Intensive scare: covid-19 ravages America

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Speed slow 135 gigabytes of network busy taxes and fees extra. See mintmobile.com. Hello and welcome to the Intelligence on Economist Radio. I'm your host Jason Palmer. Every weekday we provide a fresh perspective on the events shaping your world. No surprises in Sunday's vote. In Venezuela, the ruling party will take back the national assembly, the country's last democratic institution that will sideline Juan Guaido, widely recognized as legitimate leader, and cement the damaging dictatorship of Nicolas Maduro and the world of radio astronomy. Marked the passing of a giant this week, a 300 meters across Giant. We look back on the scientific and even cinematic history of the Arecibo telescope. First up, though, We're likely to lose.

Another 250,000 people dead between now and.

January this week, grim headlines and milestones in America. The daily COVID 19 death toll hit a new record on Wednesday. The infected patient count in hospitals past 100 for the first time. The contagion has now reached every corner.

Of the country, with 90% of all US hospitals in areas designated as coronavirus hot zones.

Cases have topped a million in Florida, Texas and in California, where Governor Gavin Newsom warned of worse to come.

Just in the last 14 days, close to 1,000 Californians have lost their lives due to COVID 19. The bottom line is if we don't act now, our hospital system will be overwhelmed. If we don't act now, we'll continue to see a death rate climb.

Health care systems are becoming overwhelmed in ways not even seen during the pandemic's panicked early stages. In the Midwest, things have been particularly dire, with intensive care units filling up, doctors and nurses exhausted. And in many places, the public just isn't acting in a way that will stem the tide.

Right now across the Midwest, we've seen a surge of COVID cases of people being rushed into hospital.

Adam Roberts is our Midwest correspondent.

In states like North Dakota, South Dakota, Iowa, when I've been talking to health workers in those hospitals, they've been telling me that ICU beds are at 80%, 90% occupation. In short, the hospitals seem to be getting quite full and sometimes quite stressed.

And how have the hospitals in the region been preparing for this surge?

Well, I spoke to several health workers, including Dan Rundy, who's with the emergency medicine department at the University of Iowa Hospitals and Clinics, that's in Iowa City. And his hospital, because it's an academic center, is just about the best equipped in the state. It's been doing everything it can to clear space, to let COVID patients have as much room as possible. So inpatients have been sent home when they can be. They've added extra ICU beds, they've been postponing elective surgeries. And Dr. Rundy told me that it's been touch and go.

From the outside, it sounds like, okay, everything was handled and we sort of met the moment, but it's just hard to convey how close you are to going from just being able to barely meet it to being overwhelmed.

And the fact that it's been handled so far has been partly down to the actions of frontline workers.

You know, we've been lucky as a healthcare system to mostly not quite break, but I think people would be shocked about sort of how close we get and just what it takes in terms of individual level responses to make the thing keep going.

So from what Dr. Rooney says, it sounds as if the public doesn't really know how bad things are at the moment.

Yes. Dr. Rooney says he worries that members of the public and governing politicians just haven't grasped what happens when hospitals get too full. Take for example, the impact of cancelling elective surgeries. There's a perhaps common misconception that those sorts of surgeries aren't important or they're not pressing.

When you hear hospitals canceling elective surgeries, that means people potentially with cancer aren't getting their tumor excised. It means people that have gallbladder disease or heart disease or vascular disease that need intervention, that are putting them at risk of really bad side effects and sickness or death. That's real. That's happening.

So when the hospitals become overwhelmed, it's not just COVID 19 patients who suffer. It's the rates of excess non virus deaths that also could surge.

And what about the situation outside urban areas like Iowa City? I mean, is the situation equal kind of across the region?

No, it's not equal. So what you see is this interrelationship between the bigger hospitals in places like Iowa City and then rural places, small hospitals that might just have one doctor and one nurse. Now these rural hospitals, they're under great strain. Not Least because many of them have closed. In the last decade or so, around 130 rural hospitals across America have closed. And that puts a lot of pressure on the ones that remain. They can be overwhelmed with just one, two or three patients coming in. And you can imagine that when Covid sweeps through a small town, maybe a local meat packing plant is affected or a prison, those hospitals are overwhelmed very quickly. I spoke to Ben Christians, who's an emergency care doctor in Sioux Falls in South Dakota, who said that for the past two months, they've been functioning at over 100% capacity of their ICU beds, and they've been adding more beds as well. And he takes in patients from 80 sparsely populated but ever more afflicted counties spread all across South Dakota and beyond. And these are patients who are coming in from as far as 150 miles to get to his relatively small hospital. And it's not surprising that those places get overwhelmed more quickly than in the bigger cities.

And why do you think the situation is so bad, particularly in the Midwest?

Well, it's moving out from the Midwest now, but the first surge hit the Midwest this autumn, I think partly because these are more northern states and it's colder weather up here, and so people are indoors and maybe spreading the virus more easily. But it's also a fact that in rural areas, in parts of northern Wisconsin and the two Dakotas, people have just not taken serious measures. It's not unusual for me when I've been reporting and wearing my mask, going into small towns to be stared at and for people to look at me as if I'm an alien, they don't want to wear masks. They don't want to do social distancing as willingly as people in the cities. And that may be why they're also being affected badly now. And the third reason is that politicians in those states, including the governors, have been refusing to order rules on masks and closing restaurants and businesses. And so it's not unusual in all of these places to have mass gatherings, people going to church, people going to bars and restaurants, even when the infection rate is extraordinarily high.

And that must be that much more frustrating for all of the frontline workers who are seeing the effects of all that.

Dr. Rundy told me it's very difficult.

The thing that's been harder is, as this has gone on, the sense that we're not really in this together as a community, as a state, as a nation. You know, we're watching people get sick, we're watching people die, we're watching our colleagues really extend themselves to prevent the system from completely breaking. And then to see scenes of full airports, full bars, to see people talking about their individual liberty with regards to a mask. That has been, that's been tough.

And a lot of the healthcare workers in other places I spoke to said exactly the same. They're frustrated, they're exhausted, some are falling ill themselves.

But is there a bright side here? I mean, haven't health professionals come a long way since the spring in terms of coping with these outbreaks?

Yes. So the saving grace of all this is frontline staff know much better ways of how to treat patients. For example, they're much slower at putting people on ventilators. They've discovered that if you're put on a ventilator, you only have a 5 to 10% chance of actually surviving it. And so far fewer people are being intubated than before. It's only the most desperate cases. And generally there are better treatments, better drugs, use of steroids, and so on. So there are reasons to be more hopeful that if you are infected, you can survive. But on the downside, we've had a big surge in infections recently in it's not just the colder weather. It's the fact that people are getting together. It's the holiday season. And Dr. Rundy said he stands by and he watches in fear because the Thanksgiving weekend that passed probably is a sign that there'll be more infections and we'll see a big surge in the weeks to come.

You know, for all the fatalists that say, well, it's a pandemic, it's a disease, what can you do? You can just look around the world at responses of places that have crushed this. And there is no reason that a place with the material wealth and the scientific expertise of the United States shouldn't have been among those countries. And the fact that we haven't, it's an enduring tragedy.

Adam, thank you very much for joining us.

Thank you.

Jason.

COVID 19 in America has cultural and even judicial dimensions. Newly appointed Supreme Court Justice Amy Coney Barrett recently tipped the balance in a ruling overturning Covid restrictions on places of worship. This week, our sister show Checks and Balance examines what her appointment will mean for the role that religion plays in public life. Find Checks and Balance later today, wherever you get your podcasts. On Sunday, Venezuela will hold parliamentary elections. It's all but certain that the dictator, Nicolas Maduro's socialist ruling party will win. The result might be in the bag, but that didn't stop the government from hiring a Pop duo to drum up enthusiasm for the vote in their catchy ode to the government broadcast repeatedly on state media, Chucho y Omar Acedo saying, it's time to fight with strength and we are going to rescue the National Assembly. That's the one branch of government still controlled by the opposition, most of whom are boycotting the vote. Losing their hold over Parliament will have big implications both for the opposition and their international backers.

The vote for the national assembly is, it seems, going to be rigged.

Stephen Gibbs is our Venezuela correspondent and is based in Caracas.

But it does matter, because it means that Nicolas Maduro takes over the last remaining institution of power that he does not control. And that is a big step in his march towards total control of the country.

And why is that change to the national assembly such a big change to the overall picture?

Well, because since a vote in 2015, which was widely assumed to be fair, the national assembly has been under the control of the opposition. Now, you could say, so what? Because following that vote, and once the opposition took control of the assembly, it was pretty promptly neutered by the regime. It set up a sort of alternative Soviet style parliament called the Constituent assembly, which it used to pass laws. But nevertheless, this national assembly has been a major thorn in the side of the Maduro government.

And why is that?

Well, because it's under opposition control and because there's a sort of dubious legality about the alternative Assembly. That means that when the government wants to sign, say, a contract with Russia or China, there's a little bit of doubt about the legality of that and how firm those contracts could be in the future. But more importantly, the national assembly has been a platform for Huang Guaido, the president of that assembly, who in 2019 used that position to argue that he should be the interim president of Venezuela on the basis that Maduro was ruling illegally after an election in 2018, a presidential election. That claim by Juan Guaido had the backing not only of the United States, but 56 other countries around the world. And that led to this sort of unusual situation we have at the moment where two people in Venezuela are claiming to be president.

And so in the coming election, then if the national assembly has taken over, Mr. Guaido is no longer its leader, therefore no longer even a plausible claim to being the interim president. But I mean, does that mean that all that international support will disappear?

According to his allies, absolutely not. His mentor, Leopoldo Lopez, who's currently in exile in Spain, gave an interview to some journalists, including the Economist, last month. He said that the forthcoming vote is a non event. That is the opposition's position because they say it's all been rigged in advance, that they can't participate under the terms that it should effectively be ignored and things carry on as normal. So they say that the national assembly in its current makeup just continues. Now, that is one argument, but it's not a bulletproof argument. I spoke to Jeff Ramsey of the Washington Office on Latin America, a think tank, about this precise issue.

There's far from a consensus on this issue among constitutional scholars in Venezuela. There's really no precedent for the national assembly to simply extend its own mandate.

And so he says that what he expects after this national assembly election is a sort of slow walk away of support from some of the international backers of Juan Guaido. So that's a problem for Guaido, a sort of drip, drip dilution of his power and his support.

Well, it's hard to argue he had a whole lot of power to begin with.

No, I mean, of course not. As the months tick on, Huang Guaido, who really, the whole point of his bid for power was to sort of disrupt the regime here and attract support from the military and have some kind of velvet revolution, a flip of sides in this country at a time of desperation. Now, it clearly hasn't happened. There's absolutely no question who has the handle on power here, that is Maduro and his government. So those that are in a bit of doubt about whether they should continue to support this might be their excuse, you could say, to try and have a rethink.

And what about the American view on all this? Do you expect it to change when Joe Biden comes into office?

We do expect a change of focus, really. I mean, Biden has made it clear that regime change is not something his administration wants to partake in. So we expect a sort of more subtle diplomatic effort from a Biden administration, probably more focus on the humanitarian side of things and an attempt to get those friends of Maduro, such as China, Turkey and Russia, somehow onside.

And on the question of humanitarian issues, I mean, through all of this, the Venezuelan people have only suffered more and more, right?

Well, unfortunately, yes. I mean, this is a country that's now it's in its seventh year of a deep recession, one of the deepest recessions ever recorded anywhere in the world. And what we've seen, particularly over the last three or four years, where there's been hyperinflation, shortages, desperate situation of public services here, is that people vote with their feet. 5 million people, a sixth of the population has fled since Maduro became president in 2013. And all of that is, of course, in total contrast to the sort of happy, triumphalist tone of the regime, including from that pop song we're hearing in the streets as it's trying to rally people to vote in its election. With its lyrics. A future with greatness is arriving. Happiness and hope are returning. I mean, it's shocking, really, just how much that rings hollow when compared with what really is going on in this country.

Stephen, thank you very much for joining us.

My pleasure.

The Arecibo Observatory was a piece of geology turned through geometry into a tool for astronomy.

Oliver Morton is, is our essays and briefings editor and occasional obituarist of the inanimate.

In the late 1950s, various people in America, some scientific, some sort of like Pentagoni, thought it'd be really nice to be able to bounce radio signals off the ionosphere, the Earth's charged upper atmosphere. Unfortunately, the ionosphere, being mainly empty space, doesn't reflect signals back very well. So if you're going to do this, you need a very, very big radar dish. And it wasn't something you could just build on a stalk and have pointing up at the sky. You actually needed to support it somewhere. So a physicist was sent out to look for holes in the ground, ideally in the tropics, ideally under American control. And the hole in the ground that he found was the one at Arecibo in northwestern Puerto Rico. If you're a geologist, you'd look at this hole in the ground and think sinkhole, which is what it is. But the untrained eye might easily see a volcano and might quite easily think about volcanoes as the lairs of Bond villains which they so often turn out to be. In fact, the sort of, like, 1960s monumentalism of Arecibo was so James Bond esque that it's kind of bizarre that the franchise didn't actually turn up there until 1995, when the telescope was used as the background for. For the finale of GoldenEye.

For England.

James?

No.

For me.

Once the telescope was up and running, though, the ionosphere turned out to be only one of the things that it was good for looking at. It had a powerful enough radio that it could bounce signals off the surfaces of other planets. And so, for instance, it discovered that what astronomers had thought about the length of the day on Mercury was completely wrong. Mercury did not always have one face turned to the sun and one face turned away. But the real joy of Arecibo was listening to the signals from deeper space. And a guy called Tommy Gold realized that you could use this big dish to listen to these strange regular pulses from outer space and realize that a pulsar was created by neutron stars as heavy as the sun, but as small as Manhattan, spinning maniacally in space, spraying particles and radio waves around them as they do. One of the most remarkable discoveries at Arecibo was a binary pulsar, a pulsar orbiting another pulsar. And this allowed the most sophisticated and beautiful check on Einstein's general theory of relativity. Even more peculiarly, one of the pulsars later on turned out to have planets, which were in fact, the first planets ever discovered outside the solar system. Another thing about the golden age of radio astronomy in the 1960s was that radio astronomers realized that if you used a radio telescope to send a message and listen for messages with your radio telescope, you could imagine if you got the rules right, that you might be able to become cosmic pen pals with someone around Sirius. Arecibo was the first radio telescope used to send messages to the stars. And that message was sent off towards a globular cluster of stars, 25,000 light years or way. As the decades drew on, though, radio astronomers became more interested in resolution. That is to say, how finer detail they can see. And that really wasn't Arecibo's thing. Also, it suffered a little bit of wear and tear, sitting as it does in a hurricane prone region. So over the past decades, it has somewhat faded from its former glory. And that was until last month, one of the cables snapped. Once one of the cables had snapped, the other cables took more weight. Then one of them snapped. At this point, the National Science foundation in America, which was in charge of running Arecibo, said, this is getting very hairy. We're closing this place down. And basically just in time. A week later, another cable snaps, and down come 800 or 900 tons of steel crashing into the aluminium dish below. But the ruin isn't all that's left, because back in 1974, Arecibo sent a message off into space. That message has now traveled 46 light years, still going strong. And encoded in its bits, in its ones and zeros, is Arecibo's picture of itself as far flung a monument as any of the works of humankind will ever have.

Oliver Morton on the Arecibo telescope, which died this week at the age of 57. That's all for this episode of the Intelligence. If you like us, give us a rating on Apple podcasts and you can subscribe to the economist@economist.com intelligenceoffer the link is in the show notes. See you back here on Monday.