Category: Coronapanic

Republicans could win in November if they gave Americans universal health insurance?

by philg

In September 2009, I wrote “Health Care Reform”. Essentially the government would take the $trillions being spent on Medicare and Medicaid and put it into buying every American a reasonably good HMO policy.

  • each resident will be given a voucher good for signing up at the clinic or HMO of his or her choice; the amount of the voucher will depend on the resident’s age and sex (the weighted average of all vouchers will equal $2,000 or whatever we’ve decided we want to spend)
  • a clinic or HMO that wishes to get any revenue from the federal government will be required to take any person who submits a voucher, regardless of preexisting conditions
  • a resident of the U.S. can switch clinics annually, let’s say on May 1.
  • the clinic is responsible to pay for the resident’s emergency medical care at another facility

A note:

One likely side effect of this reform is the return to centrality of the primary care physician. Joe Medicare Patient often does not have any doctor who understands much less coordinates his care. If Joe has seen six specialists, he may be on drugs that are working at cross purposes. If Joe is in the ICU at a typical hospital, the multiple doctors treating him may never talk to each other. Each one knows what tests and procedures he or she has ordered, but, except by looking at the patient’s chart, has no idea what the other doctors are investigating. One primary care doctor who reviewed this proposal said “The first item I address with new patients in my office is to try to get them off as many drugs as possible; when a 70-year-old is on 11 meds you better believe there are many unintended interactions.”

How has this aged and what would be different during coronaplague?

Americans want, most of all, for the Great Father in Washington to love them. “Trump, like Herbert Hoover, is ‘the man who doesn’t care.’ Biden can make that stick.” (USA Today, June 28):

Most of all, Trump is the man who doesn’t care. He doesn’t feel your pain. He doesn’t mourn the dead, comfort the grieving, or support the struggling. He doesn’t consider his words or worry that they could have consequences. He doesn’t listen to experts or ponder his options.

Congress is almost finished with its “work” for this session. If the Republicans want to win in November, why not make Americans feel that the they are loved and cared for? We don’t care about money anymore, right? We are happy to spend 100 percent of our accumulated wealth hiding from coronaplague if that is what it takes to cut the death toll slightly. We are happy to print and borrow trillions. A universal HMO policy for every resident of the U.S. wouldn’t have to cost any more than the current bleeding for Medicaid and Medicare plus whatever employers pay for mid-range coverage.

Will anyone, other than folks in the industry, miss the current system? A couple of recent news items:

At least to judge by my Facebook feed, Americans are convinced that, despite the lack of any effective therapy for Covid-19 and despite the fact that the Feds pick up the tab when the uninsured are treated for Covid-19, universal health insurance would hugely cut the number of Covid-19 deaths.

Readers: What do you think? Could Trump and the Republicans take most of the wind out of the Democrats’ sails with one big health care hand-out? (of course, all of the money for this would just come from taxpayers themselves, but somehow Americans never seem to consider that they will ultimately have to work for whatever the government “gives’ them)

Bonus pictures of the house that Medicaid and Medicare built, in Nome, Alaska, from September 2019. This single building is likely worth more than all of the rest of the houses and commercial real estate in the city.

Related:

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Department of Extrapolation: Masks worked in a hospital…

by philg

… so they will definitely work in the general population.

“Universal Masking to Prevent SARS-CoV-2 Transmission—The Time Is Now” (JAMA) says masks worked in the hospital:

In the largest health care system in Massachusetts with more than 75 000 employees, in tandem with routine symptom screening and diagnostic testing of symptomatic HCWs for SARS-CoV-2 infection, leadership mandated a policy of universal masking for all HCWs as well as for all patients. The authors present data that prior to implementation of universal masking in late March 2020, new infections among HCWs with direct or indirect patient contact were increasing exponentially, from 0% to 21.3% (a mean increase of 1.16% per day). However, after the universal masking policy was in place, the proportion of symptomatic HCWs with positive test results steadily declined, from 14.7% to 11.5% (a mean decrease of 0.49% per day). Although not a randomized clinical trial, this study provides critically important data to emphasize that masking helps prevent transmission of SARS-CoV-2.

Therefore, masks will send coronaplague packing:

First, public health officials and leaders need to ensure that the public understands clearly when and how to wear cloth face coverings properly and continue building the evidence base for their effectiveness. Second, although cloth face coverings are generally well tolerated for short periods, with prolonged use they can be irritating or difficult for some people to breathe through, especially in hot or humid environments. Innovation is needed to extend their physical comfort and ease of use. Third, the public needs consistent, clear, and appealing messaging that normalizes community masking. At this critical juncture when COVID-19 is resurging, broad adoption of cloth face coverings is a civic duty, a small sacrifice reliant on a highly effective low-tech solution that can help turn the tide favorably in national and global efforts against COVID-19.

The apparent contradiction between the bold-faced portions is not addressed.

[Potential bad news for American Karens: “It is probably safe for individuals and safe for others to drive alone…without a face covering,” (see this instructional video)]

So… the Swedes and the World Health Organization (advice through early June) are wrong about masks for the general population being effective in reducing plague? How might we be disappointed a few months down the road if we rely on this article?

  1. In a hospital people don’t have any real choice about how far apart to stand (similar to public transport). So the donning of masks won’t lead people to change their “social distance” (risk compensation and see also “Why is Sweden still not asking people to wear face masks?”).
  2. Each hospital worker has been fitted for an N95 mask (choice of at least 6 different styles) by a professional fitter.
  3. Hospital workers dispose of the masks between patients or at the end of each day. Hospital workers have access to handwashing and hand sanitizer within a step or two.

When you look at two members of the general public in a grocery store, none of the foregoing applies. Hospitals and doctors’ offices here in Maskachusetts seem to recognize this. If you need to enter one of these buildings you will be required to put your saliva-soaked face rag back into your pocket. Then you will be required to use hand sanitizer or soap and water. Then you will be given a brand-new clean paper face mask to wear. The bandana that protects society from the plague going exponential is not considered worthwhile protection inside the hospital.

Department of Sweden is still right (Karen Philip’s favorite department!): the Swedes give out free clean masks when people are getting on public transport.

Separately, if it as easy as the Mask Karens say to eliminate a virus by putting masks on the general population, why didn’t we use this technique to eliminate influenza, which has killed literally millions of Americans during my lifetime?

(What’s the downside of relying on masks? If we put our faith in masks and then, a few months down the road discover that they aren’t effective for the general population, that delays the measures that we actually need to take, e.g., moving more activities outdoors under shade structures, decluttering retail environments, having crowded high schools rent empty big box stores so that students can be spread out more.)

Bonus: allegorical photo showing the fate of those who don’t wear a mask, from the old fishing hamlet of Helgumannen. Faro, Gotland.

and another one… (Langhammars. Faro, Gotland)

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Test and trace in Virginia (8 days of patience required)

by philg

I recently spoke with two attorneys from Charlottesville, Virginia. They wanted to get tested for active coronaplague in preparation for a family reunion that included some older relatives. One is employed by the state and therefore both have absolutely top-of-the-line health insurance.

“Most of the places we called said that we couldn’t get a test unless we had symptoms,” said the wife. “We did finally find a place, but they said that the results wouldn’t be available for 8 days.”

Maybe things are better in Maskachusetts? Cambridge was offering free testing for residents and, by July 8, the entire month of July had been booked (i.e., the wait to get tested and then receive a result would be at least 25 days or so).

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Are Florida and Texas good natural experiments in the effectiveness of masks?

by philg

Given what I have seen of mask usage in practice, I do not think they will be helpful in the U.S. except maybe to delay infections by a few weeks. I agree with the Swedes and the WHO that this is likely to be a multi-year experience with the coronavirus. And there will likely be another similar virus right behind this one. So I think we would slow down viral spread more effectively by restructuring our physical environment so that it isn’t relevant whether people are using a bandana improperly (or wearing a mask with an exhaust valve, which I see regularly among the righteous of Cambridge), etc. More stuff could happen outdoors under shade structures, for example.

rickduncanlive.com: Hey! Linus dropped his security blanket. Maybe ...

I wonder if the mask is like Linus’s security blanket in Peanuts. People like to believe that they can control their fate. We hear that someone died of cancer and ask “Did he smoke?” The person is dead so it shouldn’t matter, but we want to know because we want to be assured that we won’t be killed by a random cancer and that we can extend our lives by clean living. The “science” as of March (and through early June at the WHO!) was that masks wouldn’t protect 8 billion humans from spreading coronavirus. But we didn’t like that answer so “science” gave us a new answer. It is highly comforting because we are controlling our fate, not living or dying depending on the whims of the virus and the accidents of geography (Maine versus Massachusetts, for example, a 14:1 difference in death rate).

Like most people, I hope that the universal mask laws can have some beneficial effect. But I fear that we are setting ourselves up for yet another disappointment and we will whip ourselves for not doing a good enough job. Yes, we wore masks, but too many of us did so without covering our noses. Yes, we wore masks, but that led too many of us to abandon the 6′ social distance. We wouldn’t have had a death rate comparable to Sweden’s if only we had…

This is kind of like the difference between Greek/Roman religion and Christianity. If the barbarians attack and burn your Greek/Roman city, you say “That was a terrible experience, but the gods are capricious sociopaths so we will just have to rebuild as best we can.” If the same thing happens to a Christian, he/she/ze/they must say “God is benevolent and omnipotent, so it must have been our wickedness that led to this bad outcome.”

I wonder if there is a mask experiment happening for us right now. Massachusetts and New York had a big surge in infections and then deaths back before any mask laws went into effect (May 6 here in what is now “Maskachusetts”). Florida and Texas have come out of shutdown. They are pretty well masked. We would expect the arc of the epidemics there to be less dramatic than in NY and MA due to (a) a bunch of restrictions still in place, e.g., no mass gatherings, (b) nursing homes much better protected than in MA or NY. But is the arc yet more attenuated in a way that we can perhaps attribute to Floridians and Texans being under mask orders?

Related:

  • “Flu Masks Failed In 1918, But We Need Them Now” (HealthAffairs): In 1919, Wilfred Kellogg’s study for the California State Board of Health concluded that mask ordinances “applied forcibly to entire communities” did not decrease cases and deaths, as confirmed by comparisons of cities with widely divergent policies on masking. … Second, the review of practices in 1918 demonstrates masks must be worn correctly and consistently, fully covering the nose and mouth, with sufficient layers to prevent the spread of droplets. Advocates for masks in 2020 can use this historical lesson to argue that masks must be worn properly, or they will not achieve their objectives. [Summary: this time it is different and Americans will be as good at using masks as surgical nurses]
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If you’re on an airliner packed with masked passengers, why don’t you get Covid-19 when your middle seat neighbor removes the mask to eat or drink?

by philg

A variety of U.S. airlines are going the full cattle car route, right? (see https://philip.greenspun.com/blog/2020/06/16/american-airlines-the-magic-of-air-travel-in-the-age-of-corona/ )

The theory is that the magic of masks will protect the 150 people on a 150-person Boeing or Airbus from giving each other the plague. (As a friend notes “If a bandana is effective PPE for Covid, then a saline injection is surely an effective vaccine.”)

Suppose that you’re on one of these Plague Special flights. The person sitting next to you is infected with coronavirus. You’re wearing a surgeon’s mask, which provides almost no protection for inhaling. Your infected neighbor removes his/her/zir/their bandana to drink some coffee or eat a sandwich. That’s not prohibited, right? Why don’t you get coronaplague during the 15 minutes that it takes your middle seat neighbor to eat/drink?

Suppose it is a six-hour coast-to-coast flight. Your exposure to your unmasked middle seat neighbor might be a full 30 minutes. Isn’t that long enough to transmit any virus?

Related:

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Fairfax County School Shutdown Karen thought process

by philg

A friend sent me this post from Joe the Shutdown Karen of Fairfax County:

To our fellow FCPS families, this is it gang, 5 days until the 2 days in school vs. 100% virtual decision. Let’s talk it out, in my traditional mammoth TL/DR form.

Full disclosure, we initially chose the 2 days option and are now having serious reservations. As I consider the positions and arguments I see in my feed, these are where my mind goes. Of note, when I started working on this piece at 12:19 PM today the COVID death tally in the United States stood at 133,420.

“My kids want to go back to school.”

I challenge that position. I believe what the kids desire is more abstract. I believe what they want is a return to normalcy. They want their idea of yesterday. And yesterday isn’t on the menu.

“I want my child in school so they can socialize.”

This was the principle reason for our 2 days decision. As I think more on it though, what do we think ‘social’ will look like? There aren’t going to be any lunch table groups, any lockers, any recess games, any study halls, any sitting next to friends, any talking to people in the hallway, any dances. All of that is off the menu. So, when we say that we want the kids to benefit from the social experience, what are we deluding ourselves into thinking in-building socialization will actually look like in the Fall?

“My kid is going to be left behind.”

Left behind who? The entire country is grappling with the same issue, leaving all children in the same quagmire. Who exactly would they be behind? I believe the rhetorical answer to that is “They’ll be behind where they should be,” to which I’ll counter that “where they should be” is a fictional goal post that we as a society have taken as gospel because it maps to standardized tests which are used to grade schools and counties as they chase funding.

In other words, the public school Shutdown Karens imagine that rich kids in private school won’t be working and learning! (see https://philip.greenspun.com/blog/2020/05/20/massachusetts-private-school-students-zoom-ahead/ for the educational gulf that has opened up in Maskachusetts between public and private school children; see nytimes for how low-income students of color are the Shutdown Karens’ biggest victims).

How do people in the third richest country in the United States deal with numbers?

FCPS has 189,000 children. .0016 of that is 302. 302 dead children are the Calvary Hill you’re erecting your argument on. So, let’s agree to do this: stop presenting this as a data point. If this is your argument, I challenge you to have courage equal to your conviction. Go ahead, plant a flag on the internet and say, “Only 302 children will die.” No one will. That’s the kind action on social media that gets you fired from your job. And I trust our social media enclave isn’t so careless and irresponsible with life that it would even, for even a millisecond, enter any of your minds to make such an argument.

Out of more than 8,000 people (average age 82 and 98 percent with “underlying conditions”) killed in thoroughly-plagued Massachusetts (population 7 million), exactly 0 have been under the age of 20 (dashboard). Yet the 1.1 million rich government workers, contractors, and lobbyists of Fairfax County are going to experience 302 extra deaths among children (equivalent to over 2,000 for an MA-sized population). (Of course, if they still believe the March dogma of Flatten the Curve, a 10-year school shutdown won’t have any effect on the infection/death rate among children; the same number of infections and deaths will simply be spread out.)

I’m kind of amazed at the lack of imagination and lack of expectations among the subjects of American government. Our theory used to be that the U.S. had liberty while the Chinese had competence. They had the Shanghai Metro while we had complete freedom of speech, assembly, religion, etc. Our liberties are mostly gone, subject to the potentially arbitrary decisions of state governors (the perfect example of a “a government of men rather than a government of laws”) and of the mob (getting people fired from jobs if they don’t worship at the churches of BLM, #MeToo, and the Rainbow Flag). The Fourteenth Amendment is gone, with students being entitled to an education depending on their skin color. But nobody insists on receiving competent government in return. For example, if the Karens of Fairfax want their brats to be spaced farther apart in the schools, why can’t the schools rent more space? With retail going bankrupt and office buildings shut down, would it actually be hard for every school to double its physical size? The Chinese built a hospital for 5,000 people in 10 days. A U.S. school system can’t rent a bankrupt Sears store’s old space given six months to negotiate? And then drive to IKEA for some desks? Keep in mind that Fairfax is insanely rich by U.S. standards (thank you for paying your federal taxes!).

Related:

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Coronaplague test data show that Florida successfully flattened the curve?

by philg

Florida is being described as a Covid-19 disaster zone, but I wonder if the state is being punished for its own success at the March 2020 dogma of Flatten the Curve. Here’s a chart of tests performed and percent positives from John Hopkins:

Florida’s governor ordered a shut down effective April 3. The state began reopening in May. Can we infer from the above data that Florida, with its dense linear city, was a natural plague center, but the dramatic suffering and efforts of citizens actually had a huge effect? From mid-April to mid-June, only a small percentage of Floridians who sought a plague test actually came up positive.

Let’s look at Massachusetts for contrast:

Essentially a textbook unmitigated infectious disease epidemic, right? How about New York?

So… Florida is being pilloried despite the fact that it actually might be one of the most successful examples of flattening the curve!

(Of course, just as noted by the former chief scientist of the European CDC, and just as promised by Flatten the Curve advocates here in the U.S., infections were merely delayed by this success, not prevented. So the current state of Covid-19 affairs in Florida is exactly what one would expect given the successful shutdown.)

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Donald Trump is a dictator and the U.S. is the worst place in the world for Coronaplague…

by philg

… however, according to M.I.T. and Harvard, it is essential for the welfare of foreigners that they stay here in the U.S. to be governed by Donald Trump and subjected to an unmitigated textbook-style coronaplague. See “Harvard and MIT sue Trump administration over online-only instruction for foreign students in the US” (CNN):

Harvard and the Massachusetts Institute of Technology on Wednesday sued the Trump administration over its guidance not allowing foreign students to take online-only courses in the US this fall semester.

Harvard announced earlier this week that all course instruction will be delivered online, including for students living on campus. In a statement provided to CNN, the university said the guidance stands to affect approximately 5,000 international students.

“The order came down without notice—its cruelty surpassed only by its recklessness. It appears that it was designed purposefully to place pressure on colleges and universities to open their on-campus classrooms for in-person instruction this fall, without regard to concerns for the health and safety of students, instructors, and others,” Harvard University President Larry Bacow said.

The lawsuit also underscores the challenge posed to students: “Just weeks from the start of the fall semester, these students are largely unable to transfer to universities providing on-campus instruction, notwithstanding ICE’s suggestion that they might do so to avoid removal from the country.”

If Trump is as bad as these folks say and the U.S. is an example of spectacular incompetence in managing the only thing that matters to humanity anymore (coronaplague), why wouldn’t the best thing for foreign students be an airlift back to relative coronasafety and government competence in their respective home countries?

(This is especially critical as we are informed by U.S. media that the typical victim of Covid-19 is a previously healthy teenager.)

A recent photo from a Robinson R44 of the empty Harvard campus:

(credit: my friend Tony)

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Why is it still impossible to buy N95 masks?

by philg

Americans in many states and/or cities are required by law to wear “masks” of some sort, but compliance seems to be spotty and competence yet spottier. The “mask” devolves into a saliva-soaked face rag that leaves at least the nose exposed, for example.

What about people who want to protect themselves, not simply pretend to protect others? We’re in Month 4 of Shutdown here in Maskachusetts. Why can’t we buy masks that would actually provide some protection, i.e., a paper N95 mask? Drugstores seem to have ample supplies of surgical-type masks, but I haven’t seen N95 masks anywhere. From the Home Depot site:

This medical supply site seems to have them at $8 each. This site charges $1.80 per mask (real 3M brand), but says to expect a 2-3 month wait.

The health care industry is obviously using a lot more of these than before, but is it really that difficult to make an N95 mask? Or perhaps the process of obtaining certification for a new supplier is lengthy?

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Priority for Students of Color in returning to public K-12 school

by philg

From the Educrats in Washington State: Reopening Washington
Schools 2020 District Planning Guide. The phrase “students of color” occurs six times.

Good news for Rachel Dolezal: white students will be home driving parents crazy while “students of color” will enjoy in-person instruction and socializing with other students.

If that isn’t specific enough, “Prioritize face-to-face service for students that are most impacted by the loss of in-person services, including: … Students of color”

(“intersectionality” is involved, which presumably is a positive for the job market for PhDs in comparative victimhood)

I wonder if this is another good example of what Sweden has gained by just giving the finger to the coronavirus. Sweden isn’t pitting families of different skin colors against each other in competing for scarce slots in public schools.

Also, is this another example of a Constitutional right that Americans have lost due to the governor-declared emergencies? The Fourteenth Amendment was used to require school integration because of the Equal Protection Clause. How can states re-segregate their schools in light of the Supreme Court’s interpretation of this clause?

Related:

  • “N.Y.C. Schools, Nation’s Largest District, Will Not Fully Reopen in Fall” (NYT): Classroom attendance in September will be limited to only one to three days a week in an effort to continue to curb the outbreak, the mayor said. … The decision to opt for only a partial reopening, which is most likely the only way to accommodate students in school buildings while maintaining social distancing, may hinder hundreds of thousands of parents from returning to their pre-pandemic work lives, undermining the recovery of the sputtering local economy. [Wouldn’t the parents be better off moving to a state with (a) fully open schools, and (b) good Internet connectivity?]
  • “Research Shows Students Falling Months Behind During Virus Disruptions” (NYT): “When all of the impacts are taken into account, the average student could fall seven months behind academically, while black and Hispanic students could experience even greater learning losses, equivalent to 10 months for black children and nine months for Latinos, according to an analysis from McKinsey & Company, the consulting group.”
  • https://philip.greenspun.com/blog/2020/06/18/coronashutdown-versus-un-universal-declaration-of-human-rights/ (the UN says that children have the right to go to school, with no exceptions for a powerful teachers union or a state full of Shutdown Karens)
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