Archive for the ‘Medicine and Health’ Category

The progressives surrender to the plutocracy 2

March 30, 2020

Is universal basic income the answer?

March 27, 2020

Universal Basic Income as it’s usually presented is a solution to an economic problem that doesn’t yet exist.

The imaginary problem is what happens after automation and computer algorithms make a majority of American workers unnecessary and unemployable.

The real problem is that our present economic system rewards useless and harmful work more than it does necessary work and even allows much necessary work to go undone.

There are a great many unmet needs in society and a great many unemployed people available to meet them.  It ought to be simple to match them up, but it isn’t, not within our present economic and political setup.

The coronavirus pandemic is a great revealer of who’s necessary in our society and who isn’t.  Grocery store clerks risk their lives so that I can have food in my pantry.  Yet as a class they’re on the bottom rungs in pay and social status.

They should get the equivalent of combat pay and maybe a military-type medal in awards ceremonies after the crisis is over.

I do think a UBI could be useful in the present emergency.

Send a $1,000 check every month to every man, woman and child who are willing to pledge to socially isolate themselves.

Send $2,000 or $3,000 every month to those who are doing the necessary work to keep us alive and well—health care workers and emergency responders, farmers and agricultural workers, truck drivers, grocery and drug store clerks, public utility workers, etc.  Shut down everything that’s not necessary for life and health.

[Added Later.  My idea is that the income grants would be supplementary to what people already are earning or drawing from savings.  The specific amounts are just to illustrate the concept and could be more; I don’t think they could be much less.]

The problem is – the USA may not have the capacity to do something so seemingly simple.  I read somewhere that it may take months before the government can mail physical checks in its one-time-only economic stimulus plan.

Laissez-faire conservatives used to say that the only thing government could do competently is mail out checks.  Evidently it can’t even do that nowadays.

The best practical thing that could be done immediately is for the federal government to fully fund state unemployment insurance programs and Medicaid programs up to a reasonably generous cap.

For the long run, the country needs is a full employment program more than it needs a UBI.

See to it that every needful thing is done to prepare for pandemic and weather-related catastrophe.  See to it that every practical thing is done to mitigate greenhouse gas emissions.  See to it that every needful thing is done to safeguard the lives and health of children, the elderly and the sick.

Pay all the people who do the needful work a decent wage.

If all these things were done, UBI would become an unimportant side issue.  Whether these things are possible within our current economic and political structure is a question I don’t have a good answer for.

LINK

The False Promise of Universal Basic Income by Alyssa Battistoni for Dissent Magazine.  [Hat tip to Steve B.]

Coronavirus: a tale of two states

March 26, 2020

Click to enlarge

Stephanie Jolly of Lexington, Kentucky, created this chart and posted it on her Facebook page, where it quickly became viral.

It shows that Kentucky Gov. Andy Beshear (D) acted more quickly on the coronavirus emergency than did Tennessee Gov. Bill Lee (R) and that the disease has not spread as fast in Kentucky as it has in Tennessee.

Added 3/27/2020:  But even though Kentuckians are better off than Tennesseans, thanks to Gov. Beshear’s prompt action, the number of new cases in Kentucky is still doubling every four days or so.

LINKS

Social Distancing to Fight Coronavirus: A Strategy That Is Working and Must Continue by Maura Caslyn, Emily Gee, Thomas Waldrop and Nicole Rapfogel for the Center for American Progress.

Graph comparing Ky. and Tenn. virus responses goes viral by David Mattingly for WAVE3 News in Lexington, Kentucky.

Human nature in a time of pestilence

March 25, 2020

I recently read an old paperback copy of Albert Camus’ novel, The Plague, which I’ve had on the shelf for decades.  If I ever read it before, I don’t remember..

The novel tells the story of a plague sweeping the French Algerian city of Oran.  It was published in 1947, but Camus wrote it during the German occupation of France during World War Two.

The novel’s real topic is not so much plague specifically as how people react to catastrophe.  Camus’ view is surprisingly comforting and reassuring.  The novel’s principal characters all rise to the occasion, and the political and social order, although under strain, functions as it should.

The novel begins with mysterious deaths of rats in the city, a sign of plague, but which Oran’s physicians and municipal authorities refuse to take seriously until people start dying.  The public can’t imagine something could happen that would prevent them from living their accustomed lives.

At first the public seeks to maintain a semblance of normal life while the plague rages.  As the death rate increases, the people forget what normal life was like and just deal with the ever-present threat.  Just as they’ve given up hope, the plague fades away, and people try to pick up where they left off, as if it never happened.

The novel’s six main characters show different ways of thinking and coping with catastrophe—what Camus called the Absurd, meaning things and events that have no purpose or meaning in human terms.

Dr. Bernard Rieux is a physician who at first finds it hard to believe the plague is real, but calls on the authorities to take action.  He heads an auxiliary hospital for plague victims and also helps enforce quarantine regulations.

He works long, exhausting hours.  He finds he has to harden his heart in order to do his duty.  When he visits a patient at home and finds the person is infected, he calls for an ambulance to take the person away, despite the pleas of relatives, who understand that they may never see the victim again.  In the later stages, he has to go to patients’ homes accompanied by police

He does not believe in God and denies having any overarching philosophical belief.  He does his job simply because he is a physician and that is his role.  When asked what he believes in, he replies, “human decency.”

Jean Tarroux is a mysterious character who seems to have nothing to do but hang out around town and observe life.  But then he takes the initiative to form volunteer auxiliaries to help fight the plague—for example, by disinfecting houses.

He reveals that he is a former revolutionary—a Communist, if you read between the lines, although this is never spelled out.  He joined the revolutionary cause because of his horror of capital punishment; he left it because the revolutionaries are killers themselves.

He speaks about how human beings carry plague within themselves, which I take to mean most human beings are willing to see other people die in order to save themselves or achieve their goals.

He says the great sin is refusing to speak the truth in plain language.  He says his desire is to find out whether you can be a saint without believing in God.

He is one of the last to die, hanging on to life as long as he can,  but rejecting comforting illusions.

Click to enlarge.

Father Paneloux is a Catholic priest who preaches a sermon about how the plague is God’s judgment on the sins of the people of Oran. Camus, although an atheist, took religious faith seriously and a lot of his philosophy, including this book, is a kind of dialogue with Christianity.

The priest says people ignore God’s commandments and reject his love because they confidently expect to be forgiven, but sometimes God’s patience is exhausted and he lets people suffer what they deserve.

He says God figuratively is standing over the city with a giant flail, which is used to thresh wheat and separate the  nourishing grain from useless chaff.  I find this a powerful image.

I think of the flail in terms of the coronavirus emergency, in which we are see who are the wheat (not just health workers, but grocery clerks, trash collectors, janitors and cleaners, truck drivers) and who are the chaff (hedge fund managers, corporate lobbyists, diversity trainers).

The priest joins the volunteer auxiliary and witnesses the slow, painful death of a child from the plague.  He later preaches another sermon on whether a child’s painful death can be God’s will.

He said that a Christian must believe that everything that happens is God’s will, even if you can’t understand the reason.  This includes the death of a child.  Otherwise you don’t really believe in God.

But he adds that if you accept human suffering and death as God’s will, you must be willing to suffer and die yourself.  Later Father Paneloux himself falls sick and dies painfully, but not from symptoms of the plague.

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Doubling rates of coronavirus deaths

March 25, 2020

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This chart shows that even in Japan and South Korea, the number of deaths from COVID-19 has been doubling every week.  For many nations, the doubling rate is every three days.  It is nearly that much in the United States.  So we shouldn’t be complacent about the relatively small number of people who have died so far.

Every state should do this

March 24, 2020

In a Move That Should Be Replicated Nationwide, Minnesota and Vermont Have Classified Grocery Clerks as Emergency Workers by Shane Ryan for Paste magazine.

Senate prepares big giveaway to big business

March 23, 2020

The trillion-dollar coronavirus bailout package drawn up by Senate Republicans is a giveaway to big business that does little to avert the coming economic depression.

The main features are:

  • Treasury Secretary Steve Mnuchin gets to dole out $500 billion to corporations without revealing who got what for six months.
  • Businesses are not required to keep workers on their payrolls.
  • There are no meaningful oversight provisions to prevent waste, fraud and abuse.

Democrats won a minor concession—to extend unemployment benefits for four months instead of just three.  This is trivial.  So are the relief checks being mailed out—$3,000 checks for a family of four.

Now it’s true that essential businesses can’t be allowed to fail because of a crisis not of their own making.  I criticize Walmart’s business practices, but a lot of people depend on Walmart for the necessities of life.

 It’s not possible to shut down economic activity on a large scale and not risk another economic crash.

On the other hand, Walmart shouldn’t be allowed to use government handouts to crush and buy up individually-owned businesses that compete with us.

I admit I don’t have a complete idea of what to do.  One possibility is for the federal government to fund unemployment insurance and apply it to the self-employed and gig workers as well as workers already in the system.  Another would be to provide Medicare benefits to coronavirus patients—better still, Medicare for all.

If you’re an American, I recommend you follow the Naked Capitalism blog’s headline service to keep in touch with breaking developments.

Later.  The giveaway bill was stopped—for now.  Of course Senate Majority Leader Mitch McConnell is accusing the Democrats of indifference to Americans’ economic plight.

LINKS

Stop the Coronavirus Corporate Coup by Matt Stoller for BIG.

Bailout Shenanigans: Making 2008 Look Good? by Yves Smith for Naked Capitalism.

Protect People, Not Financial Ledgers by Ian Welsh.

How Democrats Can Fix Their COVID Response by Brian Beutler for Crooked Media.

At Least Five U.S. Senators, Briefed on Coronavirus, Sold Stocks Before Market Crash by Democracy Now!

Yet another link about the coronavirus

March 20, 2020

Scott Alexander, a psychiatrist and blogger in California, posted information about the coronavirus I haven’t read anywhere else.  Click on Coronavirus 3/19/20 to read it.

How the coronavirus works

March 20, 2020

An Explanation of How Coronavirus Damages Your Body by Jason Kottke for kottke.org.  Source of the video.

The Best-Case Outcome for the Coronavirus, and the Worst by Nicholas Kristof for the New York Times.  [Hat tip to Steve Badrich]

Everything You Need to Know About Coronavirus Testing by Megan Molter and Adam Rogers for Wired magazine.

When Will a Coronavirus Vaccine Be Ready? by Laura Spinney for The Guardian.

The History of Pandemics by Death Toll by Nicolas LePan for Visual Capitalist.

The coronavirus and the new China-U.S. cold war

March 19, 2020

Xi Jinping visits Wuhan on March 10.  Photo via Unz Review

Xi Jinping is using the coronavirus pandemic to discredit the USA and to position China as the world leader and exemplar.

He contrasts China’s decisive response to the Wuhan outbreak to the slow, fumbling U.S. response.

He contrasts China’s generosity in helping other nations with U.S. economic warfare against vulnerable states.

And his government is spreading a theory that the disease originated not in a Wuhan meat market, but in a U.S. biowarfare laboratory.

Pete Escobar of Asia Times reported—

Beijing is carefully, incrementally shaping the narrative that, from the beginning of the coronovirus attack, the leadership knew it was under a hybrid war attack.

Xi’s terminology is a major clue. He said, on the record, that this was war.  And, as a counter-attack, a “people’s war” had to be launched.

Moreover, he described the virus as a demon or devil.  Xi is a Confucianist.  Unlike some other ancient Chinese thinkers, Confucius was loath to discuss supernatural forces and judgment in the afterlife.

However, in a Chinese cultural context, devil means “white devils” or “foreign devils”: guailo in Mandarin, gweilo in Cantonese. This was Xi delivering a powerful statement in code.

When Zhao Lijian, a spokesman for the Chinese Foreign Ministry, voiced in an incandescent tweet the possibility that “it might be US Army who brought the epidemic to Wuhan” – the first blast to this effect to come from a top official – Beijing was sending up a trial balloon signaliing that the gloves were finally off.  

Zhao Lijian made a direct connection with the Military Games in Wuhan in October 2019, which included a delegation of 300 US military.

Via Asia Times

The Chinese leaders claim to have the coronavirus under control in their own country, and now are taking a lead in fighting the disease worldwide.  Pepe Escobar went on to report—

Beijing sent an Air China flight to Italy carrying 2,300 big boxes full of masks bearing the script, “We are waves from the same sea, leaves from the same tree, flowers from the same garden.”

China also sent a hefty humanitarian package to Iran, significantly aboard eight flights from Mahan Air – an airline under illegal, unilateral Trump administration sanctions.

Serbian President Aleksandar Vucic could not have been more explicit: “The only country that can help us is China. By now, you all understood that European solidarity does not exist. That was a fairy tale on paper.”

Under harsh sanctions and demonized since forever, Cuba is still able to perform breakthroughs – even on biotechnology. The anti-viral Heberon – or Interferon Alpha 2b – a therapeutic, not a vaccine, has been used with great success in the treatment of coronavirus.  

A joint venture in China is producing an inhalable version, and at least 15 nations are already interested in importing the therapeutic.

Now compare all of the above with the Trump administration offering $1 billion to poach German scientists working at biotech firm Curevac, based in Thuringia, on an experimental vaccine against Covid-19, to have it as a vaccine “only for the United States.”

Via Asia Times

China’s governing philosophy is a weird mixture of Maoist thought control, Confucian conservatism, blood-and-soil nationalism and neoliberal capitalism, together with elements of independent civil society left over from the Deng Xiaopeng era.  But Chinese success and American failure to deal with the coronavirus make the Chinese system highly appealing.

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Fox News changes its mind about the virus

March 18, 2020

I don’t know the reason for the sudden about-face by Fox News personalities on the coronavirus crisis.  Maybe a member of the Murdoch family, which owns the Fox network, laid down the law.   Or maybe they all changed when President Trump changed the party line.

I have to say that Tucker Carlson has been the honorable exception to this, as he has on other things, such as the Mideast war.

Whatever the reason, I’m glad of the change.  Fox News has been a major source of misinformation and a major impediment to dealing with the pandemic.

LINKS

Fox News Moves Closer to the Truth as COVID-19 Crisis Deepens by Jason Kottke for kottke.org.

‘Dishonesty Is Always an Indicator of Weakness’: Tucker Carlson on How He Brought the Coronavirus Message to Mar-a-Lago in Vanity Fair.

‘We have a responsibility’: Fox News declares a crisis in abrupt U-turn by Adam Gabbatt for The Guardian.

Fox News Is Taking Coronavirus More Seriously, But Is Still Unserious by Jamil Smith for Rolling Stone.

What to do when the coronavirus comes

March 18, 2020

What we now expect in the COVID-19 coronavirus pandemic:

  • More than half of us will be infected.
  • The vast majority of those infected will survive.
  • There won’t be room in hospitals to care for most of the infected.

So what do we do?  Olga Kagan, a registered nurse in New York, offered tips for treating yourself at home, which I have copied below.

What you need

Acetaminophen (Tylenol) in 325 mg tablets

Ibuprofen (Advil) in 200 mg tablets.  [Note: WHO recommends avoiding Ibuprofen for coronavirus.  See comment.]

Mucinex, Robitussin or DayQuil/NyQuil, whatever your cough medicine of choice is

TissuesHumidifier: If you don’t have a humidifier, you can also just turn the shower on hot and sit in the bathroom breathing in the steam.).

If you have a history of asthma and you have a prescription inhaler, make sure the one you have isn’t expired and refill it/get a new one if it is.

How to treat symptoms

For a fever over 101, alternate Tylenol and Advil so you’re taking a dose of one or the other every 3 hours. (Again, check with your doctor before taking Advil.) 

Use both cough suppressants and expectorants (most cough meds have both). 

Drink a ton.  Hydrate.  Hydrate.

Rest lots.

If you’re sick

If you’re sick, you should not be leaving your house except to go to the doctor.

You DO NOT NEED TO GO TO THE ER unless you are having trouble breathing or your fever is very high and un-managed with meds.  

We don’t want to clog the ERs unless you’re actually in distress. The hospital beds will be used for people who need oxygen/breathing treatments/IV fluids.

If you have a pre-existing lung condition (COPD, emphysema, lung cancer) or are on immunosuppressants, now is a great time to talk to your PCP or specialist about what they would like you to do if you get sick. They might have plans to get you admitted and bypass the ER entirely.

For parents.

One major relief to you parents is that kids do VERY well with coronavirus— they usually bounce back in a few days.

No one under 18 has died, and almost no kids have required hospitalization (unless they have a lung disease like CF). Just use pediatric dosing of the same meds mentioned above.

Additional advice If someone in your family has coronavirus, they should: Stay in a separate room, use a separate bathroom, if possible; use paper plates and plastic utensils or different dishes and flatware then everyone else.

Additional advice

If someone in your family has coronavirus, they should: Stay in a separate room, use a separate bathroom, if possible; use paper plates and plastic utensils or different dishes and flatware then everyone else.

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Taking the coronavirus seriously 3

March 17, 2020

I think I have less to fear from the coronavirus than most people.  Unlike many, I live in a house alone rather than in an apartment with several.  Unlike many, I own an automobile.  Unlike many, I am a pensioner who doesn’t have to go out into the world to earn my daily bread.

I already live the life of a semi-recluse,  Being more of a recluse than I am would not be a great burden.  I have a library of unread books and an Internet connection that keeps me in touch with the world.  I am in a position to stay home except for going to the grocery store and keeping my medical appointments.

But what about the thousands of people i depend upon to keep me in my comfortable position—the thousands of people in the supply chain starting at farms and ending in the checkout line at my local supermarket?  the supply chain leading to my local drug store?  the public utilities that supply me with electricity, heat and clean water?  the whole health care network?

A new report says that emergency measures may have to last for up to 18 months or millions will die.  Are we prepared for this?

I’m 83 years old, which puts me in the vulnerable population, but even at that, my chances of survival are excellent.  Suppose there is a 50 percent infection rate, and roughly 16 percent of infected people in my age group die.  That means, all other things being equal, I have a 92 percent chance of surviving the epidemic.

Then, too, dying of a COVID-19 infection would be better than dying of cancer.  it would be far better than me spending my last years in a state of dementia—a living body with nobody home.  I accept the fact of death, at least intellectually.  Dementia is the thing I fear.

No, I don’t worry about myself.  I worry about my country.  We criticize the Chinese government for being slow to act, but what about our own government?  The first COVID-19 infection outside China was detected on Jan. 4, the first infection in the United States was detected Jan. 20 and President Trump banned travel by Americans to China on Jan. 31.

So our government at high levels has been well aware of the problem for many weeks, but it is only just now beginning to exercise leadership, and even now without long-range thought.  Local governments, too, are issuing emergency decrees without long-range planning.

Gov. Andrew Cuomo, for example, has ordered the closings of restaurants, movie theaters and casinos.  But what happens to all the small businesses that are forced to close?  How many of them will reopen after the crisis?

I do not necessarily criticize Gov. Cuomo and others who are are issuing emergency decrees.  Maybe this is the best we can do under the circumstances.

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What it takes to fight the coronavirus

March 16, 2020

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The worst of the pandemic is yet to come

March 16, 2020

Click to enlarge. Chart Updated 3/18/2020

[Updated 3/18/2020]  The chart in the upper left shows the spread of the coronavirus in Italy.  Others show that France, Germany, Spain, Switzerland and the USA are on track to follow in Italy’s footsteps.  So far the virus is spreading more slowly in Canada Sweden and the UK.  

Nobody can know for sure what will happen, and France and Germany are somewhat better prepared for a health emergency than the UK or the USA, but I don’t see anything in place that would save any of these countries from Italy’s crisis.  And of course the situation in Italy may become much worse that it already is.

Unless things change, COVID-19 will not be the last or the worst pandemic.  People and governments need to concentrate for now on dealing with the emergency, but afterwards we need to think about why we were caught by surprise, and why our globalized economic system can enable infection to spread from a single source, possibly a live-animal meat market in China, to every corner of the globe in a matter of months.

I include myself among the complacent.  I have a certain limited intellectual understanding of the crisis, but I don’t feel it in my bones.  As the saying goes, I lack the courage to believe what I know.

LINKS

The incompetence pandemic by Matthew Karnitsching for POLITICO.  Mainly about Europe.

Conceit and Contagion: How the Virus Shocked Europe by Bruno Maçães for Quillette.

The USA, China and the coronavirus pandemic

March 14, 2020

We Americans have long liked to think of our ideals of freedom and democracy as models for the world.  But China, whose leaders reject those ideals, seems to be doing a better job that we are of protecting its citizens and the world from COVID-19.

Advocates of democracy claim that our system is better because it provides a reality check.  When the government fails to do its job, the loyal opposition and free press are there to point it out.

Click to enlarge

China’s initial response to the coronavirus showed the truth of this.  The first physicians to detect the coronavirus were threatened by police for spreading false rumors.

But once China’s rulers realized the truth, they drew upon the strength of a totalitarian system, which is to be able to focus all a nation’s resources on a single objective.

By the way, I greatly admire the courageous Chinese doctors and nurses who risked their lives to stop the spread of the disease,  Not only the Chinese, but the whole world, owe them a debt.

The Chinese appear to have succeeded in stopping the spread of the disease in a relatively short time.  The number of cases in Hubei province, the center of the outbreak, seems to be leveling off at about 70,000.  This is cases, not fatalities.  Hubei has a population of 58 million, almost as great at italy, with 60 million.

Dan Wang, an American living in Beijing, reported on the effectiveness of quarantine measures there.

Click to enlarge. Source: Forbes

The problem with the Chinese system of government is: How can we be sure?  In any large, hierarchical organization, whether corporate, military or something else, those in the lower ranks will tell those in the lower ranks what they want to hear, and those in the higher ranks will tell those in the lower ranks what they want them to believe.

I think there will be a natural tendency of those on the lower levels of the Chinese hierarchy to report everything is under control, whether or not it is.  I know a college professor with a great many Chinese students.  She tells me they are all cynical about reports of success in China, and whether all Chinese cities will get the same protection as Beijing.

Under Deng Xiaopeng, there was enough of a limited free press and civil society to point out the problems.  Will this be true of Xi Jinping?

Based on what little I know, I think the Chinese have responded magnificently and the world owes them a debt.  But if the opposite were true, it would be a long time before I had any way to know it.

Here in the United States, we have Donald Trump, a totally incompetent, but democratically-elected leader who denies reality as blatantly and obviously as any Communist ruler of old.

The saving grace of our system is that his failure to lead is not hidden.  it is obvious to anyone who has eyes to see and a willingness to face facts.

And the other saving grace is that we the people can take constructive action without waiting for orders from the federal government.  State and local governments, universities, research centers, commercial corporations and civic groups are all taking corrective action.

Still, we should ask ourselves.  How is it that we are so completely unprepared?  Why do we have so few hospital beds?  Why is it that China and other countries are able to test for COVID-19 on a large scale and we are not?

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The coronavirus and exponential growth

March 13, 2020

Hat tip to kottke.org.

This video provides a good explanation of the concept of exponential growth, and particularly why there is so much concern about a pandemic that so far has claimed relatively few lives.

The reason, as explained in the video, is the rate of growth of the disease and not the absolute numbers.  Right now there is no cure for the disease and no way to prevent some spread of the disease.

But if the rate of growth can be controlled in the early stages of the disease’s spread, it can be kept under control.

One point made in the video is that there is no such things as exponential growth continuing indefinitely.  At some point the hockey-stick pattern on the growth chart becomes an S-curve and then a bell curve.  But with the spread of an infectious disease, the leveling off may not start until half or more of the vulnerable population is infected, and millions of people are doomed to die.

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The coronavirus: challenge and response

March 12, 2020

I have liberal Democratic friends who are gleeful that President Trump is responding so badly to the COVID-19 crisis.  It will show his inadequacy as a leader in a way that is unmistakable to his followers, they think.

I agree with this assessment.  By fall, the United States is likely to be facing a public health crisis and probably an economic crisis and possibly a weather-related or climate-related emergency, all together.  The nation will need a strong leader, and our current President isn’t it.

I would be happy to seem Trump rise to the occasion and prove me wrong about this.  I don’t want a million of my fellow citizens to die, even if I am not one of them, just to show that I was right.  But I don’t think Trump has it in him to be a true leader.

This would be a great political opportunity for the Democrats.  They could nominate Chance the Gardener and he might still win.  But being glad about it is the kind of extreme partisanship that liberals and progressives attribute to Trump supporters.

Also, few if any of these friends plan to make changes in their own personal lives to avoid being infected and infecting others.  How, then, are they different from Trump?

[Update 3/15/2020.  Actually, the individuals I was thinking of have in fact changed their habits in response to the emergency.  I misjudged them.  I apologize.]

No doubt President Hillary Clinton or President Jeb Bush would not have been so blind to reality..  But the United States would be unprepared to meet the crisis.  The United States has been hollowing out it ability to respond to crises for years.  Look at the responses to Hurricane Katrina, Superstorm Sandy and Hurricane Maria.  As Matt Stoller put it—

The reason America can’t handle the Coronavirus is the same reason we can’t do anything else right.  We don’t let the people who do the work have any say over how or whether the work is done.  That’s why America has mishandled various wars, the response to Katrina, the financial crisis, big tech monopolies, Boeing, the Iowa caucuses, and the crisis with Hurricane Maria in Puerto Rico.  American institutions are organized entirely around the short-term horizon of financiers, and these financiers seek to create monopolies and to grab cash by thinning out supply lines and generating hidden risk.

Source: BIG by Matt Stoller

It is not just CEOs who can’t look beyond the next quarterly report.  It also is politicians who can’t look beyond the next election. But the dynamic is the same.  The reason we Americans have hollowed out our ability to respond to emergencies is the same as the reason we have hollowed out our manufacturing capability..

U.S. Health Care: High Cost and Mediocre Results on An Economic Sense.

I hope we can learn and change.

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WHO makes it official: COVID-19 is a pandemic

March 11, 2020

T. A. Ghebreyesus

Dr. Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, officially declared the spread of COVID-19 to be a pandemic, which means it is a worldwide problem, not a number of epidemics limited to  a few countries.

His remarks to the press were partly reassuring and partly alarming.  The reassuring part is that China and South Korea apparently are bringing their epidemics under control, so it can be done.  The alarming part is that not all countries are able or willing to do what’s necessary.

Here are the highlights of what he  said.

In the past two weeks, the number of cases of COVID-19 outside China has increased 13-fold, and the number of affected countries has tripled.

There are now more than 118,000 cases in 114 countries, and 4,291 people have lost their lives.

Thousands more are fighting for their lives in hospitals.  In the days and weeks ahead, we expect to see the number of cases, the number of deaths, and the number of affected countries climb even higher.

WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction.

We have therefore made the assessment that COVID-19 can be characterized as a pandemic.  Pandemic is not a word to use lightly or carelessly.  [snip]

 We have never before seen a pandemic sparked by a coronavirus.  This is the first pandemic caused by a coronavirus.

And we have never before seen a pandemic that can be controlled, at the same time. [snip]

Of the 118,000 cases reported globally in 114 countries, more than 90 percent of cases are in just four countries, and two of those – China and the Republic of Korea – have significantly declining epidemics.

81 countries have not reported any cases, and 57 countries have reported 10 cases or less.

We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic. [snip]

Several countries have demonstrated that this virus can be suppressed and controlled.  The challenge for many countries who are now dealing with large clusters or community transmission is not whether they can do the same – it’s whether they will.  

Some countries are struggling with a lack of capacity.  Some countries are struggling with a lack of resources.  Some countries are struggling with a lack of resolve.

We are grateful for the measures being taken in Iran, Italy and the Republic of Korea to slow the virus and control their epidemics.

We know that these measures are taking a heavy toll on societies and economies, just as they did in China.

All countries must strike a fine balance between protecting health, minimizing economic and social disruption, and respecting human rights. [snip]

LINK

WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020

Photo: FABRICE COFFRINI/AFP/Getty Images

Taking the coronavirus seriously 2

March 10, 2020

America’s Coronavirus Response Has Started Slow, But Will Improve by Tyler Cowen for Bloomberg Opinion.

COVID-19 May Be a Public Health Crisis … But Not for the Reason You Think by Isis the Scientist for Skepchick.  [Hat tip to Mike the Mad Biologist.]

White House overrules CDC push for seniors to avoid flights amid coronavirus outbreak by the Associated Press.

Why Can’t America Handle the Coronavirus Crisis? by Matt Stoller for BIG.

Bern Researchers Produce New Coronavirus Fatality Estimate by Kevin Drum for Mother Jones.

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Taking the coronavirus seriously

March 7, 2020

Congress, thank goodness, is starting to take the coronavirus seriously.  I’m not sure that most of my fellow Americans are.

Matt Stoller reported—

This week, Congress passed an $8.3 billion supplemental spending bill to address the coronavirus crisis.  The bill has a number of parts, including aid for cities and states, pandemic response and vaccine research, and $7 billion in loans for small businesses hit by the disaster.  At first blush, it seems like the legislation is not that big a deal, a narrowly written bill directly responding to a crisis.  But I’ve spent some time calling around Congressional contacts, and I think this legislation is the start of a couple of important political trends.

First, Congress has just taken the lead over the executive branch on governing. Trump initially asked for just $2.5 billion to address the crisis, and Congress rejected that immediately and put in a larger number.  Just for a frame of reference, Singapore has spent $4.5 billion on its response, and Singapore has one seventieth the number of people.  Getting something in the right ballpark would be $300-400 billion, so the amount Congress passed isn’t sufficient.  Even so, it is still the case that Congress is taking the lead on setting policy and governing during a crisis.  That’s a shift in institutional power.

Second, while the Trump administration is floundering, it is not the Democrats, but a younger generation of Republicans, led in this case by Josh Hawley and Marco Rubio, who are actually the most radical in terms of seeking public political action to address the economic fallout from the disease.  Hawley just introduced legislation to give authority to the FDA to investigate drug and device shortages, a basic anti-monopoly tool.  This is necessary, because pharma is using trade secret laws to hide where their factories are located.  And Rubio …  is trying to expand government lending to businesses working on supply chain problems.

Source: BIG by Matt Stoller

President Trump’s response to the coronavirus threat has been to deny the threat is serious.  But there are administrative and institutional problems that have nothing to due with Trump.

The government has forbid the use of COVID-19 tests that haven’t been approved by the Food and Drug Administration, except for those developed by the Centers for Disease Control.  But the initial test kits developed by the CDC were faulty, and had to be recalled.  Surely it is better to have an imperfect test than no test at all.

The other problem is in the basic attitude that health care is an individual benefit, which the individual should pay for or somehow they deserve, rather than a social need.

I suppose you could make this argument for treatment of chronic diseases, such as cancer.  Infectious diseases are another issue.  Priority for COVID-19 testing should go to physicians and nurses and, after that, those whose jobs require contact with the public at large, regardless of income or “merit.”

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The health system and the profit system

March 3, 2020

Coronavirus and Systems Fragility by Rod Dreher for The American Conservative

The coronavirus and the Trump administration

February 27, 2020

The failure of the Trump administration to prepare for an epidemic is greater than I thought, as indicated by this Jan. 31 article by Laurie Garrett in Foreign Policy magazine.

The epidemic control efforts unfolding today in China—including placing some 100 million citizens on lockdown, shutting down a national holiday, building enormous quarantine hospitals in days’ time, and ramping up 24-hour manufacturing of medical equipment—are indeed gargantuan.

It’s impossible to watch them without wondering, “What would we do? How would my government respond if this virus spread across my country?”

For the United States, the answers are especially worrying because the government has intentionally rendered itself incapable.

In 2018, the Trump administration fired the government’s entire pandemic response chain of command, including the White House management infrastructure.

In numerous phone calls and emails with key agencies across the U.S. government, the only consistent response I encountered was distressed confusion.

If the United States still has a clear chain of command for pandemic response, the White House urgently needs to clarify what it is—not just for the public but for the government itself, which largely finds itself in the dark.  [snip]

In the spring of 2018, the White House pushed Congress to cut funding for Obama-era disease security programs, proposing to eliminate $252 million in previously committed resources for rebuilding health systems in Ebola-ravaged Liberia, Sierra Leone, and Guinea.

Under fire from both sides of the aisle, President Donald Trump dropped the proposal to eliminate Ebola funds a month later.  

But other White House efforts included reducing $15 billion in national health spending and cutting the global disease-fighting operational budgets of the CDC, NSC, DHS, and HHS. And the government’s $30 million Complex Crises Fund was eliminated.  

In May 2018, Trump ordered the NSC’s entire global health security unit shut down, calling for reassignment of Rear Adm. Timothy Ziemer and dissolution of his team inside the agency.  

The month before, then-White House National Security Advisor John Bolton pressured Ziemer’s DHS counterpart, Tom Bossert, to resign along with his team.  Neither the NSC nor DHS epidemic teams have been replaced.

The global health section of the CDC was so drastically cut in 2018 that much of its staff was laid off and the number of countries it was working in was reduced from 49 to merely 10.  [snip]

And though Congress has so far managed to block Trump administration plans to cut the U.S. Public Health Service Commissioned Corps by 40 percent, the disease-fighting cadres have steadily eroded as retiring officers go unreplaced.  [snip]

… State-level health leaders told me that they have been sharing information with one another and deciding how best to prepare their medical and public health workers without waiting for instructions from federal leadership. 

The most important federal program for  local medical worker and hospital epidemic training, however, will run out of money in May, as Congress has failed to vote on its funding.

The HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) is the bulwark between hospitals and health departments versus pandemic threats; last year HHS requested $2.58 billion, but Congress did not act.

Source: Foreign Policy.

The failure isn’t just Trump’s.  Congress has responsibility for oversight of the federal government.  The Democrats with their new majority in the House of Representatives could have prioritized investigating the functioning of governmental departments instead of impeachment.

For that matter, Republicans in the Senate and House could have exercised their oversight functions.  The Washington press corps could have investigated.  But if they had, would we the people have paid attention?  Or would we have found President Trump’s tweets more interesting?

But the main question now is not: Who is to blame?  It is: What do we—we Americans as a nation—do next?

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HHS chief can’t promise affordable vaccine

February 27, 2020

Alex Azar

Alex Azar, Secretary of Health and Human Services, said in a congressional hearing yesterday that he can’t promise an affordable coronavirus vaccine.

“We would want to ensure that we work to make it affordable, but we can’t control that price, because we need the private sector to invest, ” he said  “….. Price controls won’t get us there.”

Azar is a former drug industry executive and lobbyist.  When he was a senior executive and then CEO of Ely Lily, a leading pharmaceutical company, the price of insulin tripled.

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The coronavirus and the test of reality

February 26, 2020

Passengers disembark from virus-hit Diamond Princess cruise ship

Photo via New York Post.

The first duty of any government is to assure the survival of its people.  The COVID-19 strain of the coronavirus is a test of how well the world’s different governments can perform this basic duty, and they will be judged on how well they perform that duty.

It doesn’t matter whether leaders call themselves conservatives, socialists or something else.  Are they able to act effectively and without panic to meet a threat?  Are they able to face facts or do they punish truth tellers?

Here in the USA, our President and Congress have mainly been fighting over problems generated by governmental policy and a couple of things that don’t really exist—the alleged Trump-Putin collusion and the imaginary Iranian nuclear weapons program.

Now, along with the rest of the world, we face a real external threat—one that can’t be made to go away by means of public relations or changing the subject.

The Trump administration’s budget priorities are its nuclear weapons modernization program and the new Space Force.  In contrast, as Nicole Wetsman of The Verge reported—

The administration’s proposed 2021 budget for the Department of Health and Human Services (HHS) cuts $25 million from the Office of Public Health Preparedness and Response and $18 million from the Hospital Preparedness Program. The administration also asked for over $85 million in cuts to the Emerging and Zoonotic Infectious Diseases program.  [snip]

Housed at the Centers for Disease Control and Prevention (CDC), the Office of Public Health Preparedness and Response is charged with responding to public health emergencies.  It also coordinates public health responses with local and international partners and manages the Strategic National Stockpile, which squirrels away critical medical supplies for use in emergencies.

The Hospital Preparedness Program aims to ready hospitals for emergency surges of patients, and it’s already under-equipped to handle situations like the ones currently seen in China.  Right now in the US, hospitals are already swamped by the flu and are counting their supplies of protective equipment.

Cuts to the Emerging and Zoonotic Infectious Diseases program would further hamstring the CDCs ability to do research on diseases like coronavirus and to gather the scientific information that lets it prepare for outbreaks like this one. [snip]

The 2021 budget request did ask for an additional $50 million for the CDC’s Infectious Diseases Rapid Response Reserve Fund.  That fund, which was established in fiscal year 2019, is currently being used in the ongoing coronavirus response.  That money, though, is activated only after a public health threat appears.

==The Verge.

The coronavirus has not yet reached our shores.  There is still time for the U.S. to rally.  There is still time for President Trump to assume leadership.  There is still time for Democrats in Congress and on the Presidential campaign trail to make an issue of this.  Will they?

It is not just an American issue, of course.  All the world’s leaders—Xi Jinping, Narendra Modi, Vladimir Putin, Angela Merkel, Emanuel Macron, Boris Johnson and the rest—will be weighed in the same balance.

∞∞∞

The coronavirus threat makes two other things clear—the need for internationalism and the perils of globalization. Let me explain what I mean.

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