In her Wall Street Journal column, Peggy Noonan opines about how the “protected” don’t have to worry about the consequences of economic shutdowns.
“…Since the pandemic began, the overclass has been in charge—scientists, doctors, political figures, consultants—calling the shots for the average people. But personally they have less skin in the game. The National Institutes of Health scientist won’t lose his livelihood over what’s happened. Neither will the midday anchor. I’ve called this divide the protected versus the unprotected. …“
For anyone not yet convinced of the dangers to civil society posed by divisive “isms” and ideologies, including religious dogma and the murderous results of forsaking the sovereignty of the individual, this book is a must read.
James Keena calls into question the notion that our society simply swings indefinitely like a pendulum between the political right and political left. He makes the case that allegiance to either faction will eventually lead to tyranny, oppression and death.
And that the solution always returns to individual sovereignty; not Darwinian rugged individualism. It starts with a true understanding that entropy is always fought at the individual level. No one can escape that responsibility; to do otherwise unfairly burdens others with your obligation.
Karma is not a boomerang, but a seed that either bears good fruit or poisons the tree. And the bonds made between individuals, families and friends which are based on love & respect & benevolence cannot be scaled to apply between millions of strangers.
The only way to ensure the reproducibility of peaceful collaboration on a large scale is for society to be based on the bedrock principle that the only just law is one that protects individual sanctity and does not tolerate coercion. We should not coerce or allow ourselves or others to be coerced.
I think you might like this book – “2084: American Apocalypse (The Pathless Land Series Book 1)” by James Keena.
Start reading it for free: https://a.co/6mBr6gE
By Robert Nelson, MD
The 14th Amendment to the U.S. Constitution states, in part, that…
“No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.”
Every state has its own criteria for declaring a public health crisis. The the Model State Emergency Health Powers Act that was was floated following 9-11, proposed a model legislation designed to update protocols among the states to account for bio-weapons and infectious agents; and to standardize the approach among the States. There were many concerns about infringement on civil liberties and over-reach abuse from Governors. But even though it never became law, most states already had similar, albeit outdated, protocols allowing their executive branch to declare health emergencies. These states’ laws currently on the books give governors the authority to varying degrees to deprive people of use of property (business closures, etc…), prohibit peaceful assembly of groups (religious gatherings, weddings, family events, etc…) and even confine citizens to their homes during times of public health emergencies (enforceable with fines or imprisonment) all without due process of law, if certain thresholds are met; and by extension of logic, those emergency measures may continue if those same threshold criteria remain operational.
Even if we set aside the contradictions between the 14th Amendment and the power granted to States’ Governors under EHPA-like laws — given the substantial knowledge amassed about the risk of COVID-19 infections, we must question whether the criteria for sustaining a “public health emergency” still meets operational thresholds.
Based on definitions in the original model state Emergency Health Powers Act, the original cases of human-to-human COVID-19 infections certainly met the criteria for “new…infectious agent” and initial reports out of Europe and Asia justified viewing the threat as having high potential for “…a large number of deaths…” and “…widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of persons…”
There was reasonable agreement among many experts, and based on the death and devastation we saw in Italy, that COVID-19 cases could overwhelm the hospital systems’ ability to provide care for the sickest patients. This was a valid concern and represented an unacceptable risk if the calculus was accurate. Most agree, the initial reaction to temporarily shut down normal societal operations was justified.
But data coming mainly in March and April strongly suggested the initially justified fear was over-stated. And despite evidence that predictive models repeatedly over-estimated cases and fatalities, even with distancing measured factored in, many Governors have not taken their foot off the regulatory gas peddle or seriously thought of changing directions even though the evidence shows that most people are not at high risk.
So given the criteria required for declaring a public health emergency detailed above, and in light of drop in case load and data showing a much lower over-all fatality rate than originally estimated, are we still at risk for…”a high probability of a large number of deaths, a large number of serious or long-term disabilities, or widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of persons.”(?)
According to the facts, the answer is “NO.” Here’s a summary of supportive data:
- COVID-19 appears to have a very high infectivity, which means it spreads horizontally (not just close household contacts) within a population very quickly. It likely spreads quicker and easier than Influenza, which is highly contagious. It is very hard to effectively stop the spread as data from New York indicates.
- Aggregate data from around the world and compiled by many government agencies indicates that over 80% of cases are very mild with virtually complete recovery.
- Anywhere from 15 – 40% may be asymptomatic
- A look at the New York data, undeniably the epicenter in the U.S., shows…
- risk of death in people 18 – 45 to be about 0.01% or 10 per 100,000
- For people under age 18 years, the death rate approaches zero
- Two-thirds of fatal cases occurred in patients over 70 years of age
- More than 90% of those fatal cases had underlying serious illnesses
- Even for people ages 65 to 74, only 1.7 percent were hospitalized
- For those who don’t have serious underlying medical illness, the chance of dying from COVID-19 is very small, regardless of age and especially if under 50
- Nearly 25% of NYC residents tested show antibody to COVID, so real number of cases could be at least 12x more than the number of confirmed cases meaning that the true case fatality rate is much lower than we thought initially
- Herd immunity helps act a human shield, or firewall so to speak, to protect those at risk by simply cutting down on the chance they will come in contact with someone who is infected. In the absence of a vaccine, herd immunity is the best way to protect the vulnerable and thus cut down the death rate.
- In April, approximately 1,200 patients were surveyed from 113 New York hospitals over a three-day period and 66% of those admitted with COVID-19 infections were sheltering at home; most were over 51 years old, retired or unemployed; and 96% of the surveyed patients had co-morbidities, which means nearly all had another chronic medical condition prior to catching coronavirus.
- “Authors of a new study conducted by researchers at the World Health Organization and Stanford University say there is no evidence of increased transmission of COVID-19 in Wisconsin following the state’s April 7 primary election.”
- The State of Georgia’s “shelter-at-home” order expired on April 30 and many businesses were permitted to re-open on April 24 providing they observed distancing guidelines and gloves and masks where appropriate. Between April 14 – 27th, the average daily death rate was 37. From 4/28 – 5/11, there were 29 reported deaths per day on average. There were 1,500 patients hospitalized with COVID on May 1, compared to 1,133 on May 11.
- Sweden mandated very few closings and relied on voluntary compliance with distancing measures, allowing businesses and most schools to remain open throughout the pandemic. It’s death toll was somewhat higher and its Nordic neighbors who utilized mandatory shut-downs but Sweden’s death rate was lower than many western European countries such as Spain, France, Belgium and Great Britain which utilized very strictly enforced lock-down measures. And despite Sweden’s liberal approach, its healthcare system was never over-ran like in Italy.
Let’s summarize what we know.
There is no clear correlation to when various States went into lock-down and the time to peak or the magnitude of cases or deaths per 100,000. There is a similar non-correlation between countries across the same metrics.
Prevalence studies indicate number of infected people is MUCH higher than most realized suggesting COVID-19 is highly contagious yet very mild in vast majority of people. This also suggests restrictive lock-downs are minimally effective. A higher prevalence indicates a much lower case fatality rate than was originally published.
Herd immunity is vital to protecting the vulnerable. Prolonged distancing slows the herd immunity, which is likely to be the quickest and safest way to protect those most at risk.
Opening the economy gradually will be important to support the efforts of our communities to continue vigilant case monitoring and appropriate care for severe cases.
The goal of not overwhelming healthcare resources was successful. But many of those who had legitimate concerns which triggered an emergency declaration have failed to critically evaluate new data, and worse still, they have failed to fully come to grips with the consequences of keeping society and their economies locked-down.
The ability of millions of citizens to earn a living and provide for their families and keep businesses afloat (and the jobs that accompany those businesses) was/is severely compromised by overly aggressive, often coercive and sometimes punitive restrictions on basic freedoms. The negative fallout from the lock-down of 2020 will continue to pile up long after the risk from the virus has been forgotten. More people may end up being harmed by the disruptions in healthcare delivery and the loss of “non-essential” jobs, than were saved by trying to prevent the spread of a COVID-19. Ironically, the reaction to the threat of the virus could result in our self-inflicted death unless we learn to live with it.
John Daniel Davidson of the Federalist echoes the benefits of having choices made at the state and local level.
The founders wisely chose a federal republic for our form of government, which means sovereignty is divided between states and the federal government. The powers of the federal government are limited and enumerated, while all powers not granted to the feds are reserved for the states, including emergency police powers of the kind we’re seeing states and localities use now. …Much of the media seems wholly unaware of this basic feature of our system of government. …Trump explained that many governors might have a more direct line on this equipment and if so they should go ahead and acquire it themselves, no need to wait on Washington, D.C. This is of course exactly the way federalism is supposed to work. …We should expect the government power that’s closest to affected communities to be the most active, while Washington, D.C., concern itself with larger problems.
“It won’t be popular to call attention to the possibility that such actions might be an overreaction. But it’s a serious point, even if that sentiment has no hopes of carrying the day.
The federal government botched the early response to coronavirus, so why should we expect it to get its act together now? Whenever we are finally clear of this pandemic, we will need to study our response to understand what we did right and what we did wrong. With a virtually complete halt of the American economy about to begin, we should enter this phase with full awareness that it wasn’t the only choice available to us.
FCC Unveils COVID-19 Telehealth Program, Updates Connected Care Pilot
The Federal Communications Commission is using $200 million in funding from the CARES Act to launch a new program to help providers access the broadband resources they need to support telehealth programs.
Wow, the government has discovered remote digital technology medical care! Although, maybe a little late. What would we do without those innovative minds in D.C. ?!?
But there’s a better solution that’s been up and running for more than a decade; private citizens being free to act and chose what services they value. It is a solution which occurred organically when an innovative supply side acted to solve other people’s problems within a cooperative marketplace driven by mutual benefit. It is called Direct Primary Care (DPC). And it is only possible because we still have some semblance of healthcare freedom within our society. No thanks to Washington, D.C.
But step aside, the FCC with money to burn is coming to the rescue after COVID is already in full crisis mode.
Never mind that Direct Primary Care physicians have routinely integrated remote care technology platforms into their practices for a more than a decade. And set aside the fact that revenue in a DPC business model doesn’t rely on office visits (the opposite of social distancing) to trigger a billable encounter, the claim against which is paid out of a grossly over-priced pre-paid 3rd party fund that we call health insurance. Instead, the Direct Primary Care physician is paid to be available to solve problems, answer questions, triage illness/injury, provide treatment and advice via the most appropriate venue for each patient.
And last, no disrespect meant to the media outlet below for featuring this story. They are just reporting the healthcare news, as is their mission.
The commonality between the insatiable rise in both healthcare costs and college tuition, post 1965, should be obvious: Massive amounts of other people’s money in the form of government programs, payments, subsidies and loan guarantees; which economists call the 3rd-party payer effect.
As exposited in the FEE article below, the U.S. Higher Education Act introduced “incentives” into the market for higher education, encouraging both the supply side and the demand side to make decisions that they would not be as likely to make under “non-stimulated” market situations.
Similarly, the passage of Medicare in 1965 sent huge surge of money into the healthcare system. The predictable consequence of this massive revenue stream was an incentive for healthcare providers to enter the market and expand services at an unprecedented magnitude and rate. Essentially, demand was spurred by new source of financing. Amy Finkelstein, et.al have done excellent work in this area. Her work indicates that Medicare funding may have allowed hospital to spend 6-fold more than what individual levels of insurance would have predicted. And that the spread of 3rd party insurance from 1950 – 1990 may explain about 50% of the increase in real per capita spending over that time period. https://economics.mit.edu/files/788
“As Bernie Sanders tweeted last year, the cost of education, in nominal dollars, has increased by roughly 3,800 percent since the mid 1960s.
What Sanders didn’t mention was that this was when the US Higher Education Act was passed (1965), which directed taxpayer dollars to low-interest loans for students pursuing college. This increased accessibility to higher education, but the flood of federal money also caused a surge in demand and costs.
The problem isn’t unsolvable, but it will require significant changes to universities and the federal loan program. “Free” tuition and student debt forgiveness will only make the problem worse.
Instead, as University of Maryland economist Peter Morici recently argued, market discipline must be brought back to our institutions of higher learning as part of any debt forgiveness.
While policy wonks offer no shortage of proposals for tweaking the federal loan program to improve it, perhaps the best solution would be to get the federal government out of the loan business all together.”
By Jon Brock
The article below details the reasons why we need to get data right; and even more so with metadata. Because the combined effect of compiling (bad or inadequate) data does not make it more reliable; it likely compounds the error.
This is particularly problematic in scientific academy within the areas of medicine and nutrition research, as John Ioannidis has clearly exposed in his work.
Scientific data can go “absent without leave” for a number of different reasons:
- Scientists don’t archive their data properly and they lose track of it, can’t make sense of it, or their hard-drive dies and they don’t have a back-up. This happens surprisingly (and embarrassingly) often.
- Scientists begin a study but abandon it before it is completed due to lack of funds, unpromising preliminary results, or other priorities. The data might be useful in combination with data from other studies, but it’s not publishable on its own.
- Scientists selectively publish data that supports a particular theory. Inconvenient data are quietly forgotten.
- Scientists try and publish data but are unsuccessful because the results aren’t considered interesting enough by the scientific journals.
- Knowing how difficult it will be to publish a null result, scientists prioritise writing up studies that gave them more publishable results.
The end result is what’s become known as the “file drawer problem”. The published scientific literature represents only a small and biased sample of the research that has actually been conducted. The rest is stuffed away at the back of the metaphorical filing cabinet.
There’s a lot of wasted effort here — data collected and then not used. But the bigger problem is the bias in what is published.