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Anyone Been Affected by the Coronavirus?


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So I shared this over on the KC as well:

 

http://www.musicrelief.org/

 

The local St. Louis music community has pulled together to support the industry including musicians and those affected in the service industry.

 

Basically they set up at a closed venue with no staff, one sound guy, and one videographer. They are letting musicians in on band at a time (no more than 10) and cleaning everything in between. They are live streaming all weekend for 28 hours. They've set up ways to donate money online during the event.

 

[video:youtube]https://www.youtube.com/watch?v=rs3CyrUIr08

 

I shared that page on my local social media, hoping someone will run with that idea. Lord knows there would be no shortage of willing performers. I see some of the better local restaurant owners trying to do things to ease the financial strain on their employees, this seems as good an idea as any.

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I got this sent to me by a friend. It's a newspaper article, and I don't know if it's exaggerated or not. If so it describes just how serious this is.

A Medical Worker Describes Terrifying Lung Failure From COVID-19 â Even in His Young Patients

'It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy [*****], this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube.'

by Lizzie Presser March 21, 5 a.m. EDT

 

As of Friday, Louisiana was reporting 479 confirmed cases of COVID-19, one of the highest numbers in the country. Ten people had died. The majority of cases are in New Orleans, which now has one confirmed case for every 1,000 residents. New Orleans had held Mardi Gras celebrations just two weeks before its first patient, with more than a million revelers on its streets.

 

I spoke to a respiratory therapist there, whose job is to ensure that patients are breathing well. He works in a medium-sized city hospital"s intensive care unit. (We are withholding his name and employer, as he fears retaliation.) Before the virus came to New Orleans, his days were pretty relaxed, nebulizing patients with asthma, adjusting oxygen tubes that run through the nose or, in the most severe cases, setting up and managing ventilators. His patients were usually older, with chronic health conditions and bad lungs.

 

Since last week, he"s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit. He estimates that his hospital has admitted dozens of confirmed or presumptive coronavirus patients. About a third have ended up on ventilators.

 

His hospital had not prepared for this volume before the virus first appeared. One physician had tried to raise alarms, asking about negative pressure rooms and ventilators. Most staff concluded that he was overreacting. 'They thought the media was overhyping it,' the respiratory therapist told me. 'In retrospect, he was right to be concerned.'

 

He spoke to me by phone on Thursday about why, exactly, he has been so alarmed. His account has been condensed and edited for clarity.

 

'Reading about it in the news, I knew it was going to be bad, but we deal with the flu every year so I was thinking: Well, it"s probably not that much worse than the flu. But seeing patients with COVID-19 completely changed my perspective, and it"s a lot more frightening.'

 

This is knocking out what should be perfectly fit, healthy people.

 

'I have patients in their early 40s and, yeah, I was kind of shocked. I"m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they"ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can"t breathe at all.'

 

They suddenly become unresponsive or go into respiratory failure.

 

'We have an observation unit in the hospital, and we have been admitting patients that had tested positive or are presumptive positive â these are patients that had been in contact with people who were positive. We go and check vitals on patients every four hours, and some are on a continuous cardiac monitor, so we see that their heart rate has a sudden increase or decrease, or someone goes in and sees that the patient is struggling to breathe or is unresponsive. That seems to be what happens to a lot of these patients: They suddenly become unresponsive or go into respiratory failure.'

 

The lung is filled with so much fluid, displacing where the air would normally be. 'It"s called acute respiratory distress syndrome, ARDS. That means the lungs are filled with fluid. And it"s notable for the way the X-ray looks: The entire lung is basically whited out from fluid. Patients with ARDS are extremely difficult to oxygenate. It has a really high mortality rate, about 40%. The way to manage it is to put a patient on a ventilator. The additional pressure helps the oxygen go into the bloodstream.

 

'Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight. When you"re healthy, your lung is made up of little balloons. Like a tree is made out of a bunch of little leaves, the lung is made of little air sacs that are called the alveoli. When you breathe in, all of those little air sacs inflate, and they have capillaries in the walls, little blood vessels. The oxygen gets from the air in the lung into the blood so it can be carried around the body.

 

'Typically with ARDS, the lungs become inflamed. It"s like inflammation anywhere: If you have a burn on your arm, the skin around it turns red from additional blood flow. The body is sending it additional nutrients to heal. The problem is, when that happens in your lungs, fluid and extra blood starts going to the lungs. Viruses can injure cells in the walls of the alveoli, so the fluid leaks into the alveoli. A telltale sign of ARDS in an X-ray is what"s called 'ground glass opacity," like an old-fashioned ground glass privacy window in a shower. And lungs look that way because fluid is white on an X-ray, so the lung looks like white ground glass, or sometimes pure white, because the lung is filled with so much fluid, displacing where the air would normally be.'

 

This severity ... is usually more typical of someone who has a near drowning experience ... or people who inhale caustic gas.

 

'With our coronavirus patients, once they"re on ventilators, most need about the highest settings that we can do. About 90% oxygen, and 16 of PEEP, positive end-expiratory pressure, which keeps the lung inflated. This is nearly as high as I"ve ever seen. The level we"re at means we are running out of options.

 

'In my experience, this severity of ARDS is usually more typical of someone who has a near drowning experience â they have a bunch of dirty water in their lungs â or people who inhale caustic gas. Especially for it to have such an acute onset like that. I"ve never seen a microorganism or an infectious process cause such acute damage to the lungs so rapidly. That was what really shocked me.'

 

You"ll try to rip the breathing tube out because you feel it is choking you ...

 

'It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy [*****], this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube and out of his mouth. The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, we"ve had to restrain them. They really hyperventilate, really struggle to breathe. When you"re in that mindstate of struggling to breathe and delirious with fever, you don"t know when someone is trying to help you, so you"ll try to rip the breathing tube out because you feel it is choking you, but you are drowning.

 

'When someone has an infection, I"m used to seeing the normal colors you"d associate with it: greens and yellows. The coronavirus patients with ARDS have been having a lot of secretions that are actually pink because they"re filled with blood cells that are leaking into their airways. They are essentially drowning in their own blood and fluids because their lungs are so full. So we"re constantly having to suction out the secretions every time we go into their rooms.'

I do not want to catch this.

 

'Before this, we were all joking. It"s grim humor. If you are exposed to the virus and test positive and go on quarantine, you get paid. We were all joking: I want to get the coronavirus because then I get a paid vacation from work. And once I saw these patients with it, I was like, Holy [*****], I do not want to catch this and I don"t want anyone I know to catch this.

About This Story

 

The medical details in this story were vetted by an infectious disease doctor, a cardiologist and an internist at three different hospitals. All of the information about ARDS, the condition that the respiratory therapist describes, was fact-checked against peer-reviewed articles and UpToDate, a resource for physicians to check current standards in care, clinical features, and expected complications and outcomes.

'I worked a long stretch of days last week, and I watched it go from this novelty to a serious issue. We had one or two patients at our hospital, and then five to 10 patients, and then 20 patients. Every day, the intensity kept ratcheting up. More patients, and the patients themselves are starting to get sicker and sicker. When it first started, we all had tons of equipment, tons of supplies, and as we started getting more patients, we started to run out. They had to ration supplies. At first we were trying to use one mask per patient. Then it was just: You get one mask for positive patients, another mask for everyone else. And now it"s just: You get one mask.

 

'I work 12-hour shifts. Right now, we are running about four times the number of ventilators than we normally have going. We have such a large volume of patients, but it"s really hard to find enough people to fill all the shifts. The caregiver-to-patient ratio has gone down, and you can"t spend as much time with each patient, you can"t adjust the vent settings as aggressively because you"re not going into the room as often. And we"re also trying to avoid going into the room as much as possible to reduce infection risk of staff and to conserve personal protective equipment.'

 

Even if you survive ... it can also do long-lasting damage.

 

'But we are trying to wean down the settings on the ventilator as much as possible, because you don"t want someone to be on the ventilator longer than they need to be. Your risk of mortality increases every day that you spend on a ventilator. The high pressures from high vent settings is pushing air into the lung and can overinflate those little balloons. They can pop. It can destroy the alveoli. Even if you survive ARDS, although some damage can heal, it can also do long-lasting damage to the lungs. They can get filled up with scar tissue. ARDS can lead to cognitive decline. Some people"s muscles waste away, and it takes them a long time to recover once they come off the ventilator.

 

'There is a very real possibility that we might run out of ICU beds and at that point I don"t know what happens if patients get sick and need to be intubated and put on a ventilator. Is that person going to die because we don"t have the equipment to keep them alive? What if it goes on for months and dozens of people die because we don"t have the ventilators?

 

'Hopefully we don"t get there, but if you only have one ventilator, and you have two patients, you"re going to have to go with the one who has a higher likelihood of surviving. And I"m afraid we"ll get to that point. I"ve heard that"s happening in Italy.'

Bob "Notes" Norton

Owner, Norton Music http://www.nortonmusic.com

Style and Fake disks for Band-in-a-Box

The Sophisticats http://www.s-cats.com >^. .^< >^. .^<

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I heard some not-too-bright talk show host on the radio say that it's probably not going to be as bad as predicted, sure people will die, but they die anyway...and why are we taking these extreme measures and cratering our economy when so far, there have only been 450 deaths? To which he added if it does get as bad as people say, then we'll throw everything we have at it. I've heard this from other people as well, so here's the analogy I give them.

 

You're in the forest, and there's small brush fire. You think "it's not worth calling the fire department, having all those trucks and people show up would be overkill. It will probably just burn itself, and besides, it's supposed to rain later." But then the winds pick up, and all of a sudden, there's a conflagration. At that point, it's too late to bring in the fire department. Better to nip things in the bud.

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Americans have had it so good, for so long, that anyone from the man on the street to the highest reaches of government can't wrap their heads around this. The denial is palpable. It will sink in when people start having friends and relatives die. Until then, they'll think it won't happen to them.

 

The only good news is that world-wide, about 25% of the people who had active cases have recovered. That's a higher percentage than a week ago, so it means people are coming out on the other side alive. However of the total number of cases, 4% have died. So that means about 71% are in limbo, waiting to either recover or die.

 

If you want to know what's going on, don't listen to the news. You have the happy talk people who are idiots, and the gloom-and-doomers who take a morbid delight in contemplating the end of the world. If you read what epidemiologists and medical journals have to say, you'll get a much better idea of what's happening. My main takeaway is that the US is not doing what it should, with this patchwork quilt of some states locking down, and some states doing nothing. That just increases the odds that the virus will have multiple waves, and we'll have to deal with re-infections. Pretending that life is normal to help the economy will actually crater the economy more, because the whole scenario will take longer to play out. This isn't a political statement, it's one based on how viruses work.

 

I feel really bad for those whose partner got sick but they didn't, because they can't visit the hospital, see the person, stop by and cheer them up, nothing...all the while wondering whether they're going to get it too.

 

All we can do is wait, and try to take control of the situation by following the advice of people who have spent their lives studying these kinds of phenomena. They seem virtually unanimous in what they recommend.

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Here's a piece of good news!! A lot of scientists have been really concerned that if the pandemic takes hold in India, it would have extremely negative, world-wide implications. But today, PM Narendra Modi ordered a complete lockdown for the entire country, and said the following:

 

"You have seen the worldwide situations arising from the coronavirus pandemic in the news. You have also seen how the most powerful nations have become helpless in the face of this pandemic," Modi said in a live televised address to the nation on Tuesday evening ahead of the deadline.

 

"The result of a two-month study of these countries and what the experts are saying is that social distancing is the only option to combat coronavirus. That is to remain apart from each other and stay confined to within your homes. There is no other way to remain safe from coronavirus. If we have to stop the spread, we have to break the cycle of infection."

 

This guy gets it. It starts at midnight, and will go for at least 21 days. Good luck to our friends in India in containing this thing.

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Agree that this isn't / shouldn't be political.

 

The virus does not vote, nor does it persuade.

 

I received an email yesterday from a friend, we were planning on starting her album this week.

She works in elder care, an Angel Of Mercy if you will.

Yesterday morning she found out she has been exposed to Covid-19. She'll be under self-quarantine as possible for the next 2 weeks. She has a history with asthma and was hospitalized recently with pneumonia so this is scary stuff indeed!

 

I say "as possible" because her Mom was diagnosed with dementia and since breast cancer is also suspected there will be more lab work. Mom has 2 months to find a new place to live and daughter is the sole relative in a position to help. Daughter is afraid she may have already exposed Mom to Covid-19.

 

To make things worse, with all the layoffs from businesses closing, there are not enough jobs to go around. That means she will probably be inclined to continue her current position, where more exposure is inevitable.

 

Between a rock and a hard place!!!

 

That could be any of us should fate intervene.

 

Be SAFE everybody!!!!

It took a chunk of my life to get here and I am still not sure where "here" is.
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Yes. It doesn't just happen to other people. An acquaintance of mine can't breathe, coughs a lot, is running a fever, and has a prime underlying condition. She went to get tested yesterday; the results aren't back yet. I hope it's not covid-19, but frankly, she exposed herself to a crowd completely unnecessarily. Hopefully that one thoughtless moment won't turn out to be a death sentence.
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The only good news is that world-wide, about 25% of the people who had active cases have recovered. That's a higher percentage than a week ago, so it means people are coming out on the other side alive. However of the total number of cases, 4% have died. So that means about 71% are in limbo, waiting to either recover or die.

80% or more people who contract it show little or no symptoms so a lot of positive people have never been tested. The death rate is based only on confirmed cases, so until a lot more people can be tested the death rate of 4% is very misleading.

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Yes, the death rate in theory is almost certainly not 4%. As stated, it's the percentage of active cases that have died. What's unknown is not counted as active cases. You can assume that among unknown cases, there are many more infections, and many more recoveries. Similarly, you can also assume that some covid-19 deaths have been attributed to pneumonia or other flu strains.

 

Still, to get the death rate down to 1%, you'd have to assume four times more people have been infected than the active cases, and all of the uncounted ones will recover. The former seems possible, the latter unlikely. You would also have to assume that the stats established by the current, known statistics won't change; that's possible, because we may have enough of a sampling at this point that those stats will remain valid. A lot of experts seem to think that when all is said and done, the death rate will hover around the 2% mark.

 

There is much we do not know, so at the moment, all we have to go by is what we do know. Also the death rate is an average, not an absolute. The death rate in various countries can be higher or lower than the average number. Note that I am not an epidemiologist, but I do know math so that's somewhat helpful :)

 

Also the numbers will change over time. As I write this, the death rate in the US is 12% due to the huge number of active cases compared to recovered cases (50,138 compared to 361). Because the onset of large numbers of cases has been so recent, it will take a while for these people to recover. So they can't be counted as recovered yet. However, bear in mind that even if all 50,000 current active cases recover and survive, there are still 622 dead people, so the percentage wouldn't change. To get the death rate down, we need to have enough testing to show large numbers of infected people recovering.

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I would think that if the ratio of confirmed cases to known deaths remains somewhat constant (or drops) that the ratio would have some validity as a predictive number. Sure, some of those active cases will move into the known death category (and of course out of the active case tally.) But they will move at a certain rate. The known death figures should be quite solid. The actual tally of actual cases will only grow until actual testing confirms some sort of saturation point.

 

If we could just sample-test well defined statistical population groups, we could get some real predictive power I would think. But due to the need to confirm symptomatic people as positive for treatment purposes, the test equipment is going to be allocated to those situations and, from what I'm reading, not to generalized population studies (at least for a while.)

 

Because the current advice is, unless you feel seriously sick, just stay home and don't go to the doctor even if it's likely you have COVID-19. So that insures a large number of actual cases never becoming counted in the active case category (unless generalized overall population testing comes online...)

 

That is the current advice I'm seeing - is it different from other vantage points, other info sources than what I'm seeing?

 

nat

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Because the current advice is, unless you feel seriously sick, just stay home and don't go to the doctor even if it's likely you have COVID-19. So that insures a large number of actual cases never becoming counted in the active case category (unless generalized overall population testing comes online...)

 

That is the current advice I'm seeing - is it different from other vantage points, other info sources than what I'm seeing?

Yes, that's the current thinking. The problem is there are so many variables. For example, South Korea got really ahead of the curve. Currently, their death rate is 1.3%. But, there are still 5,000+ active cases, and it's unlikely all of them will recover. It seems like South Korea is indeed flattening out the curve, so there may be fewer active cases, which means that the deaths going forward from the current active cases will raise the percentage. I guess there's also the question of whether many of the deaths in Italy could have been prevented with better preparation, which would have lowered the death rate.

 

I suspect the next two weeks will be critical for New York. It's showing 26,077 active cases, and 271 deaths. That seems pretty good - only about 1% - but the big unknown is that so far, the NY stats show 0 recovered cases, and no one knows how many undetected cases there are.

 

I have no idea how this will play out...we see trends, but they seem to shift at a moment's notice.

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Another way to look at what's going on is simply the number of deaths that are occurring over time. This page by The NY Times shows exactly that, by country and by U. S. state. It's a log scale, so if the curve is going up, it's getting worse, and vice versa. Also indicated is how fast the number of deaths is doubling.

 

The number of deaths from the illness known as Covid-19 provides one of the most reliable measurements of the pandemic"s impact around the world. Testing rates for the virus differ so much that the number of positive results in a given country is not a precise barometer of how many people are afflicted. But deaths also lag infections substantially; evidence from China suggests that most patients who died from Covid-19 were infected for a month before their death.

"I'm so crazy, I don't know this is impossible! Hoo hoo!" - Daffy Duck

 

"The good news is that once you start piano you never have to worry about getting laid again. More time to practice!" - MOI

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We know how they count active cases - via the lab. And how they count deaths, of course.

 

How do they count "recovered cases"??

 

I'm guessing they track active (lab-confirmed) cases, and after X amount of time, if there's not a death, then they up the "recovered" count. If that's the case, then again, the actual-but-not-lab-confirmed cases are never counted in any category, unless some poor soul goes directly from uncounted to counted as a death....

 

Or maybe not even then if there's not an autopsy procedure to check for COVID-19.....

 

Geez, this all gets complicated. Hey Gov't - get those masks and tests going, and how much money are you throwing at research towards a vaccine??

 

nat

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Minnesota is going under a Shelter in Place order tomorrow for two weeks, and everything except absolutely essential businesses and all venues will be closed until May 1st. All schools are supposed to be online as well (but 60% or so of our people don't have good internet so that's going to be interesting). Heck, our city council can't have remote meetings because the bandwidth is being used up by the college students working from home, and now everyone else is supposed to add onto that! Anyways it's going to be interesting. Had about $2000 worth of gigs scheduled and all have been cancelled now unfortunately, including the big international festival which has been my best gig for the last five years.

 

Apparently it's too late to "flatten the curve" here now; we didn't have enough testing and resources available early enough. This is plan b, and hopefully will buy us some time to build more ventilators, make more masks, and set up more ICU rooms. 3M is based here, and Medtronic is mostly based here now.

Yamaha: Motif XF8, MODX7, YS200, CVP-305, CLP-130, YPG-235, PSR-295, PSS-470 | Roland: Fantom 7, JV-1000

Kurzweil: PC3-76, PC4 (88) | Hammond: SK Pro 73 | Korg: Triton LE 76, N1R, X5DR | Emu: Proteus/1 | Casio: CT-370 | Novation: Launchkey 37 MK3 | Technics: WSA1R

Former: Emu Proformance Plus & Mo'Phatt, Korg Krome 61, Roland Fantom XR & JV-1010, Yamaha MX61, Behringer CAT

Assorted electric & acoustic guitars and electric basses | Roland TD-17 KVX | Alesis SamplePad Pro | Assorted organs, accordions, other instruments

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I'm in economic self-isolation. No gigs until late October, everything cancelled and the Halloween parties are in a "wait and see" mode. The governor says live music draws a crowd, and in our case, it's true.

 

But I'm at home, it's 85 degrees out, the windows are open, the birds are singing, there is an ocean breeze drifting in the east windows, there's food in the fridge, food in the pantry, and we even have TP. All we need is money.

 

But more important than the money, we have our health.

 

Notes

Bob "Notes" Norton

Owner, Norton Music http://www.nortonmusic.com

Style and Fake disks for Band-in-a-Box

The Sophisticats http://www.s-cats.com >^. .^< >^. .^<

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I thought this was an interesting and sensible real-world article about corona virus. It's by a DJ who got it very early on, so it's enlightening to see what happens to someone after their personal crisis has passed.
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Two more big cancellations announced today - the InfoComm show in Las Vegas and the AES convention in Vienna, both in May. When shows like that get cancelled there are a whole lot of people affected, some money goes back in the pot, and a whole lot of money is lost.

 

At least I can quit complaining about not being able to find a decent air fare to Las Vegas.

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Since the gov't decided to help gig workers with unemployment benefits, I took the plunge. (I'll find out if I'm covered or not in a few days.)

 

It's done on-line. I started at 3PM and finished at about 9PM. I took a half hour break during a system crash for some tea and roasted mixed nuts.

To be fair, there is nothing that could have prepared the system for the present volume of claims.

 

First I had to register with Florida "Reemployment" services (newspeak for unemployment) compensation.

 

While filling out forms, it took anywhere from a minute to 3 minutes from the time you clicked "next" until the time the next page loaded. I was warned not to use back buttons but to only click the "Previous" or "Next" buttons.

 

First snag they asked for address on a page. A few pages later they asked if my mailing address was different. Assuming they were going to send me something I used the mailing address (a PO Box). Many pages later they asked for my mailing address and used the PO Box as my physical address. So I had to hit the "Previous" button a half dozen times, with the same 1-3 minute delay on each click.

 

Also in the process of I would estimate 25 or more pages, the system crashed 5 times. When it crashed I had to go back to page #1 and start all over. Some of the info was remembered, a lot of it had to be re-entered. Same 1-3 minute delays.

 

Needless to say, it was frustrating. Finally it finished at about 8:30 and said I had to register on another site, one that searches for my job title (musician) and will feed me leads. That only took 3 tries because there was not a sign-up page on the home page, eventually they asked me to sign up, I didn't know I was supposed to use my info from re-employment, so it rejected it saying there was another user with my social security number. That gave me the clue to sign up with my reemployment ID, except at re-employment I didn't have a user name so I had to click the "forgot user name" link so I could change it.

 

The reemployment site did have some COVID-19 entries so I could see it was a quickly done patchwork to the present site. With something like that, there are bound to be bugs, and my experience proved that.

 

Don't get me wrong, I'm not complaining. I'm grateful for the assistance package that was hammered out between the House and the Senate. If I get some aid, I'll still be spending as little as possible. I figure when the aid ends, if the plague isn't gone yet, I'll have some more savings to get me through.

 

And when it's safe to go out, and businesses re-open, I'll go to local businesses, spend some money, and help them get back on their feet.

 

Notes

Bob "Notes" Norton

Owner, Norton Music http://www.nortonmusic.com

Style and Fake disks for Band-in-a-Box

The Sophisticats http://www.s-cats.com >^. .^< >^. .^<

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Keep us posted on what happens. Having always worked from home except for the four years at Gibson, I'm not feeling too much of a pinch yet...although I have lost gigs, that just gives me time to create some products I want to put on my digital storefront. I've been itching to do these for a while, so I'm looking at this more like an opportunity.
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