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Archive for March 30th, 2020

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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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

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