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Archive for April 28th, 2020

New Model Shows How Deadly Lifting Georgia’s Lockdown May Be

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William Bredderman and Olivia Messer report in the Daily Beast:

Gov. Brian Kemp’s aggressive scheme to lift Georgia out of COVID-19 lockdown may cost many thousands of lives, according to models prepared by epidemiologists and computer scientists at Harvard and the Massachusetts Institute of Technology in partnership with The Daily Beast.

The findings come as governors across the United States aim to restore economic activity following months of pandemic-related infections and over 50,000 deaths—a number widely understood to be an undercount. Meanwhile, over 26 million Americans have filed for unemployment benefits in recent weeks, a number that is itself a likely undercount of the economic toll.

Georgia’s Kemp has perhaps been the boldest of any governor about moving on, issuing a pair of executive orders allowing fitness centers, tattoo and massage parlors, bowling alleys, and hair salons to reopen last Friday with some mitigation measures. Other businesses, like restaurants and theaters, began opening Monday. The state’s shelter-in-place decree, meanwhile, was slated to expire on Thursday.

Those policies are placing Georgians at spectacular risk, the new models found.

As of Friday, by official counts in Georgia, at least 871 people statewide had lost their lives to COVID-19. If Georgia had maintained its pre-Friday lockdown policy, the Harvard/MIT team’s simulation—which used data from the Johns Hopkins Coronavirus Resource Center and accounts for local demographics and health conditions based on Census and survey data—estimated the state would have logged a total of between 1,004 and 2,922 coronavirus fatalities by June 15. That fatality range, like all such ranges detailed in this article, includes deaths that had already been documented (in this case, 871).

By contrast, under Kemp’s current plan to reopen, if approved businesses returned to just 50 percent of their pre-pandemic activity (or “contact”) levels, that range could reach 1,604 to 4,236 deaths. At 100 percent of pre-shutdown activity, the projected final body count could soar to a range between 4,279 and 9,748.

Even if employee-on-employee contact returned to just one-quarter of what it was before the disease hit, and interactions among the general public—beginning April 30—reached 20 percent of the old norm, the researchers projected that deaths in the state could hit 3,563.

“What we find, no matter what we assume, is that reopening on Monday was just too early,” said Jackson Killian, Ph.D. student at Harvard’s John A. Paulson School of Engineering and Applied Sciences, who worked on the models. “If you let people go out and have contact again now, you end up causing deaths that could have been avoided.”

Based on the nature and speed of COVID-19’s spread through Georgia, Killian and his team estimated the virus may have arrived in the state as early as Feb. 1, or at least weeks before the first diagnosed cases—a possibility Kemp himself has acknowledged. To be clear, the models cannot prove or verify that the first infection happened on that date, but used it as an assumed start date based on the available information and the spread to date.

The governor’s office did not respond to repeated requests for comment for this story.

For their part, the team behind the models framed their approach not as an argument for absolutes, but a testament to dire stakes.

Continue reading.

Kemp will have blood on his hands.

Written by Leisureguy

28 April 2020 at 4:33 pm

Posted in Government, Medical

In the Midst of a Pandemic, Trump Continues to Cut Funding That May Prevent Pandemics

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Against stupidity the gods themselves contend in vain.  Matt Stieb writes in New York:

Setting aside the bigger picture of how the United States should handle its relationship with China, the president seems to possess an instinct that drives him to take the exact-wrong approach relative to his short-term goals regarding Beijing. In the seemingly prehistoric trade war from the summer of 2019, Trump hoped to protect American producers from getting “ripped off” by China but wound up devastating farmers who spent decades building customer bases across the Pacific; to offset financial losses from a trade war designed to make money, the USDA paid over $20 billion to agricultural providers in 2019.

Two weeks ago, the president made the decision to cut American funding for the World Health Organization in the middle of a pandemic. Though the United Nations agency did bungle aspects of its COVID-19 response, Trump’s reason for the cut — that the WHO was “severely mismanaging and covering up the spread of the coronavirus” and was biased to believe Beijing — were allegations that could be directed his way, as well. Despite the need for a reckoning within the agency, public health experts lambasted the president for cutting aid during a pandemic to the international organization designed to prevent pandemics. “During the worst public health crisis in a century, halting funding to the World Health Organization is a dangerous step in the wrong direction that will not make defeating COVID-19 easier,” the American Medical Association said in a statement.

Despite evidence that COVID-19 may have jumped from bats to humans — with a possible layover in the immune systems of pangolins — Politico reports that President Trump is now cutting funding for researchers determining how bat coronaviruses can infect humans because the project is linked to a lab in Wuhan, China. On Friday, the National Institutes of Health told the sponsor of the study for the past five years, EcoHealth Alliance, that all future funding was off the table and that the nonprofit would stop spending the remaining $369,819 from its 2020 grant. Politico explains why the cash flow was shut off to the project:

The group caught national attention a week ago after reports swirled that millions from its NIH grants had been sent to the Wuhan Institute of Virology, a research facility in the city where the coronavirus pandemic originated. In an email last week to NIH officials, EcoHealth Alliance President Pete Daszak denied giving any money this year to the Wuhan lab, although researchers from the facility have collaborated with EcoHealth Alliance scientists on research supported by an earlier grant.

The Wuhan lab is at the center of conspiracy theories alleging that the coronavirus outbreak began when the virus escaped the facility. U.S. intelligence agencies and scientists have not found any evidence to support the rumors.

The project, which received $3.7 million in federal grants over five years, first came to the political forefront on April 17, when a Newsmax reporter asked Trump if any of its funding had been routed to Chinese labs. “We will end that grant very quickly,” Trump responded. “It was granted quite a while ago. Who was president then, I wonder?” While the funding was first approved under President Obama, the NIH renewed it in July of last year.

There are a few logical flaws at hand. As Politico notes, . . .

Continue reading.

Written by Leisureguy

28 April 2020 at 4:20 pm

One Thing the Pandemic Hasn’t Stopped: Aggressive Medical-Debt Collection

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Alec MacGillis reports in ProPublica:

Darcel Richardson knows she’s fortunate in one sense: She still has her job as a vocational counselor in Baltimore. But despite that, she won’t be able to make her rent payment this month because she’s not getting her full salary for a while. More than $400 per biweekly paycheck — about a quarter of her after-tax income — has been siphoned off by Johns Hopkins University for unpaid medical bills at one of its hospitals.

Richardson, 60, got word of the garnishment from her employer just as the coronavirus pandemic was arriving in full force last month. “My job was going to take the money out. They don’t want to get in trouble,” she said. “I spoke with our payroll accountant, and the bottom line was, even though the crisis had begun, they still had to pay my money to them.”

In a moment when hospitals nationwide are being heralded for their role at the front lines of fighting the pandemic, some Americans continue to experience a less favorable side of hospital operations: aggressive collection for unpaid medical bills, even at a time when many of the debtors are seeing their income plunge. Debt collection is occurring on other fronts as well, over unpaid college and bank loans among others, prompting debates over protecting people’s economic stimulus checks from collection agencies or suspending garnishments outright. But collection by the very hospitals that are treating coronavirus patients brings the health and economic exigencies of the moment into especially stark relief.

In a few cases, hospitals have brought new cases against former patients in recent weeks, such as in Wisconsin, where Froedtert Hospital in Milwaukee filed 46 small-claims lawsuits even after the governor declared a state of emergency on March 12, and other hospital systems in the state filed dozens more, according to a report by Wisconsin Public Radio and Wisconsin Watch. Steve Schoof, Froedtert’s director of external communications, told ProPublica in a statement that the hospital stopped filing small claims suits on March 18. “Moving forward,” the statement continued, “Froedtert Health will no longer be filing small claims suits for medical debt collection. Unfortunately, there was a miscommunication that resulted in small claims filings after March 18. We immediately rectified this miscommunication and dismissed these small claims cases that were filed after March 18.”

More often, though, the collection stems from cases filed months before the pandemic arrived, as the legal process grinds its way forward. “Where debt collection is underway for pre-COVID medical debt, they will continue to do that,” said Jenifer Bosco, a staff attorney for the National Consumer Law Center.

In Richardson’s case, the debt stemmed from a two-day 2018 visit to Johns Hopkins Bayview Medical Center in southeast Baltimore, one of a string of medical visits she has had to make over the years to deal with a knee injury from a fall, a hip injury from a car accident, hernia repairs and back trouble. She had insurance coverage through her job, which at the time was with the state Division of Correction, but it left a balance of almost $1,000 for her to pay. Richardson, who lives by herself in a modest apartment complex just east of the city, started hearing from a collections lawyer for Hopkins last fall and tried to work out a payment schedule with him, but she couldn’t make it work.

“I just didn’t have the money,” she said. “I said to the lawyer, I might be able to pay an amount monthly, but when it came time, I just didn’t have it. What can you do when you’re caught between a rock and a hard place? I prioritize. I’m going to try to pay my rent first, pay for gas and electric, cellphone costs. And I’ve got to eat.”

The court judgment was finally entered against Richardson in Baltimore City District Court in January: $923.21, plus $34 in court costs and $138.49 in attorney’s fees. The notice of wage garnishment went out on March 6 — the day after Maryland Gov. Larry Hogan announced the state’s first three coronavirus cases. The garnishment was confirmed by Richardson’s new employer, the nonprofit drug treatment organization Gaudenzia, on March 16, the day that Hogan decreed the closure of all bars, restaurants, gyms and movie theaters, and three days after Richardson and her colleagues were barred by safety precautions from providing counseling inside prisons. She now works at a small treatment center that houses seven women, where social distancing is easier.

Johns Hopkins, by far the largest private-sector employer in the state and the largest beneficiary of billionaire Michael Bloomberg’s charitable giving, has long faced scrutiny for its aggressive collection of medical debt, including from the many low-income Baltimore residents it serves, who in theory should be able to qualify for the hospital’s charity care programs. In 2008, The Baltimore Sun reported that Hopkins and other Maryland nonprofit hospitals had filed more than 32,000 debt-collection suits over the past five years, winning at least $100 million in judgments. Last May, a coalition that includes the AFL-CIO and National Nurses United, which has been trying to organize Hopkins nurses, released a report finding that Hopkins had launched 2,400 lawsuits in Maryland courts since 2009 against patients with unpaid bills, increasing from 20 in 2009 to a peak of 535 in 2016.

In response to the 2019 report, Hopkins officials said they offered considerable free and discounted services, and that “for patients who choose not to pursue those options or who have a demonstrated ability to pay, we will make every effort to reach out to them and to accommodate their schedule and needs. In those rare occasions when a patient who has the ability to pay chooses not to, we follow our state required policies to pursue reimbursement from these patients.”

The cases have slowed in pace but not stopped altogether since the report. Bayview, one of several hospitals under the Hopkins umbrella, has filed about 60 cases over the past year, according to Maryland court records. Dozens of them, including Richardson’s, remain open. . .

Continue reading. There’s much more.

Written by Leisureguy

28 April 2020 at 3:10 pm

Sobering column on what lies ahead, Covid-19-wise

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Andrew Nikiforuk writes in The Tyee (an independent on-line news magazine based in Vancouver BC):

We have now entered the most dangerous phase of this pandemic.

We are all tired of physical isolation.

We are worried about an economic depression in a global economy already undermined by gross inequalities.

We fear for the future, and yearn for something normal even though our exhausted civilization no longer behaves normally.

We want this emergency to end. And many want it to end at any cost.

And that is where the dangers lie. For we now live in the domain of a novel coronavirus.

The virus is but five months old, a mere infant in the scheme of things. By most accounts its global adventures could last two years.

One of the few political leaders who understands the dangers ahead is German Chancellor Angela Merkel, a scientist by training. “Nobody likes to hear this, but it is the truth,” she said last week. “We are not living through the final phase of this crisis, we are still at its beginning. We will still have to live with this virus for a long time.”

But truth is usually the first casualty in any pandemic.

The historian John Barry, author of The Great Influenza, was dismayed to learn how authorities and the press regularly lied during the Spanish flu pandemic. Their key messages consisted of “don’t get scared,” or “it is just the old fashioned grippe” as tens of millions died.

By their very nature pandemics are irrational events that swallow up everything and everybody they reach. This methodical biological invader has barely begun to pull on the tattered threads of our overstretched industrial civilization.

There are only four ways out of this pandemic:

Herd immunity, which assumes immunity can be achieved and even if so will cost tens of millions of deaths while lasting no one knows how long.

A vaccine, assuming it can be made at all, and if so it is at least a year and a half away.

Elimination of the virus in geographies that seal their borders.

Or the virus gradually loses its most harmful effects on the human body and evolves into something like an old-fashioned cold.

Meanwhile, flattening the curve means beating the virus down to a tolerable level that doesn’t overwhelm hospitals and graveyards.

As we have learned, however, even flattening the curve doesn’t eliminate the reality of explosive outbreaks.

To date the pandemic has illuminated our industrial failings in spades. It exposed the fragility woven into the efficiencies we believed were designed into our systems, whether it be long-term care facilities or meat-packing factories.

The virus will continue to illuminate our weaknesses. Whenever and wherever we let down our guard, this virus will almost certainly explode with a bang.

Flattening the curve is not a victory or endpoint but a temporary holding measure. It is merely a behavioural choice that limits our mobility, and therefore the mobility of a highly contagious virus.

Even where the virus has raged explosively, such as New York City or Italy’s Lombardy region, no more than 20 per cent of the population has been infected.

That still leaves 80 per cent of the population susceptible to a second or third wave.

And so we must think clearly and do the following.

Admit what we don’t know

In these early days we don’t have answers to essential questions.

Does getting COVID-19 confer useful immunity and for how long?

If we do develop a working vaccine, how effective will it be? Will it immunize everyone all the time? Will it last for a year or a decade?

But we do know a few truths. We know that wherever this virus burns hottest, from Bergamo to Guayaquil, it kills readily.

We know the poor, the sick and the old are its primary targets. We also know that this virus can cause strokes in young adults and middle-aged people.

And we are just learning about long-term effects. It seems increasingly clear that even young, fit people can die if their level of exposure to the virus is very high.

Therefore easing restrictions before nations have developed disciplined protocols for testing, contact tracing and isolation of the infected will result in more pandemonium, and a longer emergency.

Get better data and act on it

In this dangerous phase, . . .

Continue reading. There’s more, and it’s worth reading.

I do find having each paragraph be a separate sentence is tiring. Sorry about that.

Written by Leisureguy

28 April 2020 at 9:25 am

Dark Chocolate, a good novelty fragrance

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In reflecting on yesterday’s shaving post, I thought I should make clear that novelty fragrances are not ipso facto bad — indeed, they can be quite enjoyable. Phoenix Artisan’s Dark Chocolate that I used today, for example, has a fragrance I very much enjoy, and I think I would enjoy “fresh-cut grass” as well. However, these are not fragrances that (IMO) work well day in, day out. They are a wonderful change of pace, but daily use would dull the appeal pretty quickly, I believe.

They are like dessert: wonderful as an occasional treat, but if every meal consisted of dessert, it would quickly get old.

That said, I not only thoroughly enjoy today’s fragrance (in soap and aftershave), I also got a surprisingly good shave, especially given that I absent-mindedly did a two-pass shave instead of my usual three-pass shave. I started the second pass going ATG, caught myself, then thought, “Why not?” It’s the way I shaved in high school.

When I got to my upper lip, i remembered why not: the two-pass shave is for me very uncomfortable when it comes to the upper lip. Three passes means that the stubble on the upper lip is significantly reduced before the ATG pass (and the four-pass shave makes for an even more comfortable ATG pass).

The razor today is an Edwin Jagger clone (or perhaps even an actual Edwin Jagger), and I imagine this is a Maggard stainless steel handle.

Man, I do so enjoy starting the day with a good shave. And I have to say that this morning the dark chocolate really hit the spot.

Written by Leisureguy

28 April 2020 at 9:05 am

Posted in Shaving

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