Will masks for the general public work as well against monkeypox as they did against SARS-CoV-2?

“New Yorkers told to mask up again after local patient tests POSITIVE for same genus virus as monkeypox” (Daily Mail):

An NYC patient has tested positive for the same genus virus as monkeypox sparking calls from the health department for residents to wear masks indoors – just as New Yorkers were finally returning to mask-free normalcy after COVID-19.

The health department is encouraging New Yorkers to wear face masks to protect against the new virus outbreak, as well as COVID-19 and the flu. Monkeypox primarily spreads through physical contact but can also be transmitted through respiratory droplets in the air.

Why isn’t the best advice “Leave New York City, which is one of the world’s most crowded places”? The Science is strong with the NYC health department, but ordinarily a scientific conclusion is supported by evidence. What is the evidence that a monkeypox outbreak can be stopped by ordinary residents of a city wearing masks?

In a world obsessed with avoiding viral infection, I can’t figure out why cities like New York make sense (or why boosting population density in already-crowded cities via low-skill immigration makes sense). I have a lot more confidence that someone living in the suburbs can avoid monkeypox compared to someone living in a Manhattan studio apartment and going out to the stuff that used to make Manhattan attractive.

Combining these topics, a photo from June 2021:

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Coat the garage floor with polyaspartic or epoxy? Put in an air conditioner?

For the first time in my life, I live in a house with a reasonably nice garage. The floor is a concrete slab poured in 2003. For a lot of neighbors, however, this is apparently not sufficient. Because there are no basements in Florida, the garage is a critical storage facility and also sometimes the home of N-1 or N-2 cars (where N is the theoretical capacity of the garage in cars).

Does it make sense to put in a plastic floor? The cost is about $2,700 for a polyaspartic floor, which dries quickly and therefore enables the contractor to show up from 9 am to 2 pm and the homeowner to put everything back into the garage by 3 or 4 pm. The old religion was epoxy, which I think resulted in two days of downtime for the garage and two visits by the contractor, but Science now says that polyaspartic is better?

Readers who’ve done this: Why? And what material?

Also, I’m thinking that items stored in the garage will be in better shape if the temperature and humidity are limited to some extent. It will also help with my dream Internet system since the CAT5 wires all come back to a panel in the garage and typical modems and routers are rated to operate at temperatures no higher than 40C (104 degrees in the units that God prefers). Does it make sense to try to keep the garage to a maximum of 85 or 90 degrees with a split system?

Finally, if polyaspartic is the right choice, what color? The exterior has a lot of beige and the garage door is brown, so I was thinking of “Saddle Tan”. On the other hand, most of the ones that I’ve seen are gray (e.g., “Midnight” or “Smoke” below). “California Gray” can be ruled out since we don’t want to have to wear masks and show our vaccine papers in the garage. There is no “Blue Steel” or “Magnum”, sadly.

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Colorado Supreme Court forces hospital to deal with a consumer in a semi-reasonable way

News on one of my pet topics, the ability of hospitals to hit the unwary with bills for 5-10X what a service actually costs (i.e., what 95 percent of customers pay via insurance)… “She Was Told Surgery Would Cost About $1,300. Then the Bill Came: $229,000.” (NYT, May 21):

When Lisa Melody French needed back surgery after a car accident, she went to a hospital near her home outside Denver, which reviewed her insurance information and told her she would be personally responsible for paying about $1,337.

But after the surgery, the hospital claimed that it had “misread” her insurance card and that she was, in fact, an out-of-network patient, court papers said. As a result, Centura Health, which operated the hospital, billed her $229,112.13. When she didn’t pay, Centura sued her.

“I was scared about it,” said Ms. French, 60, a clerk at a trucking company, who eventually filed for bankruptcy. “I didn’t understand because I kind of relied on the hospital and my insurance company to work out what I needed to pay.”

This week, after a yearslong legal battle, the Colorado Supreme Court ruled that Ms. French did not have to pay nearly $230,000 for the spinal fusion surgery she underwent at St. Anthony North Hospital in Westminster, Colo., in 2014.

It took 8 years of litigation to shut down the conventional scam for this particular patient. How come?

Before her surgery, Ms. French signed two service agreements promising to pay “all charges of the hospital.”

Centura asserted that, because Ms. French was an out-of-network patient, those service agreements required her to pay the full rates, listed in a giant health system database known as a chargemaster — a catalog of the cost of every procedure and medical supply Centura provided.

In Centura’s view, the service agreements “were unambiguous and French’s agreement to pay ‘all charges’ ‘could only mean’ the predetermined rates set by Centura’s chargemaster,” the court said.

But the court found that Ms. French wasn’t responsible for paying those rates because she didn’t know the chargemaster even existed and hadn’t agreed to its terms.

Justice Gabriel pointed out that courts and commentators have noted that hospital chargemasters have become “increasingly arbitrary and, over time, have lost any direct connection to hospitals’ actual cost, reflecting, instead, inflated rates set to produce a targeted amount of profit for the hospitals after factoring in discounts negotiated with private and governmental insurers.”

“They have no basis in reality,” said Gerard F. Anderson, a professor of health policy and management and a professor of international health at Johns Hopkins University Bloomberg School of Public Health.

“The hospital cannot explain to anyone why they charge the prices they charge,” he said. “They are not based on costs. They are not based on accounting principles. They are fictitious instruments created by somebody in the hospitals.”

I still can’t figure out how the hospital’s behavior, despite being conventional nationwide, was ever considered legal in any state. It wouldn’t work for a car dealer to not tell a customer in advance how much a brake repair was going to cost and then charge that particular customer 5-10X what everyone else pays.

Some detail from the opinion:

Based on its understanding of the information that French had provided, Centura estimated that her surgeries would cost $57,601.77 and that after French’s insurance payment, she would personally be responsible for $1,336.90 of that amount.

Thereafter, and notwithstanding the fact that Centura had told French that her surgeries would cost $57,601.77 and that she would personally be responsible for $1,336.90 of that amount, Centura billed French $229,112.13, reflecting its full chargemaster rates. Centura did so because it determined that it had misread French’s insurance card and that she was, in fact, an out-of-network patient. Centura calculated the amount due after subtracting from the total charges the payment from French’s insurer of $73,597.35 and French’s payment of $1,000.00 (thus, the total amount that Centura charged was over $300,000.00, notwithstanding its pre-procedure estimate that the surgeries would cost $57,601.77)

The hospital’s victimization of this lady was far worse than the NYT article reports, in other words. Her insurance company actually paid the hospital more than the originally estimated fair cost of the services provided. But the hospital decided that it had found a clever opening to go after the patient for $229,000 extra.

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The grading curve at Harvard University

A friend was considering enrolling his high schoolers in a Harvard economics class. It costs a modest $7,000 per student. What does one receive in return? An A or a B, unless one happens to be in the bottom 10th percentile (source):

(The idea of grading on a curve is anathema to flight instructors, incidentally. At least in theory, everyone should be able to achieve proficiency and graduate with a decent grade. If everyone in a class meets the A standard, why can’t everyone in the class receive an A?)

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Department of First World Problems: the Tile tracker system

One of the good things about Florida is that you can walk out of your apartment or house without bothering to put on shoes or more clothing than gym shorts and a T-shirt. The downside is that you are often leaving wallets and keys somewhere inside, thus leading to a search challenge a few hours later when it is time to drive to a restaurant. Also, your typical Floridian may have at least three vehicles for which keys are required: car, pickup, golf cart. Putting these all on one huge keyring is cumbersome.

The New York Times/Wirecutter says that the choice of tracker should be limited to Apple AirTag and Tile.

If you’re already paying $1000+ per year to be part of the Apple ecosystem, why not Apple AirTags? They’re great if you lose things outside of the house because there are so many other people paying $1000+ per year to be part of the Apple ecosystem. They’re bad in every other way, though. You can’t put them on an existing keychain because there is no hole in an AirTag. You can’t put them in your wallet because there isn’t a version that is shaped like a credit card. The AirTag’s speaker isn’t as loud. If a heretic in your house decides to use Android, he/she/ze/they won’t be able to locate anything that is attached (using a proprietary Apple keychain that costs $29 to $449) to an AirTag.

The advantages of Tile:

  • thoughtful physical packaging (e.g., a hole for your existing keyrings)
  • no need to buy all new keyrings, wallets, etc.
  • a variety of physical packages (e.g., a “thick credit card” for your wallet, a small cylinder with included adhesive for sticking to TV remotes and similar)
  • there are a lot of devices that are already “tile enabled”. Laptops from HP, Dell, Lenovo, ASUS, for example
  • louder speaker to facilitate finding within the house or yard
  • multi-platform
  • press button on Tile to make your phone sound an alert even when it is on silent (i.e., if you’ve found your keys or wallet it will be easy to find your phone)
  • lifestyle video advertising the product includes a golden retriever on the couch (sadly, lower down on the page is a photo of a hipster)

With Apple there is no subscription service offered. With Tile you can use all of the core services without paying, but if you pay $30 per year (free for the first year) you get more location history, free battery replacements, and some insurance for lost items.

It took me about 5 minutes to download the Tile app for the iPhone, create and verify an account, and activate the the first tile. Additional tiles take about 1 minute to activate. Giving a tile a custom name, e.g., “Awesome Honda Odyssey Keys” instead of “Keys” takes a scroll and an extra press or two (would be nice if this were an option when activating, which it is if you select the “Other” category). The tiles are pretty rugged. I crammed one into the clip of a Stanley FatMax contractor-grade tape measure, which also includes a strong magnet, and it works perfectly. They’re spec’d to handle immersion in water for up to 30 minutes (IP67).

Now that I’ve played with the system one question that jumps out is “Why don’t car keys, all of which already have batteries, come with Tile built in?” Surely Honda, GM, Toyota, and Ford don’t want consumers to lose their keys. The list of Tile partners is extensive so plainly it wouldn’t be tough from a business or technical point of view to integrate Tile.

More: thetileapp.com


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The war in Ukraine proves Isoroku Yamamoto right?

I haven’t written too much about the war in Ukraine because I don’t speak the languages involved, don’t know the history, and don’t know anything about military strategy and tactics. The situation for individuals is horrifying, I’m sure, and that is not pleasant to contemplate.

One feature of the war, as I understand it, is that the Russian military has had a lot of armored vehicles, e.g., tanks and ships, and these have proven vulnerable to inexpensive weapons on the Ukrainian side.

Who could have predicted this? Isoroku Yamamoto, one of the greatest thinkers and strategists of World War II (had Japan followed his advice, it would not have chosen to fight the U.S. to begin with). Admiral Yamamoto was an enthusiast for naval aviation starting in 1924 and correctly predicted that heavy expensive battleships would be almost useless going forward, vulnerable to submarines but especially to swarms of comparatively light and cheap airplanes. (And, of course, the great admiral was ultimately killed by U.S. fighter planes in 1943.)

I’m wondering why the U.S. Army wants to pay to keep 5,000 tanks in its inventory. If we’re fighting a peasant army equipped only with rifles, these tanks are obviously useful, but then we don’t need 5,000 of them. If we’re fighting a big battle in Europe, doesn’t the Russian experience in Ukraine show that the last place anyone would want to be is inside a tank and its illusory protection?


  • U.S. Army’s official page: The Abrams Main Battle Tank closes with and destroys the enemy using mobility, firepower, and shock effect. The Abrams is a full-tracked, low-profile, land combat assault weapon enabling expeditionary Warfighters to dominate their adversaries through lethal firepower, unparalleled survivability, and audacious maneuver. The Abrams tank sends a message to those who would oppose the United States as to the resolve, capability, and might of the U.S. Army.
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NYT: It is now women who become pregnant

From the May 11, 2022 NYT, “Don’t Be Fooled. It’s All About Women and Sex”:

When I was back in high school — a Catholic girls’ school in Cincinnati at the beginning of the sexual revolution — our religion class covered the abortion issue in approximately 45 seconds.

“Abortion is murder,” said the priest who was giving the lesson, before moving on to more controversial topics, like necking and heavy petting.

On Wednesday the Senate failed to pass a Democratic bill supporting women’s right to choose in anticipation of a Supreme Court decision going in the other direction.

The many, many activists who have focused their political careers on constraining women’s sexual activity aren’t going to just declare victory and go home.

All this is basically about punishing women who want to have sex for pleasure.

No mention of pregnant men and their right to choose.

From 2018, same newspaper, “A Family in Transition”:

Two fathers and the baby girl they never expected.

As traditional notions of gender shift and blur, parents and children like these are redefining the concept of family.

Paetyn’s father Tanner, 25, is a trans man: He was born female but began transitioning to male in his teens, and takes the male hormone testosterone.

“I was born a man in a female body,” he said.

His partner and Paetyn’s biological father is David, 35, a gay man.

Their daughter, they agree, is the best thing that ever happened to them.
“She’ll grow up in a very diverse home,” David said. “We surround her with people who are different.”

The first time that they saw the fetal heartbeat on ultrasound, they wept.

“Yeah, I’m a pregnant man,” he told friends and acquaintances. “What? I’m pregnant. I’m still a man. You have questions? Come talk to me. You have a problem with it? Don’t be in my life.”

The journalist and editors regard them as legitimate fathers (i.e., men):

As fathers to be, they got some of their most enthusiastic congratulations from the drag world — the regulars at the club where both men perform, dancing and lip-syncing, Tanner as a drag king and David as a sassy, 6-foot-tall drag queen in a tight skirt and size 12-wide high heels.

Apropos the current debate:

And, David said: “I hope she’s a lesbian. Then we won’t have boys coming to the house and we won’t have to worry about her getting pregnant.”

Also recently from the NYT opinion section, “It’s Time to Rage” (by Roxane Gay):

My wife’s stepfather began raping her when she was 11 years old. The abuse went on for years, and as Debbie got older, she was constantly terrified that she was pregnant. She had no one to talk to and nowhere to turn.

Her stepfather often threatened to kill her younger brother and her mother if Debbie told anyone, so when the fear of pregnancy became too consuming, she told her mother she was assaulted at school. Her mother took Debbie to a doctor, who said that because of her scar tissue, she was sexually active and must have a boyfriend. It was the early 1970s.

A pregnancy would have, in Debbie’s words, ruined her life. Today, she is 60 years old. She is still dealing with the repercussions of that trauma. It is unfathomable to consider how a forced pregnancy would have further altered the trajectory of her life.

This story is supposed to make readers see how misguided conservatives who oppose abortion are, but couldn’t the article support those who advocate for conservative sexual values? Stepfathers did not exist in significant quantities until the 1970s no-fault (“unilateral”) divorce revolution. The author’s wife was unlikely to have been abused by a stepfather in the (mythical?) white picket fence era to which Republicans yearn to return because there were hardly any divorces that left moms free to bring an unrelated adult male into a girl’s household.

Circling back to the first topic, pregnant men only recently won their own emoji but now the mainstream media pretends that they don’t exist?

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Should we take the neighbor’s 5-year-old in for a COVID-19 vaccine booster?

From the Journal of Popular Studies: “FDA Grants Emergency Use Authorization of Pfizer COVID Booster for Kids 5 to 11.” Children are facing an “emergency”, according to the scientists at the FDA. If there weren’t an emergency, by definition, the shots wouldn’t be available until completely tested and approved via normal procedures.

If a child in the neighborhood is facing an emergency, you’d be morally obligated to take him/her/zir/them to the local hospital, right? You wouldn’t let a 5-year-old bleed out on the sidewalk in front of your apartment when you could simply load the injured kid into the minivan (or Tesla if you’re a douche and/or dog lover!) and zip over to the ED.

Suppose that we suspect some of our neighbors (most of them physicians or dentists) are deplorably failing to respond to the emergency facing their young children. Are we obligated to snatch up the neglected children and rush them to to the nearest healing center for an injection? If not, why not?

If you’re at Disney World in the sexual orientation and gender identification dark ride for kindergarteners and discover that a child in the next car hasn’t received his/her/zir/their booster…

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How’s the miracle drug Paxlovid doing against COVID-19?

“Paxlovid is a miracle drug,” says a primary care doc whom I know, “because it is a miracle when I can prescribe it. Anyone who is sufficiently vulnerable to serious consequences from COVID-19 is already on drugs that have interactions with Paxlovid.” The other docs with whom I’ve talked about this drug, especially cardiologists, are generally negative regarding the drug. In their view, it will interact badly with other drugs, have bad side effects, and/or result in SARS-CoV-2 attacking the patient as soon as he/she/ze/they stops taking Paxlovid.

Chinks in the miracle drug’s armor are beginning to be described in our otherwise cheerleading media. Example from the NYT, March 25:

Certain medications or supplements, including painkillers, statins and even St. John’s Wort, may have adverse interactions with Paxlovid. So you may be advised to hold off on taking them for a week while being treated, Dr. Gandhi said. But for some medications, like drugs that regulate heart rhythm, abstaining for a week may not be possible. In those cases, your doctor may recommend molnupiravir for Covid-19 instead.

From Yale, where they understand medicine if not accounting, “13 Things To Know About Paxlovid, the Latest COVID-19 Pill”:

The FDA authorized Paxlovid for people ages 12 and older who weigh at least 88 pounds. But in order to qualify for a prescription, you must also have had a positive COVID-19 test result and be at high risk for developing severe COVID-19.

That means you must either have certain underlying conditions (including cancer, diabetes, obesity, or others) or be 65 or older (more than 81% of COVID-19 deaths occur in in this group). The more underlying medical conditions a person has, the higher their risk for developing a severe case of COVID-19, according to the CDC.

Since Paxlovid is cleared by the kidneys, dose adjustments may be required for patients with mild-to-moderate kidney disease, explains Dr. Topal. “For patients with severe kidney disease—or who are on dialysis—or those with severe liver disease, Paxlovid is not recommended; the levels of the drug can become too high and could cause increased side effects,” he says.

There is a long list of medications Paxlovid may interact with, and in some cases, doctors may not prescribe Paxlovid because these interactions may cause serious complications.

The list of drugs that Paxlovid interacts with includes some organ anti-rejection drugs that transplant patients take, as well as more common drugs like some used to treat heart arrhythmias. Paxlovid also decreases the metabolism of anticoagulants, or blood thinners, that many older adults depend on, driving up levels of those medications in the body to a point where they are unsafe, Dr. Topal explains.

It also interacts with cholesterol-lowering medications like Lipitor, but that’s less challenging for patients to overcome. “If you stop taking your Lipitor for five days, nothing bad is going to happen,” he adds.

If you are pregnant or breastfeeding, the FDA recommends discussing your options and specific situation with your health care provider, since there is no experience using the drug in these populations. If you could become pregnant, it’s recommended that you use effective barrier contraception or do not have sexual activity while taking Paxlovid.

So the ideal Paxlovid patient is morbidly obese with the blood pressure and heart health of a 22-year-old tennis star.

Pfizer wants you to take your Paxlovid every day… “FDA rebukes Pfizer CEO’s suggestion to take more Paxlovid if COVID-19 symptoms return”:

The FDA rebuked Pfizer CEO Albert Bourla’s proposed solution to reports that some patients experienced a relapse of COVID-19 symptoms after treatment with the company’s antiviral Paxlovid.

After reports said some patients who took Paxlovid rebounded and started feeling symptoms again, the CEO told Bloomberg that patients can take another course, “like you do with antibiotics.”

“There is no evidence of benefit at this time for a longer course of treatment … or repeating a treatment course of Paxlovid in patients with recurrent COVID-19 symptoms following completion of a treatment course,” John Farley, M.D., director of the Office of Infectious Diseases, said in a post.

Science is complex!

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