Elite versus Non-Elite access to COVID-19 testing

Email received from the president of Harvard, Larry Bacow, today at 1:15 pm:

Earlier today, Adele and I learned that we tested positive for COVID-19. We started experiencing symptoms on Sunday—first coughs then fevers, chills, and muscle aches—and contacted our doctors on Monday. We were tested yesterday and just received the results a few minutes ago. We wanted to share this news with all of you as soon as possible.

Two days from first symptom to test result.

Text message from an M.I.T. Ph.D. in engineering, today a little earlier:

Yes, a friend of mine in Boston had to wait 6 days to get tested, then another 4 days for the result

Ten days from symptoms to result (positive, unfortunately, and then the rest of the family caught it too, casting doubt on the 10% household transmission stat that has appeared in some articles; everyone is recovering without hospitalization).

Conversation this morning with some Harvard Medical Students:

At Partners [the Harvard-affiliated goliath of Boston-area hospital systems] we can’t order a coronavirus test unless the patient is admitted.

[Separately, the “emergency” is not so urgent as to have ruffled the feathers of the Massachusetts state government’s license raj. One of the Harvard students is 4th year and will soon be eligible for a medical license here in Massachusetts. “I don’t know how I’m going to get licensed,” he said. “There are a ton of forms that I need to give to the state and they all have to be notarized. Where will I find a notary?” I.e., the emergency is not so dire that they’re willing to give a provisional license to anyone whom Harvard Medical School verifies is a recent graduate, then sort out the rest of the paperwork after the plague has abated.]

As of September 2019, President Bacow was a cheerleader for more low-skill immigration to the U.S.. Email to the Harvard community:

Not just as a university president, but as the son of refugees and as a citizen who deeply believes in the American dream, I am disheartened by aspects of the proposed new criteria for people seeking to enter our country. They privilege those who are already educated, who already speak English, and who already have demonstrable skills. They fail to recognize others who yearn for a better future and who are willing to sacrifice and work hard to achieve it. Had these same rules been in place when my parents each immigrated, I doubt they would have been admitted, and I would not be writing this message today.

My parents, like most immigrants, loved this country in part because they had the experience of growing up someplace else. They appreciated its aspirations of freedom and opportunity for all, and never took these ideals for granted. But they were also not uncritical of their new home. They wanted it to be the very best place it could be, a goal to which we all should aspire. Indeed, it is the role of great universities to foster an environment that encourages loving criticism of our country and our world. Through our scholarship and education, through our encouragement of free inquiry and debate, we ask not just why things are as they are, but how they might be better. To be a patriot is also to be a critic and not to accept the status quo as inevitable.

The new academic year is a chance for all of us to commit ourselves to creating a community that welcomes and embraces people from across the nation and around the world, people whose distinctive voices and varied experiences are essential to our common endeavor.

At the time the email was sent, every Harvard building that I needed to access was locked down with 100% ID checks at the door by security guards assisted by RFID readers. None of the new migrants would be welcomed into a Harvard building to use the restroom or eat in the cafeteria. The University provided Bacow with a mansion in one of America’s most desirable neighborhoods; he wouldn’t be competing with the new arrivals for housing. So maybe the U.S. could grow to 400 million and Bacow’s day-to-day quality of life wouldn’t suffer.

But why would President Bacow want to see a vastly -expanded-through-low-skill-immigration United States given that it was already taking 2-4 months in the Boston area to get a non-emergency appointment with a physician, a sign of a health care system that would snap during the next breeze of demand? I guess we now know the answer: he never had to wait.

11 thoughts on “Elite versus Non-Elite access to COVID-19 testing

  1. We need a *lot more* testing, as soon as possible, and not just for the elite. The US is flying blind.

    There is no way we can isolate people if we don’t know who is infected.

    While no fan of tons of unskilled and/or illegal US immigration, I think we need to focus on other things, right now.

    • G C: Why is it a low-skill immigration story when the U.S. runs out of infrastructure? Running the world’s least efficient health care system requires about 20 million Americans (16 million direct plus folks in insurance and pharma; see https://www.exploremedicalcareers.com/1-in-8-americans-employed-by-u-s-healthcare-industry/ ). So if 3,000 new low-skill migrants arrive in the U.S. daily, either roughly 200 new trained high-skill people have to be found to work in health care OR the queues will be lengthened for every kind of treatment, including COVID-19 treatment (for which queuing may mean death). Remember that the low-skill migrants themselves generally cannot work in health care due to inability to speak English and read English and their lack of education. If the U.S. runs out of ventilators it will be literally true that Americans killed themselves in order to support low skill immigration (without which the population would be closer to 200 million, a density less conducive to epidemics and a number that is more realistic for our health care system to deal with).

    • If those low-skill immigrants don’t speak English, they will never panic!
      They don’t need to be told to self-isolate, or they won’t care. They will play soccer in parks, as they still do in NYC.
      If our hospitals run out of ventilators they will be hired as cheap mechanical ventilators.
      And if the US citizens “kill themselves in order to support low skill immigration”, as Phil put it, wouldn’t that be Darwinian evidence that IQ is overrated?

  2. Bill Gates was making the same point on his blog:
    https://www.gatesnotes.com/Health/A-coronavirus-AMA

    “Covid-19 testing standards seem grossly unfair in favor of the rich and famous. Testing is happening for people like professional sports players, even those without any symptoms at all. I’m not talking about health care workers or people in essential jobs- I’m talking about actors, actresses, sports players and so on. On the flip side, the guidance from Kaiser in WA is that you must have a fever of 101.5 and either serious shortness of breath or a bad cough, and even then testing results take 5 days or more.

    How is it that even with something like covid-19 testing, which the government is supposed to manage, the rich and famous are getting special treatment? Is there a big stash of tests that are reserved for “people that matter”? Isn’t it hypocritical for everyone else to be told they need to look out for the common good and avoid demanding too much of the health care system, meanwhile the rich and famous get whatever they want, when they want it?”

  3. >where to get notarized
    At the bank of course.

    Here in Seattle I know a person who is waiting for results since last Monday, i.e. 9 days. Test disappeared into LabCorp and there is no ETA. On the other hand if you need medical help, you need it regardless of being tested, i.e. on the individual level test is useless anyway.

    • I’d be wary of a doctor who couldn’t figure out how to find a notary, even if they went to Harvard. Shows an appalling lack of common sense.

      Having said that, the requirement should be postponed for now.

    • ScarletNumber: I don’t think he was saying that he expected to have trouble finding a notary in non-plague times. Our state is currently officially “shut down.” So it makes sense to wonder what is easily doable and what isn’t. (And do you really want to be sitting at a desk with a notary right now? Do we want all of our new doctors to have recently sat down, without PPE, next to a notary right now?)

  4. I know a medical doctor who came down with the Covid19 symptoms and pneumonia. He’s home and doing okay but it’s been 6 days since he was tested for Covid19 and still no results. He was told that since he is a doctor his test would be expedited. I guess the Harvard President and wife have more pressing essential duties than the doctor.

  5. Even if you get the test your data will be treated as a secret. So no one will see the results and never know you infected them. In Arizona a employee of the Phoenix Aviation Department was hospitalized around March 9th. He had CV19. He died on March 17. Since he was the first to die here his data was eventually made public. His boss and his work were notified of his death on March 20. So 10 days after the hospital knew he was contagious. So any hope of stopping the spread by talking to his coworkers earlier was totally wasted due to HIPPA rules.

    Please do a big set of blogs on HIPAA vs COVID 19. This should be talked about widely in the news and other places and fixed if we ever have any hope of stopping this contagion. Yes the HIPPAA rules created some good privacy laws during the AIDS era but now they need to be revised.

    • Interesting point, also too many law enforcement exceptions to hipaa. More or less seems like a way to keep health care providers from getting sued.

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