Category: Coronapanic

Vaccine misallocations only increase Americans’ faith in bigger government?

by philg

Compared to a purely private system, in which vaccine vendors merely shipped product to customers who’d ordered it, you might think that one advantage of top-down centrally managed vaccine allocation would be that vaccines would be rushed to the states that are suffering the worst plague at any given moment. “CDC director says Michigan can’t vaccinate its way out of COVID-19 surge” (ABC):

The answer to Michigan’s COVID-19 surge is “to close things down,” according to Centers for Disease Control and Prevention Director Dr. Rochelle Walensky, not an increase in vaccine supply that the state’s governor and other public health experts have called for.

Michigan’s Democratic Gov. Gretchen Whitmer declared her state a “COVID hotspot” as cases continue to rise and has asked the federal government to increase vaccines in response.

“I believe government’s role is, when we can’t take action to protect ourselves, the government must step in,” Whitmer said on Monday. “That’s where we were a year ago. That’s where we were four months ago. We’re in a different moment. Every one of us has the ability and knowledge to do what it takes.”

“If we try to vaccinate our way out of what is happening is Michigan, we will be disappointed it took so long for the vaccine to work,” said Walensky. “We know that if vaccines go in arms today, we will not see an effect of those vaccines, depending on the vaccine for somewhere between two to six weeks.”

(The comment shows that #Science is completely different in the UK and the US. In the UK, the two-dose vaccines work well enough after one shot that the second can be delayed (in order to maximize the number of people who get the first dose). In the U.S, a shot that is considered effective in the U.K. is considered useless until 6 weeks later (two weeks after the second shot.)

Meanwhile, the New York Times says that Michigan is unable to use the vaccine that it has been sent: “Ms. Whitmer has pleaded with the White House to send extra doses, even as her state has used just 78 percent of those delivered so far.” Maybe this is an example of “The war is not meant to be won. It is meant to be continuous.” (Screenplay for an adaptation of Orwell’s 1984). The federal government would rather see a governor closing schools, businesses, etc. than actually stop the virus. If not, though, refusing to send extra vaccine to an extra-plagued state seems to contradict common sense. Why not send vaccines and, if necessary, personnel qualified to deliver them, to the areas of the U.S. that are suffering from the highest case/death rate? Then wait two weeks (UK #Science) or six weeks (US #Science) for the plague to recede.

How about when there is no crisis? Can we still generate a mismatch between supply and demand? “Want a COVID shot now? You may have to leave the Bay Area” (Mercury News):

Anxious for a COVID shot? The state will open appointments up to everyone in another week, but you may not even have to wait that long — if you’re willing to drive a few extra miles to get the jab.

A handful of vaccination sites, faced with a surplus of shots, have opened their doors wide to all adults, regardless of age, employment status, medical history or where they live. All California adults 16 and older will be eligible starting April 15, but until then, demand for vaccinations and rules for who can get one vary widely from county to county and even clinic to clinic. That means finding an appointment has turned into something of an Easter egg hunt for determined Bay Area vaccine seekers, many of whom are too desperate to wait another week or worry shots will become even harder to come by once everyone in the state is eligible. Plus, the state has confirmed it expects its supply of vaccines to drop in the coming weeks, likely slowing first-dose appointments and adding to the anxiety.

UC Davis Medical Center this week began offering vaccines to all California residents 16 and older after as many as 1,500 appointments were going unused each day.

“We decided it was better to fill those appointments with people eager to be vaccinated, rather than leave slots unfilled as we waited for the calendar to turn to April 15,” spokeswoman Tricia Tomiyoshi wrote in an emailed statement. “Every vaccination is a step closer to ending this pandemic.”

It turns out that California state government, one of the most lavishly funded enterprises in human history, is no better at allocating scarce items than was the Soviet government. Thus, we have the scenes that Americans used to deride the Soviets for, e.g., people lining up once they hear that something is available, one traveling to obtain a scarce item for which a surplus exists somewhere else.

See also this Washington Post article on how vaccine doses are piling up in federal government warehouses (like at the end of Raiders of the Lost Ark) because states, e.g., plague-ridden Michigan, aren’t ordering them (due to an inability to organize and use the vaccine doses that they already have). North Carolina didn’t order their vaccine doses because it was spring break and a worldwide emergency severe enough to shut down education, social life, work, gym, suspend the Constitution (e.g., First Amendment right to assemble), etc. wasn’t enough of an emergency to force a change of plans.

One might think that the above would shake Americans’ determination to expand the size and role of the government, but instead the opposite seems to be occurring. It is a mystery to me!

(On the other hand, we could also argue that the toilet paper, paper towel, and hand sanitizer shortages of spring 2020 show that the market economy can’t cope either. The big stores weren’t willing to raise prices such that the market cleared in an Econ 101 fashion. To sell Charmin at 2-3X the regular price would have tarnished their reputation via an accusation of price gouging and profiteering. On the other hand, paper towels and toilet paper were never truly unavailable here in the Boston area. We had to buy brands we weren’t familiar with and in small quantities, e.g., at CVS and the local small grocery store, because the big box stores were sold out at their regular prices.)

Related:

  • American central planners tackle vaccine scarcity (December 31, 2020): I wonder if something more like a market economy could have done this better. The bureaucrats can send free vaccine doses to hospitals, medical and dental offices, and nursing homes. Whatever is left over goes to whatever clinic or facility bids the highest. The bidding process is necessary to ensure that clinics that have the most streamlined and efficient procedures are the ones who will get the vaccine and also to ensure that clinics won’t let doses get spoiled or expire. … At least to judge by my Facebook feed, there are a lot of suburban white and Asian Americans who feel that the cost of lockdown is negligible. They’re happy to work from home (4,000 to 6,000 square feet), order deliveries, refrain from socializing in person. These folks don’t need a vaccine because if the government recommends that they stay home for the next 5 years they will cheerfully comply. But, on the other hand, there is no central database of the Happily Shutdown. Thus, the market would be the best way to keep these folks from clogging up the vaccine line. They know that they’ll be home for another year or two, so why should they pay $500 for a shot? They’ll wait for the price to come down to $100.
  • “Nearly 40% of Marines decline COVID-19 vaccine, prompting some Democrats to urge Biden to set mandate for military” (USA Today)
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Fact-checking Donald Trump’s predictions regarding COVID vaccine availability

by philg

From September 18, 2020, an Unscientific American who was “without evidence” and who contradicted “experts”:

From the linked-to article…

President Trump said Friday that every American would have access to a coronavirus vaccine by April, contradicting his own statement of two days earlier and sowing deeper confusion about the process and timing of vaccine approval and distribution.

When Centers for Disease Control and Prevention Director Robert Redfield said earlier in the week that the general public was unlikely to get access to a vaccine until the second and third quarters of 2021, echoing other scientific leaders in the administration, Trump said he’d misspoken.

“I think he made a mistake with that statement,” Trump said Wednesday. “When he said it, I believe he was confused. I’m just telling you we’re ready to go.”

Trump then said a vaccine would be ready in weeks and swiftly made available, despite the fact that no one knows yet when sufficient data will be collected from clinical trials to show that one of the vaccines in late-stage trials is effective or safe.

What do we have from science-guided leadership (and we are assured that leadership is important in determining COVID-19 death rate)? “Biden announces April 19 deadline to make all adults eligible for Covid vaccine” (NBC):

President Joe Biden said Tuesday that all adults in the U.S. should be eligible to receive the Covid-19 vaccine by April 19 … The new deadline to expand eligibility — which is two weeks earlier than Biden had previously targeted — should not be difficult to meet since several states have already begun administering the vaccine to anyone over 16 who wants it.

“The virus is spreading because we have too many people who see the end in sight think we are at the finish line already,” Biden said. “Let me be deadly earnest with you, we aren’t finished. We still have a lot of work to do. We’re still in a life and death race against this virus. Until we get more people vaccinated we need everyone to wash their hands, socially distance and mask up.”

Asked why Biden was announcing the new timeframe when nearly every state has already moved up eligibility to the April date, Psaki said the president wanted to provide clarity and remind seniors to hurry to get their shots before the lines get long.

In case the “Experts say the president’s latest timeline is nearly impossible to confirm since none of the vaccines in development have been proved effective…” is cut off on mobile, here’s a screen shot from the desktop Twitter:

Related:

  • U.S. should approve a saline injection as a Covid-19 vaccine? (my idea from June 2020 that would have reassured a lot of folks)
  • “Italy Pushes Back as Health Care Workers Shun Covid Vaccines” (NYT, March 31): Prime Minister Mario Draghi issued a decree requiring that workers in health care facilities be vaccinated, a move that will test the legal limits of his government’s efforts to stem coronavirus outbreaks. … “Unfortunately there is huge part of doctors who are deeply ignorant,” said Mr. Burioni [a virologist with a Ph.D., but not a “Dr.” like Dr. Jill Biden, M.D.], who suggested that perhaps “the selection process for bringing people to gain a medical degree and then the medical license is not effective enough.” … Salvatore Giuffrida, the director of the hospital, Europe’s fourth largest, said he favored a vaccination requirement because it would also keep medical workers healthy and would strengthen defensive lines as a brutal third wave spreads through northern Italy.
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Success story for general aviation: transporting plague-ridden 2-year-olds

by philg

“Family catches private flight to Austin with pilot friend after getting booted off Southwest plane when their two-year-old couldn’t keep his mask on” (Daily Mail):

A family kicked off a Southwest flight after their two-year-old could not keep his face mask on turned to Facebook to complain and were offered a private flight by a family friend.

He said his family woke up at three in the morning to prepare for their flight out of Denver, Colorado.

‘I practiced with him at least two or three times at the house and every time he threw it off, but I figured that [Southwest] would work with us on the plane because he’s two,’ Michelle Harvey said.

FOX 7 reports that Peck flew his twin-engine airplane to Denver, picked up the family, and flew them to Austin at no charge.

There are already pilot groups for flying medical patients (Angel Flight and PALS), dogs (Pilots N Paws), sea turtles (Turtles Fly Too; see also Merry Christmas to the Sea Turtles and Merry Christmas (again) to the Sea Turtles). If we assume that coronapanic never ends and that recalcitrant toddlers remain recalcitrant, could it be time for a new volunteer pilot group for transporting families who don’t want their trip to turn into a mask fight? Light planes are at their best when some of the seats are occupied by children (reasonably low in weight despite one or more years of lockdown, unlike their adult counterparts).

Readers: What should the group be called? Winged Unmasked Brats (“WUB”)? Terrible Twos Take To The Skies (“TTTTTS”)?

As Joe Biden is discovering, sometimes it is best to put children in a cage…

And, in case anyone wants to see just how effective masks (for which we will fight to the death, if necessary), lockdowns, and vaccines are against our viral nemesis, here’s Sweden (unvaccinated, unmasked, unlocked) versus Israel (fully vaccinated (older/vulnerable), masked, and locked-until-recently; source):

From the above, applying the principles of coronascience, we can infer that masks, lockdowns, and vaccines work so well that applying these interventions in Israel stops a plague 2000+ miles away in Sweden.

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Thank Karen for your double mutant coronavirus?

by philg

After seeing “‘Double Mutant’ Coronavirus Variant Detected in San Francisco” (US News) and similar headlines, I called up a medical school professor friend to ask a variant of my September question: When we wear masks, does the coronavirus thank us for our service?

In that September article, I pointed out that a non-evolving virus is better off if masks don’t work:

Coronavirus is thankful when we wear masks because our misplaced faith in masks leads us to delay taking effective action against the virus, e.g., building shade structures and holding school outdoors (changing the calendar in northern states so that the school year is during the warm months), decluttering retail stores, etc.

[Update: my new example of why faith in masks spreads coronavirus… the government having told them that a bandana (which, in fact, is not worn) is highly effective PPE, people are happy to pack themselves cheek-to-cheek in a 100% full airliner. If “scientists” hadn’t sold the public on masks, it wouldn’t be legal for airlines to operate 100% full flights (flown by non-white-males) and consumers wouldn’t want to get on such a flight. Without faith in masks, the coronanxious would stay home, which is where they can actually be safe.]

and also that coronavirus might be better off if masks do work and people wear them correctly and consistently:

Consider what happens in an unmasked “give the finger to the virus” population, such as Sweden. The virus flourishes for about three months and then fails. Compare to the slow burn of the mostly-masked U.S. and the not-fade-away of completely-masked France…

Maybe the masks protect enough people that the virus can sustain itself at a low-to-medium boil. Especially in a geographically large area in which epidemics have been on different schedules, the virus keeps finding mask-protected populations to infect. The virus stays topmost in our minds, our hearts, and our media. Shouldn’t coronavirus then thank us for our service to it?

What about an evolving coronavirus, which is what we plainly have now? If we’d let the virus rage in the spring of 2020, at this point there wouldn’t be any humans left without antibodies to the not-Chinese Wuhan edition of the virus. If we assume that shutdowns and masks work, the result is that there are always going to be pockets of humans with no resistance and among whom a mini- or maxi-plague can rage. Isn’t that situation more conducive to mutations than if we’d gotten it all over with in spring 2020 and swept up?

I ran this question by my medical school professor friend. “Your thinking would have been conventional in epidemiology through 2019,” he responded, “but is unacceptable today. Another way to look at this is that humans and the virus, without these interventions into the ecosystem, would have coevolved. Think about what happens when people try to manage forests, putting out fires as best they can. Mostly what they accomplish is preserving a tremendous amount of fuel for a fire that will far exceed their ability to control.“

So… if you get infected with one of these double- or triple-mutant viruses after your vaccination, thank your nearest Shutdown Karen?

(Speaking of vaccinations, is the above irrelevant now that vaccines exist against the pre-mutation virus? I don’t think so. There are a lot of countries that are unlikely to achieve high vaccination rates. Even if the vaccines were guaranteed risk-free in a letter from God, why would people who live in countries with low COVID death rates, e.g., in Sub-Saharan Africa (map), want to go to the effort, inconvenience, and expense of getting it? Due to travel restrictions, folks from these countries have been mostly excluded from Europe and the U.S. so they wouldn’t have gotten exposure to the original non-Chinese Wuhan version of the virus. So the mutant coronavirus can always find a naïve population in which to multiply happily and we will have our travel shutdown to thank for that.)

Evidence against the above hypothesis… Brazil. The country did have a raging plague, unmitigated by orders from the president, and now is home to variants. On the third hand, Brazil was not, in fact, unmasked and open like Sweden. The president didn’t lock down the country, but the legislature and state governors were free to order masks, close schools, and generally lock things down. (example) In fact, lockdowns were so severe that researchers trying to obtain blood samples in May and June 2020 for antibody tests often couldn’t get them. (Lancet article: “By contrast with the federal government, most state governors and city mayors enforced closure of schools, shops, and non-essential services, and recommended the use of face masks.”)

Evidence for the above hypothesis… Sweden, yet again! The Swedes let the plague rage in the spring and it disappeared for the summer (i.e., the Swedes weren’t continuously incubating coronavirus) only to reappear in late November, just as the Swedish MD/PhDs said that it would. There is no “Stockholm variant” or “Swedish variant” of the coronavirus. The fearsome variants are all coming from Church of Shutdown countries: UK, South Africa, and Brazil (as noted above, a Church of Shutdown nation despite a heretic being president). From the Wikipedia page on the South Africa lockdown:

… all gatherings except for funerals were prohibited. Restaurants, taverns, bottle stores and all other stores not selling essential goods were to close during the lockdown period. [unlike in Maskachusetts where alcohol and marijuana were “essential”!] Schools, already closed a week before the lockdown period, will not reopen until after the lockdown. Non-exempt people are only allowed to leave their homes during this period to access health services, collect social grants, attend small funerals (no more than 50 people) and shop for essential goods. … South Africans were ordered not to take their dogs for a walk during the lockdown, though they may walk them around their house or apartment building

All borders of the country are closed during the lockdown, except for designated ports of entry for the transportation of fuel, cargo, and goods. International and domestic passenger flights are prohibited, except for flights authorised by the Ministry of Transport, for the evacuation of South African nationals in foreign countries, and for certain repatriations

Enforced by the military, this turned out to be the perfect environment for breeding a variant.

Separately, perhaps because I have so often used my phone from the Harvard Medical School campus, Facebook seems to think that I am a physician. Here’s an ad that the 68,000 folks at the American Medical Student Association wanted me to see:

They will teach me how to turn a “pregnant person” (remember that men can be pregnant) into a not-pregnant person via pills. As Uncle Joe Biden said, “If you don’t love abortion, you ain’t a doctor”? Separately, why does the physician have lighter skin than the patient? Isn’t this ad perpetuating stereotypes? Why not go all-in and show the darker-skinned patient with Medicaid and EBT cards?

Also in recent medical school news… “A Medical Student Questioned Microaggressions. UVA Branded Him a Threat and Banished Him from Campus.” (Reason):

“Thank you for your presentation,” said [Kieran] Bhattacharya, according to an audio recording of the event. “I had a few questions, just to clarify your definition of microaggressions. Is it a requirement, to be a victim of microaggression, that you are a member of a marginalized group?”

Adams replied that it wasn’t a requirement.

Bhattacharya suggested that this was contradictory, since a slide in her presentation had defined microaggressions as negative interactions with members of marginalized groups.

As in the former Soviet Union, at University of Virginia dissent is a sign of mental illness:

Meanwhile, the Academic Standards and Achievement Committee met to to discuss the concern card. This committee voted to send Bhattacharya a written reminder to “show mutual respect” to faculty members and “express yourself appropriately.” The committee also suggested that he get counseling.

On November 26, this suggestion became a mandate: The student was informed that he must be evaluated by psychological services before returning to classes.

The author of Medical School 2020 went through a lot of these, but wisely kept his own counsel!

Related:

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Relocation to Florida for a family with school-age children

by philg

TL;DR: We decided that the west coast was too old, that Miami was too congested, and that Jupiter, Florida, specifically the MacArthur Foundation-planned Abacoa section, was perfect.

Prior to 2020 the political control of a state or town had little impact on day-to-day life, with the exception of custody, alimony, and child support law. Republicans and Democrats might disagree regarding tax rates, government spending, zoning regulations, etc., but not about whether it should be legal to leave one’s house, go to work, attend school, breathe without a mask, interact with other humans without getting an injection, etc. After 2020, however, it is unclear why anyone would choose to be part of a political minority. For a Democrat, being in a Republican-run state means risking death from respiratory viruses that aren’t being controlled with Science (lockdowns, mask orders, coerced vaccination, 12-18-month school closure). For a Republican, being in a Democrat-run state means that one’s children aren’t guaranteed an education (though they might get surgery and show up at the breakfast table sporting a different gender), that one might lose what had been First Amendment rights, e.g., freedom of assembly, and that one will be surrounded by virtuous yard signs and bumper stickers.

For a Republican escaping a Democrat-run state, it doesn’t make sense to move to a place with a state income or estate tax (see Effect on children’s wealth when parents move to Florida). So the search process starts with intersecting the states that remained relatively free during coronapanic and income-tax-free states, which yields South Dakota, Alaska, Florida, and Tennessee. South Dakota is an awesome state for domestic asset protection trusts (along with Nevada, this is where America’s billionaires keep their trusts, but the ultimate protection may not work unless you live in SD or NV) and thus is a good place to preserve wealth from potential plaintiffs. It is a lovely place to spend the summer, but if you have school-age children you might not enjoy being stuck there December through February. With apologies to friends in Anchorage, that goes double for Alaska! Now we’re down to Florida and Tennessee. Nashville, for example, is reasonably nice in January, with average highs of 48 degrees, but Tennessee is more of a working state than a fun/retirement state. If you’re going to move, why not move to a playground? And Miami, oddly enough, despite being much warmer in winter is actually slightly cooler in the summer than Nashville. The WalletHub ranking of Coronafreedom may not give the full picture for Tennessee, whose governor declined the Central Tyrant job and did not order everyone to wear masks. However, unlike in Florida, where the governor forbade local tyrants from imposing mask laws with fines, the Tennessee governor simply delegated tyranny to counties: “Since the beginning of the COVID-19 pandemic, there has not been a statewide mask mandate in place in the state of Tennessee, however, local authorities were given the authority to issue mask mandates within their own jurisdictions.” A state with empowered local tyrants is not exactly free! Thus, as so many fleeing Wall Streeters have discovered, it all comes down to Florida.

This is a report on my own January/February exploration trip to Florida in the Cirrus SR20...

Gainesville. Beautiful campus for University of Florida, but not a beautiful or vibrant town. Apparently when the smart young people graduate they go somewhere else. Particularly unsuitable for aviation enthusiasts as the (great) airport is on the opposite side of town from the nicer real estate (tucked away in suburban developments that have a minimal relationship to Gainesville). At least with respect to Covid-19, the students seem smarter than the (cowering out of personal fear) Ivy League to whom I’ve talked recently. “We’d behave differently,” one sophomore said, “if we lived with our grandparents, but we don’t. There is no reason for us to be afraid of getting the virus and we live more than 100 miles away from our older relatives. Classes are mostly remote, so the only people that we interact with are other young people who aren’t at risk.”

Guess which department has the ugliest building? Note the students hunting for shark’s teeth in a nearby park and the selfie park at the FBO.

Sarasota. Folks with kids will want to live on the mainland rather than one of the islands (great for beach access, but the traffic can be slow getting on/off for the various services and activities that kids need). The neighborhood around the Southside Elementary School is probably the most desirable, with Camino Real being the best street and anything east of the Tamiami Trail being cheaper. Overall, however, Sarasota is more geared around the retired than those of school age. Great airport shared by air carriers and general aviation, about 13 minutes from the Southside school.

The Ringling (world’s only fine art and circus museum!) and the latest condo development for oligarchs (from my friend’s boat).

View from my friend’s apartment and his neighborhood from the air on departure…

Naples. A nice walkable downtown area. Attractive architecture. World-class restaurants at Manhattan prices (if restaurants in Manhattan were open!). There are some young people in town, but they’re apparently mostly tourists. As with Sarasota, dominated by the retired. In fact, the saying goes that “People retire to Sarasota so that they can visit their parents in Naples.” Great airport, 10 minutes from downtown, that is used only for general aviation. It was so busy in late January that jets parked on the ramp were interlaced like jets in a hangar (i.e., it wouldn’t have been possible to get one out of the middle without an hour or two of tugging).

Miami. The ultimate party town now that Los Angeles and New York have locked themselves out of the running and probably even before. “I can never get any work done here,” said one of the private equity guys I was with. KTMB is the preferred airport and it is a long haul from Miami Beach (nearly 40 minutes without traffic). KOPF is a little closer, but nobody seems to like it. If you aren’t going to hit the clubs and don’t have to be in the city for work, why put up with the congestion, traffic, and high real estate prices?

The Wynwood Walls (decluttered now that they’re charging $10 to get in), breakfast cereals for the Age of Coronapanic (Franken Fat, Cap’n Corn Starch, Obesie Os from Killkidds), transportation on which it would be good to get Dr. Fauci’s opinion regarding safety, and a group of #ScienceDeniers gathering at a rooftop club.

On the way out of town, the illegal-to-operate cruise ship pier:

Key West. We went there in a Cirrus Vision Jet to visit a Massachusetts friend who is passionate about kiteboarding and expanding government so that wise Democrats can accomplish more. As it happens, however, he lives in Key West 183 days per year and thus escapes Massachusetts state income and estate taxes. It will be folks other than him who pay for the bigger government that he advocates. Key West is so small that I think it would be tough to find specialized teachers, coaches, doctors, etc. for the modern-day helicopter parented child. The airport has a short-ish runway (5,000′) and is monopolized, with associated monopoly rates, by Bill Gates’s Signature Flight Support (jet fuel for private jet owners who are as concerned as Bill G about climate change).

Fun fact: Pan American World Airways began here. Cuba started out 90 miles away, but it is getting a little closer in spirit with every $1.9 trillion government spending bill… Found the Icon A5 on the ramp at KTMB (my flight in the A5 at Oshkosh).

Wellington Aero Club. West of Palm Beach, right up against the $25 million horse barns of America’s billionaires, you can open your garage door and taxi your twin-engine turbojet out to the 4,000′ private runway (FD38). Good public schools. Great country club for golf and tennis next door. I had a nice time here visiting a friend whose wife is a serious horse rider, but I wouldn’t want to be this far from the beach (30-40 minutes, depending on the specific beach). (See “How a Sleepy Florida Town Became the Horse Riding Capital of the World” and the 30-horse single-family stable below) My friend in Wellington (also a passionate advocate of bigger government who is careful to spend 183 days in the tax-free Land of the Deplorables!) suggested Abacoa, within Jupiter, Florida, as the best family location.

Jupiter: Palm Beach-Fort Lauderdale-Miami can be thought of as a single city, completely jammed, and with the automobile as the primary means of transportation. Juno Beach and Jupiter are the first communities on the north side of this megacity (though the Census Bureau considers them still part of the Miami metro area). The smartest folks in Germany, i.e., those who run the Max Planck Institute, picked Jupiter as the location for their one and only U.S. research lab (in neuroscience). If you’re in Jupiter you’re within a 1.5-hour drive of almost anything that you might need, e.g., the Miami International Airport and a nonstop flight to Europe, but 99 percent of needs can be handled locally. (Disney World is 2:20 away by car.) A tennis coach at the Jupiter Ocean & Racquet Club, a world class facility for (unmasked!) young learners and also great for adults, echoed my friend in Wellington regarding Abacoa, a MacArthur Foundation-created New Urbanism planned-but-not-gated community. “The schools for Abacoa are better than for the wealthier/closer-to-the-beach areas of Jupiter,” he said. [We later learned that the neighborhoods near the beach tend to be older and seasonal; not good for kids looking to play after school.] He pointed out that many of the nation’s most successful people, who could live anywhere they chose, had chosen to live in and around Jupiter. In a state that is blessed with magnificent airports, Abacoa/Jupiter got the short end of the stick. Palm Beach International is about 20 minutes away and the prices are almost reasonable due to the fact that there are three FBOs on the field. On the other hand, nobody is ever going to build T-hangars at KPBI. The North Palm Beach airport, F45, is roughly the same driving distance and it does have T-hangars, but the runway is a little short (4,300′), there is no control tower, and it is a monopoly Signature location (Jet A at $7.21/gallon; compare to $3.70 at Fort Lauderdale Executive (KFXE))

If you didn’t think inequality was as bad as the media tells you… (on the ramp at KPBI; 1960 Debonair and a newly certified Gulfstream G600):

Just south of the airport…

Abacoa. This is a planned “new urbanism” community, a bit like what you might have seen in the Truman Show movie (Seaside, Florida). It is an artificial town in that it is possible to walk/bike to a “town center”, which does have some good restaurants and a coffee shop, but the critical services, such as supermarket and Home Depot, are in strip malls on the edges or across a major road from Abacoa itself. Without traffic, it is an 11-minute drive to a beautiful dog-friendly beach.

That’s what I was able to learn in a two-week trip (including flying the Cirrus up and down the East Coast, which takes about 13 days, depending on the weather…). Measured by whether it is legal to walk out your door without a mask on, go to work, open the doors of your business to customers, send your children to school, let you children enjoy an unmasked after-school activity, etc., every part of Florida offers more freedom than New York, Massachusetts, or California. For someone accustomed to the suburban Northeast, the small yards and tightly packed houses seem like the biggest negative. In the parts of

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The silver (and gold) lining of COVID-19

by philg

COVID-19 isn’t necessarily bad. From the NYT:

Lenox Hill, one of the city’s oldest and best-known hospitals, repeatedly billed patients more than $3,000 for the routine nasal swab test, about 30 times the test’s typical cost.

“It was shocking to see a number like that, when I’ve gotten tested before for about $135,” said Ana Roa, who was billed $3,358 for a test at Lenox Hill last month.

Ms. Roa’s coronavirus test bill is among 16 that The New York Times reviewed from the site. They show that Lenox Hill arrives at its unusually high prices by charging a large fee for the test itself — about six times the typical charge — and by billing the encounter as a “moderately complex” emergency room visit.

In one case, a family accrued $39,314 in charges for 12 tests this winter, all taken to fulfill requirements for returning to work or school. In another, an asymptomatic patient walked in because she saw the banner outside and wanted a test after traveling. Her insurance was charged $2,963.

Patient bills show that at least one additional hospital owned by Lenox Hill’s parent group, Northwell Health, has charged emergency room fees to patients at a mass testing site.

Overall, a system in which a river of cash flows from Washington, D.C. favors those already big enough to hire the smartest people to navigate the system. “Some of America’s wealthiest hospital systems ended up even richer, thanks to federal bailouts” (Washington Post):

As the crisis crushed smaller providers, some of the nation’s richest health systems thrived, reporting hundreds of millions of dollars in surpluses after accepting huge grants for pandemic relief

Last May, Baylor Scott & White Health, the largest nonprofit hospital system in Texas, laid off 1,200 employees and furloughed others as it braced for the then-novel coronavirus to spread. The cancellation of lucrative elective procedures as the hospital pivoted to treat a new and less profitable infectious disease presaged financial distress, if not ruin. The federal government rushed $454 million in relief funds to help shore up its operations.

But Baylor not only weathered the crisis, it thrived. By the end of 2020, Baylor had accumulated an $815 million surplus, $20 million more than it had in 2019, creating a 7.5 percent operating margin that would be higher than most hospitals’ profits in the flushest of eras, a KHN examination of financial statements shows.

Like Baylor, some of the nation’s richest hospitals and health systems recorded hundreds of millions of dollars in surpluses after accepting a substantial share of the federal health-care bailout grants, their records show. Those included the Mayo Clinic, Pittsburgh’s UPMC and NYU Langone Health. But poorer hospitals — many serving rural and minority populations — got a tinier slice of the pie and limped through the year with deficits, downgrades of their bond ratings and bleak fiscal futures.

Wealthy hospitals also benefited because HHS used a broad definition of lost revenue. If a hospital earned less than in the year before, or simply less revenue than it had budgeted for, it could chalk up that difference to the pandemic and apply the relief funds to it.

When government gets bigger, only the big can thrive? If so, that’s a good argument for buying the S&P 500. If Congress adopts all of Presidents Biden and Harris’s proposals, government is on track to consume more than 50 percent of GDP. A big publicly traded company is going to be able to tap into the new veins of taxpayer gold much more effectively than a small business. Even if the U.S. economy stagnates, the big companies can thrive as they get a larger share of the fixed or shrinking pie.

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Maskachusetts: #Science says your backyard BBQ is illegal, but cram 150 people into a tent is okay if someone pays

by philg

An event planner whom we know says that she’s been super busy late. “People had planned backyard weddings, but they’re illegal so they’re going to pay to hold them here.” Her venue is a McMansion-sized house and a big tent with sides that come down during inclement weather. “I can have up to 150 people in the tent. It doesn’t make sense to me since a lot of these people have yards that are huge, but it is good for business.”

From the Maskachusetts State of Emergency page, which links to an appendix to Order #63:

Related:

  • Marie Antoinette of Covid: “Why is it a maximum of 10 people,” our hostess wondered, “regardless of the size of the house? Shouldn’t it be adjusted for square footage?”
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Coronascientists are the modern Aristotles?

by philg

Since the 17th century (see Francis Bacon), people who call themselves “scientists” have been using the scientific method:

  1. Make an observation.
  2. Ask a question.
  3. Form a hypothesis, or testable explanation.
  4. Make a prediction based on the hypothesis.
  5. Test the prediction.
  6. Iterate: use the results to make new hypotheses or predictions.

As previously documented here in this weblog, the “scientists” on whose advice politicians have ordered lockdowns, masks, etc. have consistently failed at Step 4 (making predictions). This failure, though, has been mostly invisible to the public due to the lack of media interest in going back a few weeks or months and comparing prediction to reality. In the rare cases when a false prediction, e.g., that the Czech Republic would have a low death rate due to masks and shutdown (in fact, the country ended up at #1 in the Covid death rate Olympics), is revisited it will be a “scientist” explaining how someone did something during the intervening period and that this action (or inaction) explains the current situation.

Is it Science when you can’t make accurate predictions, but you can tell a convincing tale? Yes! We just have to go back to 350 B.C. and Aristotelian physics. A lifted rock falls toward the earth because it is seeking its natural level. Air bubbles rise because the air seeks its natural place around the earth.

For concreteness (and remember that concrete seeks its natural level underneath highways!), let’s look at the official newspaper of those who #FollowScience. In “‘Life Has to Go On’: How Sweden Has Faced the Virus Without a Lockdown” (New York Times, April 28, 2020), the obvious comparison countries to Sweden were Ireland, Britain, and France. Once additional data are received, and it turns out Britain and France have higher COVID-19-tagged death rates than Sweden while Finland, Norway, and Denmark are outliers, the same scientifically minded folks will assert that Finland, Norway, and Denmark are the only sensible countries to which to compare Sweden and that it would be absurd to use France or Britain as a comparison. We did the same thing domestically. In March 2020, the experts predicted that locked-down Massachusetts would end up with a far lower death rate than Florida (and we should have, since only 14 percent of our population is over 65, compared to 20 percent in Florida). Now that data are available and Florida has suffered only 62 percent of the MA death rate, it is plain to scientists that comparing MA to FL would be nonsensical.

(The article has a funny-in-retrospect section:

From the first signs of the pandemic, the Swedish Public Health Authority decided that a lockdown would be pointless. “Once you get into a lockdown, it’s difficult to get out of it,” the country’s state epidemiologist, Anders Tegnell, said. “How do you reopen? When?”

California teachers’ union answer: never! To the Swedes who say “Life Has to Go On,” the majority of Americans say, resoundingly, “No, it does not!”)

A more recent example… “Iowa Is What Happens When Government Does Nothing” (December 3, 2020, Atlantic, owned by someone who got rich by marrying Steve Jobs and now advocates for unlimited migration into parts of the U.S. other than her own Palo Alto neighborhood):

The story of the coronavirus in the state is one of government inaction in the name of freedom and personal responsibility.

“In a lot of ways, Iowa is serving as the control group of what not to do,” Eli Perencevich, an infectious-disease doctor at the University of Iowa Hospitals and Clinics, told me. Although cases dropped in late November—a possible result of a warm spell in Iowa—Perencevich and other public-health experts predict that the state’s lax political leadership will result in a “super peak” over the holidays, and thousands of preventable deaths in the weeks to come. “We know the storm’s coming,” Perencevich said. “You can see it on the horizon.”

Experts expect to see a spike in COVID-19 cases in the state roughly one week from now [December 10], two weeks after the Thanksgiving holiday. That spike will likely precede a surge in hospitalizations and, eventually, a wave of new deaths—maybe as many as 80 a day, Perencevich, the infectious-disease doctor, estimates. Add Christmas and New Year’s to the mix, and Iowans can expect to see nothing less than a tsunami, Perencevich says.

What actually did happen? From the NYT:

Cases peaked on November 13. Given that “cases” are subject to much human whim, e.g., whether people are fed into PCR machines or not, let’s look at deaths:

What happened to the predicted “tsunami” of death after Christmas and New Year’s gatherings? Deaths peaked on December 15. a month after the “case” peak and, thus far, have failed to reach that level again.

Readers: What do you think? If Aristotle can be a great “scientist” despite an inability to predict projectile trajectories or planetary orbits, is it also reasonable to call the coronascientists great despite their inability to predict the likely impact of coronavirus?

Related:

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How many people will die from having sat around the house for a year?

by philg

What is the most sensible scientifically informed response to a virus that attacks the obese and unfit? Sit at home next to the fridge for a year. Could this kill us? “Inactivity Drives 1 in 14 Deaths Globally, New Data Suggest” (Medscape, March 31):

The high cost of a sedentary lifestyle just became a bit more evident ― a new global study shows that inactivity drives up to 8% of noncommunicable diseases and mortality.

Physical inactivity, defined as engaging in less than 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week, is estimated to have caused 7.2% (95% CI, 5.4 – 9.0) of all-cause deaths and 7.6% (95% CI, 6.1 – 9.3) of cardiovascular disease (CVD) deaths, according to investigators led by Peter T. Katzmarzyk, PhD, associate executive director for population and public health sciences, Pennington Biomedical Research Center, Baton Rouge, Louisiana.

Note that the study was done using 2016 data. See “Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries” (BMJ)

What about the expectations that Americans would die from the disruption in non-Covid health care ordered by governors? “The Untold Toll — The Pandemic’s Effects on Patients without Covid-19” (NEJM, June 2020) had anecdotes, but no numbers. “Surge in Advanced Cancers Follows COVID-19 Into 2021” (MedPage Today, March 31, 2021) offers some survey data:

Two-thirds of radiation oncologists said new patients more often have advanced-stage disease at their initial clinic visit as compared with prior years. Consistent with data from multiple other sources, three-fourths of respondents said patients have skipped routine cancer screening, and two-thirds said COVID has interrupted treatment for existing patients.

“What we have learned one year into the COVID-19 pandemic is that radiation oncologists continue to see the harmful effects of the pandemic on our patients,” said Thomas J. Eichler, MD, chair of ASTRO’s board of directors, during a webinar to discuss the survey findings. “The data are clear that people with cancer are facing additional burdens in these difficult times.”

(bonus points to this doc for including the phrase “in these times”)

The same publication reminds us that feeling safe is not just about Covid-19. The director of abortion services at a clinic in Bangor, Maine writes “It’s Time for You to Be More Inclusive — Yes, You.”:

Small steps to support transgender patients go a long way in their healthcare

I recently saw a new patient seeking help addressing substance abuse issues. It was our first time meeting, so when I entered the exam room, I introduced myself with my name and my pronouns, as I always do. Before I even offered any advice or asked a question, the patient’s face lit up with a smile. She explained that she was a transgender woman, and hearing me introduce myself with my pronouns was a huge relief, because it showed her that I would treat her with respect.

She quickly opened up to me, describing how she was grappling with a host of challenges and stresses that were made even worse because other people in her life — including other doctors — didn’t understand, didn’t respect, or outright rejected her identity.

Something as simple as including your pronouns when you introduce yourself can indicate that you are an ally and contribute to a sense of safety and inclusion.

I say that I provide abortions, prenatal care, birth control or other resources to pregnant people, not just pregnant women, because all people deserve the right to make their own decisions about if, when, or how they want to have children, without facing judgement.

Separately, if there is a person on this planet who can get through a winter in Bangor, Maine without drinking heavily, consuming drugs, and considering a gender change, I would love to meet him/her/zir/them.

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We now know the price of freedom: $0

by philg

Continuing the Passover-Freedom theme… what is the actual price tag that Americans put on freedom? “The Curious Case of Florida’s Pandemic Response” (Atlantic) suggests that the value is $0.

To the extent that winning a pandemic is possible, Florida seemed to be winning the pandemic.

(the author does not consider the possibility that Floridians did not enter the COVID Olympics)

Governor Ron DeSantis bragged that Florida drew a straight flush of pandemic outcomes: “open schools, comparatively low unemployment, and per capita COVID mortality below the national average.”

But the closer I looked, the more holes I found in the simple pro-Florida narrative.

Yes, Florida is seeing falling COVID-19 cases and hospitalizations. But so is just about everywhere else. And its overall pandemic performance is just about typical.

As far as I can tell, though, it didn’t. At 4.8 percent, its unemployment rate is 18th in the country, and not meaningfully different from that of the median states, South Carolina and Virginia, at 5.3 percent. Real-time data tracking state spending and employment show that Florida is doing, again, no better than average. Compared with January 2020, its consumer spending is down 1 percent, which is right in line with the national average. Its small-business revenue is down about 30 percent—again, almost exactly the national average. These statistics may be missing something. But the national narrative of an exceptionally white-hot Florida economy doesn’t match the statistical record of its performance.

What this nation desperately needs is low-skill immigration so that we have lots more people to house:

Since 2012, Miami home prices have increased by 94 percent, nearly the exact same as those in Los Angeles in that time. Prices are soaring as inventory melts away; Florida’s active listings fell by 50 percent last year, and it’s not doing enough to keep up with demand.

A rare moment of checking to see whether coronascience has any predictive value:

In 2020, smart media figures and scientists predicted that COVID-19 would especially ravage Florida, given its open economy and elderly population. They were wrong. Why? Did Florida just get lucky? Is this mostly about the salutary benefits of the outdoors, or the coronavirus’s sensitivity to heat and humidity? Do strict lockdowns simply fail the cost-benefit analysis? The answer to all three questions may be yes.

What’s most interesting to me is that the author implicitly values the freedoms to walk out of one’s door, walk outside without a mask, meet friends at a restaurant, host a party at one’s house, etc. at $0. If two people, one confined to his/her/zir/their home by a governor’s executive order and one free to send children to school, go to work, play a sport, socialize, have the same amount of money they are equally well off. So it makes sense to look at the statistics gathered by economists and pronounce a state (or a society) a success or failure based on those statistics. (We also see this applied to Sweden; people will look at a list of countries ranked by COVID-19-tagged deaths per capita and note Sweden’s position without pointing out that it avoided the lockdowns, masquerades, etc.)

From Wellington, Florida… (Why does the realtor rank “Pool” above “Hangar”?!?!)

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