Health Care Justice

On this day:
180
Twelve inhabitants of Scillium in North Africa are executed for being Christians. This is the earliest record of Christianity in that part of the world.
1762
Catherine II becomes tsar of Russia upon the murder of Peter III of Russia.
1791
Members of the French National Guard under the command of General Lafayette open fire on a crowd of radical Jacobins at the Champ de Mars, Paris, during the French Revolution, killing as many as 50 people.
1794
The sixteen Carmelite Martyrs of Compiegne are executed 10 days prior to the end of the French Revolution’s Reign of Terror.
1918
On the orders of the Bolshevik Party carried out by Cheka, Tsar Nicholas II of Russia and his immediate family and retainers are murdered at the Ipatiev House in Ekaterinburg, Russia.
1918
The RMS Carpathia, the ship that rescued the 705 survivors from the RMS Titanic, is sunk off Ireland by the German SMU U-55; 5 lives are lost.
1936
Spanish Civil War: An Armed Forces rebellion against the recently-elected leftist Popular Front government of Spain starts the civil war.
1938
Douglas Corrigan takes off from Brooklyn to fly the “wrong way” to Ireland and becomes known as “Wrong Way” Corrigan.
1989
First flight of the B-2 Spirit Stealth Bomber.
1996
TWA Flight 800: Off the coast of Long Island, New York, a Paris-bound TWA Boeing 747 explodes, killing all 230 on board.
1998
A diplomatic conference adopts the Rome Statute of the International Criminal Court, establishing a permanent international court to prosecute individuals for genocide, crimes against humanity, war crimes, and the crime of aggression. 

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The creation of the ICC (above), lauded by many for its supposed good intentions, is a genuine, Old World artifact.

In this particularly non-American event, self-appointed people appointed unelected bureaucrats to exert power over others, like colonizers.

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Is Mamdani really a national story? Should national figures really meet with him?

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At what point do presidential executive orders become abusive?

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Can you give up Intifada, like chocolates for Lent?

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Can the President of the United States delegate executive and pardoning power?

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The White House aides are taking the Fifth. The White House aides are taking the Fifth!

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"For CIA veterans, what truly shocked their conscience was Trump‘s cold betrayal of Ukraine and his open embrace of Russia.

For a decade, American spies, politicians, citizens, and journalists had wondered aloud about the president’s affinity for Putin. Was Trump really his useful idiot? Could the Russians have something on him? Was it conceivable that he had been recruited? Or had he recruited himself? Was it simply that he liked Putin because he wanted to be like Putin – an autocrat with absolute power? It had been a mystery.

But now the answer was apparent, as clear as a bolt of lightning. Trump wasn’t Putin’s agent. He was his ally. The president of the United States had gone over to the other side."--from Weiner's "The Mission"

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Health Care Justice

From a Megan McArdle article in the WashPo:

In more than 20 years of covering policy, I have witnessed some crazy stuff. But one episode towers above the rest in sheer lunacy: the November 2020 meeting of the CDC’s Advisory Committee on Immunization Practices. Sounds boring? Usually, maybe.

But that meeting was when the committee’s eminent experts, having considered a range of vaccine rollout strategies, selected the plan that was projected to kill the most people and had the least public support.

In a survey conducted in August 2020, most Americans said that as soon as health-care workers were inoculated with the coronavirus vaccine, we should have started vaccinating the highest-risk groups in order of their vulnerability: seniors first, then immunocompromised people, then other essential workers. Instead of adopting this sensible plan, the Centers for Disease Control and Prevention advisory committee decided to inoculate essential workers ahead of seniors, even though its own modeling suggested this would increase deaths by up to 7 percent.

…Why did they do this? Social justice. The word “equity” came up over and over in the discussion — essential workers, you see, were more likely than seniors to come from “marginalized communities.” Only after a backlash did sanity prevail.

…That 2020 committee meeting was one of many widely publicized mistakes that turned conservatives against public health authorities. It wasn’t the worst such mistake — that honor belongs to the time public health experts issued a special lockdown exemption for George Floyd protesters. And of course, President Donald Trump deserves a “worst supporting actor” award for turning on his own public health experts. But if you were a conservative convinced that “public health” was a conspiracy of elites who cared more about progressive ideology than saving lives — well, there was our crack team of vaccine experts, proudly proclaiming that they cared more about progressive ideology than saving lives.

This is one of the reasons we now have a health and human services secretary who has devoted much of his life to pushing quack anti-vaccine theories.

Nursing Homes and EVs

There is no guarantee that those who implement a policy are trustworthy or effective or that they are impervious to the temptations associated with power. Nor is there any reason to believe that they will choose the means that best serve the articulated goals of the group instead of the means that best serve their private goals.--Levy

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Sustained prosperity, as distinct from occasional windfalls, owes little or nothing to natural resources: witness West Germany, Switzerland, Japan, Singapore, Hong Kong, and Taiwan. The wide differences in economic performance between individuals and groups in the same country with access to the same natural resources throw into relief the personal and cultural differences behind economic achievement.--Bauer

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While media coverage tends to hype the benefits of climate policy, it plays down the costs, which Mr. [Richard] Tol’s analysis shows are substantial. Based on the latest cost estimates of emission reductions from the United Nations climate panel, he finds that fully delivering on the 1.5-degree Paris promise will cost 4.5% of global GDP each year by midcentury and 5.5% by 2100. This means that likely climate policy costs will be much higher than the likely benefits for every year throughout this century and into the next. Under any realistic assumptions, the Paris agreement fails a basic cost-benefit test.--Lomberg

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Nursing Homes and EVs

A new rule proposed by the Centers for Medicare and Medicaid Services (CMS) seeks to radically increase federally mandated staffing levels in nursing homes in two ways. First, the rule, if finalized, would require every nursing home in the nation to have an RN on-site at all times, which is much more than the current requirement of eight hours daily, five days weekly. It would separately impose new minimum staffing ratios, requiring a certain number of RNs and CNAs per resident per day.

Not even half of the nation’s nearly 15,000 nursing homes are currently staffed at the level required by the proposed rule, as facilities across the nation are contending with a workforce shortage.

The nursing home workforce has declined by 12 percent since the start of the COVID-19 pandemic. Since President Biden took office in 2021, inflation is up more than 17 percent and labor costs for nursing homes are now 22 percent higher than they were at the start of 2020. Yet CMS expects nursing homes to find an additional 3,267 RNs to satisfy the 24/7 RN part of the rule. This would cost nursing homes $349 million per year and would increase annual costs for residents by almost $2,180.

To meet the rule’s minimum staffing ratio requirement, an additional 12,639 RNs and 76,376 CNAs would be needed nationwide, costing nursing homes $4.2 billion per year at an average cost of $13.24 per resident per day. So, implementing the two parts of this rule would require upwards of 15,000 new RNs, plus more than 76,000 CNAs.

This assumes those nurses are there, and there is no evidence they are. This promises shortages, closures, and deprivation, all in a good cause.

If you are reminded of EVs, you are right.

PTSD

Netflix has a new documentary on Blue Zones, regions in the world such as Okinawa Prefecture, Japan; Nuoro Province, Sardinia, Italy; the Nicoya Peninsula, Costa Rica; Icaria, Greece; and Loma Linda, California, where people appear to live “extraordinarily long and vibrant lives.” What are the secrets of such blue zones and how can you live to be 100?
One explanation is that remarkable age records result, not from better health or greater longevity, but from the historical accumulation of illiteracy-driven errors and the modern dynamics of poverty-driven fraud.


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Will on China's Leninism.

Such a state has, however, two incurable defects: All policies are subordinate to the primary objective of maintaining the party’s dominance. And the party incubates society’s elites, who insinuate themselves everywhere into allocating wealth and opportunity. Absent market signals, this produces cascading inefficiencies in the allocation of society’s human and material resources.

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Public restrooms are being added Downtown as part of what officials are calling the Pittsburgh Potty Initiative. They are also calling outhouses 'restrooms.' 

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PTSD

From the NIMH.

"Anyone can develop PTSD at any age. This includes combat veterans and people who have experienced or witnessed a physical or sexual assault, abuse, an accident, a disaster, a terror attack, or other serious events. People who have PTSD may feel stressed or frightened, even when they are no longer in danger.

Not everyone with PTSD has been through a dangerous event. Sometimes, learning that a relative or close friend experienced trauma can cause PTSD.

About 6 of every 100 people will experience PTSD at some point in their lifetime, according to the National Center for PTSD, a U.S. Department of Veterans Affairs program. Women are more likely than men to develop PTSD. Certain aspects of the traumatic event and biological factors (such as genes) may make some people more likely to develop PTSD.
What are the symptoms of PTSD?

Symptoms of PTSD usually begin within 3 months of the traumatic event, but they sometimes emerge later. To meet the criteria for PTSD, a person must have symptoms for longer than 1 month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The symptoms also must be unrelated to medication, substance use, or other illness.

The course of the disorder varies. Although some people recover within 6 months, others have symptoms that last for 1 year or longer. People with PTSD often have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders.

After a dangerous event, it is natural to have some symptoms. For example, some people may feel detached from the experience, as though they are observing things as an outsider rather than experiencing them. A mental health professional—such as a psychiatrist, psychologist, or clinical social worker—can determine whether symptoms meet the criteria for PTSD.

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:At least one re-experiencing symptom
At least one avoidance symptom
At least two arousal and reactivity symptoms
At least two cognition and mood symptoms
Re-experiencing symptomsFlashbacks—reliving the traumatic event, including physical symptoms, such as a racing heart or sweating
Recurring memories or dreams related to the event
Distressing thoughts
Physical signs of stress

Thoughts and feelings can trigger these symptoms, as can words, objects, or situations that are reminders of the event.

Avoidance symptoms:

Staying away from places, events, or objects that are reminders of the experience
Avoiding thoughts or feelings related to the traumatic event

Avoidance symptoms may cause people to change their routines. For example, some people may avoid driving or riding in a car after a serious car accident.

Arousal and reactivity symptoms:

Being easily startled
Feeling tense, on guard, or on edge
Having difficulty concentrating
Having difficulty falling asleep or staying asleep
Feeling irritable and having angry or aggressive outbursts
Engaging in risky, reckless, or destructive behavior

Arousal symptoms are often constant. They can lead to feelings of stress and anger and may interfere with parts of daily life, such as sleeping, eating, or concentrating.
Cognition and mood symptomsTrouble remembering key features of the traumatic event
Negative thoughts about oneself or the world
Exaggerated feelings of blame directed toward oneself or others
Ongoing negative emotions, such as fear, anger, guilt, or shame
Loss of interest in previous activities
Feelings of social isolation
Difficulty feeling positive emotions, such as happiness or satisfaction

Cognition and mood symptoms can begin or worsen after the traumatic event. They can lead people to feel detached from friends or family members."

Now the question: Does this look familiar? Does the U.S. have PTSD?

NHS

The Kremlin dismissed Boris Johnson’s claim that Russian President Vladimir Putin threatened him with a missile strike.

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An increase in the minimum retirement age to 64 from the current 62 is part of a flagship reform package pushed by President Emmanuel Macron to ensure the future financing of France's pensions system.

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AlphaZero was set up in late 2017. Almost immediately, it began training by playing hundreds of millions of games of chess against itself. After about four hours, it was the best chess-playing entity that ever had been created. The lesson of this story: Under the right conditions, AI can improve very, very quickly.

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NHS 

The NHS is getting slow but persistent criticism, as are many of the government--run health care systems in Europe.

In December, as many as 500 patients per week were dying in Britain because of E.R. waits, according to the Royal College of Emergency Medicine, a figure rivaling (and perhaps surpassing) the death toll from Covid-19. On average, English ambulances were taking an hour and a half to respond to stroke and heart-attack calls, compared with a target time of 18 minutes; nationwide, 10 times as many patients spent more than four hours waiting in emergency rooms as did in 2011. The waiting list for scheduled treatments recently passed seven million — more than 10 percent of the country — prompting nurses to strike. The National Health Service has been in crisis for years, but over the holidays, as wait times spiked, the crisis moved to the very center of a narrative of national decline.

Some Ukrainian refugees in the UK are returning back home to get medical care.

[Thiel] has described British people’s affection for the state-backed health service as “Stockholm syndrome.”

The venture capitalist’s comments came during a Q&A session after a speech at the Oxford Union, a 200-year-old debating society, on Monday. He also said that the crisis-stricken health service, currently grappling with strikes and long wait times for emergency care, was making people sick and needs “market mechanisms” to fix it. Such mechanisms include privatizing parts of it, avoiding rationing and loosening regulations…

“In theory, you just rip the whole thing from the ground and start over,” Thiel said after an address in which he argued that a perceived fear of disruption was holding back technological and scientific developments. “In practice, you have to somehow make it all backwards-compatible in all these ridiculous British ways.”

The first step to fixing the NHS was, he said, to break away from the view that it is “the most wonderful thing in the world” and understand it as an “iatrogenic” institution, which means it makes people sick.

Our Pandemic Response Model

“Fallacies do not cease to be fallacies because they become fashions.” ― G.K. Chesterton

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The American Board of Internal Medicine (ABIM) recently voted to remove Dr. Peter McCullough, one of the nation’s leading cardiologists, from his certifications in cardiovascular disease. Mr. McCullough’s sin had nothing to do with his performance in caring for patients, but rather with questioning the necessity of the COVID-19 vaccine for younger populations.

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By the 2030s, the world will generate around a yottabyte of data per year — that’s 10 to the 24th bytes, or the amount that would fit on DVDs stacked all the way to Mars.

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Caplan on Magness’s and Michael Makovi’s thesis that Karl Marx’s prominence is due chiefly to the fact that his name was used in a successful coup by totalitarians in 1917:
To speak plainly, academics after 1917 tacitly applied a “might makes right” or at least a “might makes credible” heuristic. When Marx’s followers were an inbred cult, academics treated them like an inbred cult. Once they took over a major country, however, academia “reassessed.” Predictably, they found that the only philosopher whose adherents ruled a country was actually worth reading on his merits.

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There are more than 3,000 federal crimes and an estimated 300,000-plus federal regulations that can be enforced by agencies empowered to seek criminal punishments.

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Our Pandemic Response Model

Nothing is easy. And everything is interconnected. Even failure has a legacy.

Here is Jay Bhattacharya on Biden’s pandemic 'plan:’

'The Biden plan enshrines former president Donald Trump‘s Operation Warp Speed as the model response to the next century of pandemics. Left unsaid is that, for the new pandemic plan to work as envisioned, it will require us to conduct dangerous gain-of-function research. It will also require cutting corners in the evaluation of the safety and efficacy of novel vaccines. And while the studies are underway, politicians will face tremendous pressure to impose draconian lockdowns to keep the population “safe.”

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This policy effectively guarantees that lockdowns will return to the U.S. in the event of a new pandemic. Though the lockdowns did not work to protect populations from getting or spreading COVID—after 2.5 years, nearly everyone in the U.S. has had COVID—public health bureaucracies like the CDC have not repudiated the strategy. Imagine the early days of the next pandemic, with public health and the media fomenting fear of a new pathogen. The impetus to close schools, businesses, churches, beaches, and parks will be irresistible, though the pitch will be “130 days until the vax” rather than “two weeks to flatten the curve.”'

It should be remembered that these programs so decried by the Right were initiated by Trump.

The Future of Health Insurance?

The midterm elections indicate that a growing number of voters seem inclined to make cool-eyed calculations as unenthralled adults: Do not seek the best imaginable political outcome; seek instead to avoid the worst.--Will

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Michael Gerson, a neo-con political advisor--especially for Bush, speechwriter, evangelical Christian, and editorial writer for the WashPo has died of kidney cancer. A controversial guy. In October 2017, Gerson referred to President Trump's "fundamental unfitness for high office" and asked whether he is "psychologically and morally equipped to be president? And could his unfitness cause permanent damage to the country?" He cited "the leaked cries for help coming from within the administration. They reveal a president raging against enemies, obsessed by slights, deeply uninformed and incurious, unable to focus, and subject to destructive whims"

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The New York Post buried Trump's 2024 campaign launch on page 26: "Florida Man Makes Announcement."

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Amazon.com Inc on Tuesday launched Amazon clinic, a virtual platform where users can connect with healthcare providers to help treat common ailments like allergies and skin conditions.

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...he thought that monopolists are “like *Incubusses* (who) doe suck the very vital spirits, and drive into one vein that masse of blood which should cherish the whole body.” Those who were excluded from membership in this fraternity and those who had to bear the increased costs caused by monopoly, were forced to suffer “a kind of slavery upon him in his own country” which Thomas Johnson wanted to see abolished as soon as possible.--Thomas Johnson (1645) reviewed by Hart

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The Future of Health Insurance?

Things change, sometimes for good reason. Except for health care. Everyone knows that single-payer systems are best. And inevitable. All roads lead to single-payer.

But here is another view.

In 2000, around 100,000 Swedes had private health insurance. Today, there are seven times as many, in a country of 10 million people. In 60% of cases, the insurance is paid for by the employer. According to the Swedish insurers’ organization Svensk Försäkring, the rate can vary from 300 to 600 crowns on average per month. For those dealing with health problems, the advantages are quicker consultations and avoiding long waiting lines.

Single-payer systems are failing.

Single-payer’s magic has historically worked via just a few channels:
1. Some amount of monopsony allows the government to bid down medical services below market rates.
2. Political imperatives lead to lower training burdens, lower staffing ratios, and lower certainty in diagnosis and treatment.
3. Obfuscation of possible alternatives diminishes demand for costlier care.

The author (Cowen) concludes that the demographics of the modern West are simply growing and changing too fast to allow for economic management by single payors.

Returning to Covid

Returning to Covid

From an article by Topol who is very discouraged by the government's response to Covid. He supports the Chinese position of Zero Covid Deaths, taking a moral rather than scientific high ground. It's an interesting thought process, assembling points to create a collage, then vaulting to a program. Unsettling.

"Prior to Omicron we could, with a booster, assume there was well over 90-95% vaccine effectiveness vs severe disease. It is clear, however, from multiple reports, including the UK Health Security Agency and Kaiser Permanente that this level of protection has declined to approximately 80%, particularly taking account the more rapid waning than previously seen.

...we have a highly unfavorable picture of: (1) accelerated evolution of the virus; (2) increased immune escape of new variants; (2) progressively higher transmissibility and infectiousness; (4) substantially less protection from transmission by vaccines and boosters; (5) some reduction on vaccine/booster protection against hospitalization and death; (6) high vulnerability from infection-acquired immunity only; and (7) likelihood of more noxious new variants in the months ahead

During the Delta wave in the United States, vaccinated individuals accounted for 23 per cent of the deaths, whereas this nearly doubled to 42 per cent during the Omicron wave. This is attributable to waning of protection, lack of boosters, and the diminished protection against Omicron (BA.1).

...we should adopt the new policy of Zero Covid Deaths. This is diametrically opposed to Covid capitulation. This builds, in part, on the tools that we already have, knowing that the vast majority of deaths occur in people age 60 plus (92% of US hospitalizations have been in people age 50+). All such people need to have vaccination and booster coverage but our CDC has failed to convey their life-saving impact from the get go, a veritable booster botch job as recently reviewed by Kaiser Health News. That’s why we have 31% of Americans who had had 1 booster shot whereas most peer countries are double that proportion. And why we rank 60th in the world’s countries for boosters, and especially poorly among older Americans compared (<65%, age 60+) with many Western Europe and Asian Pacific countries (~85-90%). That doesn't even speak to the need for a 4th dose in this high-risk group or that lack of intensive monitoring of our 7 million immunocompromised people who are not getting help to guide their protection with assay of neutralizing antibodies, or receiving Evusheld monoclonal antibody preventive protection. But well beyond the use of boosters and vaccines, and easy, rapid access to Paxlovid, we absolutely need an aggressive stance to get ahead of the virus—for the first time since the pandemic began—instead of surrendering. That means setting priorities, funding, and the realization, unfortunately, that the pandemic is far from over. Our Covid vaccines and medications are an order of magnitude more effective than what we have for influenza, but even our current level of deaths (we have already had over 175,000 Covid deaths in 2022), no less what may be in store, is still >10-fold in excess of seasonal flu (about 30,000 per year). That is totally unacceptable, nearly totally preventable loss of lives at scale."

CDC, not OK (WSJ)

CDC, not OK (WSJ)

From the WSJ on the CDC:

One problem is that bureaucracies always seek to expand their power and reach, often at the expense of their core mission. The CDC is no exception as it has sought to address social and environmental issues that are better left to the states or other agencies. Meantime, it has failed in its core responsibility, which is to track diseases, collect data to inform decision-making, and deploy resources to support local public-health responses.

At the start of the pandemic when public officials were blind to the virus spread, CDC employees failed to follow standard lab operating procedures and contaminated Covid tests. Even after the agency realized its blunders, it refused to share virus samples with private commercial labs to help develop and deploy tests.

Dr. Walensky now plans to make the agency more “action-oriented.” But the CDC’s problem isn’t inaction. It has taken wrong and often counter-productive actions, including support for lockdowns and other government coercion. 

As our contributor Scott Gottlieb explained in his book “Uncontrolled Spread,” agency scientists took a proprietary interest in their intellectual property: “Companies seeking to make the test kits described extended negotiations with the CDC that stretched for weeks as the agency made sure that the contracts protected its inventions.”

This culture of control has hamstrung the CDC’s response in other ways. During the early months of pandemic, the CDC struggled to set up technical systems to analyze and share data. Some hospitals had to fax in information. Frustrated by the CDC’s pace, Health and Humans Services Department leaders seized control of the Covid data in summer 2020.

Democrats accused the Trump Administration of politicizing the CDC, but HHS’s seizure made data more transparent. The CDC now posts more Covid data, but often late and it omits critical information. Instead of publishing raw data for outside scientists to analyze, the CDC often only releases studies that support its policies, such as mask mandates.

Politics drives many CDC decisions, including one last spring not to collect information on breakthrough Covid cases lest this show declining vaccine efficacy. Its school reopening guidance was written in part by American Federation of Teachers chief Randi Weingarten

Most egregious was its eviction moratorium. The eviction ban was first imposed under Donald Trump, but the Biden Administration repeatedly extended it based on dubious science that purported to show it reduced the virus spread. The Supreme Court eventually ruled it illegal. The CDC’s usurpation of Congress and states continued with its illegal mask mandate on public transportation, also based on thin science.

The agency’s public guidance is often confusing. But the larger problem is that its recommendations are seemingly arbitrary and don’t acknowledge scientific uncertainty. The agency has also been slow to adjust its guidance. Last spring it was still advising the unvaccinated to wear masks outdoors.

While failing at its core responsibility, the CDC has stretched its powers and mission. Consider a CDC study in May, which attributed increased gun violence in 2020 among young, black men in part to “longstanding systemic inequities and structural racism.” Its suggested remedy: More government transfer payments.

Ms. Walensky commissioned a review of her agency in the spring, and it’s ironic that she hasn’t made it public since one criticism is the CDC’s lack of transparency. Instead she has released boiler-plate recommendations such as “promote results-based partnerships,” “translate science into practical, easy to understand policy,” and “prioritize public health communications.”

More spending is Dr. Walensky’s other proposed remedy. The agency received a 7% raise this year, but she wants more for a new office of “equity” to increase workforce diversity and improve communications with minority groups. Isn’t that what the CDC’s Office of Equal Employment Opportunity and Office of the Associate Director for Communication already do?

It’s hard to believe the U.S. would have handled Covid worse if the CDC didn’t exist. The agency needs to shrink and focus on its central mission: Tracking and helping to stop disease.

Monkeypox

 Monkeypox

The World Health Organization has activated its highest alert level for the growing monkeypox outbreak, declaring the virus a public health emergency of international concern.

More than 16,000 cases of monkeypox have been reported across more than 70 countries so far this year, and the number of confirmed infections rose 77% from late June through early July, according to WHO data. Men who have sex with men are currently at highest risk of infection.

Europe is currently the global epicenter of the outbreak, reporting more than 80% of confirmed infections worldwide in 2022. The U.S. has reported more than 2,500 monkeypox cases so far across 44 states, Washington, D.C., and Puerto Rico.

In contrast to Covid-19, monkeypox is not a new virus. Scientists first discovered monkeypox in 1958 in captive monkeys used for research in Denmark, and confirmed the first case of a human infected with the virus in 1970 in the nation of Zaire, now called the Democratic Republic of the Congo.

Monkeypox is primarily spreading through skin-to-skin contact during sex. Men who have sex with men are at the highest risk right now, as the majority of transmission has occurred in the gay community. However, the WHO and the CDC have emphasized that anyone can catch monkeypox regardless of sexual orientation. Does this sound familiar?

Lewis, the WHO’s monkeypox expert, said 99% of cases reported outside Africa are among men and 98% of infections are among men who have sex with men, primarily those who have had multiple, recent anonymous or new sexual partners. The virus has been detected outside the gay community, but transmission has been low so far. The CDC confirmed monkeypox in two children on Friday.

The WHO and CDC have repeatedly warned against stigmatizing gay and bisexual men, while at the same time stressing the importance of communicating the reality of how the virus is currently spreading so people in communities at highest risk can take action to protect their health. Does this sound familiar?

Although monkeypox can spread through respiratory droplets, that method requires prolonged face-to-face interaction, according to the CDC. Health officials do not believe monkeypox is spreading through small aerosol particles like Covid. 

Monkeypox is in the same virus family as smallpox, though it causes milder disease.

Five deaths from the virus have been reported in Africa this year. No deaths have been reported outside Africa so far. Wait. What?

Some Vaccines in History

Some Vaccines in History

2003

December 13, 2002, the president of the United States announced that smallpox vaccination would be offered to some categories of civilians and administered to members of the military and government representatives in high-risk areas of the world. The events that precipitated that historic announcement included a series of terrorist attacks during the 1990s, which culminated in the catastrophic events of 2001.

By July 25, 2003, the total number of civilian vaccinees was 38,004—far short of the 500,000 that had been given as a program target and still short of the 50,000 that CDC had suggested in GAO’s assessment (CDC, 2003c; GAO, 2003). A year later, on July 31, 2004, civilian vaccinations had reached a cumulative total of 39,579 (CDC, 2004c). Nearly 2 years after the beginning of the program, smallpox vaccination has all but come to a halt, with a mere handful of vaccinations each month.

Late March and early April 2003—Concerns about vaccine and program safety reach high point in response to reported fatal cardiac adverse events and cases of heart inflammation, known as myo/pericarditis.

April 2003—Smallpox vaccination compensation plan is enacted in response to widespread concern about vaccine-related injuries.

2005

Apr 29, 2005 (CIDRAP News) – In a recent study, some laboratory and public health workers who received smallpox shots reported several side effects that have not shown up in other studies, including joint and abdominal pain, backache, and breathing difficulty.

The side effects were reported by both first-time vaccinees and previously vaccinated workers but were more common in the first-time vaccinees, according to the report by James Baggs and colleagues at the Centers for Disease Control and Prevention (CDC) in Atlanta.

"As with recently described cardiac adverse events [following smallpox shots], our unexpected findings of increased proportions of subjects with joint pain, abdominal pain, backache, and difficulty breathing are suggestive of systemic involvement and warrant further study," says the report, published in the Apr 15 issue of Clinical Infectious Diseases.


 

 

Vaccine Fever

                                                                     Vaccine Fever

Why do people feel so strongly about vaccines? Vaccines are pretty well understood. Is it the incoherence of the policy? Like, for example:
Centner Academy in Florida told parents any student who gets vaccinated must quarantine for 30 days. That's because of a belief that vaccinated students can infect unvaccinated students, local radio reported. This is a school saying this.
An infectious disease expert characterized that belief as "science fiction."

This has become so irrational that there is a question in my mind as to whether or not incompetence is enough to explain it.

Now this:
Los Alamos National Laboratory soon will require its entire workforce to be vaccinated against COVID-19 under a new policy. It is said that scores of top scientists will leave rather than comply.

Now, if I told you that the Chinese had infiltrated the health care system for the purpose of taking advantage of American stubbornness and independence to undermine the culture and the science of the nation, would you think that remotely believable?

Fear and Trembling

 

                                          Fear and Trembling

The weird, zombified staggering West is now beginning to settle in to live with the Virus. The rationale for destroying the economies have mutated from protecting the hospitals to herd immunity to Lord knows what.  

What have we learned so far?

Well, the Virus is slippery and we know that there are not a lot of real specifics. But announcing all positive cultures regardless of the circumstances seems to be pretty good scare tactics. And the development of mutations in viruses, once thought to be a definition of the life form, has become a shocking revelation.

The politicians and their agents in the press now pursue us from pillar to post.

The End of the Curve

 

                             The End of the Curve

This is a good snippet from the WSJ:

"The novel coronavirus has caused suffering and heartbreak, particularly for older adults and their loved ones. But it also has a low mortality rate among most people and especially the young—estimated at 0.01% for people under 40—and therefore never posed a serious threat to social and economic institutions. Compassion and realism need not be enemies. But Covid mania crowded out reasoned and wise policy making.

Americans groaned when leaders first called for “two weeks to slow the spread” in March 2020. Months later, many of these same Americans hardly blinked when leaders declared that lockdowns should continue indefinitely. For months Covid had been elevated above all other problems in society. Over time new rules were written and new norms accepted.

Liberty has played a special role in U.S. history, fueling advances from independence to emancipation to the fight for equal rights for women and racial minorities. Unfortunately, Covid mania led many policy makers to treat liberty as a nuisance rather than a core American principle.

…..

Covid mania is also creating new conflicts over vaccine mandates. The same people who assured the public that a few weeks of lockdown would control the pandemic now argue that vaccinating children, for whom no vaccine has yet been approved, is essential to end the pandemic. Children account for less than 0.1% of Covid deaths in the U.S. Is enough known about vaccines to conclude that their benefits outweigh potential risks to children?

“Yes” is the answer of a salesman, not a scientist. Mandating a vaccine for children without knowing whether the benefits outweigh the risks is unethical. People who insist we should press on anyway, because variants will prolong the pandemic, should be reminded that a large reservoir of unvaccinated people in the U.S.—and in the world—will always exist. We cannot outrun the variants."--wsj

Underlying some of this "thinking" is "zero tolerance." But "zero tolerance" is a moral goal, not a scientific one. And increasingly we in this beleaguered land are forced to see the tiny minority--in this case the outlier in the tiny illness mortality rate among the young--as the more threatened norm.

Our Plagues are Just Starting

 

                                         

                   Our Plagues are Just Starting

Anyone watching the series "Wolf Hall," a terrific story with a benign handling of Wolsey and Cromwell, was probably jolted by the sudden deaths of Cromwell's wife and two daughters who awoke well one morning and died the next day, a cataclysmic illness of sudden and devastating consequences that, even now, has never been explained. It was a common story at the time. "The Sweating Sickness."

The "sweating sickness" first appeared around the time Thomas Cromwell, later chief minister to Henry VIII, was born, at the end of the dynastic Wars of the Roses, and there has been some debate concerning the possibility that it arrived with the invading army of the first Tudor king, Henry VII, in 1485.

By the time it disappeared in 1551 it had caused five devastating outbreaks. To observers on the other side of the Channel, whose countries had apparently remained miraculously untouched (though a later outbreak did spread to Calais), this disease was Sudor Anglicus, or the “English Sweat”.

Suggestions that have been made over the years include influenza, scarlet fever, anthrax, typhus or some SARS-like pulmonary enterovirus. All, however, have had some clinical or epidemiological aspect that  didn’t quite fit the description of the sweating sickness.

Then in 1993, an outbreak of a remarkably similar syndrome occurred among the Navajo people in the region of Gallup, New Mexico. This episode, known as the "Four Corners outbreak" after the region of the south-western USA in which it was located, turned the attention of sweating sickness investigators towards its causative agent: Sin Nombre virus. ("Without Name") Sin Nombre is a hantavirus, a member of a group of viruses that were mostly previously known in Europe for causing a kidney failure syndrome, and a cousin of several tropical fever viruses transmitted by biting insects. The new disease was given the name hantavirus pulmonary syndrome (HPS).

We know that the climate of Europe was becoming progressively colder from the late middle ages onwards. Perhaps some subtle change in rodent ecology made life harder for the virus. For instance, the Four Corners HPS outbreak was linked to the El Niño climatic oscillation.

If you aren't worried yet, you should be. There has been a scary mystery illness in history. The scary mystery illness is associated with heat; it disappeared with cooling. So, in our modern associative world, global warming might well result in the return of a scary disease, maybe the sweating sickness. And the sweating sickness is a disease that, while not understood at all, is scary. Warming. A mystery illness that is scary. 

Please don't let any government officials know about this. Especially the CDC or we'll have weeping public officials everywhere. And new, fierce, Chicken Little Legislation.

We'll probably all end up with the military quartered in our homes, just for  safety's sake.

Popular Covid Myths

 

                                               Popular Covid Myths

Magness on Facebook listing the popular mythological positions and beliefs about Covid. This raises the question, when does erroneous news become propaganda?

False beliefs about COVID that nonetheless have widespread adherence in the media, academia, and parts of the epidemiology profession:

- Large numbers of Americans refuse to wear masks (Reality: mask adoption has held steadily around 80% since July https://docs.cdn.yougov.com/cimt2pupbs/econToplines.pdf)

- Large numbers of Americans are skeptical of the vaccine (Reality: 75% of Americans indicate that they plan to take it in surveys - higher than most European countries https://www.nature.com/articles/s41591-020-1124-9/figures/1)

- Large percentages of Americans believe in conspiracy theories about COVID's origins or believe the virus is a hoax (Reality: most of these conspiracy theories only resonate among a tiny minority of the US population, which is about the same for most other countries https://docs.cdn.yougov.com/…/Globalism2020%20Guardian%20Co…)

- The reason the spring lockdowns failed is because not enough Americans followed directions and stayed home when they were told (Reality: US mobility patterns in the spring almost exactly matched Germany, the Netherlands, and several other middle-of-the-pack European countries https://www.aier.org/article/fact-checking-fauci/)

- The reason the spring lockdowns failed is because the US reopened too early (Reality: the US reopening was slower than almost every country in Europe except for the UK https://www.aier.org/…/did-the-us-lockdown-too-late-and-op…/)

- Trump opposed the lockdowns and ignored the epidemiology models (Reality: The federal government directly and explicitly adopted a policy based on Neil Ferguson's Imperial College model on 3/16. https://www.nature.com/articles/d41586-020-01003-6… Trump also specifically touted Ferguson's model and spent most of the year explicitly citing its projections to claim credit for lives it supposedly saved. 

https://www.aier.org/…/professor-lockdown-now-claims-to-ha…/)

- Trump sidelined Fauci in favor of the anti-lockdown recommendations of Scott Atlas (Reality: Fauci has repeatedly and publicly credited Trump for following his policy recommendations. 

https://www.huffpost.com/…/fauci-trump-listened_n_5f5815ffc… 

Atlas did not even join the task force until August, and was constantly outnumbered by the Fauci-Birx-Collins faction after he arrived)

- The fall lockdowns in the UK were secretly delayed due to the influence of Great Barrington Declaration co-author Sunetra Gupta over the Prime Minister (Reality: Gupta met with Downing Street at the urging of the anti-lockdown minority in the government, but was promptly ignored by Johnson and Matt Hancock. Many of the scientists who are now claiming the UK should have locked down in September or October were publicly stating at the time that lockdowns were off the table and a "strawman" 

https://www.aier.org/…/so-much-for-the-strawman-of-lockdow…/)

- The fall/winter surge of COVID is because we failed to lock down again (Reality: the largest and most severe fall/winter surge is in California, which also has one of the most restrictive fall lockdowns. 

https://www.politico.com/…/12/23/california-covid-surge-450…)

Reinfection

 

                                   Reinfection

Some info on re-infection, optimistic.

For months now, people have been watching closely to see if it’s possible to get re-infected with the coronavirus. It’s taken a while for the signal-to-noise to get better, but by now there’s no doubt that the answer is yes, it’s possible. We’ve just had the first of these in the US, a man in Nevada who was infected twice six weeks apart, with the second round being worse than the first. And in the Netherlands, the first fatality from a reinfection has been reported. All this sounds immediately like bad news, but I’m going to break out the same advice I was handing out yesterday: don’t panic.

Why not? Because from everything we can see, re-infection is a very rare event. The confirmed examples worldwide could possibly be counted on your fingers (depending on whose count you believe) out of at least 38 million total cases. Looking at the Netherlands case, this was an 89-year-old patient with Waldenström’s macroglobulinemia, a type of leukemia that affects two different varieties of B-cells. She was being treated with chemotherapy to impair. B-cell production, and was thus immune compromised, and the second infection occurred two days after her latest round of treatment.

in each of these cases, the unfortunate patients involved were infected by different variants of the coronavirus than they had the first time around. That’s pretty much what you have to show to be sure that it’s a real re-infection – otherwise you’d always wonder if the virus had just never really been cleared the first time. The first-round versus the second-round sequences show some real differences – not gigantic ones, but real. Second, these two second-round viruses were different from each other as well, so it’s not like some particular new supervirus is stomping around re-infecting people around the world. Third, in neither of these reports was it the widely publicized D614G strain coming back around the second time. That mutation really doesn’t figure into either of these cases at all, so watch out for anyone who’s mixing those stories together.

Fourth – and here’s where we start digging into some details – note that the mutations in both of these new re-infection cases have nothing to do with the Spike protein. There’s no change in the Spike in the Nevada sequences (they both had D614G), and the changes in the Netherlands sequences are conserved ones that don’t lead to changes in the protein in that region. Antibodies don’t care about genetic sequences; they respond to the eventual proteins that are displayed, and from what I can see, the Spike proteins of all of these strains are identical.

That’s important for several reasons. For one, the vaccines under development are all raising antibodies and T-cells to the Spike region. That was identified early on as the most promising antigen, building on the work during the SARS and MERS outbreaks. Note also this new paper, a thorough look at the various antibody fractions in patients who have recovered from coronavirus infection. The authors find that Spike-targeting neutralizing antibodies persist out to the limits of their study (five to seven months) while antibodies to the nucleocapsid region (N), which are also raised in most people by infection, disappear more quickly.

--From an article by Lowe

So, reinfection occurs. It is rare. It involves a mutation of the organism, not a reestablishment of the original organism and the areas of the organism being targeted by the current research does not mutate so the proposed therapies should still work.

Viral Stats

                                                             Viral Stats

One element of the Virus is how little we know about it. This has led to a remarkable acceptance of the most draconian measures because the possibilities, when broad, inspire fear and allow the implementation of any perceived solution. We are willing to kill a malaria-bearing mosquito with anything, even a hammer.

So far, about 79% of recorded Covid-19 deaths are among people age 65 and over, while people under age 35 account for just 1% of known deaths from the disease. Nearly a third of Covid-19 deaths has hit people who are at least 85 years old, death-certificate data from about 188,000 deaths, the latest available, show.

This elderly population was affected substantially in the springtime, when significant outbreaks hammered northeastern states like New York, New Jersey and Massachusetts and spread through nursing homes. Deaths connected to long-term-care facilities recently topped 81,000 and have consistently made up about 40% of all U.S. Covid-19 deaths, according to a Wall Street Journal tally of state and federal data.

Research suggests the virus kills about 0.6% of people it infects, but estimates vary widely and the rate varies significantly by age. This is far less than the death rate from other serious but less-widespread coronavirus infections—SARS and MERS, also known as Middle East respiratory syndrome—but about six times as deadly as the seasonal flu.

Accolades

                                       Accolades


These are difficult times and any optimism should be valued. Emergent Ventures from Mercatus Center and George Mason University has created prizes related to innovative approaches to The Virus. It should make everyone feel better--for the future if not the present. .Here is the list of winners:

1. Social leadership prize: Helen Chu and her team at the University of Washington.

Dr. Helen Y. Chu, an infectious disease expert in Seattle, knew that the United States did not have much time…

As luck would have it, Dr. Chu had a way to monitor the region. For months, as part of a research project into the flu, she and a team of researchers had been collecting nasal swabs from residents experiencing symptoms throughout the Puget Sound region.

To repurpose the tests for monitoring the coronavirus, they would need the support of state and federal officials. But nearly everywhere Dr. Chu turned, officials repeatedly rejected the idea, interviews and emails show, even as weeks crawled by and outbreaks emerged in countries outside of China, where the infection began.

By Feb. 25, Dr. Chu and her colleagues could not bear to wait any longer. They began performing coronavirus tests, without government approval.

What came back confirmed their worst fear. They quickly had a positive test from a local teenager with no recent travel history. The coronavirus had already established itself on American soil without anybody realizing it. (from nyt)

2. Data gathering and presentation prize: Avi Schiffmann

A self-taught computer maven from Seattle, Avi Schiffmann uses web scraping technology to accurately report on developing pandemic, while fighting misinformation and panic. He is seventeen.

3. Prize for good policy thinking: The Imperial College researchers, led by Neil Ferguson, an epidemiologist.

Neil and his team calculated numerically what the basic options and policy trade-offs were in the coronavirus space. Even those who disagree with parts of their model are using it as a basic framework for discussion.

4. Prize for rapid speedy response: Curative, Inc. (legal name Snap Genomics, based in Silicon Valley)

Originally a sepsis diagnostics company, they very rapidly repositioned their staff and laboratories to scale up COVID-19 testing. They also acted rapidly, early, and pro-actively to round up the necessary materials for such testing, and they are currently churning out a high number of usable test kits each day, with that number rising rapidly. The company is also working on identifying which are the individuals most like to spread the disease and getting them tested first.

Medicare For All

Has there ever in history been a multiracial democracy aside from America?

                                    Medicare For All

A Ms. Pipes is president, CEO and the Thomas W. Smith fellow in health care policy at the Pacific Research Institute. Her latest book is “False Premise, False Promise: The Disastrous Reality of Medicare for All” (Encounter 2020), which gives you an idea where her thinking lies. She wrote about Medicare for All recently.

A single-payer program would pay doctors at rates similar to Medicare reimbursement levels, already at least 25% less than private insurance pays, according to estimates by Charles Blahous of the Mercatus Center. Under the current legislative drafts of Medicare for All, government rates over the first decade would be 40% lower than those paid by private insurers.

That amounts to an enormous pay cut for doctors. U.S. physicians earned on average $313,000 in 2019, according to Medscape’s international physician compensation report. The average physician in the U.K. earned only $138,000. The Commonwealth Fund reports that American general practitioners earned a little more than $218,000 on average in 2016, compared with $146,000 in Canada and $134,000 in the U.K.

Nearly 80 million people live in areas with too few primary-care professionals, the Kaiser Family Foundation reports. Even under current policies, the country may face a shortage of as many as 120,000 doctors in a decade, according to the Association of American Medical Colleges.

The prospect of lower pay and stressful work would also discourage young people from entering the profession. Medical school is expensive; the median graduate takes on $200,000 in debt. It’s time-consuming, too. The typical doctor spends four years in medical school, followed by three to seven years in residency and fellowship. Lucrative jobs in finance, technology and law require far less preparation time.

One report from FTI Consulting found that Medicare for All would reduce the projected number of U.S. physicians in 2050 by about 44,000, including more than 10,000 primary-care doctors. Patients would have to compete for appointments with a dwindling number of overloaded and underpaid doctors.

Ms. Pipes ended her discussion with this great line about Medicare for All:
Everyone would have coverage, but that’s not the same thing as care.

The Apprentices

                                   The Apprentices

As we sit in our isolation, reveling in the joys of globalization and government power experiments, we can all be reassured that these times are going to prepare us for future similar risks. This is a dress rehearsal for "The Big One." 

But what if getting the Corona 19 Virus and its attendant  immunity protects you from "The Big One?"