Why We Need a Universal Healthcare System

As some asshole with a blog has mentioned many times, we need a universal healthcare system. Forget for a moment the discussion we had during the presidential primary season about exactly what that system would look like and WHO WILL PAY FOR IT?!? Having been around and in public health and infectious disease for many moons, it is obvious that we need a universal healthcare system–not necessarily a universal health insurance system (we’ll return to that in a bit). This is prompted by something Jen Gunter recently wrote on the Twitter machine:

If we had a unified healthcare system*, we would have the possibility of being able to track not only influenza-negative ICU admissions, but things like reported COVID-19 symptoms, even if testing hadn’t been available (and a national patient identifier would prevent ‘double reporting’–someone whose doctor reports symptoms, and then checks into the hospital wouldn’t be counted twice). And state by state differences in reporting wouldn’t be an issue either.

It would not be trivial to build this on the fly, but it could be done in a universal system. Right now, we have no way of tracking these data. There would be, at least, the potential to do that tracking. But in our balkanized healthcare system (and that’s an insult to the Balkans), we just can’t, expect in a few places, where consolidation has led to some private systems that could pull these data semi-regionally. We also have multiple reporting system and LIMS, and there’s no easy way to report or get these data–if at all.

Realistically, in the U.S., the only political program with the heft to build such a system is the Medicare-for-All movement. Despite pundits like Bill Scher arguing otherwise, none of the other options have the potential to get us there (and, please, the ACA tried, and utterly, utterly failed. Just don’t with that). Sure, a handful of economists can engage in fantasy discussions about a hybrid Japanese-Dutch decaf system with a lemon twist, but, within the context of U.S. politics and existing legislative infrastructure, Medicare**-for-All is the only way to get to this unified system.

*Arguably, an administration that built a unified healthcare system also would have had a much better public health response, so this might have been redundant. Better redundant though, than dead.

**Though the Medicare-for-All proposals actually resemble Medicaid for All much more.

Posted in COVID-19, Healthcare | 2 Comments

Links 4/2/20

Trump_oneonfacebook
Links for you. Science:

Coronavirus carriers with no symptoms could spread disease, Italian study shows (pre-print pdf here)
COVID-19 needs a Manhattan Project
Ugh, Coronavirus Closures Will Force Rats Into People’s Homes: As scraps from restaurant dumpsters dwindle, the rodents will have to find other sources of food.
A Genomic Perspective on the Origin and Emergence of SARS-CoV-2

Other:

The missing six weeks: how Trump failed the biggest test of his life
The U.S. Tried to Build a New Fleet of Ventilators. The Mission Failed. As the coronavirus spreads, the collapse of the project helps explain America’s acute shortage. (it’s as if CEOs and investment banks are trying to turn everyone into militant socialists)
The Pandemic Could Overwhelm the Insurance Industry. We Must Expand Tricare for Everybody Who Needs It (thank workers for their service)
Collapse
Don’t panic about shopping, getting delivery or accepting packages
Andrew Cuomo’s Coronavirus Response Doesn’t Mean He’s Crush-Worthy
The government must pay people to stay home
Trump is failing at wartime leadership
Tax Justice and Modern Monetary Theory – A Guide
You Know Them By Their Tweets
What the Coronavirus Means for Climate Change
Medical Expert Who Corrects Trump Is Now a Target of the Far Right
Firms rush to make at-home tests for coronavirus: But initial wave backs off after FDA warning
D.C. School Nurses Say They Were Given A Choice: Fight COVID-19 Or Face Possible Layoffs
Dems can’t have the one thing they desperately need: A presidential do-over. Now what?
The Cultural Bailout We Need Has Been a Long Time Coming
A sexual assault allegation against Joe Biden has ignited a firestorm of controversy
The Ibuprofen Debate Reveals the Danger of Covid-19 Rumors: An online furor over whether it’s safe to use the fever reducer reveals how people are sharing incomplete—and sometimes bad—information.
Marie Newman: Coronavirus Makes ‘Medicare For All’ More Likely To Happen
Bonanza for Rich Real Estate Investors, Tucked Into Stimulus Package
Can History Help Us Cope With Covid-19?
A South Korean Covid-19 Czar Has Some Advice for Trump

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On COVID-19, News Organizations Need to Replace Their Political Journalists with Their Science Journalists

The news media must step it up in their coverage of the COVID-19 pandemic. Yes, there are lots of good explainers, but too much of the ‘premier’ coverage is being driven by celebrity political journalists. They are inclined, as is almost always the case, to treat COVID-19 in the typical political horse race/gossip column manner. So, stories about bad (horrible) public health policy are recast as ‘conflict’ between political actors. Once you have ‘conflict’, you slide into that ‘he said/she said’ crapola, and it’s all downhill from there–at that point, the reporting is actively doing a disservice to the public.

Science journalists, more often than not (nobody’s perfect), will ask what the science is (i.e., what should be done), and then try to figure out what is actually being done (the policy). The personality conflict crap only emerges within the context of those two questions*. It’s worth noting that some of the most explosive stories, such as hospitals’ inability to purchase masks have not been broken by White House press corps gossip, but by science and policy-oriented journalists.

Science reporters also have the added advantage of having dealt with multiple forms of denialism, ranging from creationism to global warming denialism, so they have some experience on how to write around that.

News organizations need to pull off their political reporters and place their science reporters front and center. These cretins are are going to get thousands of people killed.

Whether this applies to topics other than COVID-19 is left as an exercise for the reader.
*Trump’s malignant narcissism is part of the story, though most celebrity political journalists will never say or write that.

Posted in COVID-19, News Media | 1 Comment

Links 4/1/20

Trump_idesofmarch
Links for you. Science:

Thousands of covert coronavirus cases go under the radar in Wuhan, Chinese-led researchers say (paper here)
The untold origin story of the N95 mask
Vera C. Rubin Observatory, our best shot at finally explaining dark energy, nears completion
Can a century-old TB vaccine steel the immune system against the new coronavirus?
The coronavirus isn’t mutating quickly, suggesting a vaccine would offer lasting protection

Other:

It’s a good thing we eliminated polio in the 1950s because there’s no way in hell we could eliminate it under the 21st century health economics conventional wisdom
Doctors And Nurses Say More People Are Dying Of COVID-19 In The US Than We Know: “The numbers are grossly under-reported. I know for a fact that we’ve had three deaths in one county where only one is listed on the website,” one California ER doctor told BuzzFeed News. (this happens all the time with infectious disease; it was a very serious problem even before COVID-19)
RON DeSANTIS SHUTS THE DOOR AND LEAVES THE WINDOW OPEN
Whitmer: Feds told vendors not to send medical supplies to Michigan
Several participants test positive for coronavirus after Maryland curling event
How The Absence Of Remote Voting Saps Individual Members Of Power
Elderly Asian elephant is euthanized at the National Zoo
After $25 million stimulus, stunned NSO players receive one-week notice from Kennedy Center
100 Days From Now, Presidential ZOOM Press Conference
The Coronavirus Stimulus Bill Is a $2 Trillion Slush Fund for Washington Cronies
The Novel Coronavirus has a Well-Known Left-Wing Bias
Coronavirus Is A Defining Test And American Government Is Failing It. It’s not just Trump. Our politics are unfit for this calamity.
Red April: What happens on the first of the month when residents, restaurants, and retail stores don’t pay rent?
Insiders recount how Sanders lost the black vote — and the nomination slipped away
Genealogy of a Pogrom
Stop Trying To Make Andrew Cuomo Happen
Notes On A Nightmare #3: A Disturbing Turn in Right-Wing Thought
Bought some ancient Chinese terra cotta horses on Craigslist
The Postal Service Is Breaking Down: Covid-19 has already begun to take its toll on the overextended USPS workforce.
Workers Are Warriors in the Fight Against the Coronavirus. The pandemic is putting the lives of countless workers at risk. They deserve a new deal.
Spanish capital ditches ‘unreliable’ Chinese coronavirus test kits

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South Korea as a Baseline for the U.S.: The Soft Bigotry of Low Expectations

Or ‘nuking the goalposts’ if you prefer. After yesterday’s daily attempt by Il Trumpe to hide the greatest dereliction of duty by a president* in my lifetime (for perspective, I’m not young, and there have been some real doozies during that time), the Trump administration is now hoping that ‘only’ between 100,000 to 240,000 Americans will die from COVID-19.

During yesterday’s pathetic spectacle of national humiliation, he kept referring to the one to two million who could die if we do nothing. That’s not moving the goalposts, that’s nuking them.

The standard should be South Korea. It’s a technologically sophisticated nation of 50 million people that recorded it’s first COVID-19 infection on the same day the U.S. did. So the baseline isn’t the one to two million that would die if we did nothing, it’s multiplying South Korea’s COVID-19 infections and deaths by 6.5.

For anyone tempted to engage in armchair Orientalism, and do the South Korea Confucious argle bargle, they have brawls on the floor of their legislature. This isn’t a nebulous cultural difference we could not overcome. Our failure isn’t due to American Exceptionalism, it’s a result of presidential ineptitude.

By the way, as of yesterday, South Korea had COVID-19-related 162 deaths. Scaled to the U.S. population, that would be 1,053 deaths. The U.S. currently has had 3,789 COVID-19-related deaths, with no sign of abatement anytime soon.

Impeach him. Impeach him now. Our lives depend on it.

*If we’re going to militarize a civilian office, then dereliction of duty is an appropriate phrase.

Posted in Conservatives, COVID-19, Fucking Morons, Resistance Rebellion And Death | Leave a comment

Links 3/31/20

Trump_determinedtostrike
Links for you. Science:

FDA authorizes first rapid ‘point-of-care’ test for coronavirus (most hospitals already have the machine, so this can be deployed very quickly–might have been by the time this list o’links has spooled out)
An orally bioavailable broad-spectrum antiviral inhibits SARS-CoV-2 and multiple endemic, epidemic and bat coronavirus (in mice)
Let’s talk about what happens if you get COVID19 and recover. Are you immune to the disease? How long does the immunity last? And what does that mean for your life and for the public health and economy of our society?
COVID-19: the biology of an effective therapy
Everyone In Iceland Can Get Tested For The Coronavirus. Here’s How The Results Could Help All Of Us.

Other:

Social distancing won’t last forever. But ending it by Easter will kill people.
Canada’s Coronavirus Response Shows Why We Need Medicare for All to Fight This Pandemic
Their Fault
Internal Emails Show How Chaos at the CDC Slowed the Early Response to Coronavirus
Florida Congressman Spars With Other Lawmakers Over Federal Relief Money For Howard University
Virus Victim: The once flush D.C. government is facing a fiscal meltdown.
In Coronavirus, Industry Sees Chance to Undo Plastic Bag Bans (though for self-service, I would much rather use my own bag)
Here’s Where You Can Get A Coronavirus Test In The D.C. Area
‘Extremely unusual’: Md. 7-Eleven employee tests positive for coronavirus after co-worker fakes test result
Trump’s Priority Is Making Sure Someone Else Takes the Blame If Things Go Bad
Whitman-Walker Waits 7 Days To Get Patients’ COVID-19 Test Results Back. “The messaging we have been getting is that we need to pursue testing through the commercial lab for our patients.”
5 interesting things we learned about the Ward 2 race from a recent poll
Gilead Sciences Backs Off Monopoly Claim for Promising Coronavirus Drug
“Our Goal Should Be to Crush the Curve”: A doctor-scholar who studied the 1976 mishandling of swine flu says the president is wrongly choosing between saving lives and saving the economy.
Can the Intra-Party Rift Be Healed, At Least For Now? Or Must the Fight Be Fought in 2020?
Congress’ new stimulus bill doesn’t do enough to protect voting in November. The next bill must
And Then The Moment Passes
The New Unemployment Report Makes It Clear: We’re Staring Disaster in the Face
Confusion within the CDC, and its limited use of testing, gave COVID-19 a head start in the U.S.
Even in a Pandemic, the University of Illinois Doesn’t Care About Its Grad Workers (public pressure forced them to change)
New Haven’s First Responders Need Housing. One University Is Rolling Out the Red Carpet. Yale Is Not. As COVID-19 spreads through southern Connecticut, the city’s mayor is asking for help. The University of New Haven answered the call.

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Questions D.C. Journalists Should Ask about COVID-19

And I don’t mean Wor-Shing-Tun, I mean D.C. local reporters (though if other local and state level journalists ask these questions, that would help their own communities).

On the whole, D.C.’s response to COVID-19 has been reasonably good. The city has taken it seriously, though, like just about every other place in the country, the shutdown happened after St. Patrick’s Day ‘weekend’ (that is going to haunt us in a couple of weeks). But residents have been, for the most part, following a voluntary, self-imposed, rigorous stay-at-home regime* (the streets were empty starting Sunday of St. Patrick’s Day ‘weekend’).

The city also has done a reasonable job releasing COVID-19 related statistics. D.C. Health** reports both the positive and negative tests, as well as the number of recovered patients (along with available respirators). So it’s not bad. But there is still more information we need, and it’s up to local journalists, most of whom aren’t science reporter types, to ask good questions. Fortunately, we–and we refers to this asshole with a blog who has been an infectious disease microbiologist for a very long time–like helping! So here are some questions local reporters should ask D.C. Health:

  1. How many COVID-19 positive people are asymptomatic? How many were pre-symptomatic? This can give us some hints about how many people are infected but not sick. The majority of tested people turn out to be negative, but how many of those tests are for asymptomatic people who came in contact with someone, versus someone presenting symptoms? You want the raw numbers for this, by the way. not percentages. If they can’t answer the pre-symptomatic question, then you need to ask why they aren’t following up with those patients, and what they are doing to track them.
  2. How many people who are tested for COVID-19 due to COVID-19-like symptoms test negative? This tells us how many of the negatives were sick with something else (“Great news! You have influenza!”), as opposed to being screened as a precaution.
  3. Are there any efforts to track or surveil*** urgent care and private doctors for reports of COVID-19 symptoms? If not, why not? Right now, all we know about are those who are getting tested, and many of these people are sick (often very sick). This would give us a rough estimation of what is going on in the larger community.

Anyway, this would be good information for citizens to have, so please ask the questions.

*While the federal government was too cavalier about the safety of the federal workforce, by March 17, mandatory telework was in place for many agencies, which helped (obviously, some people still need to show up given their jobs).

**That’s what we call the state department of health.

***You don’t need every case report, just a subsample–though if we had universal healthcare, we would have this information readily available.

Posted in COVID-19, DC, News Media | 2 Comments