The cure might be worse than the disease
President Trump wants to re-open the economy, and that means that I should automatically oppose it because it will cause some people to die.
That is 100% true.
But will more people die if we continue the lockdown?
This is not a hyperbolic question.
No model or guesswork is required to foresee the deadly impact. Job losses cause extreme suffering. Every 1% hike in the unemployment rate will likely produce a 3.3% increase in drug overdose deaths and a 0.99% increase in suicides according to data provided by the National Bureau of Economic Research and the medical journal Lancet. These are facts based on experience, not models. If unemployment hits 32%, some 77,000 Americans are likely to die from suicide and drug overdoses as a result of layoffs. Scientists call these fatalities deaths of despair.Then add the predictable deaths from alcohol abuse caused by unemployment. Health economist Michael French from the University of Miami and a co-author found a "significant association between job loss" and binge drinking and alcoholism.
The impact of layoffs goes beyond suicide, drug overdosing and drinking. Overall, the death rate for an unemployed person is 63% higher than for someone with a job, according to findings in Social Science & Medicine.
These are hard numbers based on historical patterns. There is no doubt that at a certain point the lockdown will kill more people than the virus.
Calls at suicide hotlines have increased by 800 percent.
There is also one other factor that is not included above.
“Eviction equals death. That’s never been more obvious than at this moment and in the public health crisis that we’re living in.”
- Julian Smith-Newman, a member of the Los Angeles Tenants Union
Just 69% of US apartment renters had paid all or part of this month’s rent by 5 April – down from 82% a month earlier – according to the National Multifamily Housing Council, an apartment industry group... The National Low Income Housing Coalition estimates that 10 million low-income US households were paying 50% or more of their income toward rent – and therefore at higher risk of experiencing homelessness – before coronavirus. Now, they estimate 1.5 million more could soon be in the same position.
That's about 13.4 million renters plus families that couldn't pay rent.
There are temporary bans on evictions, but in many cases they are useless.
The coronavirus-relief bill passed last month by Congress prohibits foreclosure on federally backed mortgage loans for 60 days, covering some 30 million homeowners. The bill also prohibits rental evictions for 120 days for properties secured by a government-backed mortgage. That covers about half of all multifamily homes. Beyond that, however, protections for renters tends to be haphazard, varying widely by state...
Many of these states are in effect simply delaying hearings, typically for 60 or 90 days or until the state’s emergency declaration lifts.
36 states still allow for evictions. Some states require tenants to demonstrate they’ve been affected by virus outbreak before they are shielded from eviction.
Even before the lockdown, one out of four renters spent over half of their income on housing. Among these households, half had less than $10 in savings.
Evicting tens of thousands of families will cost lives in ways that aren't listed above:
1) homeless shelters can't afford social distancing, and
2) suicide rates among homeless populations are nine times that of the US general population.
So keep in mind the tens of thousands of people that we will be killing with this lockdown. It's mathematically certain to happen.
Comments
OT: It's even worse for commercial renters
slightly OT
A lot of small businesses won't make it
It's a feature not a bug
More power to the Fortune 100
I've seen lots of changes. What doesn't change is people. Same old hairless apes.
More specific numbers
link
Right now we're losing 12
Right now we're losing 12 thousand a week, and that's after we've flattened the curve. The death rate for doctors and nurses is outrageous. Sure yuppies that work from home will do fine, but until we stop killing young health care professionals due to lack of basic protective equipment the entitled class is just going suffer through getting paid to read the net.
You either didn't read the essay
or don't understand the situation, or both.
The most vulnerable are being hurt by the lockdown.
@gjohnsit I read both and
The working class can collect unemployment. Gig workers can go home and live with the folks. Meanwhile the rest of us keep working, and it's mostly the working class getting sick.
The reality is that we just don't have the data yet.
Which leaves our "decision-makers" in a bad situation.
No matter what they decide to do, some among the commentariat (which includes us c99p contributors) are going to criticize them, sometimes in the harshest terms imaginable. The Daily Telegraph is bitching because the London's rapid-built 4000 bed (with over 2k ICU beds) hospital admitted only 19 patients over Easter. Well ... does that mean the decision makers should not have equipped it?
There's a flip side to the severe and well-deserved contempt that we heap upon the incompetent jackasses in government (or industry, for that matter) who invoke the Bush Administration motto, "Nobody could have predicted X," when in fact lots of people predicted X, including, speaking for myself anyway, "us".
The flip side is that when somebody in government (or industry) errs on the side of caution, it's not fucking fair to beat them up if they turn out to have been over-cautious -- especially when the cost on the downside is potentially really, really high. And when the expensive cautious policy is aimed at actually preventing a disaster, the policy-maker is now in a blathersphere lose-lose position, because if their policy is successful, there will be no catastrophe -- and irrational blatherati will jump up and down, mocking them for paying whatever price was paid on their preventative policies.
This happened, most of you will recall, on New Year's Day, 2000. The world didn't end. And ever since, mocking idiots have mocked and derided the investment that went into fixing the Y2K bug. Well. What did they think was going to happen, after the expenditure of all those billions of dollars? This is such a bizarre tail-eating bit of epistemology that it blows my little mind. My god, just imagine what the blatheroar had still been a catastrophe despite all that money spent!
And that's how this is going to play out. All over the place, including this place, people are triumphantly pointing at the failure of 1,000,000 randomly selected people to have already died as evidence that the whole thing is just a scam cooked up by whomever it is that the particular commenter most loves to hate and fear. Well, WTF? Jesus, what the fuck would it look like if the disease kept spreading at geometric rates in spite of the lockdowns? That would be apocalyptic.
Here's an interesting thing: Just today, I read one blatherer blathering that the virus does not in fact aerosolize. And then I read another blatherer blathering that there's no evidence it can be passed on from surfaces. It seems we're running out of mechanisms for this virus to spread, which is pretty surprising considering how fast it spreads. Seems like there must be a whole lot more people kissing people they probably shouldn't be kissing that I was ever aware of. I'm suddenly feeling really left out.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
The Daily Torygraph (DePiffle's former employer)
complaining about spending money on stuff that might help people??
Say it ain't so.
Gëzuar!!
from a reasonably stable genius.
thank you for using
paragraph breaks; it's hard for me to read your comments when you don't. as to this?:
i hadn't clicked in, but if you're referring to this on the Swiss Covid-19 report:
yes, the WHO got a lot wrong apparently, but wondering about it, i dug up: COVID-19: What a New Study Says and Doesn’t Say About the Possibility of Airborne Transmission’, By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor: March 20. you'll likely understand the experiment and conclusions better than i, but the conclusions:
That nurse's analysis is useful with respect to the
study she's discussing, which may have been part of what informed the WHO's updated recommendations on March 29. I didn't check the citations.
On the other hand, this, from the SWPRS site:
... turns out to be simply not true. The WHO statement from March 29 makes it clear that they do not know whether Covid-19 is subject to "airborne transmission" -- which is, importantly, a technical term. Their recommendation was that medical staff continue to behave as if "airborne transmission" is possible. It's just that the circumstances under which they expect "aerosolization" to happen are limited (e.g., during intubation procedures).
For myself, I'm surprised to learn that coughing and sneezing do not normally produce aerosol-sized particles, but only droplets large enough to quickly settle out of the air.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
actually, so am i,
and i'd just come back to edit my comment to reflect that.
Under our current paradigm
... This is true. The deaths of despair have been ramping up for years as more and more people who have been struggling to keep their heads above water become exhausted and drown. The sudden deluge of people without the means to sustain themselves will result in even more deaths of despair.
But it is obscene that we are required to choose between death by virus and death by despair. Other countries are making plans for an emergency UBI and housing those who need it. We could offer our citizens a life preserver, too.
So true
The choices shouldn't be:
1) risk catching the virus
2) going broke, hungry, homeless
But it looks like those are the only choices the ruling class are giving us.
This comment is the condensed, no bullshit, version
The question in my mind is how many people are coming to this realization? I think many have known it for a long time on some level. Being actually faced with those two choices is another. Maybe. How many are willing to fight to change this reality when it risks whatever cushion they think they have? I bet we get through the worst of this and hardly any of us will have been convinced that we have to fundamentally change America regardless of the pain to us individually and personally.
The only way that might occur is if this gets really bad and drags on for a couple of years or more. Only when the more comfortable of us, the upper middle class and above, realize that our masters will happily sacrifice us to a virus or starvation as long as they retain power and their hoard of money and tangibles. As long as some of us can think we have enough that is ours and have the illusion there is still a ladder to pull up, it ain't changing.
Had this occurred a year ago the story might be a bit different.
"Ah, but I was so much older then, I'm younger than that now..."
People are starting to rise up
— armed people — demanding that the
incubationisolation end. They want to work and go to church or school or go shopping. Social restrictions may be an affront to their sense of civil rights. I think it's important to pay attention to the people who actually own the civilization.I was wondering what I would do if I were a ruler facing hoards of people holding handguns and rifles. What would you do?
Here's what I came up with: I'd tell Outsiders — those who want to do normal things like go to work and attend social gatherings — to go ahead and do so. I'd tell them we would do our best to provide them with normal city services on a volunteer basis. Can't force city and state employees at gunpoint but I imagine many government employees would also want to return to work. Public programs to help them cope with the health challenges of the epidemic would continue and improve. I'd thank Outsiders for invigorating the economy.
I'd tell everybody else to continue to isolate themselves. I'd have those in quarantine and isolation notify the city, so we can monitor their wellbeing. Then I would use available and emergency funds to open new services to make sure they had adequate food and necessary services. I'd open-fully staffed hotlines to make sure their concerns were heard and attended to during their isolation. We would broadcast news and advice to help those sequestered. On a means-tested basis, internet and other utilities would be provided to isolating residents. I'd try to expand Medicaid and I would thank them for not burdening medical services with virus cases.
Families and groups that have breadwinners who go to work outside of quarantine would not be considered part of the isolated population.
.
That could be a fixed liability, regardless of decisions made now. People are fragile.
[edit = typos]
I went to the store today and everything seemed normal
You wouldn't know that most of the country is shut down. Sure there were stickers on the floor for where people should stand and the lanes were marked one way and wrong way. A few people were wearing masks but most weren't. Means Amazon and Walmart are making buko bucks while many small businesses are closed and might not open again.
If the game is making it mandatory for people to stay home then they have to help support them so they don't lose every they have worked for. Of course there is plenty of money for that cuz we saw how they gave money to corporations that didn't even need it right now. And the only one that has to keep paying their employees are the airlines. Pelosi got $25 million for the Kennedy center who then laid off its employees.
And it's not just going to be the people who commit suicide that are going to die. People who have cancer and other diseases aren't getting their aggressive treatments. Take just one preventable disease, skin cancer. If people can't see their doctors to get that diagnosed in time they might not be able to beat it. How many more preventable diseases are going undiagnosed? I'm sure there are so many other issues we can't think of.
Hard choices huh?
Hard choices, indeed.
I've also noticed that a reality gap is opening between what people are experiencing on television, and what people are experiencing in their own lives. This is a very creepy manifestation and it should not be occurring with such frequency. wtf?
I picked up groceries today and ran a quick errand. I was my second time outside since late February. I saw the same things you did, and I expected as much. I also saw some things that seemed 'off.' I was more concerned when I got home than I was when I ventured out. Still trying to process the reasons why.
.
This is long established social science. We know these obligations at the governmental level and academically. The Witness Protection Program comes to mind. But, fundamentally, it is the reason why people in Afghanistan and Iraq have Single Payer Universal Health Care. Their Single Payer has been the American Tax Payer, for the past 20 years. Plus, there is Disaster Relief and FEMA, which help people pay the bills until things get back to normal.
So, we know from Social Sciences the practices that are necessary to prevent socio-political chaos and collapse.
So, what the fuck does Congress think they are doing with their stimulus bills? They are incompetent, and they are criminally negligent. They should recuse themselves. We need to elect some sane, intelligent, and informed people to replace them
This is not an opinion. It is a determination based on facts in evidence.
A reality gap has opened, and USians are gazing into the abyss. This is going to leave a mark.
Reality gap
Spot on. This is what I was trying to say as my main point. I hear that everything has been shut down making me think that it's a ghost town outside, but once in the store it was like nothing was happening. Yves sums it up better too.
The essential workers are mostly low paid ones and their companies are not enforcing social distancing nor are they providing workers with PPE especially masks. Why the hell not? Anyone who gets sick because of this neglect has a great worker's compensation case against their employer. Except Trump wants to give them immunity from liability.
Nurses in one hospital were not given N95 masks and some were given none at all. Good for them to strike. They are pissed at how they are treated as disposable.
The workers in the paper mill are also being treated as disposable and good for them to shut them down.
From the comments
I got gas today too and outside the traffic was light, but inside people act like nothing is happening there too. More stickers on the floor and a plastic barrier for the cashier, but the time before I went there she had it open. Huh again?
Bingo.
Israel too has single payer. Why shouldn't they when we give them $100 million per day? And for gawd's sake why the hell are we doing that? The Christian Right or because they are our land based aircraft carrier and partners in crime?
Of course there is plenty of money for us to have it too, but Nancy paygo just refuses to allow it because she gets bribed by insurance companies not too. That this country puts profits before its people is so f'cking asinine I'm surprised that people have put up with it. But then it goes back to government is so bad they can't do it. Bullshit. They do it with Medicare and veterans insurance, but they keep both programs under funded to make them look incompetent. This and that people think that health care is not a human right. Propaganda and manipulation works so damn well doesn't it?
I don't think congress is incompetent. Criminally negligent of course because they don't do what they are elected to do. This is taking care of we the people. And people like to just blame Trump for the lack of response. Of course he's to blame, but what if that was the plan all along by the real people in charge? Flub it up for a few weeks and get rid of the unwanted. The number of people in nursing homes that are sick and dying is staggering. The nurses there weren't given protection either at the beginning and some are still not.
But scientists knew that a global pandemic would hit and very soon and yet here we are. The supplies and plans for it were neglected. This article says that they knew about it in 2008, but nothing was done. How about 2005 and earlier?
https://www.rt.com/news/485718-experts-warned-pandemic-years/
And look at what has come of it. The heist. More restrictions of our civil rights and gawd only knows how far they will take it. The time is right for a general strike, however people who don't have money and get offered jobs are primary going to choose to get paid again. So it's up to the people who are working now. And does anyone feel a tad bit guilty of seeing them working while you aren't? I do even though I don't work. I just feel bad for them. But oh now another thing that divides us. Well played.
Phew I winded myself. Sorry for the typos in my original comment. I failed to hit what iPad wrote for me.
Speaking of nursing homes being wiped out
This is horrible news.
The regulations on nursing homes have become almost nonexistent because the industry keeps getting congress to relax the rules. This has been happening over many administrations and it's so bad that if I ever have to go in one I'll shoot myself first. I first started going into nursing homes since I was 17 and many of them were bad then. The last time I went into one I came out in tears. I can't begin to imagine what they are like during this epidemic. This country needs a hang your head in shame day. For years. Gawd damn our government that has done what it has to us.
I 'd like to think that the depraved mis-management
...of US nursing homes would be the tipping point — the final thing that breaks the nation's morale and sense of superiorty. The fact is, this institutional trashing of the lives of our elders, is a fundamental test of whether or not the US can be considered a 'civilization' at all. If we have failed this particular test, then we are beyond reform on every level — moral, cognitive, spiritual, and intellectual. What has happened to these elders is a clear reflection of who we really are. It's reflected in the way we ravage and despoil our environment and resources, the wellbeing of the people, the purity of our food and water, the health of our natural preserves and sanctuaries, the negligent hostility we have for the institution of public health that Covid-19 made so clear, and our violent distain for global humanity.
Above all, the nursing home debacle shows the world that we have no respect, even for ourselves, and no self-awareness to hold us back from revealing our craven ignorance and incurious cruelty. USians vote for the monsters who enable — through deregulation and social negligence — the wretched and ruined lives that our 'civilization' produces.
By the same token, this hideous American tragedy seems to resonate with the precise balancing of opposing forces that are neutralized and conserved under the laws of physics. Physics does seem to hold sway even over human affairs, and dispenses justice over time. What could be more natural?
depraved mis management indeed
Well said:
We have long treated our elders as something unwanted and should be out of sight. Not all people in the homes of course, but many of the ones who go into ones that take Medicaid and are just a hedge fund run business who have such lax rules that they should have been shut down decades ago. As I said I first stared visiting them when I was 17 and I was abhorred way back then. Those memories still haunt me today. The neglect is something that would never happen if we valued people over profits. The response to COVID has turned a spotlight on the negligent hostility and contempt that our government holds us in. We have so many throw away people here and what is happening in the nursing homes, homeless shelters and the rest of the long list of people that are treated as disposables just highlights that. Media Hansen (sp) from the Intercept is telling people who won't vote for Biden that they are responsible for how Muslims are treated in the future Trump administration. I asked him if felt the same way when Obama was bombing countless Muslim countries and killing hundreds of thousands of them?
I couldn't say this any better. Thank you for doing so.
That congress is just okay with our rising rates of women dying during birth. That our childhood rates of deaths are going up. That lifespans for the working and lower class are going down as opposed to the elite class and their utter contempt and neglect for the 100,000 or more who die every year from lack of health care and affordable medications just shows how vacuous they are and how sociopathic many are. The bailout and the topic of this essay just confirms that.
excellent;
your worry is well-represented in the Twittersphere, as well.
excellent prescription,
but one Q concerning this:
I'd tell everybody else to continue to isolate themselves. I'd have those in quarantine and isolation notify the city, so we can monitor their wellbeing.
isolate and quarantine them where? b at MoA mae up for lost time by saying that those who'd tested positive for coronavirus should be isolated with others...in what almost sounded like tent cities or compounds. i found it eye-blinking, myself. but his point may have been that quarantining with one's home with others might be counterproductive as in: spreading the disease, as if it wouldn't have already.
but i love this:
I think it's important to pay attention to the people who actually own the civilization.
China figured this out in the blink of an eye.
I based my ideas loosely on the system China used to stop the virus. And some Ideas I got from Taiwan. China ws very generous in providing for the people, but they were also determined to save everybody they possibly could at the same time. Whole regions were quarantined, but mostly inside their own homes. Travelers who may have been exposed to the virus were quarantined in newly finished apartment buildings or hotels. In the countryside, they were put up in humble motels. They were held from two weeks to a month and tested daily.
In my scenario, I'm only dealing with residents in a city. I'm trying to satisfy everyone's goals so they don't shoot me. So, I want to slow the virus, protect those in quarantine, provide government services so businesses make money, find jobs for people who want to work. And provide excellent protective gear to anyone living or working on the Outside.
To answer your question if anyone in the Quarantined groups develops symptoms or tests positive, It will be within the first 10 days of quarantine. They can be moved to any of the nearby hotels the government has commissioned. They are fed and provided with internet and video conferencing for daily medical check ups and for visiting with family and friends. After the infection resolves itself, they can return to their homes and family in quarantine.
People and families that choose to isolate together at home are all required to test negative. The negative tests then triggers the government to begin protecting their assets and providing food and needed health care. Those with quarantine status cannot leave their homes until the virus stops or a vaccine becomes available.
However, families or individuals can pull themselves out of quarantine status anytime they want, and join the Outsiders who are working and going about their local business.
Outsiders may at some point decide to put themselves and their homes into quarantine status and register for government protections and support services. They will be tested to make sure their group is free of the virus before they begin.
No one is a prisoner in a FEMA tent.
The Chinese trust their government much more that we trust ours.
i thank you for your lengthy
explanation, especially as you say it's based on the chinese model.
Your statistics
referring to the unemployed are actually about people with no money. Nobody despairs from having to stay home, eat pizza, and watch Netflix. They despair from having no money. That can be fixed by sending them money. OTOH, people in abusive relationships cooped up with their abuser have a no-kidding problem.
EDIT:
To really answer this question you would have to build models for deaths based on a variety of shutdown levels. For example, there are probably many fewer traffic fatalities with the reduced level of driving. Not merely because of fewer vehicle miles driven, but because a nearly empty road is much safer to drive on. Fewer workplace accidents if you aren't at work. Fewer plane crashes if there are few flights. Fewer boating accidents. We have left the majority of influenza cases behind us until next winter, but the lockdown that reduces C-virus transmission will also reduce standard influenza which accounts for thousands of deaths annually.
The models almost certainly don't exist, because nobody ever needed them.
"The greatest shortcoming of the human race is our inability to understand the exponential function." -- Albert Bartlett
"A species that is hurtling toward extinction has no business promoting slow incremental change." -- Caitlin Johnstone
about this:
well, really, the bolded portion:
i've been slowly working on calls for "coronavirus emergency" Khanna used to call it UBI) aside from andrew yang, who's now a CNN commentator; i hadn't known that. i want to hear it from those introducing bills, and their cosponsors.
my fear is that even if it would pass, then be signed into law, it would become permanent. as of yet, i haven't even discovered the house bill # of the khanna/ryan one.
but permanent UBI could easily mean no remaining social safety net.
Maybe our owning class --
-- just wants a smaller working class.
Y'know the isolation period doesn't have to be so bad. It's being made bad because our ruling class has a total contempt for us, and really doesn't care if we die in great droves.
For a counterexample, see Spain.
“Those who make Bernie Sanders impossible will make Luigi Mangione inevitable." - Dan Berger
My Wife listens to Rush
Not because she agrees, but to find out what is going on. I find it odd that there isn't some kind of Rush -> Fox -> Trump watch of the so-called opposition. So the last two days Rush has pushed 2 topics:
A: This is just the flu
B: The Chinese government quickly understood how dangerous this and weaponized it
Now these two arguments are told in different hours so the fact the logic of it being nothing but the flu, yet the Chinese have weaponized this makes no sense. But neither does Climate Change denial. Or trickle down. Or any of the other BS they sell. The left is crap at countering it.
But this is the logic we have to fight. It isn't logical. We have no help because the DNC would rather blame China that actually change any policy.
So as I told my wife, this is the debate with this particular virus:
A: Let it run it's course, which will most assuredly kill my mom (me a big maybe)
B: Try to slow it down which will mean a lot of people will lose everything.
Now, if we had a functioning government, it wouldn't be that stark. But since both parties know more about how to effect the lives of Venezuelans and Iranians than their own people, I doubt serious anyone in Washington gives a rats ass about small town USA. They sure haven't shown any interest in the last 40 years. Reagan/Bush/Clinton/Bush/Obama?
My dad had a nice union job that paid decent. Health Care. Pension. I started work in a grocery store that was union. Clinton came along. Walmart came along. Store was closed. Factory jobs moved overseas.
So yes, people are hurting. But let's not forget why. The right is already making marches blaming Dem governors for daring to keep their people alive. That is their goal to get Trump re-elected. Blame Dems.
We shouldn't help them. But we should use actual science and knowledge on how to re-open, how to control this, and how to keep everyone safe. We should have had been on top of this months ago. It was easy to see what economic ramifications it was going to have on the average American. Trump and Congress failed miserably. They don't represent us.
As it is now, we have entire nursing homes being wiped out. We should be better than that.
Great comment
Brilliant.
I am not so sure that this is accurate
extrapolation of data. While I think the data on suicides per X based on despair is accurate, I am not so sure that the particular situation that we are in now will have the outcome that matches the predicitions. Maybe? Maybe not? Just a month ago I came across this article that suggested we might end up with a net gain in population because the number of people who WON'T die of air pollution. They claim that lessened economic activity= less air pollution= 100,000 who die per year in the US might not die.
https://www.forbes.com/sites/jeffmcmahon/2020/03/11/coronavirus-lockdown...
I know in my situation while I am unemployed and will be for at least 6 weeks, I am not dealing with despair. Not suicidal.
The worst comment I can make to this is
"Arbeit macht frei".
I would want to have both, work and freedom. The virus does what it wants. Let us do what we want and may be at the end we won't care for the virus anymore. I think it would be good. Getting restless the longer the lockdown lasts.
Let my people work, let my people go, yeah,
[video:https://youtu.be/rp2WdyeAHIM]
Wishing you the best. PS: agree with your essay very much.
https://www.euronews.com/live
Video that shows how much treatment is being denied
[video:https://www.youtube.com/watch?v=IBjY0NQcbKg&list=TLPQMTcwNDIwMjCY850cA_Z...
So in addition to what is list in this essay this shows the issues that are being untreated which will allow for more deaths. I have a few spots that are very worrisome and want to get checked out, but my doctor isn't seeing routine patients right now. Great.