Florida Lets Measles Run Free

The Daily Escape:

Highland Lighthouse, North Truro, Cape Cod, MA – February 2024 photo by Barbra A. Bentley

Let’s take a break this Saturday from a) Russia’s infiltration of the Republican Party and b) the growing realization that unless House Speaker Mike Johnson Johnsonless whips his members into shape before March 1st, we’ll have a government shutdown. Instead let’s focus today on Measles.

You are a witness the continued collapse in US public health standards since Florida’s Surgeon General has said its ok for unvaccinated kids to attend public school even though there are measles outbreaks. From KFF News:

“With a brief memo, Florida Surgeon General Joseph Ladapo has subverted a public health standard that’s long kept measles outbreaks under control. On Feb. 20, as measles spread through Manatee Bay Elementary in South Florida, Ladapo sent parents a letter granting them permission to send unvaccinated children to school amid the outbreak.”

More:

“The Department of Health ‘is deferring to parents or guardians to make decisions about school attendance,’ wrote Ladapo, who was appointed to head the agency by Florida Gov. Ron DeSantis, whose name is listed above Ladapo’s in the letterhead.”

With his brief memo, Ladapo has subverted a public health standard that’s long kept measles outbreaks under control. This is where you wind up after decades of indoctrination of libertarianism and neoliberalism, where “freedom” becomes anarchy, a rejection of the ability of the state to impose restrictions, even in the name of public safety.

Everyone in America knows that measles is highly contagious, that it kills, and can do lasting damage. More from KFF:

“Most people who aren’t protected by a vaccine will get measles if they’re exposed to the virus. This vulnerable group includes children whose parents don’t get them vaccinated, infants too young for the vaccine, those who can’t be vaccinated for medical reasons…”

The CDC advises that unvaccinated students stay home from school for three weeks after exposure. About 1 in 5 people with measles end up hospitalized, 1 in 10 develop ear infections that can lead to permanent hearing loss, and about 1 in 1,000 die from respiratory and neurological complications. They reported that in 2023, childhood immunization rates had hit a 10-year low.

Worse, only about a quarter of Florida’s counties had reached the 95% threshold at which communities are considered protected against measles outbreaks, according to data posted by the Florida Department of Health in 2022.

Rebekah Jones, a data scientist who was removed from her post at Florida’s health department in 2020, over a rift regarding Coronavirus data, said:

“I think this is the predictable outcome of turning fringe, anti-vaccine rhetoric into a defining trait of the Florida government,”

A strategy of letting measles spread (which can wipe out your body’s immunity memory) while Covid is still pin-balling its way around the country? Sounds legit.

The way that things are going with public health in the US, it’s only a matter of time until the health departments of other western countries start issuing travel health notices for their citizens wanting to visit the US, advising them of the diseases that are being left to run free, particularly in Florida.

From The Nation:

“In 2022, Georgetown University political scientist Donald Moynihan wrote a piece on how to undermine the administrative state….No country becomes a world power without a capable public service.”

Perhaps the corollary, as stated by The Nation’s Gregg Gonsalves is this:

“No country becomes healthy without a capable public health system.”

That describes America today. More from The Nation:

“We did terribly on Covid…part of the reason was that our fundamentals were weak, but our politics are also set up to undermine public health….This has implications well beyond…the pandemic. It’s about how we expect to survive and thrive in America….This is a disaster in slow motion, and we’re watching it unfold as bystanders.”

There you have it: another thing to lose sleep over, and the election is still 7+ months away. Will there be enough infant deaths to generate sufficient outrage to roll this decision back?

Highly doubtful.

Wrongo is leaving you with that thought and is segueing into our Saturday Soother, where we take a break from doom scrolling and spend a few stolen moments alone with our thoughts. Here on the Fields of Wrong, there is still snow on the ground. So while we hope that spring is just around the corner, there’s little evidence to support it.

To help you relax, grab a seat by a south-facing window and watch and listen to Samuel Barber’s “Adagio for Strings”, played here by the Vienna Philharmonic, and conducted by Gustavo Dudamel. Dudamel is scheduled to become music director of the New York Philharmonic in 2026. This performance was a part of the annual free Vienna Summer Night Concert in 2019.

This is the fourth time Wrongo has featured this composition, although you are seeing this particular version for the first time.

Barber finished the Adagio in 1936. In January 1938, Barber sent an orchestrated version of the Adagio for Strings to Arturo Toscanini. The conductor returned the score without comment, which annoyed Barber. Toscanini later sent word that he was planning to perform the piece and had returned it simply because he had already memorized it!

It was performed for the first time by Toscanini in November, 1938. Here, it is conducted by Gustavo Dudamel in 2019, like Toscanini did, without a score:

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Biden’s Plan To Cut Drug Prices

The Daily Escape:

Mars on left, Earth on right – image by alofeed

The Biden administration released its list of 10 prescription medicines that will be subject to the first-ever price negotiations by Medicare. This is a big deal because Medicare covers 66 million older Americans, people who routinely take very expensive drugs.

Until recently it was illegal for Medicare to negotiate prices with drug companies. But the Inflation Reduction Act (IRA), passed last August, gives Medicare that power. It also forces companies to pay a rebate to Medicare if their drug prices rise faster than inflation. The Congressional Budget Office estimates that price-capping measures will reduce Medicare expenses (and the federal deficit) by $96 billion by 2031.

The list includes drugs for diabetes, arthritis, and Crohn’s disease, and could sharply lower medical costs for patients. Reuters says that the US Centers for Medicare & Medicaid Services (CMS) spent $50.5 billion between June 1, 2022 and May 31, 2023 on these 10 drugs. That was about 20% of the total cost of drugs in the Medicare prescription drug program known as Part D.

The WaPo had an opinion piece by David Goldhill, CEO of SesameCare.com, a digital marketplace for discounted health services: (brackets and emphasis by Wrongo)

“The pharmaceutical industry earns almost 50% of its worldwide revenue here [the US], as do medical information-technology firms. [Medical] Device makers earn 40% of their money in the US. And this understates things, because US revenue is generated from higher prices, so margins are greater. If the US accounts for half of a company’s revenue, it probably contributes at least 75% of its profits.”

This has always been the business plan for Big Pharma: Make your money in the US and take whatever scraps of profit you can get in other markets.

That market subsidy is paid by American taxpayers generally (through the funding of Medicare) and by US pill-takers specifically when they pay higher co-pay prices for the drugs that help with their chronic conditions. The Economist points out that prescription medicines in America cost two to three times more on average than in other wealthy countries:

The blue dots are the price paid in the US for brand name drugs. The grey dots are prices paid in the various countries for all US drugs sold in those countries. The comparison of brand name to generics shows how much greater the cost is to an American.  It also follows that US patients’ out-of-pocket expenses, (the slice of drug costs not covered by insurance), are among the highest in the world.

It’s understandable why Biden’s move to start negotiations on some of the most expensive drugs has been fiercely opposed by the pharmaceutical industry. Essentially, high US drugs costs underwrite what amounts to a subsidy for buyers of the same drug sold when it’s outside the US.

Many of the Big Pharma have jumped on the legal bandwagon, challenging price-setting provisions in the IRA. More from the Economist:

“Since the law’s passage over 50 companies have blamed the IRA in earnings calls for clouding their prospects.”

A quick primer on drugs. Most medicines are either small-molecule drugs or large-molecule drugs. The former are the kind of pills that line our medicine cabinets. Large-molecule drugs, (also called biologics), are more complex and must be injected. The IRA grants biologics 13 years of pricing freedom after a drug is approved, while small-molecule drugs get only nine years post-approval before they must face Medicare’s bean counters. The industry estimates that small-molecule brands could lose between 25% and 40% in overall revenue due to the earlier cap on prices.

PhRMA, the pharma Industry’s lobbyist argues (and Republicans back them) that high US prices reflect the high cost of drug development. The pharmaceutical manufacturers are, of course, suing to stop the price negotiations. They say that allowing the government to negotiate lower bulk prices for drugs will stifle innovation, and will cut funds for research.

One thing that Big Pharma wants to avoid showing us is that they rely on smaller, more agile biotech firms for ideas. Between 2015 and 2021, 65% of the 138 new drugs launched by Big Pharma originated mostly from smaller firms. So, while innovation isn’t totally gone from the big firms, what they’re mostly doing is marketing the intellectual property of small pharmaceutical firms.

It didn’t take long for Republicans to jump on the decision to allow Medicare to negotiate drug prices. From Politico:

“Piggybacking on the pharmaceutical industry’s strategy, Republicans are working to persuade Americans that the Biden plan will stifle innovation and lead to price controls.”

Politico quotes Joel White, a Republican health care strategist:

“The price control is a huge departure from where we have been as a country….It gets politicians and bureaucrats right into your medicine cabinet.”

Politico says that the GOP effort to reframe the drug price debate may hurt them, since they plan largely to run on inflation, while the Biden plan will lower drug prices. Also they quote a new poll from the Kaiser Family Foundation (KFF) that shows 58% of independent voters trust Democrats to lower drug costs compared with 39% of Republicans.

Our politicians and pundits have bleated at us for years about being an “exceptional nation” – but what we really are is exceptionally gullible. As long as the large healthcare and pharmaceutical companies insist on standing between American consumers and their health needs, maximizing their profit will always come first.

We also continue to elect leaders who lobby for keeping corporations unleashed so that they can make as much profit as possible, while saying that the “market” will decide where the public good is prioritized. This keeps us hopelessly mired in a grossly expensive, and often ineffective healthcare system.

We continue to let ourselves be convinced by corporations and our politicians that reforming healthcare is impossible. That the solutions and methodologies used by other developed nations are substandard, and/or somehow immoral.

The Hill reported that the 14 leading US drug companies paid out more in stock buybacks and dividends from 2016 to 2020 than they spent on research and development. Those firms spent $577 billion from 2016 to 2020 on stock buybacks and dividends, $56 billion more than the $521 billion they spent on R&D. So, it’s oblivious how Big Pharma could easily fund their R&D with lower drugs prices.

It is also useful to remember that America has more healthcare billionaires AND healthcare bankruptcies than any other country. Those two things are inextricably linked.

As long as the pharmaceutical companies can maximize profits by buying politicians rather than by charging higher prices in other countries – the American people are the ones who will continue to get screwed.

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Sunday Cartoon Blogging – November 14, 2021

The weekend got off to a good start with Bannon indicted and Britany freed. But the final outcome at COP26 is the big news. The final agreement was announced on Saturday. It calls for reductions in coal and fossil fuel use and a transition to renewables. Those are all firsts in the more than 25-year history of UN climate talks.

Still, countries like Saudi Arabia or China were resistant; so the wording had to be significantly watered down. Wednesday’s draft mentioned phasing out coal, but Saturday’s speaks only of accelerating “efforts towards the phase-out of unabated coal power”.

What seems to have happened is a lot of speechifying, including Boris Johnson sounding a lot like Greta Thunberg. But not much happened in terms of concrete political action.

There is some good news: a net-zero pledge from India, a commitment from the US and China to work together, and a toothless but significant global agreement to reduce methane emissions.

One thing that is easy to overlook is that there were no climate deniers among the countries represented at COP26, a first. But a preliminary analysis of the agreement published by Carbon Brief suggests that, all told, the agreements coming out of COP26 may shave only 0.1 degree Celsius off of future warming.

The disconnect between rhetoric and reality has several possible explanations, but Occam’s Razor suggests it can be explained best in three words: Talk is cheap.

As Wrongo has said, not all the climate change news is bad: the probabilities of the worst-case scenarios seem to be falling a bit. The flip side of this is that, at present, the probability of the best-case scenario (holding global warming to 1.5 degrees C. above the pre-industrial baseline) also seems to be fading, and all of the medium-range outcomes look pretty terrible. On to cartoons.

Climate warriors won’t fight:

Infrastructure Week finally arrives:

Not everyone is enthusiastic about Infrastructure week:

GOP is unfriending the infrastructure-positive Republicans:

Ted Cruz is one of the smarmiest politicians ever, so it isn’t a surprise that he tried to score political points by going after Sesame Street’s Big Bird, who tweeted that he had gotten his COVID-19 vaccine. “My wing is feeling a little sore,” he said, “but it’ll give my body an extra protective boost that keeps me and others healthy.” It was a nice thing to tell children now that they can get the vaccine. Cruz didn’t see it as nice, nor did the Right-wing blowhards on Fox News and Newsmax. They were livid about Big Bird’s message:

Republicans turn back the clock:

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Texas Takes Off Its Masks

The Daily Escape:

Monument Valley, AZ – Winter 2019 photo by Petar_BG

From CNN:

“Gov. Greg Abbott announced…he’s lifting the mask mandate in Texas, even as health officials warn not to ease safety restrictions. Abbott….issued an executive order rescinding most of his earlier executive orders like the mask mandate…‘Too many Texans have been sidelined from employment opportunities. Too many small business owners have struggled to pay their bills. This must end. It is now time to open Texas 100%…’”

Texas is among the worst states in vaccination rates, especially in the poor and minority communities. But to Abbott, that’s no problemo!

Like Trump before him, since they’re most likely Democratic voters, he doesn’t seem to care so much.

Biden replied: (emphasis by Wrongo)

“We are on the cusp of being able to fundamentally change the nature of this disease because of the way in which we’re able to get vaccines in people’s arms.…The last thing, the last thing we need is Neanderthal thinking — that, ‘In the meantime, everything’s fine. Take off your mask. Forget it.’ It still matters.”

Biden’s calling Abbott a Neanderthal may make their meeting after Texas’s next natural disaster less hospitable than the last one. OTOH, Abbott is undermining a national strategy to end the pandemic.

Think about it: In a marathon, you don’t call yourself a winner at mile 24, because the race is 26+ miles long. Abbott’s declaring victory early.

America’s running a marathon against Covid and its variants. It’s a miracle that we now have three acceptable vaccines to combat the virus. It’s been a long struggle trying to ward off the disease. So many have died, in part because so many Americans have refused to stay physically distant, and when they can’t, to mask up.

After a year, we finally have a president who takes the virus and the methods to control it seriously. But there’s no question that a large sub-set of our people are either vaccine or virus skeptics who will refuse to act to protect themselves or others.

Leadership on the town, state and federal levels have worked to contain the spread of infections and deaths, finally with some success. And now, just when we can have some optimism again, when we can envision a time where we can return to some form of normal, a few of the Republican Abbotts of America pull the plug.

By eliminating Texas’ mask mandate, Abbott’s betting that fewer, not more cases and deaths will occur. Every time a governor has relaxed these guidelines, cases and deaths have risen. See this tweet from Julian Castro:

After @GregAbbott_TX reopened Texas businesses in May, we saw a 300% jump in hospitalizations.

The question that Abbott and other governors (like Mississippi‘s Tate Reeves) need to answer is, what constitutes an acceptable number of increased cases? Or deaths? If Abbott and Reeves are so concerned about the economies of Texas and Mississippi, shouldn’t they have figured out acceptable casualty counts?

How many Texans/Mississippians are worth sacrificing so that their states’ business owners can have a better year?

Abbott is betting that the pandemic no longer poses a serious threat in Texas. Here is what’s really happening on the ground:

Does Abbott simply care more about businesses than people? How can someone responsible for the health, safety, and well-being of his fellow citizens treat that responsibility so cavalierly? Presiding over a state that from a virus viewpoint, is a larger version of South Dakota, isn’t a great way to demonstrate one’s leadership chops.

What’s going on right now is a contest between the literally incredible achievements of medical science, and the almost literally incredible stupidity and perversity of our right-wing politicians.

Tune in to see who wins this exciting race! Spoiler, there won’t be any winners.

The Biden administration says there will be enough doses available to vaccinate every adult by the end of May. The soon-to-be-passed Covid relief package has money to assist states deliver their doses.

The latest KFF COVID vaccine monitor poll puts the “definitely refuse” the vaccine at 15%. They also found that about 18% had been vaccinated, 37% would get it as soon as it was available, and 22% would wait and see how well it is working. So, we might be able to get up to around 75% vaccine uptake voluntarily.

Having a President rather than a Twitter troll in the White House seems to be helpful. Who could have predicted?

Even with the millions of doses of the vaccines that are coming, a spike in Texas may mean that instead of getting them where they’re needed, we’re going to be spending time, money, and shots in a place that could have avoided another spike in the first place.

But most of the sociopaths in the Republican Party can’t accept a good thing, even when it’s handed to them.

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Saturday Soother – February 20, 2021

The Daily Escape:

Winter waterfall, Seward County, NE – photo by Roger Richters

Finally, we have some good news. Yesterday, Wrongo wondered if we had become the “can’t do” nation, and right on cue, NASA’s Perseverance Mars Rover touched down on Mars.

Since this is 2021, the Rover has a Twitter account, and immediately tweeted:

Those people at NASA and the Jet Propulsion Laboratory (JPL) threw a dart that had to travel 292.5 million miles and it hit the bullseye. It landed in the Jezero Crater, which is probably an ancient river delta. Perseverance will now look for fossilized pond scum that, if found, may possibly contain evidence of life on Mars.

Wrongo’s question is: What are the chances of applying some of that futuristic science here at home to stop the country from melting down? Maybe handling some “simple” stuff, like keeping the lights on in Texas. Or applying some mojo to getting our kids back in school?

It was also heartening (and affirming) that all the rocket scientists in the JPL control center were wearing masks. We can accomplish amazing things, but in real life, we still need to work on our humanity.

Wrongo is old enough to have been around for the launch of the first Sputnik. That brought with it the sense that the US wasn’t necessarily the best or the brightest of countries. We had many, many launch failures in our efforts to land on the moon. On September 12, 1959, the Russian Luna 2 hit the moon, but it took another five years for the US also to hit the moon with Ranger 4.

In 1966, Surveyor 1 landed and sent data back for two months before going dark.

Gradually NASA’s technology got better. And now, we routinely expect our space missions not only to launch, but also to reach their objective. We’ve tried a lot: Of multiple attempted Mars landings by many countries, ten have now had successful soft landings.

In 1971, the Soviet Union sent probes Mars 2 and Mars 3, each carrying a lander. The Mars 2 lander failed to land and impacted Mars. The Mars 3 lander became the first probe to successfully soft-land on Mars. In 1976, two American Viking probes entered orbit about Mars, and each released a lander module that made successful soft landings on the planet’s surface. You can see a list of all the Mars landings, (both successes and failures) here.

And now, we have landed our most advanced Rover.

it’s wonderful what science can bring us, both here on earth, but also, far away from earth. It’s depressing how science has delivered super-computers into the hands of billions, and yet somehow, it’s only made many of them stupider.

So, back to a normalized Saturday Soother, that time when we step away from Twitter and the comic stylings of Ted Cruz and forget about the DC carousel for a few minutes.

Let’s start by brewing up a mug of Trust the Process Full Natural ($18.99/8oz.) from Red Rooster, a Floyd, VA (pop. 432) roaster. It apparently has a subtle tropical fruit note suggesting lychee.

We still have about 8” of snow cover, so indoor sports are on the table for the weekend. Time to grab a seat by a window, and listen to “Mars”, from Gustav Holst’s Planet Suite, written between 1914 and 1916. Here it is played by The Royal Liverpool Philharmonic Orchestra and conducted by Sir Charles Mackerras:

We should make this Mars’ anthem once we have colonies there.

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Saturday Soother – July 18, 2020

The Daily Escape:

The comet NEOWISE over Stonehenge, England – July 2020 photo via NASA

Happy Saturday fellow disease vectors! Global interest in the comet has been large, but sadly, not enough to make it page one news. From the NYT:

“Eager sky watchers are turning to the heavens as Comet NEOWISE, one of the brightest comets in a generation, starts climbing ever higher among the evening stars.

A majority of comets fly through the solar system invisible to humans, usually too small and dim to be seen with the naked eye. The last frozen ice ball that gave us a big show was Hale-Bopp, a comet that was visible for nearly 18 months around its closest approach to Earth in 1997.

Officially designated C/2020 F3, Comet NEOWISE was discovered on March 27 and had until this week been visible only to committed comet viewers willing to wake up in the early pre-dawn hours. But on Monday, NEOWISE tipped into the post-sunset sky and has even been spotted by people living near city centers with all the light pollution.”

To see NEOWISE, look up at the northwest skies about an hour and a half after sunset. Experts suggest going to the darkest area you can for best viewing. Find the Big Dipper and follow its ladle as it arcs in the direction of the horizon. We have far too many trees to make it visible at the Mansion of Wrong.

The last comet to put on such an impressive show was Hale-Bopp, way back in 1997. Wrongo and Ms. Right have a photo of Hale-Bopp taken about a mile from our (then) home in New Hampshire. Hale-Bopp passed above our local meeting house on the night of a poetry reading by the late, great Donald Hall, a local resident who became the US poet-laureate in 2006.

Comets, like volcanoes, and pandemics were, in the time of prehistory, believed to be signs of punishment from the gods. It seems incredible that we as a species have figured out so much of the natural world that left our ancestors cowering in caves.

It’s too bad our social and moral abilities haven’t advanced as far in the same time.

We know about these comets due to NASA’s Near-Earth Object Wide-field Infrared Survey Explorer (NEOWISE), a satellite that assists NASA’s efforts to identify and characterize near-earth objects, particularly those that might harm the earth.

It’s worth thinking about why we make the investment to detect invisible threats from the universe, but are seemingly unable to deal with threats that we can see right here on earth.

The next time NEOWISE comes by will be 6,800 years from now. Let’s hope our descendants will be around to see it.

Our Saturday coffee experience remains on break, but it looks like a hot weekend here in Litchfield County, CT. We currently have two turkey mommas parading their clutches of chicks around the fields of Wrong. One group is nearly full-grown, while the other appears to have hatched about a month later. Both were seemingly born with an aversion to humans, despite being with us every day.

Wrongo is going to attempt to repair his weedwacker and put it to some use in the early hours of the day. In the meantime, relax at an appropriate physical distance and listen to Arthur Rubinstein play the Brahms “Intermezzo Op.117, No. 2”. Rubinstein died in 1982, so it is nice that we have the ability to hear and see him all these years later. He was five years old when this piece was composed by Brahms.

This is a mellow work, though just beneath the surface, there are moments of darkness and tension. Doesn’t that sound like America?

This intermezzo is one of Brahms’ more popular solo piano works:

Those who read the Wrongologist in email can view the video here.

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Sunday Cartoon Blogging – June 28, 2020

Why should you wear a mask? Wrongo’s FB friend (an MD) explained it well:

 “We don’t wear the mask to keep ourselves safe or even to make other people comfortable. We wear masks so the germs that spill out of the holes in our faces via water droplets and aerosols get caught in the mask and don’t get into other people’s eyes, nose or mouth or land on their wounds, clothes, hands or face….That way transmissions end with us. We stop the spread and can go about life almost like usual. Masks are also a great visual reminder of what’s going on…people stay back a bit. I actually wonder if that visual reminder is what so many people hate about masks. Do they want to pretend this is not happening or not a big deal or that they aren’t utterly failing society in every way?”

From Pew Research: (emphasis by Wrongo)

“Democrats and Democratic-leaning independents are about twice as likely as Republicans and Republican leaners to say that masks should be worn always (63% vs. 29%). Republicans are much more likely than Democrats to say that masks should rarely or never be worn (23% vs. 4%).

Republicans also are less likely than Democrats to say they have worn masks in stores or other businesses always or most of the time in the past month.”

Fact Tank says that only 49% of conservative Republicans say they have worn a mask all or most of the time in the past month, compared with 60% of moderate Republicans.

All of this explains where the virus is expanding:

Wearing a mask is more threatening than an attack by terrorists:

Europe thinks we should wear masks:

A tough year gets tougher:

Times like these call for better drinking choices:

The presidential race is shaping up to be a real fight:

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Who Should Fight America’s Pandemics?

The Daily Escape:

Lightning strikes with rainbow, Dickinson, ND – photo by Lightcrafterartistry

COVID-19? Nobody thought anything like this would ever happen. Wrong. Lots of people did. From VOX:

“Per capita, the United States is currently seeing about twice as many confirmed coronavirus cases as Canada and about 30 percent more deaths.”

The key difference between the US and Canada says David Fisman an epidemiologist at the University of Toronto:

“We have a federal government that is supporting provinces’ responses….You have a chief executive who is directly undermining the public health response.”

Politics and politicians by definition, are always in the loop in a national emergency. Yesterday, we talked about how civic-minded politicians stand aside, letting the experts decide strategy. Then they help the experts by making the government work to support the strategy. And they then help with communicating priorities to citizens.

Our national response to the pandemic has been mostly incompetent. The wealthiest, most scientifically advanced country in history has been brought to its knees by a virus it knew was coming. As late as 2016, we had a coordinated national strategy to combat pandemics.

What can we do to insure we do a better job in the future?

This has been a hot topic in pundit land for the past few weeks. There are two threads of discussion: First, make the US military the leader in fighting pandemics. Alternatively, an “empowered” civilian agency or possibly, an empowered public-private partnership should direct the fight.

Let’s start by talking about how civilian government agencies might do a better job, if they were “empowered” and also funded. In 2005, GW Bush said: (emphasis by Wrongo)

“If we wait for a pandemic to appear, it will be too late to prepare….we need medical personnel and adequate supplies of equipment…In a pandemic, everything from syringes to hospital beds, respirators masks and protective equipment would be in short supply….If a pandemic strikes, our country must have a surge capacity in place that will allow us to bring a new vaccine on line quickly and manufacture enough to immunize every American against the pandemic strain…”

Bush thought it would take $7 billion to build out his plan, plus annual appropriations thereafter. But that wasn’t supported by Congress. Obama built on Bush’s plan, but his efforts also were not sustained by a Tea Party Congress. Trump’s FY 2021 budget proposal reduces CDC funding by 16%. It was submitted just 11 days after the WHO declared the Coronavirus a public health emergency.

What should we be doing? First, we need to invest in ourselves, to break our reliance on offshore sources of PPE and pharmaceuticals. We saw that China stopped exporting PPE to the US, husbanding it for their own needs, and subsequently, showing a preference for shipping these goods to nations they perceived as friendlier.

Second, we need to empower an elite governmental team to combat a pandemic. The 2014 Ebola outbreak told us we needed a health security infrastructure. By 2016, America had coordinated an “all-government response” to the next pandemic. Laurie Garrett, a science journalist summed up the infrastructure created by Obama as a:

 “…special elite corps inside of the National Security Council, the Department of Homeland Security, Health and Human Services and CDC…an emergency capacity for surge drug approval at FDA… a lot of co-ordination with the states… a division that was doing nothing but training hospitals in infection control and appropriate epidemic responses… and…Study on how to surge hospital beds, how to surge physicians out of retirement…”

Sounds great, no? It needs to be rebuilt if we are to have effective control of our pandemic response.

The story of using the military also begins with Garrett. In September 2014, she briefed the Joint Chiefs of Staff on how the US military could help the countries affected by Ebola. She says that this was:

“…unprecedented in US history; we’d never mobilized US military for a medical response like that before”.

But today, the military wants the job. From Roll Call:

“To many lawmakers, the Defense Department is an attractive place to fund medical programs, partly because the defense budget is so large and enjoys support from both political parties, especially Republicans.”

Congress not only funds the NIH, it also provides $1 billion a year for DOD research labs looking into cures and treatments for cancers and other diseases.

Going forward, the military would like to see an increased focus on health as a part of national security. The debate is not a matter of either health security, or military security, it has to be both.

With a new administration, we need to think beyond stimulus packages, to fundamentally rethink what national security means. In the next pandemic, we can’t be scrambling for enough face masks to protect our medical professionals and hoping that the military can save us.

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Monday Wake Up Call – April 27, 2020

The Daily Escape:

Harvest Moon over Bisti Badlands, south of Farmington, NM – 2019 photo by navidj.

Question: How many Americans have died from COVID-19? A: 54,024 as of Sunday.

Question: How many Americans died in the Vietnam War? A: 58,220.

Barring a miracle, we will pass that Vietnam milestone this week. By then, there will be more than one million confirmed cases, and 60,000 deaths in the US. Can we take a minute, and try to place the Coronavirus in the context of the dead and broken bodies from Vietnam?

Vietnam took ten years to reach that horrible number, while COVID-19 has met it in less than three months. Wrongo served during the Vietnam War. It was a trying time for all Americans. We were disunited at home, at much at war with each other, as with the Viet Cong. It scarred at least a generation, and there are still victims of both the domestic and foreign fights among us.

Today’s fight against the Coronavirus may become the current generation of 20-something’s Vietnam. Jobs won’t come back quickly, friends and family are dying, and the lack of testing and a vaccine will make life scarier for young people than for any other group.

Like Vietnam did to the boomers, Coronavirus could scar young people for years to come.

As we head into month four of the outbreak, we know that we are undercounting deaths. The Economist reported on one aspect of the undercount early in April, comparing cardiac arrest deaths in NYC to the historical average:

Are the increased rate of cardiac arrest deaths really COVID-19 deaths? A strong case can be made that they are. Back to the Economist, who says that the outbreak will be worse in the South: (emphasis and parenthesis by Wrongo)

“Places with older residents and more diabetes, heart disease and smoking have higher CFRs (case-to-fatality rates)…..Counties with lots of poor or black people tend to have more health problems, less social distancing and fewer ICU beds. Yet CFRs in such areas are even higher than you would expect from these factors alone.

Together, these variables leave a geographic footprint….the highest death rates will probably…be…in poor, rural parts of the South and Appalachia with high rates of heart disease and diabetes. Worryingly, the three states that announced plans this week to relax their lockdowns (Georgia, Tennessee and South Carolina) are all in this region.”

It didn’t have to be like this. There’s plenty of blame to go around, but in the end, the single most important factor in America’s disaster of a response was the lack of early testing. That will be a greater disaster if we fail to keep growing testing as the lockdowns end.

One thing that’s difficult to comprehend is the lack of empathy for the dead and their families and friends by some Americans. Most can rouse themselves to celebrate the first responders, health care workers, and “essential” workers, but not all can.

The WaPo has analyzed all of Trump’s Coronavirus briefings, and found this:

“The president has spoken for more than 28 hours in the 35 briefings held since March 16, eating up 60% of the time that officials spoke….Over the past three weeks, the tally comes to more than 13 hours of Trump — including two hours spent on attacks and 45 minutes praising himself and his administration, but just 4½ minutes expressing condolences for coronavirus victims.”

Trump has not even ordered American flags lowered in tribute to the dead, while some governors have. New Jersey’s Governor Phil Murphy and New York’s Governor Andrew Cuomo both did in April. As Susan B. Glasser said in the New Yorker:

“Trump, who has in the past personally asked for the flags to be lowered after a shooting or a politician’s death, can’t even bring himself to do this much for victims of the coronavirus.”

Time to wake up, America! We must tread carefully for the next few months, because we truly know very little about the virus. For example, there’s no evidence that Coronavirus antibodies prevent reinfection.

To help you wake up, listen to “Road to Nowhere” written by David Byrne for the 1985 Talking Heads album “Little Creatures”. Here, it’s performed in 2012 by David Byrne and St. Vincent, live in Paris with a brass band:

Sample Lyric:

Well, we know where we’re going
But we don’t know where we’ve been
And we know what we’re knowing
But we can’t say what we’ve seen

Those who read the Wrongologist in email can view the video here.

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Should America Be Reopening Now?

The Daily Escape:

Poppies, Antelope Valley, CA – 2020 photo by user_greg. Part of the annual spring “super bloom” in CA.

Given Trump’s decision to open the country to walking around while infected, it’s becoming clear that for the administration, the business of America is strictly business.

But this is wrong. In a pandemic, the business of America is not business; it’s public health. Absent public confidence that the virus is at least under control, many businesses and workers won’t be comfortable heading back to work, no matter what politicians say:

“More than eight in 10 voters, 81%, say Americans “should continue to social distance for as long as is needed to curb the spread of coronavirus, even if it means continued damage to the economy…. Democrats (89%) are more likely than Republicans (72%) to say Americans should continue the “social distancing” measures”

Looks like Trump holds a minority view. To see if there was any concrete basis for saying the US was in a position to reopen soon, Wrongo looked at the COVID-19 Tracking Project’s state-level numbers, and subtracted the terrible NY numbers from the rest. Here’s the result:

The conclusion is that NY isn’t all that terrible compared to the rest of the US. It has a decreasing share of America’s total infections and deaths. But the highlighted rate of increase in deaths in the rest of the US since April 12th should concern the White House.

In fact, the seven-day average for growth in new cases shows that cases in the rest of the US are growing faster. NY is growing at 5.27%, while the rest of US is growing at 5.83%.

And the news from the places without lockdowns isn’t good. Politico reports that hot spots have erupted in farm belt states where governors insist lockdowns aren’t needed:

“The only hospital in Grand Island, Neb., is full. The mayor…asked for a statewide stay-at-home order that the GOP governor insists isn’t needed. More than one-third of those tested for coronavirus in the surrounding county are positive — and there aren’t enough tests to go around.

Grand Island is the fourth-biggest city in a state President Donald Trump and his top health officials repeatedly [say is]…keeping the virus at bay without the strict lockdowns 42 other states have imposed.”

New cases in Nebraska and in Iowa, South Dakota and other parts of the heartland are starting to spike. This should be raising concerns about whether we’re controlling the disease. Here’s Nebraska’s Republican Gov. Pete Ricketts saying that voluntary social distancing is working: (emphasis by Wrongo)

“This is a program that depends on people exercising personal responsibility and their civic duty….This is about making that decision, not the heavy hand of government taking away your freedoms.”

All of a sudden, as if they saw the bat signal, Republicans want to do the “Live Free or Die” thing. From the Daily Beast:

“A protest movement is taking hold targeting states that have extended social-distancing rules, closed schools, and restricted access to large religious gatherings. And it’s being fed by loyalists and political allies of President Donald Trump.”

This seems to be “spontaneous” support for Trump’s effort to reopen the economy.

In Michigan, a demonstration called “Operation Gridlock” protested Governor Whitmer’s shelter-at-home orders. Michigan has the third-highest number of COVID-19 cases in America, and the lockdown lowered infections. But Republicans criticize the order. Several thousand cars blocked the Lansing streets to protest what they see as an infringement of their liberty.

A lot of calories are going into the open vs. lockdown debate. It’s all a waste of time. How will we get a healthy economy if we eliminate the lockdown before we have any chance of stopping the mass transmission of this disease?

People aren’t staying at home because governments told them to. They’re doing it because it’s not safe to be out there. They aren’t going to go to work willingly in crowded offices, or travel, or attend concerts unless the danger is visibly lessened. And the economy will not recover until people are willing to do these things.

It’s not about flipping a switch. Businesses reopening will happen in small steps, as public health officials and political leaders, especially mayors and governors (and businesses), work to establish the basic conditions for a return to economic activity.

The bottom line is that the people are in control. We had to be convinced to stay home, and now we’ll have to be convinced to go out.

You go first, should be the people’s mantra. Trump should go back to holding MAGA rallies immediately. He should put his life and those of his supporters, where his mouth is.

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