Tensions Rise in Push to “ReOpen”

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A protester in Jefferson City, MO carried signs expressing the main sentiment of those wanting to open up non-essential business again in the state of Missouri. While the state’s guidelines allow the businesses to still operate, many county and cities are more restrictive. Photo by Janet Ayers, from St. Louis, who attended the rally.

Tensions flared early this week in the form of physical protests as the frustrations of Kansans and Missourians overflowed from social media and took nearly 1200 to the streets of the Missouri capital, Jefferson City.

Channel 13 KRCG in Jefferson City interview with Janet Ayers (1)

Facebook posts are packed with opinions – but also personal stories of Americans whose livelihoods suddenly crashed in late March and early April.

Nikki (last name withheld at her request], of St. Louis, is an IT specialist who was furloughed April 1 along with 2/3rds of her company’s workforce, she said. She wanted to keep the name of the company private, she said, because she hopes to get her job back there if that becomes a possibility soon. The company, however, is a subcontractor out of the state of New York that provides hospitality for sports and concert events – an industry that is hard-hit by the pandemic that is prohibitive for the gathering of large crowds. She’s looking for other work while still hoping something will work out at the company from which she was furloughed. “The uncertainty of what is to come has many of us wondering ‘What do we do?’ and not knowing when and if we are coming back,” she said. She had enough set aside to pay rent through June and bills through July and paying on her student loan, keeping her credit score in good standing. Another concern is that she and her family have only four more weeks of health insurance. (This source is not anonymous – name withheld by request to protect her job prospects.)

Dr. Jeffrey Salin Orthopedic surgeon with Kansas City Bone & Joint Clinic has office in Kansas and Missouri.

Dr. Jeffrey Salin with Kansas City Bone & Joint Clinic said his staff has taken a 20% pay cut and the doctors are going without pay during the shutdown in Kansas and Missouri – both states where Salin has offices. “We don’t want to have to furlough our people,” said Salin about the pay cuts. The entire staff took pay cuts starting March 26. None of his staff or patients have tested positive.

Salin practices at St. Luke’s South, Menorah Medical Center and Olathe Medical Center, specializing in joint replacement surgeries which are deemed “elective” surgeries right now and have been temporarily suspended. Salin also owns an ambulatory surgery center called Overland Park Surgical Suites. “We are only able to operate there at this time,” Salin said. Medicare presently requires their patients receive surgery in hospitals so those operations cannot be done in Salin’s surgery center. Salin did say that his staffs have the PPE that they need.

Heart KC asked Dr. Salin: What part of KCBJ is non-essential?

“This is a hard question to answer,” Saline said. “What does non-essential mean? I think that people that are having horrible pain from arthritis or from a fall are essential.”

Salin also offered other solutions for reopening the practice: “We need to operate on healthy people who have been in quarantine. People who are not exposed to the virus. People who are otherwise healthy should undergo procedures especially on an outpatient basis.”

COVID-19 has created a new safety protocol for Salin’s surgeries. “Currently when we do surgery, we intubate the patient. The facility must let the room air “turn over” before and after intubation. We have a formula that lets us know how long this will take. Staff/patients are not allowed in the room until this happens. We must wait about 25 minutes for the air to circulate before we can do the next case of the day.”

Salin said there are risks with continuing to stay closed. “My biggest concern right now is people not going back to work. Those who rely on insurance from their jobs will not be able to afford the copay for surgery/healthcare due to insufficient funds from not having a job.”

He also said he’s concerned for the mental well-being of his patients and others. “When people do not have a job and they are responsible for providing an income for a family, that can create a sense of hopelessness. This can lead to depression and suicide.”

A continued shutdown will present a unique set of problems for every entity and business. For surgeons, like Salin and hundred of others in the Heartland, the log jam of cases becomes larger every day. “The biggest issues will be access after the pandemic is over. There is such a massive backlog so the wait time for people will be prolonged. Before the pandemic we were booked through June. Now, those 2 months of cases must be added somewhere.

The financial impact on health care facilities will also be impacted, Salin said. “Some medical institutions which have limited cash on hand will be strained financially. Some of them may have to close. Our economy needs to reopen as soon as it is safe to do so.”

Some gynecologist offices cancelled appointments for well-woman exams that included routine cancer screenings such as pap-smears. One such office, Specialists in Women’s Care in Kansas City, KS, postponed visits deemed “elective” until July. A Johnson County gynecologist office, Mirabile MD Beauty, Health and Wellness, which provides services for women to treat “fibroids, depression, hormone deficiency, migraines and weight issues” temporarily closed its office except for medical emergencies.

COPYRIGHT NOTICE: THIS ARTICLE IS PROTECTED BY COPYRIGHT LAWS. NO PART OF THIS ARTICLE CAN BE REPRODUCED WITHOUT EXPRESSED WRITTEN PERMISSION OF THE AUTHOR. ALL RIGHTS RESERVED ©2020.

Architect Mike Henzlik, owner at Henzlik Enterprises, in Montrose, Missouri, said he has had clients put a hold on building projects. “Which means lags in construction jobs down the road,” said his wife Michelle, in an interview today with Heart KC via social media. “As far as getting our economy going, we have to get people moving again by opening things up. A lot of people are ready to start getting out, but where do we go?” said Mike.

Frustrated protesters posting on ReOpen Missouri and ReOpen Kansas’ Facebook pages were met with angry responses by those who pointed out that most of the protesters in the videos of the Jefferson City protest on Tuesday were not social distancing or wearing masks – as had been advised by Missouri’s protest organizer Josh Schisler. Schisler made his own video during the Jefferson City protest – calling for the other protesters to march to the Governor’s mansion. Cars passing the protesters honked their horns. Media interviewed protesters, appearing for the most part to try and keep their distance using boom mics and wearing masks. But as evidenced in the videos posted by media and by participants, social distancing was not always possible or, by some protesters, purposely not attempted.

Just on the other side of the state line in Kansas, citizens expressed similar frustrations and fears on the ReOpen Kansas Facebook page and called for protests on the capitol in Topeka – but with far fewer members than the ReOpen Missouri page. Many posed the question: “Who knows anybody who even has COVID-19?” Most replies on the ReOpen pages were “No” – but a few said they did know people who either had the disease or presently have it.

Conspiracy theories were abundantly shared.

“I think the goal is to crush small businesses so that the powers that be control everything,” said one poster.

On the ReOpen Missouri site were videos and interviews with Dr. Rashid Buttar, who has been a frequent interview subject by sites that counter Coronavirus Task Force member, Dr. Anthony Fauci. According to Wikipedia, Dr. Rashid Buttar “is an American osteopathic physicians from Charlotte, NC known for his controversial use of chelation therapy for numerous conditions, including autism and cancer. He has been reprimanded by the North Caroline Board of Medical Examiners for unethical treatment of patients.”(2) Buttar continues to practice despite the formal reprimands. He has been criticized for his use of intravenous hydrogen perioxide to treat cancer. (2).

Conflicting Rules – Confused Residents

Rapidly evolving and changing developments resulting in near-daily press conferences and information updates on city, county and state information pages – many which are dedicated to COVID-19 – attempt to give citizens the latest directives on what is and is not happening and what is or is not advised or allowed.

Government officials attempting to comply with advise from health department officials, are also faced with pressure to come up with dates for “reopening” – the catch-word for allowing businesses to begin to operate again. These dates don’t always align from city to county to state, appearing to cause confusion for residents who may live, for instance, in the state of Missouri, but the county of Greene, in which is the city of Springfield, MO. Rules there are more stringent than the state of MO rules for businesses.

The state of Missouri FAQ page states that businesses not essential do not have to close. However, several Missouri counties and municipalities have imposed stricter closures than the state. Parson stated at today’s press conference that the local governments could impose stricter rules – but not less strict rules than the state. Dozens of posters on ReOpen Missouri Facebook page blamed Parson for rules imposed by counties and cities, stating that Parson should tell the counties and cities what to do.

https://ded.mo.gov/content/stay-home-order-business-faq

From the above link, the Missouri State order regarding businesses that to not qualify as “essential” are advised they do not have to close:

Frequently Asked Questions

Do work places that do not qualify as “essential” businesses have to close?

No.  Businesses that are not covered by the guidance from the U.S. Department of Homeland Security, Cybersecurity & Infrastructure Security Agency (CISA) discussed in the Order may remain open but must comply with the social gathering and social distance requirements of the Order.  This means that no more than 10 individuals can occupy a single space, this includes both employees and customers.  Individuals must also maintain at least 6 feet of distance between themselves and others. Employees must also practice good hygiene and sanitation to limit the spread of COVID-19. Businesses are also encouraged to allow individuals, where feasible, to work from home to achieve optimum isolation.

Businesses can seek a waiver of the social gathering requirements from the Director of the Department of Economic Development. However, there is no waiver for social distance requirements for non-essential businesses, and those must be followed by at all times even with a waiver from the social gatherings limitation. 

However, in both the city of Springfield and Greene County, for instance, the parameters are more strict:

https://www.springfieldmo.gov/CivicAlerts.aspx?AID=6727

And, the City of St. Louis, which is tallying nearly one quarter of the deaths from Missouri’s COVID-19 cases, Board of Alderman Lewis Reed introduced Tuesday, April 20, resolution 5 authorizing “the creation of a special committee for the purpose of addressing the impact of the COVID-19 pandemic to the City of St. Louis.”

While Kansas City Mayor Quinton Lucas said discussions were underway to extend the stay at home order there for 3 more weeks, Clay County, which is mostly the northern boundaries of Kansas City, will roll back their state-at-home order. Last week, the order had been extended to May 15 but it will now be pulled back to May 3, lining up with the statewide state-at-home order.

The state of Kansas Stay-at Home Order is also set to expire May 3, 2020.

While compared to New York City, Louisiana and other hot spots around the United States, Kansas and Missouri cases are far lower, for many citizens of the two neighboring states, the spread of the virus looms threateningly. To others – many of who are watching their bank accounts dwindle while their pantries empty and unemployment and stimulus checks fail to materialize, the economic fallout looms as a greater threat.

Part Two in the Discussion of Economic Recovery in the COVID-19 Pandemic

In Part One, the question between opening up the Heart Land for business again might pose the question:

“How many fatalities can we stand?,” said economist Chris Keuhl of Kansas City, KS., in a recent interview with Heart KC.

His discussion continues:

The Ugly Truths

“Traditionally for serious cases of the flu we’ve been able to tolerate 2.5 – 3% per million. And that’s what the COVID-19 is if you are under the age of 40.

If you are over the age of 55 or 60, then the fatalitiy rate is 13.9% and that’s what has got people spooked because they are saying ‘Well, that’s unacceptably high.’

And the economists go: ‘You’re right…but…unemployment of 22 million is unacceptably high, too,’” said Keuhl.

What would be the fatality rate with 22 million people out of work?

“It’s hard to tell,” Keuhl said, “because people don’t instantly die because they don’t have a job. But you have social dislocation, suicide rates go up, people start committing crimes, or become more testy with their spouses, there’s all kinds of follow-ons. It’s impossible to predict. The vast majority of people are not going to become suicidal because they lost their jobs but there will be a percentage of people that do.”

Dr. Salin with Kansas City Bone and Joint Clinic, also was concerned about the rates of depression and suicide among people not working and agreed we are all facing a difficult choice. “At some point, we need to weigh the positive and negative effects of a severe economic recession vs. the effects of the pandemic. We should ask ourselves what is the right of the majority of this country and what is best for them?”

It’s a decision that seems cruel on the surface but Americans can learn life-saving lessons form other parts of the world who have dealt with the crisis longer.

HeartKC asked Keuhl to elaborate more on what Americans can observe and learn from other countries handling of the crisis? Are we learning anything from China?

Keuhl was blunt: “Yes, we now know that hiding what you are dealing with for two months is a really stupid thing to do. By the time they finally admitted there was a problem, it was already rampant in Wuhan. China was fairly clumsy in their response, the South Koreans were not. They reacted really fast and tested really fast and probably had the best experience of any of the Asian countries.

 What kind of country is China? It’s not Communist, Keuhl said, in the sense that some people may think.

“The best way to describe China is that they are authoritarian but it’s a highly capitalistic country in every respect. It’s just that it’s run by a small cadre of leaders. So, it has a capitalistic economy with a authoritarian political system,” said Keuhl. 

Furthermore: “What got them in trouble was: a regional leader in Wuhan was hiding [the sickness] from their own government. Then it got to be too big of a problem. As soon as the authorities at the central government got wind of this, they came in and took over in Wuhan and executed 10 leaders of that city.” 

“Line them up against the wall and shot them,” he said. “It’s, like, ‘The next time you lie to us, all of you die.’” 

“All the sudden all the decisions are being made by Bejing, not by regional authorities. Chinese don’t like being lied to,” Keuhl said.

“They don’t have any problem lying to other people…” he added.

China was very aggressive imposing the at-home rule. 

“If you look at South Korea or Germany or Sweden, you have a little bit less of an issue because their population was more cooperative just naturally,” Keuhl said.

The trust that the South Koreans have in their government worked out particularly well for them in a crisis like this.

“South Korea just has a very different approach to security and it always has. They believe their government. The government said ‘stay home’ and they did,” he said.  

“The Germans, for the most part, they immediately responded: ‘You gave an order. We are Germans. Where would you like us to line up?’ It’s, like, that’s what they do.” 

How did the American response compare insofar as cooperation?

“We don’t.

It’s like: ‘Stay Home’: ‘I don’t want to’ ‘I want to go the store’ ‘I want to go to the ball game’ ‘You can’t tell ME what to do, by God,’” Keuhl said.

“Well, okay, fine. It’s a disease. It doesn’t have a political party. It doesn’t care if you are left or right,” he added.

And that’s the thing about the Germans: all the political leaders from the far left and the far right all came together on the same stage and said “Everybody needs to do this.” 

“The Germans just said ‘Follow orders.’ 

When you look at something like the recommendations from the very beginning: If we would all agree to do this for 4 or 5 weeks – we would be on top of it.” 

But, if only SOME of us do it, it’s useless, Keuhl warned.

“You’ve got the guy who says ‘you can’t tell me what to do’ and he’s got it and goes out and infects others. Most of the people who get it, don’t know they have it.

If it weren’t for that, it would just be a matter of finding people who are sick and treating them. It makes it doubly dangerous,” Keuhl said.

Unfortunately, others who get it may get a really bad case of it. That’s the problem with not having the testing. 

Keuhl pointed to the lack of testing as a critical failure to help identify the infected.

“If people knew they had it, then they could act accordingly. You could keep them home for two weeks. At this point, I had a friend who tried to get tested. Was told to come back in 4 weeks,” Keuhl said.

Insofar as being able to point to who should stay at home and who is safe to go out, this virus has proved to be more difficult than other viruses.

“Isolating is kind of polyanna. Because it assumes you can determine who is or is not vulnerable in some simple way. 

It comes right down to testing. You have the option of staying home voluntarily or like the Chinese, we’ll put you in a barracks and keep you there for a month. 

The concept is not inaccurate, it’s just that at this point we can’t really tell who is and who is not vulnerable,” Keuhl said.

“The Question Nobody Wants to Deal With”

“How come we were so unprepared? Not just the U.S. but EVERYBODY. We’ve been dealing with viral attacks every year for 10-15 years because we’ve had SARS, MERS, Ebola, swine flu, bird flu – it happens. We deal with it every year. How were we not ready for this?” Keuhl asked.

“We’re not alone in this. There are at least 50 countries that got caught flat-footed. 

The Germans were over-prepared by accident. They overbuilt their hospitals and they were about to shut down about half of them. ‘Well, good thing we didn’t do that.’ 

Nobody has a silver bullet for this. I just wish people would quit sniping at each other.”

The Solutions

“We don’t know who’s sick SO: testing, testing, testing, testing, testing,” Keuhl emphasized.

“We’re testing about 9,000 per million, which is 1/3 of the Germans or South Koreans. The hot spots are gonna get tested first. 

Most countries who are trying to open are saying: minimize contact, retail establishment and restaurants, social distancing, reducing the exposure – but you still don’t have the same confidence as if people get tested. And, of course, if they can get a vaccine.

I certainly understand people who are concerned about what’s happening with the economy – I’m an economist. I’m sitting here going, “Oh my God, we can’t keep this up much longer. But it does little or no good to open up prematurely and then have to shut down again. That would be truly devastating.”

ReOpening

“What this really all depends on when you are talking about reopening,” Keuhl said, “is reopening isn’t going to do any good if the consumer doesn’t resume their old behaviors. If you open everything up and people are, like, ‘Nope, I’m still scared, I’m not going to change,’ it doesn’t do you any good. You have an economy that is 80% dependent on consumers. So, if they are not prepared to resume, it isn’t happening.”

He continued: “So, if you are opening up and shut down again, that consumer is mind-spooked now and they’re not gonna come back for a long time. 

They [consumers] need to be able to say ‘Under these conditions, I’m safe and I can go back to my normal behavior. But if I go out and everybody gets sick again, by God I’m gonna hunker down for months.'”

How Are We Going to Do This?

“Slowly,” Keuhl advised. “It all comes down to timing. If we get to a point where we can cautiously start to re-acclimate our economy, we’ll be in recovery mode within a month or two.

We’re trying to do in this recession what we’d do in a normal recession – only faster. We recovered in 2008 but it took six years. We don’t want to take six years. So what we are trying to do can we be back to normal by the end of the summer? Possibly. A lot of economists are thinking we could end the year with 1.5% growth…which is not good but it’s not awful. 

Timing, Keuhl reiterated.

If we don’t recover until August, we won’t make that. We’ll be in active recession. At the moment, we are looking at one quarter, at least two, of recession.

As far as the bickering, protests and disagreements among people, Keuhl said:

“They are frustrated and they’re scared. That goes back to the fact that we don’t have consistent leadership. What we need at this point is for everybody to be on the same page – at least publicly. They can argue all they want privately.”

Keuhl pointed once again at the German model that is working successfully even where people are divided in their politics but come together against the common enemy.  

“The Germans – the right and the left – it’s hard to find two parties more opposed,” Keuhl pointed out. “They HATE each other. But when those two leaders stand up together and say ‘We need to beat this virus.’ Holy crap, that’s being adults. As soon as they get this (COVID) under control, they’ll be back at each other’s throats.

But at the moment, they are saying “We have a bigger issue. Let’s deal with the virus,” Keuhl said.

“Then we can start fighting again.” 

Testing sites have been expanded in both Kansas and Missouri now. Contact your County health department or your doctor for testing if you feel you are ill but do not yet feel you need emergency treatment.

In Leavenworth, KS, for instance:

The Leavenworth County Health Department has expanded its testing capabilities.

If you are experiencing any symptoms that you feel are related to COVID-19, please call the Health Department at (913) 250-2000, Option 3, to be screened. The hotline is open Monday – Friday, 8 AM – 5 PM.

Testing will be conducted by drive-thru at the Leavenworth County Health Department daily at a set time. If you qualify for testing, additional instructions will be given.

 

This story is dedicated to Terrance Lewis of Leavenworth, KS, who lost his month long battle with COVID-19 on April 20, 2020.

(1) https://www.youtube.com/channel/UCNXjJ4Igw2Ir8774eBNb4yA Special recognition and thanks to Jefferson City, MO, Channel 13 KRCG Newsroom youtube channel

(2) https://en.wikipedia.org/wiki/Rashid_Buttar

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