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March 26, 2020

CAFE Insider Newsletter #65

Dear Reader,

Four weeks ago, I did not even know the term “social distancing,” much less what it meant to practice it. And now, I’m already fed up with it, as I’m sure most of you are. But my family and I will persist for as long as necessary because we put our faith in the doctors and scientists who preach its effectiveness.

Some have pointed out that the term, “social distancing,” is a misnomer. What we are really doing is physical distancing. In this time of uncertainty and suffering, true social distancing would be the worst possible prescription for our souls and psyches. While we may have to hunker down in our homes and observe the six-foot rule when in public, we need social closeness more than ever. It’s challenging. You can shelter in place with your nuclear family, if you are part of one. But the concentric circles of relationships beyond that core are more difficult to keep up. And so we turn to our vilified electronic devices to connect us to friends and family outside our bunker. Our smartphones and tablets and laptops are not just a means to keep up with work, school, and the news; they are lifelines to the communities we care about.

As I tweeted last night, “One of the only silver linings of this whole miserable mess of times is reaching out to, and hearing from, old friends just checking in. It’s wonderful.” I added wishfully, “And when Dr. Fauci says it’s ok, I’m throwing a yuge party for all of us.”

Such a party seems far off, sadly.

But these daily check-ins have been spirit lifting. You may have found the same. I’ve checked in with old friends in California, Maryland, Texas, D.C., Florida, Illinois, and the UK. So many have reached out to me also. It’s as if everyone on your holiday card list got a memo reminding them you don’t have to wait a whole year to drop a line. There is an outpouring of outreach, and that has been a blessing.

I’ve also been hearing from many of you – people who read these notes or listen to the podcasts. These have been a comfort too. I appreciate your struggles and successes, your varied takes on the state of the country, also your advice and good wishes.

There’s one check-in I’d like to share with you. Earlier this week, we received an email at the Stay Tuned account with the subject line, “Warm regards to Bashir Khan.” The message was this: “Hi Preet – I know your father-in-law because he comes to my library frequently. Please let him know that I’m thinking of him and wishing him well.” The writer was Melissa Morgan, who works at the local library that was a second home to my father-in-law, Bashir. He liked to sit among the books and read the news of the day, over time befriending many members of the staff. When he stopped being able to drive himself, my sister-in-law would take him. It was a vital part of his routine, but it had been hard to maintain recently as he struggled physically.

It was a small thing, this email check-in from a stranger, who felt my father-in-law’s absence at the library and just thought to reach out. It’s hard to explain why it touched me so, but it did. Words of concern and acts of kindness seem much needed now.

Part of it may be that it’s a sad time for my family. You see, I don’t have good news about Bashir. He won’t be back at the library. Yesterday morning, at the age of 91, he passed away. He was home, in no pain, and at peace.

His death was not COVID related. This, I realize, is something you have to say these days, when anyone dies. The virus seems to find a way to involve itself in every death now. In our case, it meant that my wife couldn’t go to Chicago to be with her father at the end, even when we knew it was coming. That’s been the most painful part of this. I know others have had similar experiences. And it is crushing.

Bashir’s life, on the other hand, is an inspiration. He was born in a small town in India in the eventful year of 1929. Guess what the life expectancy was for a male born in the late 1920’s, in colonial India? It was 28. I looked it up: 28.26 years, to be exact. But notwithstanding that miserable actuarial prediction, Bashir survived India’s bloody partition in 1947 when part of his Muslim family relocated to Pakistan; put himself through college and medical school; emigrated to America; built a thriving medical practice in Chicago; and started a family with his young Jewish wife whose own father had fled Nazi Germany in the 1930’s. He led a remarkable and full life. Like my own father, against magnificent odds, he embodied the American Dream. I wish I had a fraction of the bravery of either of these two men.

Bashir was a kind and gentle patriarch and ever so proud of his family. May he rest in peace.
I know that many of you are going through painful times too. It’s not easy living in this age of pandemic. I know some try to completely shut out the news, which is impossible. Others read every last awful ICU story, which is inadvisable. And there is a terrible feedback loop in operation. The contagion causes anxiety, and the resulting anxiety itself feels contagious.
I’m as much concerned about everyone’s mental health as their physical well-being. Physical distancing remains necessary, but social closeness is vital. That’s why the check-ins are so important and sustaining. Reach out to old friends, gather online, send good wishes. Every gesture means more now. While you are counting the days to the party, make the days count. And let me know how you’re doing.

Be well and be kind.

My best,



As Congress moves toward passing a sweeping stimulus package to address the impact of the coronavirus pandemic, more and more members of both chambers are being forced into quarantine as a result of exposure to the virus. On Sunday, Rand Paul became the first sitting Senator to be diagnosed with the virus, forcing several additional Senators, including Mitt Romney, to self-quarantine as a precaution. Senators Paul and Romney join at least 30 other members of Congress who have so far been sidelined by illness or quarantine.

The alarming spread of coronavirus through Congress has ramped up calls for establishing a system that would allow members to cast their votes remotely. On Monday, nearly 70 House Democrats sent a letter appealing to the House Rules Committee to allow for remote congressional voting. In their letter, the members wrote:

Unfortunately, during such circumstances, requiring Members to vote in person may pose public health risks or even be physically impossible for persons under quarantine. We need to provide a mechanism through which Congress can act during times of crisis without having to assemble in one place.

In response, the House Rules Committee released a 23-page report this week throwing cold water on the feasibility of remote voting. The report outlined a multitude of challenges around the constitutionality, security, and logistics of such a system. The report states:

Article I of the Constitution mentions in various places the need to bring Members together to conduct business. The Constitution speaks of “meeting” (Art. I, Sec. 4, Cl. 2), “assembling” (Art. I, Sec. 3, Cl. 2), and “attendance” (Art. I, Sec. 5, Cl. 1) in describing how Congress would conduct its business.

Most concerning to the Rules Committee was the lack of legal precedent, which would make any legislation passed remotely — including the largest and most far-reaching stimulus bill in American history — vulnerable to challenges in the courts. According to the report, “If challenged, remote voting would be a novel question for a court and there is no guarantee of a favorable ruling affirming its constitutionality.”

However, some legal scholars have advocated for both the constitutionality and utility of a system of remote voting. Last week, famed Harvard Law Professor Laurence Tribe tweeted, “The Constitution isn’t an obstacle to voting remotely or virtually — either in Congress or at the polls.” Tribe expounded on that view in a quote within the House Democrats’ letter, arguing, “The Constitution needn’t and shouldn’t be construed to preclude virtual presence any more than it had to be constituted to treat air travel or indeed email as something other than interstate commerce or electronic surveillance as less than a fourth amendment search and seizure.”

In that same letter, the Dean of UC Berkeley Law School, Erwin Chemerinsky, argues, “Article I, Section 5 says: ‘Each House may determine the Rules of its Proceedings.’ I believe this is authority for a house of Congress to use remote voting, especially given our emergency situation.”

The Supreme Court decided a similar matter in United States v. Ballin (1892). In that case, the Court declared constitutional a change to the way the House measured a quorum, holding that the Constitution “has prescribed no method” for determining the presence of a member, “and it is therefore within the competency of the house to prescribe any method which shall be reasonably certain to ascertain the fact.”

In addition to the endorsements from several high-profile members of the legal community, political pressure is mounting on Senate leadership to consider remote voting. Last Tuesday, Senate Majority Leader Mitch McConnell told reporters, “We will deal with the social distancing issue without fundamentally changing Senate rules.” Yet this week, following Senator Paul’s positive coronavirus diagnosis, two Republican senators came out in support of remote voting. Most strikingly, Senator Lindsey Graham of South Carolina — a proud institutionalist who had previously opposed changing voting rules — tweeted on Monday, “I totally support the idea of remote voting so that the Senate can continue to operate during this crisis. We should make this change before the Senate leaves town.”

Despite the increasing threat of coronavirus and the rapidly shifting views of key members of Congress, the likeliest solution remains the oldest: utilize Congress’s existing rules to allow for passage of a bill based on unanimous consent or voice vote. Those options, which bypass the need for a physical quorum, were used the last time attendance in Congress dropped as a result of the 1918 Spanish Flu.

Should Congress move to allow remote voting in a time of national emergency — or do the challenges associated with this untested legal question outweigh the benefits? Let us know your thoughts by writing to us at [email protected], or reply to this email


This week’s guest on Stay Tuned is Andy Slavitt. A veteran healthcare industry entrepreneur and reformer, Slavitt served as President Obama’s Acting Administrator of Medicare and Medicaid Services during the final two years of the administration, helping to fix the website and salvage the Affordable Care Act. Since then, Slavitt has continued to fight for healthcare coverage, founding the nonprofit United States of Care and the medical investment fund Town Hall Ventures. Slavitt has been a steady voice during the coronavirus crisis, offering daily updates on the virus on Twitter and helping to amplify solutions to the crisis, from crowdsourcing N-95 respirator masks to releasing detailed priorities for Congress.

In this excerpt from his conversation with Preet, Slavitt discusses President Trump’s assertion that the country should reopen by Easter:

Scientists are referring to this as the Easter Massacre. [Trump] said he’d like hundreds of people or thousands of people to sit next to each other in church…Here’s my message to people: There are going to be many, many Easters in your life. There are going to be many, many happy occasions in your life. This is a time of some sacrifice.

Listen to today’s episode and the bonus, and share your thoughts by writing a review or emailing us at [email protected]


Marc Lipsitch is the Director of the Center for Communicable Disease Dynamics at Harvard’s T.H. Chan School of Public Health. An epidemiologist and microbiologist by training, Lipsitch is an expert on pandemics who has been a voice of clarity through the chaos of the coronavirus crisis, charting the path forward to end the pandemic. Follow him @mlipsitch.


If you haven’t already, listen to this week’s special episode of the CAFE Insider podcast: “Pandemic Ethics & Glimmers of Hope” featuring guest Juliette Kayyem and follow along with this transcript.

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That’s it for this week. We hope you’re enjoying CAFE Insider. Reply to this email or write to us at [email protected] with your thoughts, suggestions, and questions.

—The CAFE Team: Tamara Sepper, Sam Ozer-Staton, Julia Doyle, Calvin Lord, David Kurlander, David Tatasciore, and Matthew Billy.