Later On

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Archive for March 2020

President Trump in his own words

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Dana Milbank collected President Trump’s actual statements for a virtual fireside chat:

The coronavirus is very much under control in the USA. We have it totally under control. I’m not concerned at all. It’s one person coming in from China. We pretty much shut it down. It will all work out well. We’re in great shape. Doesn’t spread widely at all in the United States because of the early actions that myself and my administration took. There’s a chance it won’t spread. It’s something that we have tremendous control over.

Looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away. One day it’s like a miracle, it will disappear. Just stay calm. It will go away. The Democrats are politicizing the coronavirus. This is their new hoax.

Whatever happens, we’re totally prepared. Totally ready. We’re rated number one for being prepared. We are so prepared like we never have been prepared. Taking early intense action, we have seen dramatically fewer cases of the virus in the United States. We’re very much ahead of everything.

This is a flu. I didn’t know people died from the flu. Here, we’re talking about a much smaller range. It is very mild. Some people will have this at a very light level. Some of them go to work.

The mortality rate is much, much better. In my opinion it’s way, way down. I think it’s substantially below 1 percent. A fraction of 1 percent. I think the numbers are going to get progressively better as we go along. This is just my hunch.

We have very little problem in this country. We only have five people. We only have 11 cases. Out of billions of people, 15 people. They’re getting better, and soon they’re all going to be better, hopefully. We’re going very substantially down, not up.

The United States, because of what I did and what the administration did with China, we have 32 deaths at this point. To this point, and because we have had a very strong border policy, we have had 40 deaths. As of this moment, we have 50 deaths. I have a feeling that a lot of the numbers that are being said in some areas are just bigger than they’re going to be.

Frankly, the testing has been going very smooth. The tests are all perfect. Anybody that wants a test can get a test. The tests are beautiful. We have a tremendous testing setup.

I don’t believe you need 40,000 or 30,000 ventilators. We are very close to a vaccine. A matter of months. You take a solid flu vaccine, you don’t think that could have an impact? Hydroxychloroquine and azithromycin, taken together, have a real chance to be one of the biggest game changers in the history of medicine. Based on very strong evidence.

I would love to have the country opened up and just raring to go by EasterNo way I’m going to cancel the convention. Stock Market starting to look very good to me!

We’re the ones that gave the great response. I’d rate it a 10. We’ve done a fantastic job. I think they should be appreciative. Gallup just gave us the highest rating. The highest on record.

I like this stuff. I really get it. Maybe I have a natural ability. We think it’s going to have a very good ending. We’re going to win faster than people think. I hope.

This blindsided the world! Who could have ever predicted a thing like this? This was something that nobody has ever thought could happen to this country.

I’ve always known this is a real, this is a pandemic. I felt it was a pandemic long before it was called a pandemic. I always treated the Chinese Virus very seriously.

If you’re talking about the virus, no, that’s not under control for anyplace in the world. I was talking about what we’re doing is under control, but I’m not talking about the virus. I didn’t say Easter. It was just an aspiration. I am giving consideration to a QUARANTINE.

So you’re talking about 2.2 million deaths. If we could hold that down…between 100,000 and 200,000, and we all together have done a very good job. START MAKING VENTILATORS, NOW!!!!!! FORD, GET GOING ON VENTILATORS, FAST!!!!!! Invoke “P”. I want our life back again.

It was nobody’s fault. No, just things that happened. I don’t take responsibility at all.

Written by LeisureGuy

31 March 2020 at 7:31 pm

A Major Medical Staffing Company Just Slashed Benefits for Doctors and Nurses Fighting Coronavirus — because profits above all

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Isaac Arnsdorf has an interesting report in ProPublica:

Emergency room doctors and nurses many of whom are dealing with an onslaught of coronavirus patients and shortages of protective equipment — are now finding out that their compensation is getting cut.

Most ER providers in the U.S. work for staffing companies that have contracts with hospitals. Those staffing companies are losing revenue as hospitals postpone elective procedures and non-coronavirus patients avoid emergency rooms. Health insurers are processing claims more slowly as they adapt to a remote workforce.

“Despite the risks our providers are facing, and the great work being done by our teams, the economic challenges brought forth by COVID-19 have not spared our industry,” Steve Holtzclaw, the CEO of Alteon Health, one of the largest staffing companies, wrote in a memo to employees on Monday.

The memo announced that the company would be reducing hours for clinicians, cutting pay for administrative employees by 20%, and suspending 401(k) matches, bonuses and paid time off. Holtzclaw indicated that the measures were temporary but didn’t know how long they would last.

“It’s completely demoralizing,” said an Alteon clinician who spoke on the condition of anonymity. “At this time, of all times, we’re putting ourselves at risk but also putting our families at risk.”

Some co-workers are already taking on extra burdens such as living apart from their families to avoid the risk of infecting them, the clinician said. “A lot of sacrifices are being made on the front line that the administration is not seeing because they’re not stepping foot in a hospital,” she said. “I’ve completely lost trust with this company.”

Other employers will soon follow suit, Holtzclaw said, citing conversations with his counterparts across the industry. “You can be assured that similar measures are being contemplated within these organizations and will likely be implemented in the coming weeks,” he wrote.

However, another major staffing company for emergency rooms, TeamHealth, said its employees would not be affected. “We are not instituting any reduction in pay or benefits,” TeamHealth said in a statement to ProPublica. “This is despite incurring significant cost for staffing in anticipation of surging volumes, costs related to quarantined and sick physicians, and costs for PPE as we work hard to protect our clinicians from the virus.”

Alteon and its private-equity backer, Frazier Healthcare Partners, didn’t immediately respond to requests for comment.

Private equity investors have increasingly acquired doctors’ practices in recent years, according to a study published in February in JAMA. TeamHealth was bought by Blackstone Group in 2016; another top staffing firm, Envision Healthcare, is owned by KKR. (The staffing companies have also been implicated in the controversy over “surprise billing.”)

Hospital operators have also announced cuts. Tenet Healthcare, a Dallas-based publicly traded company that runs 65 hospitals, said it would postpone 401(k) matches and tighten spending on contractors and vendors. Emergency room doctors at Boston’s Beth Israel Deaconess Medical Center have been told some of their accrued pay is being held back, according to The Boston Globe. More than 1,100 staffers at Atrius Health in Massachusetts are facing reduced paychecks or unpaid furloughs, and raises for medical staff at South Shore Health, another health system in Massachusetts, are being delayed. Several other hospitals have also announced furloughs. . .

Continue reading.

Profits über alles. “Best healthcare system in th world.” Not.

Written by LeisureGuy

31 March 2020 at 5:06 pm

Amazon Fired the Warehouse Worker Who Organized a Walkout Over Coronavirus

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Paul Blest reports in Vice News:

After he helped organize some of his fellow workers to walk out at an Amazon warehouse on Staten Island over coronavirus-related safety concerns, Chris Smalls was fired from his job. Amazon says he violated a company order to self-quarantine and put his fellow workers at risk of contracting the coronavirus; he says it’s retaliation.

“It’s a shame on them,” Smalls told VICE News. “This is a proven fact of why they don’t care about their employees, to fire someone after five years for sticking up for people and trying to give them a voice.”

Amazon says that they fired Smalls for “violating social distancing guidelines and putting the safety of others at risk.”

“He was found to have had close contact with a diagnosed associate with a confirmed case of COVID-19 and was asked to remain home with pay for 14 days, which is a measure we’re taking at sites around the world,” Amazon said in a statement provided to VICE News. “Despite that instruction to stay home with pay, he came onsite today, March 30, further putting the teams at risk. This is unacceptable and we have terminated his employment as a result of these multiple safety issues.”

Amazon has publicly confirmed that two workers at the JFK8 warehouse have tested positive for coronavirus, though Smalls told VICE News Monday that he believes several more workers have contracted the illness than Amazon is publicly confirming. . .

Continue reading.

Written by LeisureGuy

31 March 2020 at 12:51 pm

Posted in Business, Medical

A Medical Anthropologist Tells Us Why She Was So Wrong About Coronavirus

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Matthew Gault writes in Vice’s Motherboard:

In the early days of the coronavirus pandemic, many public health experts were sure that the virus could be beaten before it had a disastrous impact: as long as testing was robust, and the systems in place functioned properly, America would pull through relatively unscathed.

They may have been right, but we’ll never know, because testing has not been robust, and the systems in place have all failed miserably.

One expert I spoke with in late February was Theresa MacPhail, a medical anthropologist, Assistant Professor at Stevens Institute of Technology, and author of the book The Viral Network: A Pathology of the H1N1 Influenza Pandemic. MacPhail worked with the CDC in 2009 as a volunteer intern as part of its Global Disease & Detection unit, taking part in global conference calls on the H1N1 pandemic and seeing how the organization is structured. She was in Hong Kong during its H1N1 outbreak.

In late February, she spoke optimistically with me about America’s ability to handle the coming Covid-19 outbreak. In early March, she got sick with what she believes to be Covid-19. She reached out to me recently, insisting to go on the record again to say that she was wrong, and that she put too much faith in the CDC and America’s ability to manage the crisis.

How are you feeling?
I feel guilty. I feel like I should have known better.

What was it about our previous conversation that made you feel guilty?
I made a lot of assumptions and didn’t think twice about having made them. I know I’m not alone, I’m just one of the only people that is saying publicly, “Well, I got this completely wrong.”

I think it was overconfidence. I feel like what we’re seeing is a bit of hubris. We’re basically suffering, partially, because there was no plan for when the [Center for Disease Control] fucked up, because they don’t fuck up, or they haven’t in the past. They don’t have a protocol for when they can’t do an assay. And that’s exactly what happened. Their assays didn’t work. And there was no plan for that.

What do you mean by an assay?
I just assumed that the US system would be a little bit better, would be a little bit more robust and do more testing and containment than China was able to do, and I just couldn’t have been more wrong.

When we talked, I was still so confident that this response was gonna look like the 2009 [H1N1] pandemic response, which was a good response. Initially, it had some problems… but once they realized what was going on, they kicked into gear and everything went pretty well.

One thing that’s super different is that the CDC in 2009 provided central leadership. They were proactively reaching out to state, regional, and local Health officials saying, ‘Here’s what you need to be doing. Here’s what this should look like.’ And people did it.

I am scared and enraged because there’s no central authority here. I don’t understand what’s going on.The CDC isn’t giving press briefings. They’re just absent. And that could be because the administration is muzzling them. Or it could mean that there’s disarray inside the CDC. And I guess all of that will come out.

But I feel guilty because I knew them. So it’s a bit like not wanting to think your Uncle Bob did something wrong or was capable of doing something wrong. That’s why I feel bad, because I just assumed that this response would look like the old response. And it doesn’t at all, and I just feel so awful.

I wasn’t one of those people sounding the warning alarm. I really felt like we had a shot at containing [it]. But that meant that we had to have tests. I didn’t realize what 10 years of underfunding public health had done.

You got sick after we spoke last, right?
I was never tested, but if I had to lay bets I would say I have it. I’m still sick now. I’m on day 25. I got sick on March 1. It was the classic sore throat, feeling a little bit disgusting, and then at day five or six my fever started to spike. It got as high as 102.5 and never went below 100, despite taking massive amounts of fever reducer.

I started having tightness in my chest. I had a dry cough. I went to the ER on March 9. They put me in a separate room. Before all this went down, I had been contacted to go to Washington to the House of Representatives and give a public statement before Congress about what we’ve learned in pandemics past. Of course, that all got shot out of the water.

I asked the ER doctor, “Can you tell me in your professional opinion, are you prepared for this?” He said, “Absolutely not.” He had been doing this for 12 years. He was there for the 2009 pandemic. He said in 2009 they were overprepared. They had extra flu kits, they had extra supplies, they were ready. They had been prepared by the Department of Health. The communication had been clear. He said, “I hate to tell you this but we’re underprepared now. We don’t have extra supplies. We don’t have any tests.” That’s when I started to think, “This is serious.”

The only way we get out of this, the only way we return to a semblance of normal, is massive testing. And I’m starting to get worried because when are we doing that? It’s mind boggling.

You’ve mentioned a few times that past responses were better. What do you mean? . . .

Continue reading.

Written by LeisureGuy

31 March 2020 at 12:47 pm

Kushner Firm Built the Coronavirus Website Trump Promised

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Self-dealing is the norm with the Trump administration. Robinson Meyer writes in the Atlantic:

On March 13, President Donald Trump promised Americans they would soon be able to access a new website that would ask them about their symptoms and direct them to nearby coronavirus testing sites. He said Google was helping.

That wasn’t true. But in the following days, Oscar Health—a health-insurance company closely connected to Trump’s son-in-law, Jared Kushner—developed a government website with the features the president had described. A team of Oscar engineers, project managers, and executives spent about five days building a stand-alone website at the government’s request, an Oscar spokesperson told The Atlantic. The company even dispatched two employees from New York to meet in person with federal officials in Washington, D.C., the spokesperson said. Then the website was suddenly and mysteriously scrapped.

The site would not have helped many Americans even if it had launched. Today, more than two weeks after the president promised a national network of drive-through test sites, only a handful of such sites have opened, and fewer than 1 million Americans have been tested.

The full extent of Oscar’s work on the project has not been previously reported. The partnership between the administration and the firm suggests that Kushner may have mingled his family’s business interests with his political interests and his role in the administration’s coronavirus response. Kushner’s younger brother Joshua is a co-founder and major investor in Oscar, and Jared Kushner partially owned or controlled Oscar before he joined the White House. The company’s work on the coronavirus website could violate federal ethics laws, several experts said.

For the past several weeks, Kushner has led a “shadow task force” on the coronavirus, separate from Vice President Mike Pence’s official committee, according to The Washington Post. Kushner’s team, composed of federal officials allied with Kushner and outside corporate executives, has met in the headquarters of the Department of Health and Human Services. A senior official at that agency called Oscar to ask for its help on March 13, the day of Trump’s press conference, the Oscar spokesperson said.

Kushner’s group has focused on expanding and publicizing coronavirus testing, especially at drive-through locations. Oscar’s website would have asked users if they were experiencing symptoms of COVID-19, the illness caused by the virus, and surveyed them about other risk factors, including their age and preexisting conditions. It also would have listed a limited number of testing locations nationwide, including some of the drive-through sites that Trump promised. It was designed to look like a government-developed product, provided freely by the Department of Health and Human Services to the American public. Oscar posted the source code for the site to Github, where The Atlantic reviewed it.

The site resembled a version of a tool Oscar had already built for its customers in response to the crisis, but it was “adjusted to meet the specifications and requirements set by the federal government,” Jackie Kahn, the Oscar spokesperson, said in an emailed statement. That Oscar had already been working on a coronavirus-testing website when HHS called to ask for help was a coincidence that had nothing to do with Kushner, Kahn suggested. She declined to say whether Oscar had discussed that site with Joshua Kushner or any board members or investors before Trump’s March 13 press conference.

Oscar donated its work freely and never expected to be paid for the project, Kahn said. The company is “not, nor has ever been,” a contractor or subcontractor for the government, she said, which would make it harder for the government to pay Oscar for its work. The work was “all at the direction of HHS,” she said. “The website never saw the light of day,” she added in an interview today.

That may not matter from an ethics perspective. The ad hoc nature of Kushner’s task force has already collided with federal laws. Oscar’s involvement deepens Kushner’s ethics and conflict-of-interest problems.

“It’s not typical. It’s usually not allowed,” Jessica Tillipman, an assistant dean at the George Washington University School of Law and an expert on anti-corruption law, told me.

Oscar’s relationship with the Trump administration could breach federal law in two ways, Tillipman and other experts told me. First, companies are generally not supposed to work for the federal government for free, though some exceptions can be made in a national emergency. “The concern, when you have some free services, is that it makes the government beholden to the company,” Tillipman said.

More important, she said, any Kushner involvement may have violated the “impartiality rule,” which requires federal employees to refrain from making decisions when they even appear to involve a conflict of interest. The rule also prohibits federal employees from making a decision in which close relatives may have a financial stake. Such a situation would seem to apply to Kushner and Oscar. In 2013, Jared and Joshua were the “ultimate controlling persons in Oscar’s holding company,” according to a New York State report that Mother Jones dug up earlier this month. . .

Continue reading.

Written by LeisureGuy

31 March 2020 at 12:17 pm

Experimental AI tool predicts which COVID-19 patients develop respiratory disease

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ScienceDaily has an interesting report:

An artificial intelligence tool accurately predicted which patients newly infected with the COVID-19 virus would go on to develop severe respiratory disease, a new study found.

The work was led by NYU Grossman School of Medicine and the Courant Institute of Mathematical Sciences at New York University, in partnership with Wenzhou Central Hospital and Cangnan People’s Hospital, both in Wenzhou, China.

Named “SARS-CoV-2,” the new virus causes the disease called “coronavirus disease 2019” or “COVID-19.” As of March 30, the virus had infected 735,560 patients worldwide. According to the World Health Organization, the illness has caused more than 34,830 deaths to date, more often among older patients with underlying health conditions. The New York State Department of Health has reported more than 33,700 cases to date in New York City.

Published online March 30 in the journal Computers, Materials & Continua, the study also revealed the best indicators of future severity, and found that they were not as expected.

“While work remains to further validate our model, it holds promise as another tool to predict the patients most vulnerable to the virus, but only in support of physicians’ hard-won clinical experience in treating viral infections,” says corresponding study author Megan Coffee, MD, PhD, clinical assistant professor in the Division of Infectious Disease & Immunology within the Department of Medicine at NYU Grossman School of Medicine.

“Our goal was to design and deploy a decision-support tool using AI capabilities — mostly predictive analytics — to flag future clinical coronavirus severity,” says co-author Anasse Bari, PhD, a clinical assistant professor in Computer Science at the Courant institute. “We hope that the tool, when fully developed, will be useful to physicians as they assess which moderately ill patients really need beds, and who can safely go home, with hospital resources stretched thin.”

Surprise Predictors

For the study, demographic, laboratory, and radiological findings were collected from 53 patients as each tested positive in January 2020 for the SARS-CoV2 virus at the two Chinese hospitals. Symptoms were typically mild to begin with, including cough, fever, and stomach upset. In a minority of patients, however, severe symptoms developed with a week, including pneumonia.

The goal of the new study was to determine whether AI techniques could help to accurately predict which patients with the virus would go on to develop Acute Respiratory Distress Syndrome or ARDS, the fluid build-up in the lungs that can be fatal in the elderly.

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Written by LeisureGuy

31 March 2020 at 11:38 am

Posted in Health, Medical, Science, Software, Technology

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The Unbelievable Tale of Jesus’s Wife

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Ariel Sabar has in the Atlantic a lengthy but fascinating account of his tracking down how that papyrus fragment that referred to the wife of Jesus came about. It reads like a Dan Brown novel (one of which may have sparked the idea), but without the violence. The academic who pushed the papyrus fragment, Karen King, comes out looking not very good. The story begins:

On a humid afternoon this past November, I pulled off Interstate 75 into a stretch of Florida pine forest tangled with runaway vines. My GPS was homing in on the house of a man I thought might hold the master key to one of the strangest scholarly mysteries in recent decades: a 1,300-year-old scrap of papyrus that bore the phrase “Jesus said to them, My wife.” The fragment, written in the ancient language of Coptic, had set off shock waves when an eminent Harvard historian of early Christianity, Karen L. King, presented it in September 2012 at a conference in Rome.

Never before had an ancient manuscript alluded to Jesus’s being married. The papyrus’s lines were incomplete, but they seemed to describe a dialogue between Jesus and the apostles over whether his “wife”—possibly Mary Magdalene—was “worthy” of discipleship. Its main point, King argued, was that “women who are wives and mothers can be Jesus’s disciples.” She thought the passage likely figured into ancient debates over whether “marriage or celibacy [was] the ideal mode of Christian life” and, ultimately, whether a person could be both sexual and holy.

King called the business-card-size papyrus “The Gospel of Jesus’s Wife.” But even without that provocative title, it would have shaken the world of biblical scholarship. Centuries of Christian tradition are bound up in whether the scrap is authentic or, as a growing group of scholars contends, an outrageous modern fake: Jesus’s bachelorhood helps form the basis for priestly celibacy, and his all-male cast of apostles has long been cited to justify limits on women’s religious leadership. In the Roman Catholic Church in particular, the New Testament is seen as divine revelation handed down through a long line of men—Jesus, the 12 apostles, the Church fathers, the popes, and finally the priests who bring God’s word to the parish pews today.

King showed the papyrus to a small group of media outlets in the weeks before her announcement—The Boston Globe, The New York Times, and both Smithsonian magazine and the Smithsonian Channel—on the condition that no stories run before her presentation in Rome. Smithsonian assigned me a long feature, sending me to see King at Harvard and then to follow her to Rome. I was the only reporter in the room when she revealed her find to colleagues, who reacted with equal parts fascination and disbelief.

“The Gospel of Jesus’s Wife” papyrus (Karen L. King / Harvard / AP)

Within days, doubts mounted. The Vatican newspaper labeled the papyrus “an inept forgery.” Scholars took to their blogs to point out apparent errors in Coptic grammar as well as phrases that seemed to have been lifted from the Gospel of Thomas. Others deemed the text suspiciously in step with the zeitgeist of growing religious egalitarianism and of intrigue around the idea, popularized by The Da Vinci Code, of a married Jesus. The controversy made news around the world, including an article in these pages.

A year and a half later, however, Harvard announced the results of carbon-dating tests, multispectral imaging, and other lab analyses: The papyrus appeared to be of ancient origin, and the ink had no obviously modern ingredients. This didn’t rule out fraud. A determined forger could obtain a blank scrap of centuries-old papyrus (perhaps even on eBay, where old papyri are routinely auctioned), mix ink from ancient recipes, and fashion passable Coptic script, particularly if he or she had some scholarly training. But the scientific findings complicated the case for forgery. The Gospel of Jesus’s Wife had undergone—and passed—more state-of-the-art lab tests, inch for inch, than almost any other papyrus in history. . .

Continue reading. This is just the beginning…

Written by LeisureGuy

31 March 2020 at 11:31 am

A great shave and a fine-bristled brush

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I noticed (perhaps again) how very fine are the bristles of this Yaqi brush. The synthetic knot is in a “Target Shot” pattern, modeled (I’m told) on the quadrant aiming pattern used by submarines in WWII. I shook out all excess water and got an excellent lather from Phoenix Artisan’s Avo Nice Shave shaving soap.

The Yaqi DOC razor, in a cammo pattern to match the brush handle, is an very good razor and I easily achieved a BBS result in three smooth and trouble-free passes. A splash of Avo Nice Shave aftershave, and I’m back to unpacking and organizing.

Written by LeisureGuy

31 March 2020 at 10:40 am

Posted in Shaving

Taxpayers Paid Millions to Design a Low-Cost Ventilator for a Pandemic. Instead, the Company Is Selling Versions of It Overseas.

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Corporations are sociopaths. Patricia Callahan, Sebastian Rotella, and Tim Golde report in ProPublica:

Five years ago, the U.S. Department of Health and Human Services tried to plug a crucial hole in its preparations for a global pandemic, signing a $13.8 million contract with a Pennsylvania manufacturer to create a low-cost, portable, easy-to-use ventilator that could be stockpiled for emergencies.

This past September, with the design of the new Trilogy Evo Universal finally cleared by the Food and Drug Administration, HHS ordered 10,000 of the ventilators for the Strategic National Stockpile at a cost of $3,280 each.

But as the pandemic continues to spread across the globe, there is still not a single Trilogy Evo Universal in the stockpile.

Instead last summer, soon after the FDA’s approval, the Pennsylvania company that designed the device — a subsidiary of the Dutch appliance and technology giant Royal Philips N.V. — began selling two higher-priced commercial versions of the same ventilator around the world.

“We sell to whoever calls,” said a saleswoman at a small medical-supply company on Staten Island that bought 50 Trilogy Evo ventilators from Philips in early March and last week hiked its online price from $12,495 to $17,154. “We have hundreds of orders to fill. I think America didn’t take this seriously at first, and now everyone’s frantic.”

Last Friday, President Donald Trump invoked the Defense Production Act to compel General Motors to begin mass-producing another company’s ventilator under a federal contract. But neither Trump nor other senior officials made any mention of the Trilogy Evo Universal. Nor did HHS officials explain why they did not force Philips to accelerate delivery of these ventilators earlier this year, when it became clear that the virus was overwhelming medical facilities around the world.

An HHS spokeswoman told ProPublica that Philips had agreed to make the Trilogy Evo Universal ventilator “as soon as possible.” However, a Philips spokesman said the company has no plan to even begin production anytime this year.

Instead, Philips is negotiating with a White House team led by Trump’s son-in-law, Jared Kushner, to build 43,000 more complex and expensive hospital ventilators for Americans stricken by the virus.

Some experts said the nature of the current crisis — in which the federal government is scrambling to set up field hospitals in New York’s Central Park and the Jacob K. Javits Convention Center — underscores the urgent need for simpler, lower-cost ventilators. The story of the Trilogy Evo Universal, described here for the first time, also raises questions about the government’s reliance on public-private partnerships that public health officials have used to piece together important parts of their disaster safety net.

“That’s the problem of leaving any kind of disaster preparedness up to the market and market forces — it will never work,” said Dr. John Hick, an emergency medicine specialist in Minnesota who has advised HHS on pandemic preparedness since 2002. “The market is not going to give priority to a relatively no-frills but dependable ventilator that’s not expensive.”

The lack of ventilators has quickly become the most critical challenge to keeping alive many of the people most seriously sickened by the virus. Ventilators not only help people breathe but also can provide pressure that holds the lungs open so the air sacs don’t collapse.

Neither HHS nor Philips would provide a copy of their contract, citing proprietary technical information that would have to be redacted under a Freedom of Information Act request. But from public documents and interviews with current and former government officials, it appears that HHS has at times been remarkably deferential to Philips — and never more so than in the current pandemic.

From the start of its long effort to produce a low-cost, portable ventilator, the small HHS office in charge of the project, the Biomedical Advanced Research and Development Authority, or BARDA, knew that it might need to move quickly to increase production in an emergency and insisted that potential partners be able to ramp up quickly in the event of a pandemic.

But the contract HHS signed in September 2019 gave Philips almost a year before it had to produce a single Trilogy Evo Universal, and two more years to fulfill the order of 10,000 ventilators. . .

Continue reading. There’s much more.

Written by LeisureGuy

30 March 2020 at 5:13 pm

Concatenation: An experimental video

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30 March 2020 at 4:41 pm

Posted in Video

What are the best foods?

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Written by LeisureGuy

30 March 2020 at 11:30 am

The Contrarian Coronavirus Theory That Informed the Trump Administration

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“Misinformed” might be better. Isaac Chatiner writes in the New Yorker:

President Trump, who at one point called the coronavirus pandemic an “invisible enemy” and said it made him a “wartime President,” has in recent days questioned its seriousness, tweeting, “WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF.” Trump said repeatedly that he wanted the country to reopen by Easter, April 12th, contradicting the advice of most health officials. (On Sunday, he backed down and extended federal social-distancing guidelines for at least another month.) According to the Washington Post, “Conservatives close to Trump and numerous administration officials have been circulating an article by Richard A. Epstein of the Hoover Institution, titled ‘Coronavirus Perspective,’ which plays down the extent of the spread and the threat.”

Epstein, a professor at New York University School of Law, published the article on the Web site of the Hoover Institution, on March 16th. In it, he questioned the World Health Organization’s decision to declare the coronavirus outbreak a pandemic, said that “public officials have gone overboard,” and suggested that about five hundred people would die from covid-19 in the U.S. Epstein later updated his estimate to five thousand, saying that the previous number had been an error. So far, there have been more than two thousand coronavirus-related fatalities in America; epidemiologists’ projections of the total deaths range widely, depending on the success of social distancing and the availability of medical resources, but they tend to be much higher than Epstein’s. (On Sunday, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, estimated that there could be between a hundred thousand and two hundred thousand deaths in the U.S.) In a follow-up article, published on March 23rd and titled “Coronavirus Overreaction,” Epstein wrote, “Progressives think they can run everyone’s lives through central planning, but the state of the economy suggests otherwise. Looking at the costs, the public commands have led to a crash in the stock market, and may only save a small fraction of the lives that are at risk.”

Epstein has long been one of the most cited legal scholars in the country, and is known for his libertarian-minded reading of the Constitution, which envisions a restrained federal government that respects private property. He has also been known to engage with controversial subjects; last fall, he published an article on the Hoover Institution Web site that argued, “The professional skeptics are right: there is today no compelling evidence of an impending climate emergency.” Last Wednesday, I spoke by phone with Epstein about his views of the coronavirus pandemic. He was initially wary of talking, and asked to record his own version of the call, which I agreed to. During our conversation, which has been edited for length and clarity, Epstein made a number of comments about viruses that have been strongly disputed by medical professionals. We have included factual corrections alongside those statements.

What did you want to achieve with your pieces?

What did I want to achieve with my pieces? First of all, I am not a politician. What I did is that I looked at the standard model that was put out in the New York Times [in an Op-Ed by Nicholas Kristof and Stuart A. Thompson, published on March 13th], which was backed up by other models in other places, and it occurred to me that I just did not think that the underlying assumptions there were sound. The single most important thing to me was not to get my own estimate of what the number is. The most important thing was to look at that curve, which seemed to suggest that there would be ten million cases a day during a ten-day or so band in the middle of July, and to explain why, in relationship to all other things I know about evolutionary theory, that this just has to be wrong. The better way to have phrased the paper would have been to say that the traditional models, which were used for the last flu season, for the 2009 H1N1 situation, are much better approximations of what is likely to happen than these rather scary kinds of projections.

You wrote last week, “In the United States, if the total death toll increases at about the same rate, the current 67 deaths should translate into about 500 deaths at the end.” We are currently at eight hundred deaths—over eight hundred deaths. [This was true when we spoke; the number is now over two thousand.]

First of all, let me just say I wrote an amendment to that, the thing I regret most in that whole paper. But I was not so much interested in explaining why my number was right. I was interested in explaining why the other projections were wrong.

O.K., but your number was surpassed in about a week, and now we’re already—

I understand that, but the point about that is that, first of all, there was a simple stupid error, which is you would never want to put it in a model that total deaths in the United States relative to the world would be one per cent. So if you just inflated it to five per cent or ten per cent, then all of a sudden you’ve got a number which is either five or ten times as high.

Secondly, suppose I should have been wiser in this and said, as I referred to the flu vaccine and later on to the H1N1 situation, if those are your benchmarks, then the number goes up to, say, between fifteen thousand and forty thousand deaths, as opposed to the one million-plus that are projected. [The Times model projected, without interventions by governments or citizens, a million deaths in the U.S.; with such interventions, the model showed that number dramatically decreasing.] And, remember, the one million-plus is on a model which is universal and worldwide, and you should expect to see something like that somewhere else. And there’s no evidence whatsoever that any of the situations, even in Italy, is going to approach the kinds of numbers that you had there. And so I am truly sorry about that [five hundred] number. I regard it as the single worst public-relations gaffe I’ve made in my entire life. But the question to ask, Isaac, is not whether I chose the right number but whether I had the right model.

Something else you wrote, in an earlier piece, was, “Why has there been such a dramatic mismatch in the responses to ordinary flu and the coronavirus?” Is that a question you’re still unsure about?

Look, the basic problem is, I think, in effect, that the tendency on the part of many people to treat this particular thing as unique is a mistake. There’s an underlying, standard model that you want to use, and the question is how you stuff it full of parameters. That is, numbers you add into it to make what’s going on. And, so, the situation that you get is you cannot use any exponential system because essentially then everybody is going to be dead, because things just keep doubling, doubling, and doubling. . .

Continue reading, especially if you want to be infuriated by smug arrogance arising from a particularly intense instance of the Duning-Kruger effect. (The interviewee is a legal scholar, not a doctor and particularly not an epidemiologist, though he feels quite comfortable making authoritative-sounding statements based on his ignorance.)

Written by LeisureGuy

30 March 2020 at 9:37 am

Why You Should Ignore All That Coronavirus-Inspired Productivity Pressure

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Aisah S. Ahmad writes in the Chronicle of Higher Education:

Among my academic colleagues and friends, I have observed a common response to the continuing Covid-19 crisis. They are fighting valiantly for a sense of normalcy — hustling to move courses online, maintaining strict writing schedules, creating Montessori schools at their kitchen tables. They hope to buckle down for a short stint until things get back to normal. I wish anyone who pursues that path the very best of luck and health.

Yet as someone who has experience with crises around the world, what I see behind this scramble for productivity is a perilous assumption. The answer to the question everyone is asking — “When will this be over?” — is simple and obvious, yet terribly hard to accept. The answer is never.

Global catastrophes change the world, and this pandemic is very much akin to a major war. Even if we contain the Covid-19 crisis within a few months, the legacy of this pandemic will live with us for years, perhaps decades to come. It will change the way we move, build, learn, and connect. There is simply no way that our lives will resume as if this had never happened. And so, while it may feel good in the moment, it is foolish to dive into a frenzy of activity or obsess about your scholarly productivity right now. That is denial and delusion. The emotionally and spiritually sane response is to prepare to be forever changed.

The rest of this piece is an offering. I have been asked by my colleagues around the world to share my experiences of adapting to conditions of crisis. Of course, I am just a human, struggling like everyone else to adjust to the pandemic. However, I have worked and lived under conditions of war, violent conflict, poverty, and disaster in many places around the world. I have experienced food shortages and disease outbreaks, as well as long periods of social isolation, restricted movement, and confinement. I have conducted award-winning research under intensely difficult physical and psychological conditions, and I celebrate productivity and performance in my own scholarly career.

I share the following thoughts during this difficult time in the hope that they will help other academics to adapt to hardship conditions. Take what you need, and leave the rest.

Stage No. 1: Security

Your first few days and weeks in a crisis are crucial, and you should make ample room to allow for a mental adjustment. It is perfectly normal and appropriate to feel bad and lost during this initial transition. Consider it a good thing that you are not in denial, and that you are allowing yourself to work through the anxiety. No sane person feels good during a global disaster, so be grateful for the discomfort of your sanity. At this stage, I would focus on food, family, friends, and maybe fitness. (You will not become an Olympic athlete in the next two weeks, so don’t put ridiculous expectations on your body.)

Next, ignore everyone who is posting productivity porn on social media right now. It is OK that you keep waking up at 3 a.m. It is OK that you forgot to eat lunch and cannot do a Zoom yoga class. It is OK that you have not touched that revise-and-resubmit in three weeks.

Ignore the people who are posting that they are writing papers and the people who are complaining that they cannot write papers. They are on their own journey. Cut out the noise.

Know that you are not . . .

Continue reading. There’s much more.

Written by LeisureGuy

30 March 2020 at 9:20 am

Coronavirus-inspired song hit

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Written by LeisureGuy

30 March 2020 at 9:05 am

I figure out the Fine slant — now it’s a favorite. One little change in technique…

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First, of course, comes the prep: wash my (two-day) stubble with MR GLO, then a very pleasant and fragrant lather with Tallow + Steel’s take on bay rum, using the Kent BK4, a lovely brush with a light touch.

Next, I finally found the groove with the Fine slant, which I can wholeheartedly recommend as not only extremely efficient but also — now — very, very comfortable. Previously, I had found that it would throw off the occasional nick, but that was because I was making an elementary error: bad blade angle. This morning I focused on keeping more of the cap on my face — aiming for the blade angle of the Baby Smooth, for example — which I did by keeping the handle a little farther from my face than I had.

It was night (previously) and day (now): totally comfortable, totally non-threatening, and a fantastic shave. This razor has now jumped in the first rank among my razors, and I can recommend it without reservation — well, one reservation: keep the handle away from your face so more of the cap contacts the skin. Wait, two reservations: keeping the handle away from your face and use a very light touch: that’s all it needs.

What a terrific razor! I’m very pleased with it. I’ll be using it again soon.

A splash of Grog, and I went to the supermarket for another batch of greens to cook.

Written by LeisureGuy

30 March 2020 at 9:00 am

Posted in Daily life, Shaving

The U.S. Tried to Build a New Fleet of Ventilators. The Mission Failed.

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Why? Because capitalism degrades US capabilities. Nicholas KulishSarah Kliff, and  report in the NY Times:

Thirteen years ago, a group of U.S. public health officials came up with a plan to address what they regarded as one of the medical system’s crucial vulnerabilities: a shortage of ventilators.

The breathing-assistance machines tended to be bulky, expensive and limited in number. The plan was to build a large fleet of inexpensive portable devices to deploy in a flu pandemic or another crisis.

Money was budgeted. A federal contract was signed. Work got underway.

And then things suddenly veered off course. A multibillion-dollar maker of medical devices bought the small California company that had been hired to design the new machines. The project ultimately produced zero ventilators.

That failure delayed the development of an affordable ventilator by at least half a decade, depriving hospitals, states and the federal government of the ability to stock up. The federal government started over with another company in 2014, whose ventilator was approved only last year and whose products have not yet been delivered.

Today, with the coronavirus ravaging America’s health care system, the nation’s emergency-response stockpile is still waiting on its first shipment. The scarcity of ventilators has become an emergency, forcing doctors to make life-or-death decisions about who gets to breathe and who does not.

The stalled efforts to create a new class of cheap, easy-to-use ventilators highlight the perils of outsourcing projects with critical public-health implications to private companies; their focus on maximizing profits is not always consistent with the government’s goal of preparing for a future crisis. [Emphasis added. – LG]

“We definitely saw the problem,” said Dr. Thomas R. Frieden, who ran the Centers for Disease Control and Prevention from 2009 to 2017. “We innovated to try and get a solution. We made really good progress, but it doesn’t appear to have resulted in the volume that we needed.”

The project — code-named Aura — came in the wake of a parade of near-miss pandemics: SARS, MERS, bird flu and swine flu.

Federal officials decided to re-evaluate their strategy for the next public health emergency. They considered vaccines, antiviral drugs, protective gear and ventilators, the last line of defense for patients suffering respiratory failure. The federal government’s Strategic National Stockpile had full-service ventilators in its warehouses, but not in the quantities that would be needed to combat a major pandemic. . .

Continue reading.

Written by LeisureGuy

29 March 2020 at 8:29 pm

Something is seriously wrong with President Trump

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Read this. It should turn your stomach.

Written by LeisureGuy

29 March 2020 at 7:49 pm

The missing six weeks: how Trump failed the biggest test of his life

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Ed Pilkington and Tom McCarthy report in the Guardian:

When the definitive history of the coronavirus pandemic is written, the date 20 January 2020 is certain to feature prominently. It was on that day that a 35-year-old man in Washington state, recently returned from visiting family in Wuhan in China, became the first person in the US to be diagnosed with the virus.

On the very same day, 5,000 miles away in Asia, the first confirmed case of Covid-19 was reported in South Korea. The confluence was striking, but there the similarities ended.

In the two months since that fateful day, the responses to coronavirus displayed by the US and South Korea have been polar opposites.

One country acted swiftly and aggressively to detect and isolate the virus, and by doing so has largely contained the crisis. The other country dithered and procrastinated, became mired in chaos and confusion, was distracted by the individual whims of its leader, and is now confronted by a health emergency of daunting proportions.

Within a week of its first confirmed case, South Korea’s disease control agency had summoned 20 private companies to the medical equivalent of a war-planning summit and told them to develop a test for the virus at lightning speed. A week after that, the first diagnostic test was approved and went into battle, identifying infected individuals who could then be quarantined to halt the advance of the disease.

Some 357,896 tests later, the country has more or less won the coronavirus war. On Friday only 91 new cases were reported in a country of more than 50 million.

The US response tells a different story. Two days after the first diagnosis in Washington state, Donald Trump went on air on CNBC and bragged: “We have it totally under control. It’s one person coming from China. It’s going to be just fine.”

‘A fiasco of incredible proportions’

A week after that, the Wall Street Journal published an opinion article by two former top health policy officials within the Trump administration under the headline Act Now to Prevent an American Epidemic. Luciana Borio and Scott Gottlieb laid out a menu of what had to be done instantly to avert a massive health disaster.

Top of their to-do list: work with private industry to develop an “easy-to-use, rapid diagnostic test” – in other words, just what South Korea was doing.

It was not until 29 February, more than a month after the Journal article and almost six weeks after the first case of coronavirus was confirmed in the country that the Trump administration put that advice into practice. Laboratories and hospitals would finally be allowed to conduct their own Covid-19 tests to speed up the process.

Those missing four to six weeks are likely to go down in the definitive history as a cautionary tale of the potentially devastating consequences of failed political leadership. Today, 86,012 cases have been confirmed across the US, pushing the nation to the top of the world’s coronavirus league table – above even China.

More than a quarter of those cases are in New York City, now a global center of the coronavirus pandemic, with New Orleans also raising alarm. Nationally, 1,301 people have died.

Most worryingly, the curve of cases continues to rise precipitously, with no sign of the plateau that has spared South Korea.

“The US response will be studied for generations as a textbook example of a disastrous, failed effort,” Ron Klain, who spearheaded the fight against Ebola in 2014, told a Georgetown university panel recently. “What’s happened in Washington has been a fiasco of incredible proportions.”

Jeremy Konyndyk, who led the US government’s response to international disasters at USAid from 2013 to 2017, frames the past six weeks in strikingly similar terms. He told the Guardian: “We are witnessing in the United States one of the greatest failures of basic governance and basic leadership in modern times.”

In Konyndyk’s analysis, the White House had all the information it needed by the end of January to act decisively. Instead, Trump repeatedly played down the severity of the threat, blaming China for what he called the “Chinese virus” and insisting falsely that his partial travel bans on China and Europe were all it would take to contain the crisis.

‘The CDC was caught flat-footed’

If Trump’s travel ban did nothing else, it . . .

Continue reading.

Written by LeisureGuy

29 March 2020 at 11:47 am

A World Without Partisan Gerrymanders? Virginia Democrats Show the Way

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Note what Democrats do. Jesse Wegman writes in the NY Times:

Politicians rarely give up power voluntarily. They never give it up when they have free rein to lock it in for at least a decade, and exact long-overdue revenge against their political opponents.

But a group of Virginia Democrats did just that earlier this month, when they voted in favor of an amendment to the State Constitution stripping themselves of the power to redraw legislative district maps in 2021, after the decennial census.

Last fall, Democrats won majorities in both houses of the Virginia Legislature; with a Democratic governor already in office, they took full control of the state government for the first time in a generation. They had unlimited power to fashion the new maps in their favor, cementing their own grip on power just as Republicans around the country have done since the last redistricting cycle in 2011. Some Republican maps are so biased that they have given the G.O.P. legislative supermajorities even when the party loses the statewide popular vote, which happened in Wisconsin in 2018. So it’s entirely understandable for Democrats who regain power to want payback — now.

And yet nine Virginia Democrats agreed to put down their partisan swords and join Republicans to support the new amendment, which would require that the state’s district maps be drawn by a bipartisan commission made up of lawmakers and regular citizens. Voters must ratify the amendment in November before it will take effect.

The Democrats’ vote was a display of integrity and selflessness by members of a party with unified control of government. It placed long-term interest in the health of representative democracy over the shorter-term partisan benefits that both parties have been happy to exploit when they control redistricting.

The Virginia amendment’s passage is all the more important in the present moment, when voters everywhere have been left at the mercy of self-serving state lawmakers, thanks to the Supreme Court’s refusal to intervene to stop even the most extreme partisan gerrymanders. The ruling last June, by a 5-to-4 vote, asserted that redistricting was a political matter to be resolved by the states, not the federal courts. The justices thus enshrined one of the most corrosive and anti-democratic practices in American politics.

Virginia’s new amendment would establish a 16-member commission, made up of eight lawmakers and eight citizens, divided evenly between the two major parties. A supermajority of both lawmaker and citizen commissioners would have to agree on a proposed map to send it to the Legislature and governor for approval. If they can’t, the job shifts to the State Supreme Court.

The amendment, which under the State Constitution had to pass the Legislature twice in a row before going to the voters, was first approved in 2019 by overwhelming bipartisan margins . . .

Continue reading.

Written by LeisureGuy

28 March 2020 at 8:57 pm

A Complete Guide To Actually Getting Somewhere With Meditation

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David at Raptitude has an interesting and useful introductory guide to meditation. It’s well worth reading. It begins:

It seems as though we’ve entered the “What do I do with myself?” phase of social distancing. Over the last week or two, several billion daily routines essentially evaporated, and now each of us has to make a new one. Indoors.

The wonderful comments from last week’s post offer a glimpse into the still-forming routines of more than 500 people. A major theme is getting back to things that ground us and keep us present: reading, arts and crafts, phoning old friends, yoga, baking, and meditation.

Basically, everyone’s trying to stay healthy, sane, connected, and as helpful as they can be from home. My hope is that we’ll come out of this experience changed in exactly those ways: some degree healthier, saner, more connected and more helpful.

Not everyone has more time these days, but with everything closed, we have fewer ways to spend it. So it’s a good time to dive into home-based pursuits that make us healthier and more resilient. As one person put it, “It’s bad time for many things, but it’s a good time to read the classics, bake bread, and learn to meditate.”

I can’t help anyone with their baking goals, but I can definitely help anyone who wants to use this time to become a meditator. Given my platform and my particular skills, perhaps the most useful thing I can do for our species right now is to help some of its members finally get somewhere with meditation.

After all, it can be learned without leaving the house, it requires no equipment, and its benefits are especially pertinent right now: the ability to cultivate calm, focus, and emotional resilience in the midst of uncertainty. It can help people work better from home, and sleep better at night.

Meditation is also something you can do now — today, despite all the current restrictions on normal life ­­– that will begin moving you towards a place of less anxiety and more clarity of mind.

Making Meditation Click

I say “get somewhere” with meditation because, while most aspiring meditators do experience some benefit, most probably don’t experience the life-changing level of calm and focus meditation is known for.

They may continue to do meditate a little, and get something out of it, but it never becomes transformative. It doesn’t have the profound quality-of-life benefits they probably hoped for when they started. . .

Continue reading. There’s much more.

Note later in the post the free small course in Three-Minute Mindfulness.

Written by LeisureGuy

28 March 2020 at 11:02 am

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