Florida implements my renal dialysis-inspired COVID care idea (sort of)

Since all that hospitals are generally doing for COVID-19 patients is providing supportive care (i.e., not treatment) and, in fact, patients can do just as well at home with an oxygen bottle (nytimes), it seemed like an obvious idea to look for a way to handle COVID-19 patients somewhere other than a hospital. If nothing else, this would prevent the COVID-19 patients from infecting workers and patients within the hospital. If we could build renal dialysis capacity, why not COVID-19 treatment centers? is my idea from April 2, 2020:

On the one hand, the U.S. health care system is kind of lame. It consumes a ton of money. New York State spends $88 billion per year on its Department of Health, $4,400/year for every resident, mostly just for people on welfare in New York; Mexico spends about $1,100/year across all citizens, including those with jobs. The U.S. health care system delivers feeble results. Life expectancy in Mexico is 77 versus 78 in the U.S. Despite this prodigious spending, New York has completely failed to protect its residents from something that isn’t truly new.

On the other hand, the U.S. managed to build enough renal dialysis capacity to keep 468,000 Americans with failed kidneys alive. This is a complex procedure that requires expensive machines, and one that did not exist on a commercial basis until the 1960s.

Of course, one issue is that we had decades to build up all of this renal dialysis capability while we have only about one more month to build COVID-19 treatment capacity. But once we have built it, can we sail through the inevitable next wave or two of COVID-19?

(Looks like I can take credit for predicting “the inevitable next wave or two of COVID-19” (the U.S. is officially in Wave #3? BBC).)

If renal dialysis can be delivered in a strip mall, why not COVID-19 care? Florida has taken a step in the direction that I suggested nearly 1.5 years ago. From https://floridahealthcovid19.gov/monoclonal-antibody-therapy/ :

Note that the locations are not hospitals. They’re not empty strip mall shops or big box stores as I’d expected, but rather parks and libraries (i.e., existing state-owned facilities). But maybe this is because these are the state-run operations rather than private sector. (Also, as far as I have seen, South Florida isn’t in the Zombie Apocalypse retail vacancy situation that Boston is.)

Also, I wonder if the 9-5 hours support my analogy between the Vietnam War and our War on COVID-19. We were in a fight where the fate of democracy all around the world was at stake… but the upper-middle class back home kept playing tennis and golf and President Johnson and Congress kept larding on social welfare programs without considering the cost. Right now we’re in an unprecedented emergency. Our best and brightest technocrats are using advanced technology and trillions of dollars against an enemy that has already killed more Americans than all wars combined… but we will fight the enemy from 9-5. (I don’t think this is completely fair because the Florida state government has treated COVID-19 as a respiratory virus to be managed like the flu, not as an entirely new phenomenon nor as something that can be vanquished by government action.)

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Nation’s leading Shutdown Karens complain that schools were shut down

This is kind of fascinating… the New York Times, which was a principal cheerleader for lockdowns, now complains about American public schools having been shut for roughly one year… “The School Kids Are Not Alright” (NYT, August 22):

One of the most distressing aspects of the Covid pandemic has been seeing governors and state education officials abdicate responsibility for managing the worst disruption of public schooling in modern history and leaving the heavy lifting to the localities. Virtually every school in the nation closed in March 2020, replacing face-to-face schooling with thrown-together online education or programs that used a disruptive scheduling process to combine the two. Only a small portion of the student body returned to fully opened schools the following fall. The resulting learning setbacks range from grave for all groups of students to catastrophic for poor children.

From the start, elected officials seemed more concerned about reopening bars and restaurants than safely reopening schools that hold the futures of more than 50 million children in their hands.

Could this be the new definition of chutzpah? (replacing the former “that quality enshrined in a man who, having killed his mother and father, throws himself on the mercy of the court because he is an orphan.”)

The rest of the editorial is about new ways for President Biden to force every American schoolchild to wear masks for 7 hours per day. Having bravely confronted the Taliban, Uncle Joe will now turn his post-nap attention to K-12ers who are wearing chin diapers, under-nose masks, or running wild:

President Biden took the right approach on Wednesday when he announced that his Education Department would use its broad authority to deter the states from barring universal masking in classrooms.

How much difference will this make? See “The Science of Masking Kids at School Remains Uncertain” (New York, August 2021):

At the end of May, the Centers for Disease Control and Prevention published a notable, yet mostly ignored, large-scale study of COVID transmission in American schools. A few major news outlets covered its release by briefly reiterating the study’s summary: that masking then-unvaccinated teachers and improving ventilation with more fresh air were associated with a lower incidence of the virus in schools. Those are common-sense measures, and the fact that they seem to work is reassuring but not surprising. Other findings of equal importance in the study, however, were absent from the summary and not widely reported. These findings cast doubt on the impact of many of the most common mitigation measures in American schools. Distancing, hybrid models, classroom barriers, HEPA filters, and, most notably, requiring student masking were each found to not have a statistically significant benefit. In other words, these measures could not be said to be effective.

In the realm of science and public-health policy outside the U.S., the implications of these particular findings are not exactly controversial. Many of America’s peer nations around the world — including the U.K., Ireland, all of Scandinavia, France, the Netherlands, Switzerland, and Italy — have exempted kids, with varying age cutoffs, from wearing masks in classrooms.

(As with physics, e.g., Katherine Clerk Maxwell‘s equations, the predictions from coronascience will be different depending on the country in which the experiment is conducted.)

Another interesting media phenomenon is cheering for school districts that defy governors’ orders to reopen fully. See “How three school districts are defying state restrictions on mask mandates” (CNN) for example:

The debate over masks in schools has reared its head once again with the new academic year, and a handful of states have taken steps to restrict local officials’ ability to implement their own masking requirements, either through the governor’s office or state legislatures.

These restrictions — made despite guidance from the US Centers for Disease Control and Prevention recommending masks for everyone in schools regardless of vaccination status — have prompted showdowns between state officials and some local school districts, who say they’re trying to protect their communities, particularly students who are ineligible for vaccines.

Perhaps most prominently, several Florida school districts have decided to impose mask mandates, defying an executive order by Gov. Ron DeSantis that forbids such requirements and threatens to take away school funding if school districts don’t allow students to opt-out.

But some school districts have taken more methodical approaches, carefully circumventing state restrictions on mask requirements through careful legal maneuvering or apparent loopholes.

The school bureaucrats’ motives are noble. They want to protect their communities and especially the children. The nobility of their motive is one reason that a governor’s order cannot apply to them.

What if, in April 2020, a school district in a rural area of a state had said “we’re reopening our school in defiance of the governor’s shutdown order because we are trying to protect our children’s future and ensure that they have enough education to thrive. We aren’t suffering from a plague the way folks in the big city who ride the subway to their Tinder dates are”? Would the same journalists have praised such defiance?

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Internment camps for the unvaccinated?

Nobody loved my previous modest proposal: Euthanize the unvaccinated?

Here’s another idea for keeping the righteous safe from those who deny #Science… internment camps for the unvaccinated. Korematsu v. United States affirmed FDR’s decision to send Japanese-Americans into camps. World War II was a bad situation, but Japanese-Americans were a minor and speculative threat. Nonetheless, the Supreme Court held that the Constitution did not apply #BecauseEmergency.

Consider that COVID-19, at least according to our media, has already killed far more Americans than died in World War II (and the death of an 82-year-old with diabetes and cancer is actually more tragic than the death of a healthy 18-year-old soldier). So the emergency is far more severe right now than whatever we had concerning us in 1942 when Roosevelt issued Executive Order 9066. This is certainly no time to let purported Constitutional rights interfere with public health.

We are also informed that the unvaccinated are 99.2 percent responsible for spreading coronaplague and for COVID-19 deaths. The unvaccinated are a clear and present danger to themselves and others.

Isn’t the logical next step placing the unvaccinated into internment camps for their own protection? “Imperfect Vaccination Can Enhance the Transmission of Highly Virulent Pathogens” (PLOS, 2015):

Could some vaccines drive the evolution of more virulent pathogens? Conventional wisdom is that natural selection will remove highly lethal pathogens if host death greatly reduces transmission. Vaccines that keep hosts alive but still allow transmission could thus allow very virulent strains to circulate in a population. Here we show experimentally that immunization of chickens against Marek’s disease virus enhances the fitness of more virulent strains, making it possible for hyperpathogenic strains to transmit. Immunity elicited by direct vaccination or by maternal vaccination prolongs host survival but does not prevent infection, viral replication or transmission, thus extending the infectious periods of strains otherwise too lethal to persist. Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts.

The only way to keep the unvaccinated safe from the super-COVID that we’re breeding by vaccinating those who were never at significant risk (with an imperfect vaccine) is to place the unvaccinated into camps where they can be isolated from the vaccinated population.

Readers: What do you think of this idea? And could Andrew Cuomo be repurposed to run one of the camps? He has experience ordering the infected into nursing homes. (But if he hadn’t done that, the hospital situation could have been worse; see Our hero’s hospital is full (but not with patients who should be there).) Maybe Cuomo could be tasked with rounding up the unvaccinated and ordering them into the Protection Camps. If that’s too big a task for one person, Cuomo could be in charge of outreach to young unvaccinated women.

Loosely related… a fixer-upper in Bodie, California, in the same dry Eastern Sierra environment as Manzanar.

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Envy in the Home Depot parking lot

In prep for our move to the Florida Free State, we stopped at Home Depot in Waltham, Maskachusetts to pick up some packing supplies and a trash barrel (out of stock, of course, like everything else in the U.S. economy).

Here’s a rare situation in which the owner of a Ferrari 458 Italia would have to be envious regarding our Honda minivan:

(And what do they sell at Home Depot that would fit into a Ferrari?)

Readers: What do you think about the yellow brake calipers? Has this trend run its course, so to speak? Why can’t wheels be wheels, including everything that is part of the wheels? Why do they have to be part of the body?

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COVID-19 is sure to kill you, but life insurance rates haven’t changed

I’m preparing to teach a class at Florida Atlantic University and one of my talking points will be “look at insurance rates if you want to understand the risk of data loss.” In other words, a risk cannot be unquantifiable if there are insurance companies willing to sell coverage for that risk.

Then it occurred to me that we could calibrate our level of coronapanic to what insurance companies are doing. The media informs us that life expectancy has plummeted in the United States. Healthy young people are being felled by the mighty Delta variant and it is urgent for them to get vaccinated (so that the headline can read “Healthy young vaccinated person killed by COVID-19″? See “Nearly 60% of hospitalized COVID-19 patients in Israel fully vaccinated”).

Insurance companies do have a health screening procedure for their larger policies, e.g., trying to exclude those with heart conditions, morbid obesity, etc. If COVID-19 is a significant risk for those the insurance companies consider “healthy” then rates have surely gone up, right?

“Has COVID-19 made life insurance more expensive? These researchers say they have the answer” (MarketWatch, December 2020):

The coronavirus pandemic has produced grim numbers that keep rising, like case counts, hospitalization rates and deaths.

But there’s [one] that hasn’t increased this year: the cost of life insurance.

“We find limited evidence that life insurance companies increased premiums or decreased policy offerings due to COVID-19,” researchers said Monday in a study analyzing more than 800,000 life insurance-policy quotes from almost 100 companies between 2014 and October 2020.

University of Kentucky and Illinois State University economists did discover fewer policies being extended to the oldest of potential policyholders, above age 75. But even then, the cost of those premiums did not noticeably increase.

How are we able to sustain our high level of panic if the insurance companies aren’t adjusting their rates?

Related:

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Knocking it out of the park with high-end audio

I stopped by Goodwin’s High End, an audio store that has been going reasonably strong since 1977. Coronapanic has been great for business. Governors helpfully locked people into their homes where they had little else to do other than seek maximum sound quality. “We have customers in all 50 states now,” said Alan Goodwin.

What’s state of the art in turntables these days? A $120,000 Basis:

What if you want to listen to digital? You download, maybe from hdtracks.com, to a local specialized server and connect that to a microwave-sized D/A converter:

Streaming is generally best for browsing rather than critical listening, but if you must stream, Tidal and Qobuz are reasonable options.

Electrostatic speakers are no longer in. It is all about dynamic speakers, individually priced only slightly more than a new car.

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Islam is more powerful than Rainbow Flagism?

An Islamic army has beaten the U.S. military’s proxy force in Afghanistan. The embassy that flew a rainbow flag in June was overrun in August. The U.S. military is nominally secular, but its focus for the past 10 years has been on all things LGBTQIA+ (See “Obama hails end of U.S. military restrictions on gays,” Reuters 2011, for example, and “With Transgender Military Ban Lifted, Obama Cements Historic LGBT Rights Legacy,” NBC 2016).

Given the enormous asymmetry in equipment and funding and the stunningly rapid victory of the Muslim faithful armed with basic rifles, is it now fair to say that Islam is more powerful than America’s current state religion?

Is Rainbow Flagism truly our military’s official religion? The U.S. Air Force:

Our Navy, in 2017:

Seventeen days later, they proudly rammed a cargo ship with a $1.8 billion destroyer and, two months later, smashed a different destroyer into a tanker.

Our Army:

(Trump had a West Point graduate and then a former Army Ranger in the role of Secretary of the Army; Biden appointed someone who had never served in the U.S. military.)

Recruiting new soldiers under the rainbow flag:

Separately, why was it only LGBTI that was celebrated by the U.S. Embassy Kabul? Why not LGBTQIA+?

Perhaps the above post is too negative. Maybe we should say that we’re proud of having spent 20 years and $4 trillion (counting PTSD disability pensions to veterans and all of the welfare that will need to be paid out to Afghan immigrants and their descendants) to transform a nation. When we started the war, Afghanistan was being governed by the Taliban. Now that two decades of war are over and we have run away, the Taliban are governing Afghanistan.

Related:

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Incentives and Coronapanic

In response to Recycle Chinese and Soviet anti-landlord propaganda to bolster support for Rochelle Walensky’s rent moratorium order?, Mitch wrote:

So getting vaccinated and slowing the spread increases one’s chance of having to pay rent. The incentives are not well aligned.

(The government says nobody has to pay rent in an area where COVID-19 transmission is occurring (90 percent of current renters covered). And they say that getting the vaccine will stop transmission (except that it doesn’t, according to the same government). Thus, it would be financially irrational for a community of renters to get vaccinated.)

“New Rule Raises Question: Who’ll Pay for All the Covid Tests?” (NYT) also raises a question of how people will respond to economic incentives:

Among the employers taking a different approach is Rhodes College in Tennessee: It will require unvaccinated students without a medical or religious exemption to pay a $1,500 fee per semester to cover the costs associated with a weekly coronavirus testing program.

To avoid paying $3,000 per year, in other words, an unvaccinated student need only get some card stock to feed into a laser printer and create his/her/zir/their own vaccination record. HIPAA would prevent the school from calling whatever “healthcare professional or clinic site” is written down on the record, right? In any case, on my CDC card, the clinic site information does not contain the full city/state nor any contact info. A college would have to be very motivated indeed to try to determine whether a vaccination card is genuine. The vaxyes service checks the lot number against the date of administration, but presumably this would also check out fine if the student copied the information from a virtuous friend who actually got the shots:

An initial review to ensure a match personal identification and vaccine card, vaccine dates make sense, lot numbers, and possible fraud markers.

If colleges want the unvirtuous to admit their thoughtcrime and unreasonable resistance to government pressure, wouldn’t it be smarter to offer the testing at no charge? Then the only incentive to forge a vaccine card would be avoiding the inconvenience and discomfort of weekly testing, not $3,000 in cash on top of that.

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How the Taliban can fund and run Afghanistan forever

“The Taliban Have Claimed Afghanistan’s Real Economic Prize” (NYT):

How exactly the Taliban plan to keep all systems running, in one of the poorest countries of the world that depends on more than $4 billion a year in official aid and where foreign donors have been covering 75 percent of government spending, is an urgent question. The state’s bankruptcy has tempted some Western donors into thinking that financial pressure — in the form of threats to withhold humanitarian and development funding — could be brought to bear on the new rulers of Afghanistan. Germany already warned it would cut off financial support to the country if the Taliban “introduce Shariah law.”

But those hopes are misplaced. Even before their blitz into the capital over the weekend, the Taliban had claimed the country’s real economic prize: the trade routes — comprising highways, bridges and footpaths — that serve as strategic choke points for trade across South Asia. With their hands on these highly profitable revenue sources and with neighboring countries, like China and Pakistan, willing to do business, the Taliban are surprisingly insulated from the decisions of international donors. What comes next in the country is uncertain — but it’s likely to unfold without a meaningful exertion of Western power.

One reason foreign donors inflate their own importance in Afghanistan is that they do not understand the informal economy, and the vast amounts of hidden money in the war zone. Trafficking in opium, hashish, methamphetamines and other narcotics is not the biggest kind of trade that happens off the books: The real money comes from the illegal movement of ordinary goods, like fuel and consumer imports. In size and sum, the informal economy dwarfs international aid.

For example, our study of the border province of Nimruz, published this month by the Overseas Development Institute, estimated that informal taxation — the collection of fees by armed personnel to allow safe passage of goods — raised about $235 million annually for the Taliban and pro-government figures. By contrast, the province received less than $20 million a year in foreign aid.

In other words, Afghanistan is in some ways like a super filthy version of Switzerland.

Also interesting, Antonio Garcia Martinez on recent events:

… the cream of American society and the flower of its finest universities, can only understand the world as projections of the country’s own domestic neuroses. Our current elites, whether in media or politics, squint at the strange peoples and languages of whatever international conflict and only see who or what they can map to their internal gallery of heroes and villains: Who’s the PoC? Who’s the Nazi?

And if the situation can’t be mapped, such as Afghanistan or the recent protests in Cuba, it’s utterly ignored for being just completely beyond human comprehension or concern.

This is the true privilege of being an American in 2021 (vs. 1981): Enjoying an imperium so broad and blinding, you’re never made to suffer the limits of your understanding or re-assess your assumptions about a world that, even now, contains regions and peoples and governments antithetical to everything you stand for. If you fight demons, they’re entirely demons of your own creation, whether Cambridge Analytica or QAnon or the ‘insurrection’ or supposed electoral fraud or any of a host of bogeymen, and you get to tweet #resist while not dangling from the side of an airplane or risking your life on a raft to escape.

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Archival properties of CD-ROMs after 20 years

As part of the move from Maskachusetts to the Florida Free State, I decided to dispose of all of the CD-ROMs that were lying around in the garage and hangar. These contained backups of long-discarded PCs, 600 MB drum scans that I previously considered too large to maintain on an NAS or local drive, etc.

Despite the crummy storage conditions (temps ranging from 0 degrees to 100 degrees F and high humidity at times), only 2 out of nearly 100 CD-ROMs were problematic for reading with the $75 ASUS Blu-ray burner purchased in 2015 as part of a new PC build. (Would all of you cryptominers please let me know when you’ve stopped so that I can refresh this 6.5-year-old machine?)

Among the scans, I found this one of an early coronascientist:

Here’s a Fuji 617 slide of an oil refinery in Benicia, California:

Check out the detail:

Not bad for old tech and a single image rather than stitched-together multiples!

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