of the results. Therefore, I am going to focus on the number of hospitalizations and deaths because those numbers are more concrete.

 

 

For today, March 27th, I am projecting 7,568 hospitalizations and 142 deaths. My projections track toward reaching a maximum of 15,000 hospitalizations in 11 days. And we are tracking to 5,700 deaths, with a daily peak of about 250 per day. Don’t be alarmed if daily hospitalizations and deaths double over the next week and a half. That would be a good sign as most predictions show a multiple of my projections. It means that the lock down is working.

 

 

The next few days are so critical because we are 11 days from lockdown, so we’ll know in the next few days if we dramatically slowed the number of new people being infected because the average number of days from first symptoms to hospitalization is 12-13 days.

 

 

Please let me know if you find any info that would be helpful to include in the model. This needs to be a group effort.

 

 

Be safe and shelter in place. We can beat this.

 

 

NY Update – March 28th

 

 

I was looking for 7,568 hospitalizations and it came in at 7,328 up from 6,481. This is huge news! As I said each day is super critical. The 240 shortfall is a big number and means the lockdown is working for sure. It is not just the single datapoint that is encouraging. The 3 day trend is very positive and the number of new hospitalizations has peaked.

 

 

As a result I am taking my peak hospitalizations down to 12,000 from 15,000. And the number of ventilators down to 3,000. And I cut my projections for hospital beds needed tomorrow down to 8,142. If the lockdown didn’t work we would have been at 10,655 beds today going to 13,454 tomorrow. It is working!

 

 

The 209 new deaths was surprising this early, and a big jump from 134 the day before. The total deaths stand at 728, but I have total deaths of 809 to date, based on the model. I don’t think NY captured all of the earlier deaths and so I believe this is partially a catch up. We will know a lot more in the next day or two. The other possibility is deaths are happening faster than the avg 5.1 days I modeled or the distribution is off, but I don’t think the death rate can be off because my cumulative total is still a little higher. I am projecting 164 deaths tomorrow.

 

 

If we stay locked down and don’t spread the virus there won’t be many people who are still infected by May 1st. That’s why I believe we will be in a position to open up. But we need to remain vigilant.

 

 

I feel great about NYC, but am concerned about what I am seeing elsewhere in the country. In order to keep deaths in the US below 20,000 we need to lock down the country like we did NYC immediately.

 

 

VIDEO: “BANDANAS AND DIAPERS”

Yesterday Governor Lee denied his Department of Health told doctors to use “MAKESHIFT” masks like bandanas & diapers…

…so we found THE WEBINAR WHERE THEY SAID IT.

Trust doctors.

Speaking of MASKS… As Lee’s Dept. of Health encourages doctors to strap diapers on their faces… His PRIVATE BUSINESS is still operating, and appears to have plenty of masks for their employees

YARBRO: “I think we should make sure we’re actually adjusting to the emergency at hand.”

Senator Jeff Yarbro calls for NO-EXCUSE ABSENTEE BALLOTS to let ALL Tennesseans vote by mail 👏🏽, rather than Sen. Gardenhire’s (clearly dangerous) bill to bring EVEN MORE PEOPLE TOGETHER.

VIDEO: “Nathan Bedford Forrest Day Should Be Removed”

Rep. London Lamar’s bill would remove KKK GRAND WIZARD DAY in Tennessee.

Rep. Andy Holt (“We’ve all done things we wish we hadn’t”) and Rep. Mike Sparks (“atrocities on both sides”) push back.

Governor Lee has said he won’t reaffirm it.

CASADA: “I Strongly Oppose A Living Wage”

Disgraced ex-Speaker Glen Casada opposes a Rep. Jason Hodges bill that requires companies getting incentives to come to TN to pay their employees fair wages.

RELATED: TN leads Flag of United States in min. wage jobs, inequality is at record levels.

PUTNAM CO. LIBRARY: Holt’s Witness’ Drag Queen Story Hour “Genitalia Exposure” Story Didn’t Happen

Rep. Andy Holt (R-Dresden) has a bill being carried by Paul Bailey (R-Sparta) in the Senate that seeks to impose censorship on libraries by forming parental boards which would be able to decide what can and can’t be in them.

The Tennessee Library Association opposes the bill, saying libraries already have local control, and pointing out discrimination would open the libraries up to lawsuits.

Holt & co. say it isn’t about discrimination, it’s about protecting kids – but witnesses that spoke in support of the bill are openly anti-LGBT, tweeting proudly about that designation on multiple occasions.

Both witnesses who supported Holt’s bill were self-described preachers who spoke of an incident at the Putnam County Library where a Drag Queen “exposed their genitalia” to a child.

We’ve seen no reports of any such incident, or anyone being arrested for doing this – which is obviously ALREADY A CRIME – so we called the library to ask about it. Here’s that conversation:

HOLLER: You had Drag Queen Story Hour at the Putnam County Library, and witnesses at a hearing this week say somebody exposed themselves to a child. Did that happen?

PUTNAM LIBRARY: “No. Well – one can never prove a negative, right? I can’t flat-out say it didn’t happen. But ONE: No library staff witnessed that happening. TWO: It was never ever reported to any staff. THREE: We had police on the scene during certain parts of that day. Nobody ever filed a police report. Nobody ever notified the police that this happened. So we assume it didn’t happen.”

HOLLER: They say they have a picture of it. Have they ever brought that to you? Or the police?

PUTNAM LIBRARY: “Not that I’m aware of. They never brought it to me. I’m pretty sure they never brought it to the police. Because I imagine they would’ve had a police report, and they would’ve come investigated that.”

He also went on to tell us they had an LGBT display with books during Pride Week, but they were age appropriate, not pornographic in any way, and they ended up removing it when enough locals asked them to.

We also checked in with a spokesperson from the Drag Queen story hour situation, who told us:

“Rich Penkoski is a street preacher who does online videos. His group, Warriors for Christ, is a hate group per SPLC. He has a photo of a supporter in drag squatted down talking to a child outside Putnam Co Library that he has blurred to look like it’s obscene.

These are the facts: He has never been inside one of our events. Our Facebook page has videos of our readings. We haven’t used a public library since Jan 2019 because the crowds are too big for the library. We’ve been using private venues since March 2019. All of our volunteers have to pass a background check.”

BOTTOM LINE: Penkoski and Pastor James Fortunato are claiming someone exposed themselves to a child – which is already a crime – but did nothing about it? And they’re question the morality of others?

This bill is quite obviously about censorship and discrimination. Call your reps.

 

UPDATE — Penkoski reached out to us about the incident, and maintains it did happen, saying:

The library staff is lying. We absolutely did tell them about the man exposing himself. I have an email that I sent to them and the board with the photos. You also never mentioned the librarian who called for violence against me and solicited help from a group in Louisiana who made local news for issuing death threats against me.

UPDATE 2 — Penkoski has sent us the pictures in question. There does not appear to be any genitalia, only exposed underwear – and would seem to make sense that the library took no action.

The parents were right there. They claim the bill is about parental control, yet are making a big deal about something the parents don’t seem to have pursued.

Also, here they are wondering why the police and the news are being unresponsive.

VIDEO: Rep. Andy Holt & The TN GOP’s ANTI-LGBT LIBRARY CENSORSHIP Bill

Backed by hostile anti-LGBT witnesses, Rep. Andy Holt openly advocates library “CENSORSHIP” as he pushes a bill targeting LGBT events at libraries — a bill the Tennessee Library Association says would inevitably lead to lawsuits.

Here’s a little of what one of the witnesses tweeted recently… proudly anti-LGBT:

WATCH: