Category: Domestic Policy

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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Can We Get Our Act Together?

The Daily Escape:

Hummingbird with bee balm – 2014 photo by JH Cleary. Hummingbirds arrived on the fields of Wrong yesterday.

When was the last time that America got its act together when it needed to? It’s been a very long time, probably not since WWII, or possibly, during our effort to immunize everyone, once there was a polio vaccine. That’s between 65 and 75 years ago.

We didn’t get our act together during the Vietnam era. We’re reminded of that with yesterday’s 50-year anniversary of the Kent State shooting in 1970, when four unarmed college students were killed by soldiers of the Ohio National Guard. It was a small, but significant tragedy that became a part of a greater national tragedy, the Vietnam War.

We didn’t get our act together after 9/11 when we attacked Afghanistan and Iraq. Like Vietnam, we’ve been losing to people who wear sandals and fight with antique weapons, for 50+ years.

These aren’t the only examples. New Orleans was whacked by Hurricane Katrina, but a week later, survivors were still sitting on roof tops surrounded by floating corpses. Even now, 15 years later, there is still evidence of damaged buildings in the city’s 9th Ward.

We haven’t gotten our act together to fight the COVID-19 pandemic. We’re currently seeing 1,750+ deaths per day. While the death toll is dropping in NYC and NJ, it’s rising pretty much everywhere else.  Here’s a chart showing the growth in cases, not deaths:

The dotted lines are a 7-day moving average, which allows us to see the trends more clearly. Politicians outside of the NY metropolitan area who are busy relaxing restrictions look like they’re simply giving up and pretending it’s over, when it isn’t. Ohio Gov. Mike DeWine (R) is dropping requirements that residents wear masks. It is now a “strong suggestion”. Kentucky Gov. Andy Beshear (D) wants residents to wear masks starting May 11, but will not enforce it.

Getting our act together has never been a feature of America’s Coronavirus fight. A depressing story in the New Yorker, “Seattle’s Leaders Let Scientists Take the Lead. New York’s Did Not”, sheds light on Seattle’s response vs. New York City’s. Although the initial coronavirus outbreaks emerged in both cities at roughly the same time, by the second week of April, Washington State had about one recorded fatality per 14,000 residents. New York’s death rate was nearly six times higher.

The article describes how Seattle’s political leadership followed a tried and tested CDC playbook for epidemics, called the CDC’s Field Epidemiology Manual, which places public health and scientists at the core of the response. New York’s mayor DiBlasio cut NYC’s public heath bureaucrats out of the loop. In early March, both NYC’s mayor and NY’s governor Cuomo were giving speeches de-emphasizing the risks of the pandemic, as the city was announcing its first cases.

This partially explains why Washington State has less than 2% of coronavirus cases in the US, while NY has 27%.

We’re all familiar with the confusion of message and policy sown by Trump as the primary national spokesperson for the pandemic, a person notoriously hostile to science. His team includes Mike Pence, Dr. Fauci from the NIH, Dr. Deborah Brix from the State Department, and Jared Kushner, from the family. With contributions from Mike Pompeo and Steve Mnuchin.

The New Yorker quotes Dr. Tom Inglesby, director of the Center for Health Security, at Johns Hopkins:

“When there are so many different figures, it can cause real confusion about whom to listen to, or who’s in charge of what….And, if the response becomes political, it’s a disaster, because people won’t know if you are making recommendations based on science or politics…so there’s the risk they’ll start to tune out.”

From the NYT:

“As President Trump presses for states to reopen their economies, his administration is privately projecting a steady rise in the number of coronavirus cases and deaths over the next several weeks. The daily death toll will reach about 3,000 on June 1…nearly double from the current level of about 1,750.”

Math tells us that this will amount to about 81,000 more deaths by then, making the total somewhere around 150,000, assuming that the death rate remains on its current trend.

Should we expect that America will continue to flub it’s response to the pandemic? If so, Aaron Sorkin and Jeff Daniels will have to re-do the famous opening scene from “The Newsroom” where Daniels says “America is not the greatest country in the world anymore”:

Since we haven’t gotten our act together for so long, a failure to control the 2020 COVID-19 pandemic will be depressingly similar to the tragedies of the past.

Failures of leadership, coupled with warring political factions who refuse to work together for a common good.

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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 4Âœ 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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Sunday Cartoon Blogging – April 19, 2020

One week ago, the cumulative US COVID-19 death toll was 15,000. Seven days later, the death toll is now 36,000. That means in a week, about 21,000 Americans have died, a growth rate of 140%. In the past two months, here’s how US coronavirus deaths have grown:

  • Feb 17: 0 deaths
  • March 17: 111 deaths
  • April 17: 36,997 deaths

Although deaths are a lagging indicator for how successful we are in our efforts to contain the Coronavirus, and despite all the happy talk about flattening the curve, this looks like a rocket ship leaving the launch pad.

The Navy has now tested about 94% of the crew on the USS Theodore Roosevelt, the aircraft carrier that was sidelined with a Coronavirus outbreak. As of Friday, 660 crew members (of about 4,865) have now tested positive for Coronavirus.

However, of those 660 who were positive, 60% have not shown any symptoms associated with the illness. This should cause us to question the true rate of infections in the US. The proportion of people who are asymptomatic carriers worldwide remains unknown, but at 60%, the Theodore Roosevelt’s figure is higher than the 25%-50% range Dr. Fauci laid out in early April.

Taking these two data points together, America should proceed carefully as it leaves the lockdown.

On to cartoons. Another day, another spin of the big blame wheel:

With big business, some things never change:

If not his signature, then certainly his fingerprints:

The right’s narrative that can kill:

Individual responsibility has consequences:

John Roberts has to live with his Wisconsin voting decision:

 

 

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Saturday Soother – April 18, 2020

The Daily Escape:

Rainbow appears over NYC at 7pm, the time of change of shift for NYC’s health workers – April 13th 2020 photo by Steve Braband. Thanks to reader Shelley VK.

An argument by those who want to end the lockdown about those who think we should keep it is:  “You have shut down the economy because you think even one death is too many.”

That is a misrepresentation of what America’s governors have done. They really have said: “We reduced the economy and restricted daily activities because otherwise, as many as a million people might die.”

What is missed by the “live free or die” folks is that these actions were taken to reduce the risks to human life from the pandemic. They say, you shouldn’t ask us to stay locked down, because “life is full of risk anyway”.

To a degree, they are correct. Lockdowns only work for the privileged. They don’t work for everyone, because the level of income support and debt relief provided by the government is inadequate to the need. If landscapers are not essential in a state, they don’t work. But since they live paycheck to paycheck, they won’t be able to buy food. And when they see others working and earning, that’s got to be angering.

If we ask people for sacrifice and compliance, the country must at least secure their short term needs.

Since the government isn’t providing adequately for those needs, rebelliousness, non-compliance, and virus denialism are on the rise, as we saw in Thursday’s large demonstration in Michigan.

In Connecticut, Wrongo’s home state, the major issue every spring is passing the town budget. With a COVID-19 shutdown in effect, Governor Ned Lamont (D) issued an executive order suspending in-person voting for the next fiscal year’s budget. And there is no vote by mail option in CT.

His order has been met with livid anger on the right and left, conjuring up “no taxation without representation” and calls to “stand up for your rights”. People are saying if they can shop using social distance, why can’t they vote using social distance?

What angers many in town is that voters have rejected several budgets in recent years. The town then lowers the numbers, and it goes back to voters who eventually approve it. They could simply roll over last year’s approved budget, but instead, they’re going to pass a budget increase along with an increase in taxes, without ratification by voters.

The executive order seems wrong-headed, and it’s making people very angry. And so non-compliance will grow, as will denialism that the virus is a serious health problem.

All of this may help the virus flare up again soon.

In a comment, blog reader Terry McKenna brought up the concept of the “Tragedy of the Commons”, the idea that all individuals have a right to consume a resource even if it comes at the expense of other individuals. If demand overwhelms supply, every individual who consumes an additional unit directly harms all others who can no longer benefit from it.

Most Americans don’t think about how their actions impact others. Most are unwilling to even temporarily comply with limitations placed on them for the common good. With Operation Gridlock in Michigan, we’re seeing more proof that when human health and safety go up against the almighty dollar, humans will lose.

People should remember that finding a vaccine for the virus is not a sure thing. There’s also little reason to believe that once a vaccine is found, that it will be completely effective. The longer people are allowed to think that universal Coronavirus immunity is just around the corner, the angrier they will get when that isn’t the case.

Until we know if a vaccine is likely or not, the current political climate won’t be conducive to rational discussions about difficult decisions. The virus can’t spread itself, but it seems to have plenty of helpers.

On this spring Saturday, let’s forget about non-compliance and the Coronavirus for a few minutes. Let’s have a brief respite, and indulge in a Saturday Soother.

Start by inviting your besties to a Quarantini video conference. The term “Quarantini” was actually coined several years ago on the podcast “This podcast will kill you”, hosted by two disease ecologists/epidemiologists. Wrongo prefers Irish single malts, but pour whatever makes you happy. And make a toast: Confusion to our enemies!

Next, settle back and spend a few minutes watching and listening to a parody tribute to NY Governor Andrew Cuomo, from Randy Rainbow, “ANDY!”:

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

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Problems With The COVID-19 Data

The Daily Escape:

Sunrise in Monument Valley, UT – photo by therealmindzeye. Note the sun star!

Happy tax day! Here are the updated COVID-19 seven-day results as of 4/13:

  • The number of new cases has plateaued. The average rate of increase for the past seven days is 6.88% vs. 5.00% on 4/13. But, this is a function of how many tests are conducted.
  • The number of deaths is increasing more slowly, averaging 11.94% for the past seven days vs. 7.35% on 4/13.
  • More people were tested on 4/13 than on any day in the past seven days, but we still lag April 4th, which was the country’s high point in tests at 229,268.

We all hear the daily recitation of new cases, deaths and tests, but as Wrongo said last week, there are multiple issues with the data that politicians and public health officials are relying on for decision-making.

Cathy O’Neil, who writes at Bloomberg and blogs as the Mathbabe, has a column addressing reasons to doubt the COVID-19 data. Here are a few of her points: (emphasis and brackets by Wrongo)

“1. The number of infected is close to meaningless. Only people who get tested can be counted, and there still aren’t enough tests…anecdotal evidence suggests that people need to be ill enough to be hospitalized [to get tested]. About 10% of cases merit hospitalization, so the actual number of infected might be about ten times larger than what’s reported.

2. The tests aren’t accurate and the inaccuracies aren’t symmetric. In particular, they produce many more false negatives than false positives….Some research suggests that the false negative rate could exceed 30%.

3. The number of tests doesn’t equal the number of people tested. Because the tests are so inaccurate, some people get tested twice….This means that the share of the population tested compared to the number of people found to be infected paints a rosier picture than reality…another reason to believe that the actual number of infected is higher.

4. The numbers aren’t in sync. People sometimes die weeks after being hospitalized, and they get hospitalized a week or more after testing positive for the virus. So we shouldn’t expect the “number of deaths” curve to flatten until pretty long after the “number of cases” curve does.

5. The meaning of hospitalization is changing. Officials have recently presented flattening hospital admissions as a positive sign. But it takes a lot more to get somebody to the hospital these days. Hotlines are jammed, ambulances are scarce, standards for who gets hospitalized have drastically changed, and people are avoiding overwhelmed emergency rooms. So fewer hospitalizations doesn’t necessarily mean that the situation is getting better.

6. Deaths aren’t reported immediately or consistently. Various operational issues, such as paper filing and notifying next of kin, determine when a death actually gets registered. This might help explain why the most deaths tend to get reported on Tuesdays.

7. Deaths outside hospitals aren’t being reported. When people die at home or in nursing facilities, veteran homes, or prisons, they’re not always counted…..When France started reporting fatalities in nursing homes, their death count increased by 40%. Belgium reports nursing home deaths pretty well, and they’re finding 40% of deaths occur there.

8. The policy for attributing deaths isn’t consistent. Once somebody is gone, why waste a valuable test? So doctors might not mention Covid-19 as a contributing cause. It’s a judgment call, especially when someone was sick already. This might have a very large effect on the data in certain environments like rehab facilities and nursing homes.

9. Officials may have incentives to hide coronavirus cases. China, Indonesia and Iran have all come under scrutiny for their statistics…..So don’t assume that officials are above…manipulation.

10. What happens in one place, or on average, might not be applicable everywhere. Some small studies suggest that the Covid-19 mortality rate is about 1% of the infected population. But that doesn’t mean it will be the same in the US, or in New York City….As we’ve seen in recent days, such disparities are disproportionately affecting people of color.”

You should follow the Mathbabe. We all rely on the count, but as Cathy says, we may not know the true numbers for some time. Testing needs to be done systematically, particularly on asymptomatic people, once we decide to end the lockdowns.

For deaths, accurate numbers may never be available. It’s possible to estimate using the number of unexpected deaths compared to a year earlier. But even that’s not ideal, because lockdowns might suppress other kinds of deaths — traffic accidents, for example — since people are forced to stay at home.

Despite flaws in the data reporting, we’re all obsessed with learning how America is responding to the pandemic. And the daily updates on tests, cases, and deaths gives us a reasonable clue about what to expect, when things might get better, or how our leaders are doing with the response to the virus.

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More on What’s Next

The Daily Escape:

Sunrise, Mauna Kea, HI – 2020 photo by laramarie27

Here’s the COVID-19 tracking report as of April 12:

The rate of increase in infections and deaths appear to have plateaued, while deaths as a percentage of cases continues to rise. Testing hovers around 140,000 per day, still growing slower than the rate of new infections.

The next chart seems to indicate that opening the lockdown would be a mistake. The impression is that the rest of the country isn’t doing as badly as New York. Here is a comparison of cases in New York to cases in the rest of the US:

On the 12th, infections in the rest of the US started to grow faster than new infections in NY. The rate of new deaths in the rest of the US has also become a larger share of total US deaths. So far, there is little evidence to conclude that the administration should reverse the lockdown strategies of the states.

Today we continue with yesterday’s question, “what’s next?”

When parts of the US, and eventually all of it come out from physical and economic quarantine, we will attempt to return to “normal”. Normal will bring with it a level of economic devastation, bankruptcy, and household impoverishment that will almost certainly be beyond what politicians can now imagine.

To bridge across to a sustained level of economic activity, the Federal government and the Federal Reserve will have to add substantial stimulus beyond the $2 trillion so far, possibly an additional $5+ trillion, in new stimulus.

Most of those new funds will have to go to individuals and small businesses in the form of outright grants. Otherwise, small and medium size firms will not be able to reopen their doors after a prolonged shutdown.

Grants to individuals will be most important. Renters and homeowners will have no means to become current on back rent and mortgage payments. Without these funds, the impact within the financial sector will exceed that of the Great Recession, as rents and mortgages would go unpaid for months. Foreclosures and evictions would skyrocket.

Local and state governments that rely on tax revenue from sales taxes, income taxes, real estate and property taxes will be deeply affected as well.

Bipartisan talk in DC of a new effort to create $2 trillion in infrastructure funding makes sense as a source of jobs and needed economic revival. It will also jump start the downstream suppliers of steel, cement and heavy equipment.

The Federal government may have to take equity stakes in large companies like it did in the 2008 auto bailout. In a fashion, this will make the US look a lot more “socialist” than it did in 2019.

There will also be psychological fallout that will be difficult to anticipate. Axios thinks the Coronavirus may be a defining experience for Generation Z, shaping its outlook for decades to come, disrupting its entry to adulthood and altering its earning potential, trust in institutions and views on family and sex.

Pew Research says that nearly half of workers ages 16-24 held service jobs in bars, restaurants and hotels — many of which have now been shut down or greatly scaled back. And young workers with less experience are the first to be let go.

Nearly 25% of US workers, 38.1 million out of 157.5 million, are employed in industries most likely to feel an immediate impact from the COVID-19 lockdown. Among the most vulnerable are workers in retail trade (10% of all workers) and food services and drinking places (6%). In total, these two industries employ nearly 26 million Americans. More from Pew:

“Workers in these industries have lower-than-average earnings. Across all industries, the average weekly earnings in January 2020 were $975. By contrast, workers in food services and drinking places earned only $394 per week on average. Workers in the other high-risk industries had earnings ranging from around $500 to $600 per week.”

Hence the need for a financial bridge by the federal government.

Part of the new normal must be adequate inventory of medical supplies to deal with any future replay of the Coronavirus or another pandemic. The NYT reports that China today makes about 80% of the world’s antibiotics, along with the building blocks for a long list of drugs. That supply can be shut off at any time, for any reason. It is now painfully obvious that health care must be a primary national security concern, something our politicians were blind to just a few months ago.

Will these, and other necessary things change?

So far, we have a redux of 2008. The Fed and Treasury have decided to bailout speculative capital and big corporations, let small businesses fail, and let the working poor employed by small business to become even more impoverished.

Will there be a Marshall Plan for us?

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Monday Wake Up Call – What’s Next Edition

The Daily Escape:

Chamisa plants near Abiquiu, NM – photo by zuzofthewolves

(Publishing of daily COVID-19 data is on hold while Wrongo tries to understand inconsistencies in the data)

Trump isn’t wrong to begin thinking about what comes next. At some point, we will again poke our heads out of our burrows, and feel the warmth of sunlight. We’ll attempt to resume the life we had before the virus struck. There are two risks in this: First, will we be back in the swing of things too soon? And second, what should we demand be different, given what the nation has experienced?

In Trump’s view the answer is simple. He wants most people back to work in time to have a robust economy come Election Day. He’s targeted May 1st as the start date for his governor buddies to begin revitalizing the economy.

Once again, the Trump administration is showing itself to be utterly incapable of dealing with this crisis.

He’s moving the country to re-open, despite warnings from public health officials and from most state governors. Here’s a germane comment on Wrongo’s Saturday’s column by long-time blog reader Terry McKenna:

“We really know so little. To begin with, we don’t know how the virus spreads. We are learning but that’s all. In the beginning, we guessed wrong that it was not spread by healthy (asymptomatic) persons. Doctors disagree over the size of the droplets that carry the virus. So we are almost like we were before we had the germ theory where all we can do it isolate.

Also “test” is a simplistic word. Which test? We need a test that tells a clinician that someone had the virus in his system, and a test with a fast result is essential. But a negative test means little, especially in a healthy (asymptomatic) person, because in the absence of a vaccine, that person could be infected next week or next month. So we need a test of antibodies – but even still, we don’t know how long immunity lasts.

And then we have the notion that the president can order the country back to work. Even if a business reopens, who will come? And yes, I know someone will, but imagine the NY Mets having their opening day May 15. Will anyone show up? And if they do, will we see a spike in sickness a few weeks later?

We need time for the science to do its work. We may get lucky, viruses do became less virulent over time (sometimes to re-emerge with vigor).”

A partial re-opening of those portions of the economy that are now shuttered is a risk both to the workers, and to the returning customers. Terry is right to ask if we’ll see a spike in sickness a few weeks later, and if we do, what will be Trump’s plan then?

Broadening out our view, many are starting to think about what needs to be different post-pandemic. As we emerge from this crisis, we have a rare opportunity to focus on change: Do we want a Star Trek, or Blade Runner future? A utopian, or a dystopian one?

As Viet Thanh Nguyen said in the NYT:

“Our real enemy is not the virus but our response to the virus — a response that has been degraded and deformed by the structural inequalities of our society.”

We have a once-in-a-generation opportunity to rebuild for tomorrow. Or will we just prop up the economic and political process that has given us today’s problems? As an example, if we don’t want sick and contagious people trying to go to work, America must have paid sick leave.

During the lead up to passing the CARES Act, Democrats in Congress recognized this, but at the behest of business lobbies, the Act exempted 80% of all workers, including all those working at firms with over 500 employees AND those working at firms with under 50 employees!

Here’s an illuminating chart:

And in America, add $600 for four months for 20% of our workers. This is post-Reagan America. Assistance to the poor and working class is given grudgingly, and with strings attached. The rich and corporations are showered in subsidies since they are too virtuous and important to let fail. MAGA really means “Make Americans Grovel Again”.

What has to die after Covid-19 is the myth that America is the best country on earth. We’re not as healthy as we thought we were. The symptoms — racial and economic inequality, callousness and selfishness, have been covered up by our unquestioned acceptance of American Exceptionalism.

We’ve lost our right to that view, despite the many, many small acts of heroism every day by health workers and all the “essential” hourly workers who face becoming infected every day.

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Stimulus Money is Going to Churches

The Daily Escape:

View of Mt. Rainer from Reflection Lake WA – 2018 photo by NathanielMerz

Here is the 7-day look at the national numbers for COVID-19:

The rate of growth in deaths as a percentage of cases continues to rise, while the rate of increase in cases picked up slightly on 4/6, although overall, it is slowing vs. 7 days ago. Testing is still growing, although the rate of growth in tests is now about equal to the growth in cases.

A little-noticed part of the $2 trillion stimulus package allows the federal government to provide money directly to US churches to help them pay pastor salaries and utility bills. From NPR: (emphasis by Wrongo)

“…the $2 trillion economic relief legislation…includes about $350 billion for the Small Business Administration (SBA) to extend loans to small businesses facing financial difficulties as a result of the coronavirus shutdown orders. Churches and other faith-based organizations are among the businesses that qualify for aid under the program, even if they have an exclusively religious orientation.

So, we’re not simply speaking of not-for-profit subsidiaries of churches such as charities. The Trump administration is saying churches themselves will qualify for direct loans. Apparently, the program is based on the average monthly payroll of a church school or the parish, which is extrapolated to eight weeks. The cost of maintaining staff for that period becomes the loan amount.

From the SBA’s statement:

“Faith-based organizations are eligible to receive SBA loans regardless of whether they provide secular social services….No otherwise eligible organization will be disqualified from receiving a loan because of the religious nature, religious identity, or religious speech of the organization.”…

The SBA’s regulations currently exclude some religious entities. Because those regulations bar the participation of a class of potential recipients based solely on their religious status, SBA said it will decline to enforce those subsections and will propose amendments to conform those regulations to the Constitution.

The SBA is quoting a 2017 Supreme Court decision, Trinity Lutheran v. Comer, which was the first time the Court said the government is required to provide public funding directly to a religious organization. Chief Justice Roberts wrote for the majority in the 7-2 decision. The key argument was that Trinity Lutheran faced discrimination solely because of its identity as a church. That, the Court decided, was discrimination. From the opinion:

“There is no question that Trinity Lutheran was denied a grant simply because of what it is….A church.”

The grant was for refurbishing the church’s playground.

But in this case, the SBA is offering direct funding of religious entities with money provided by tax dollars from the rest of us. We’re likely to see this in the courts soon.

This isn’t the first time that the Trump administration provided funds directly to churches, synagogues, mosques and other religious organizations. In 2018, the Federal Emergency Management Agency (FEMA) changed its rules to make houses of worship eligible for disaster aid.

First Amendment watchers have reacted. Alison Gill, legal and policy vice president of American Atheists said:

“The government cannot directly fund inherently religious activities….It can’t spend government tax dollars on prayer, on promoting religion [or] proselytization. That directly contradicts the Establishment Clause of the First Amendment.”

If they want Federal funds, shouldn’t they pay Federal taxes?

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Monday Wake Up Call – April 6, 2020

The Daily Escape:

Texas bluebonnets, Round Rock, TX – 2018 photo by dried_fruit

Here are the latest national numbers (which will be out of date by the time you read them). From The COVID Tracking Project: (as of 4/4)

  • Number of daily cases: 305,755, up 33,767 or +12.4% vs. April 3
  • Rate of case increase: 12.4% vs. 13.75% on 4/3 and 15% average for the past week
  • Number of deaths: Total 8,314, up 1,352 vs. April 3
  • Rate of deaths increase 4/4 vs 4/3: 19.4% % vs. 20.4% on 4/3
  • Daily number of tests 4/4 vs. 4/3: 1,623,807, up 226,945 over 4/3
  • Rate of increase in tests: +16.2% vs. previous day

The rates of growth in cases and deaths have begun to slow. In the past week, they are in a decelerating trend, declining by about 1%/day. Testing is growing, which is a very good thing.

Just when you think you can’t get any more cynical about America’s response to the pandemic, we tumble to the fact that about a third of hospital emergency rooms are now staffed by doctors on the payrolls of two physician staffing companies, TeamHealth and Envision Health. They are owned by two Wall Street private equity firms. Envision Healthcare employs 69,000 healthcare workers nationwide while TeamHealth employs 20,000. Private equity firm Blackstone Group owns TeamHealth; Kravis Kohlberg Roberts (KKR) owns Envision. Private equity is the term for a large unregulated pool of money run by financiers who use that money to invest in, lend to, and/or buy companies and restructure them.

Wrongo began hearing that despite the urgent pleas from hospitals on the front lines of the COVOID-19 outbreak, nurses and doctors were being taken off schedules in nearby places once “elective” procedures were suspended, as they are at many hospitals and clinics. That means the associated revenues were lost, or at the very least, postponed.

Here’s a report from Yahoo Finance:

“KKR & Co.-backed Envision, which carries over $7 billion of debt amassed through one of the biggest leveraged buyouts in recent years, reported steep drops at its care facilities. In just two weeks, it suffered declines of 65% to 75% in business at its 168 open ambulatory surgical centers, compared to the same period last year, the company said in a private report to investors. About 90 centers are closed.”

Private equity has taken over more and more of hospital staffing, including emergency departments. The legal fig leaf that allows private equity firms like Blackstone and KKR to play doctor is that their deals are structured so that an individual MD or group of MDs is the nominal owner of the specialty practice, even though the business is stripped of its assets. The practices’ operating contracts are widely believed to strip the MDs of any say in management.

Care of the sick is not the mission of these companies; their mission is to make profits for the private equity firms and its investors. In 2018, Paladin Healthcare, an entity owned by private equity baron Joel Freedman, bought Philadelphia’s Hahnemann University Hospital. This hospital served the poor, and Freedman closed it down so he could use the land to build luxury apartments.

When the city recently asked to use the empty hospital as part of its solution for the Coronavirus pandemic, Freedman demanded $1M/month in rent. Overcharging patients and insurance companies for providing urgent and desperately needed emergency medical care is bad enough. But holding a city hostage?

In another example, STAT reports on another private equity firm: (emphasis by Wrongo)

“Alteon Health, which employs about 1,700 emergency medicine doctors and other physicians who staff hospital emergency rooms across the country, announced it would suspend paid time off, matching contributions to employees’ 401(K) retirement accounts, and discretionary bonuses in response to the pandemic…The company also said it would reduce some clinicians’ hours to the minimum required to maintain health insurance coverage, and that it would convert some salaried employees to hourly status for “maximum staffing flexibility.”

NY’s Governor Cuomo and others are pleading to have doctors come out of retirement, and here we have skilled doctors who have the training and are being asked to work fewer hours? All of the Republican talk about “choice” and “markets” in healthcare is just self-serving BS that benefits their buddies.

Time to wake up America!

Why do private equity firms continue to benefit from the “carried interest” tax loophole? Shouldn’t they shoulder their part of the financial grief the pandemic is causing to our country?

To help you wake up, here is John Lennon’s 1970 song, “Isolation”. It appeared on John Lennon/Plastic Ono Band. It has a whole new meaning in today’s context:

Sample Lyric:

We’re afraid of everyone,

Afraid of the sun.

Isolation

The sun will never disappear,

But the world may not have many years.

Isolation.

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

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