Epsilon Theory PDF Download (paid subscription required): Don’t Test, Don’t Tell
I believe that a healthy society should not have only one voice.Li Wenliang, Wuhan physician, born October 12, 1986, died February 7, 2020.
Last night, I received a Twitter DM that included screenshots of an email that went out to staff at the UC Davis Medical Center. After checking for authenticity, I posted the screenshots in a tweet of my own.
And that’s when, as the kids would say, it blew up.
I want to highlight a couple of quotes from this email.
Since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered. UC Davis Health does not control the testing process.
The facts here are pretty clear. Patient comes in from another hospital on Wednesday, Feb. 19 – this is one week ago – already intubated and on a ventilator, and the doctors at UC Davis – who have treated other COVID-19 cases – IMMEDIATELY suspect COVID-19.
But the CDC refuses to test for COVID-19.
Why? Because it didn’t fit their “criteria” for testing. They didn’t know for sure that the patient was in mainland China within the past 14 days, and they didn’t know for sure that the patient was in close contact with another confirmed case, so BY DEFINITION this patient can’t possibly have COVID-19. No test for you!
This is “Don’t Test, Don’t Tell” and it is the single most incompetent, corrupt public health policy of my lifetime.
And it’s happening all over the country.
Here, take a look at yesterday’s press conference from Nassau County, Long Island.
Excruciating. They spend the first five minutes of the presser congratulating each other. Then the update: 83 people are in self-quarantine at home, where they are supposed to “check their temperature” daily. Don’t have a thermometer? Not to worry! The Nassau County Health Commission will provide one for you!
Who are the 83 in self-quarantine? Why, they’re everyone that Homeland Security says should be in self-quarantine, based on “current guidelines” of someone who was in mainland China within the past 14 days.
Has it been 15 days since your mainland China visit?
Have you been to Northern Italy in past 14 days?
Have you been to Iran in past 14 days?
Have you been to South Korea in past 14 days?
Well, no self-quarantine for you! You’re fine!
And here’s the kicker. Not only is there ZERO tracking or monitoring of anyone who has been swimming in the coronavirus stew of South Korea, Northern Italy and Iran, but let’s say that you have in fact been to one of those areas recently and now you’re feeling sick. You go to the doctor and you tell her the whole story. Both of you suspect it might be COVID-19. You’re trying to do the right thing here. You call the county health authority. You call the state health authority. You call the CDC. And then you learn the awful truth of Don’t Test, Don’t Tell.
It’s not that testing is not available.
It’s that testing is not ALLOWED.
I’m not panicked. I am perfectly calm.
But I am really, really pissed off.
Because here’s the other quote from the UC Davis email that I’d like you to pay close attention to:
When the patient arrived [Wednesday], the patient had already been intubated, was on a ventilator, and given droplet protection orders because of an undiagnosed and suspected viral condition. … On Sunday, the CDC ordered COVID-19 testing of the patient and the patient was put on airborne precautions and strict contact precautions.
Translation: for four days, every healthcare professional treating this patient at UC Davis was exposed to airborne transmission of COVID-19. And so was every healthcare professional at the hospital before UC Davis. Because the CDC refused to test this patient for COVID-19 in a timely manner, the doctors and nurses and technicians caring for this patient were put at risk.
We are asking a small number of employees to stay home and monitor their temperature.
This is the part of the story that we must yell at the top of our lungs.
Don’t Test, Don’t Tell is not just hiding the true extent of COVID-19 cases in the United States.
Don’t Test, Don’t Tell is not just perpetuating the politically corrupt “Yay, Containment!” narrative of this White House.
Don’t Test, Don’t Tell is endangering the lives of our doctors and nurses.
Just like in China.
Just like in Wuhan.
A city falls when its healthcare system is overwhelmed. A city falls when its national government fails to prepare and support its doctors and nurses. A city falls when its government is more concerned with maintaining some bullshit narrative of “Yay, Calm and Competent Control!” than in doing what is politically embarrassing but socially necessary.
That’s EXACTLY what happened in Wuhan. More than 30% of doctors and nurses in Wuhan themselves fell victim to COVID-19, so that the healthcare system stopped being a source of healing, but became a source of infection. At which point the Chinese government effectively abandoned the city, shut it off from the rest of the country, placed more than 9 million people under house arrest, and allowed the disease to essentially burn itself out.
And so Wuhan fell.
The disaster that befell the citizens of Wuhan and so many other cities throughout China is not primarily a virus. The disaster is having a political regime that cares more about maintaining a self-serving narrative of control than it cares about saving the lives of its citizens.
We must prevent that from happening here. From happening anywhere. Yes, containment has failed. But that does NOT mean the war is lost. We can absolutely do better – SO MUCH BETTER – for our citizens than China did for theirs.
The CDC’s Don’t Test, Don’t Tell policy came crashing down last night. So did Trump’s “buh, buh the flu” and “Yay, Containment!” narratives.
Now let’s get to work preparing for the fight to come.
Not in panic. Not in fear. But with resolve, sacrifice and righteous anger for those who would use us instrumentally for their own political ends.
Clear eyes. Full hearts. Can’t lose.
Epsilon Theory PDF Download (paid subscription required): Don’t Test, Don’t Tell
Can you please make this into a .pdf. I’ve been sharing these with my “pack”… Thank you!
“When it becomes serious, you have to lie.” ~ Jean-Claude Juncker, former President of the European Commission, May 2011
Agreed! We need more of these in PDF. They just don’t print well.
Could it be there is a shortage of test kits and the criteria are a rationing mechanism?
Ben, what changes have you made, if any, in your personal life in response to this? Do you think domestic travel limitations make sense in the US?
Killer Math: CA’s governor just announced the state is “monitoring” 8,400 patients for potential CoVid-19 infection and has only 200 test kits. (source ft.com)
Yep! It’s up now.
I think there’s a shortage of test kits in the US from sheer incompetence, but the criteria are the result of an entirely different sort of sheer incompetence.
You’re exactly right. Same thing happening in Canada right now. Same attitude/approach during SARS. I was a physician during SARS in Toronto at the time. Nothing has changed at all, unfortunately. Only a singular ability to avoid any introspection by the respective public health/government officials who are in charge of coordinating a rational response… Thanks for writing this entire series.
After watching Little Hands Wednesday night, I was apprehensive as to the market’s response today. Appropriately so. But, his grasp of the situation is typical of his grasp - or is that what the market is telling us?
Thank you Ben!
They needed at least a two week cushion to keep the stock market up so the “elites “ (the Neocons, Larry Summers, the Clinton’s, GS Partners, etc.) had time to sell all their stocks! We didn’t wait. Began buying April Put Options on FAAMG stocks when the S&P was still ramping. The complacency and stupidity is just incredible. ZH published an article the other day containing a list of supplies to obtain to self quarantine and care for an infected family member. It came from some “preppers” guide. Well worth researching. It’s gonna take more than a few N100 masks!
Because there are apparently asymptomatic carriers spreading COVID-19 (https://jamanetwork.com/journals/jama/fullarticle/2762028), my plan to protect my loved ones majors on nutrition instead of a potentially futile attempt to avoid being infected.
As the article above explains, “Fourteen percent of confirmed cases have been “severe,” involving serious pneumonia and shortness of breath. Another 5 percent of patients confirmed to have the disease developed respiratory failure, septic shock, and/or multi-organ failure—what the agency calls “critical cases” potentially resulting in death. Roughly 2.3 percent of confirmed cases did result in death.”
Because septic shock is already a leading cause death word wide, I’m considering having the life saving Marik Protocol tattooed on my ass.
I actually wanted to put this in the comments on the cargo cult of Covid19 post, but for some reason it would not go through, so here it is instead :
Thank you Rusty, this is a great one……
Some questions for all of us
Given all our discussions here about the markets turning into political utilities and the high probability of massive fiscal spending in the next few years, perhaps this complacency on the Covid19 is not entirely misplaced?
So far the talking heads have been all about supply chain breakdown due to Mainland China.
What happens when there is a breakdown in demand –from US and EU and Japanese consumers – when the virus spreads and fears mount?
Those who willfully choose path of spiritual, mental and physical loss under standard conditions do not deserve compassion upon realization of such loss - else, it is disrespect to those who were affected by the loss captively and to those who exert active efforts to make a gain under same conditions. We are responsible for what we know and more importantly to explore what we dont in order to realize most gains and avoid losses.
I think (opinion, not fact) that the initial slowness of market response was exactly what you say: the effects of a continued belief in central bank intervention, at least in market world. Basically consistent with every other minor correction since 2009. It seems like we’re now in a position of reflexivity, where the market being down creates feedback loops to narrative structure, models and the willingness of investors to believe those omnipotence narratives for our political institutions. We’ll look at the same data again next week to see if it reflects this opinion.
But no, I don’t think it’s impossible that there could be a shock-and-awe fiscal/monetary policy bundle that changes this dynamic.
As to your second question, at a certain point whether something is fundamentally supply or demand shock gets pretty muddy (and less important). You’re right to point out that consumer demand has not really been stressed here yet. And may not yet, depending on how the whole event unfolds. This is part of the reason why the uncertainty factor that exists because of Don’t Test Don’t Tell is so perilous. There are potential cascade effects that are nearly impossible to predict - and even harder to discount.
Couple of three things:
How much trust of big Gov, Pharam, Corp. etc. will be destroyed by the mismanagement of this pandemic?
People and life situations are not homogenous. Standard conditions is a necessary but false fulcrum for your insight.
guess we’ll have to watch and move in real time as this virus situation unfolds…
War of the Worlds; COVID-19.
Wherein Viral People are consumed by a virus.
There is in COVID-19 another elemental force at work; GREED, not just FEAR.
Wuhan is - and at present isn’t - a major industrial manufacturing center.
GREED AND FEAR=MARKETS.
I mean; the underlying terror of Corporate Media and the Stock market is the supply chains aren’t working, because the workers can’t come to work.
Toyota just reopened some factories at 40% staff, rest can’t make it in.
I mean the stock market drop is real, and the fear isn’t of COVID-19: its the shelves being empty.
Walmart and Target are already warning publicly that by April they’re going to have empty shelves for many goods.
The neoliberals could give a damn if 50-100 million die, they care that the great Just In Time supply chain is out of time.
The Strangest thing; its War of The Worlds.
“After all man’s weapons and devices had failed, the Invaders were undone by the smallest of creatures that nature in her wisdom had put on this earth: the lowly germ. For the moment that ate of our food and drank of our water, they were doomed. For not for nothing do men live, or die in vain.”
Goodbye Neo-Liberal Pod People.
Wait; its sheer incompetence to not have a vast stockpile of test kits for a new disease only identified a few weeks ago?
There were some FDA and other roadblocks put up it seems, but incompetence is the wrong word.
Flat out this sort of thing used to be called yellow journalism, but we live in the age of the internet.
It seems competence requires clairvoyance; the ability to prepare for non-existent diseases.
Actual Incompetence; not anticipating global Petri dish would contaminate or eliminate “global supply chains” and so impact what’s really important: $$. The lack of money is the root of this hysteria, the media and the markets are in meltdown because COVID-19 isn’t just a pandemic; It’s the COVID-19/Manufacturing and Retail Crisis of 2020.
And it is, isn’t it?
Two separate issues:
I think you’ve created a straw man here. Who is demanding clairvoyance? Let’s simply define competence on the described dimensions as how we stack up against other countries, who had information at the same time as we did. How quickly did we adjust our PUIs compared to other countries? How quickly did we produce and make WORKING tests available with clear instructions to local hospitals? I don’t think we stack up especially well against our peers on any of those dimensions. I also don’t think ‘incompetent’ is the wrong word to use to describe that.
Yes, the economic repercussions of a potential pandemic and the social distancing response to it are significant. I’m probably in the camp of thinking those will end up being the biggest impacts, at least in central cases. I’m not so sure that I would characterize this as incompetence as much as I think it was a classic short vol trade on an underlying system with real fragility. Global, concentrated, fragile JIT supply chains are beneficial to equity owners…until they aren’t. I think it’s fair to say it was probably underdiscounted, but it was a conscious bet.
I think you’ve gotta live your life, as more than likely (IMO) we’re all going to get it eventually, so no sense going off the grid entirely. But I am absolutely eliminating any sort of optional travel. And we’ve got lots of Purel. And we live on a farm where we can’t see our neighbors. I’ll say this, though, for my meetings in NYC this week and next … I’m driving my car into the city instead of taking Metro North.
I think trust was already pretty far gone. But this is the last nail in the coffin.
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