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Seismic Noise Has Dropped by up to 50%, allowing quieter earthquakes to be detected. That’s me you hear yelling.

2020-04-09
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a photo of me, by me, looking quizzical. I’m not mad, really I’m not. Or we’re all mad here.

This morning I posted a link to a NYT story that had multiple bits of new information.  One of the more important bits (that I didn’t get to this morning) was that seismometers all over the world have responded to the lockdown orders that have some 90% of the world’s population staying home other than for essential activities.  I personally was little affected by that order (even though I live in California).

As a result of that “stay at home” order, we (not I) are mostly staying at home.  I still take walks in the splendid isolation of my abode among the peach and almond trees.  I still go to the pharmacy for the medications that I take, most important of which is ibuprofen.  I still go to the grocery store.  All my banking needs are taken care of online and most of my bills are paid online.

My wife is still working as a physician assistant.  We still fill up the gas tank on our Toyota Highlander.  Nothing has changed except that I am posting to this blog more frequently.

Yet the seismometers say the world is quieter, and as a result we can hear the smaller earthquakes and the little things that are just the earth’s crust moving around.  What is more, the air quality in Los Angeles has greatly improved.  Now wouldn’t it be grand if all of the people who were running around like chickens with their heads cut off would just stay still?

I know, that’s terribly cynical.  I do feel bad, very bad, for all the people who are dying miserably, alone, because they are under quarantine or isolation in the hospital.  Yet human existence is suffering, or so the Buddha says.

So, if you meet the Buddha on the road, kill him.  Or don’t.  I’d rather you didn’t.  You don’t have to follow every ridiculous instruction you get, do you?

Only follow an instruction if it makes sense– or if you can make sense out of it, which means you may have to think about it for a while.

What did the Buddha mean when he said, if you meet the Buddha on the road, kill him?  Let me know if you figure out what it means.  I’ll be sitting here, quietly listening.

SeaBoard Foods Pork Processing Plant in Guymon OK employs 2600, invests $100 million in plant but can’t do anything about hospital for town of 11,000 with 840 COVID cases.

2020-07-09

photo by David Mark courtesy of pixabay.com

This town and its hospital was the subject of an article in Medpage Today dated July 5.  The hospital is called Texas County Memorial Hospital, and it has been in trouble for several years.  The hospital has been run by management companies which have extracted fees but failed to come up with plans that developed sufficient funding to keep an obstetric wing open (it closed in 2018 after losing $1M a year) or to stock emergency drugs like rattlesnake antitoxin or Activase for strokes and heart attacks.

The town of Guymon has a population 11,000– it is the county seat of Texas County– and its largest employer is a pork-processing plant that employs 2,700 people.  The plant is run by Seaboard Foods Corporation and has been there at least 25 years.  The town is isolated, to say the least; the nearest other hospital is 40 miles away.  There is nothing around Guymon except empty prairie and a few circular irrigated fields.  Liberal, Kansas is the nearest town of any size, with 20,000 people.

The issue with Guymon is that Seaboard Foods in February 2020 planned to spend $100 million on the pork-processing plant there, including $20 on real property and $80 on capital improvements.  They agreed to pay $1 million in 2018 to settle a civil suit by the federal government for hiring “undocumented” foreign workers (the plant is staffed by people from multiple foreign countries.)

Yet they couldn’t spend anything to help the hospital.  This is important because there was a COVID-19 outbreak at the plant this spring.  As of May 21, there were 641 positive tests, almost a quarter of the employees.  In the county (which has only twice as many people altogether as live in the town) there were 820 cases and four deaths reported.  Supposedly no-one at the plant died.  The father of one worker, who was 56 and had been recovering from coronary bypass surgery, did die– despite never leaving the house except to walk the dog while wearing a mask.

The hospital was unable to treat the people who died because they couldn’t accommodate them with their antiquated ventilation system and physical plant.  The hospital laid off half of its almost 200-person staff due to the financial problems over the past few years.   Patients who needed hospitalization for the virus were often transferred by ambulance to larger hospitals a hundred miles away.  With $1.3 million in emergency funds from the US Army Corps of Engineers, the hospital was able to convert the closed maternity wing to a COVID ward– but not until June.

Parenthetically, there has been scientific speculation that the low temperatures (4 degrees Celsius) at which meat processing plants work are ideal for transmission of coronavirus because the virus survives longer outside the body at low temperature and high humidity.  This is one reason (of many) why there are such huge outbreaks of COVID-19 at these plants.

Why didn’t Seaboard Foods put some money into the hospital?  Because they had to make a profit on pork processing for human consumption.  By the way, the county went for he-who-must-not-be-named in a big way in 2016, partly because most of the people who work at the plant can’t vote.  It seems to me that the company should be fined at least $1.3 million to recoup the emergency funds the feds spent on the hospital.  At least.

The problem here is something that conservatives are really good at: socializing costs and privatizing profits.  This is why Walmart can pay minimum wage, and then its employees have to get Medicaid and food stamps to survive.  This is not right.  Poor people shop at Walmart, and the federal government subsidizes the cost.  Meanwhile, the family that owns Walmart is one of the richest families in the world.  This is not right.

Geopolitics: Where do we stand? Why does the US retreat from involvement in the world, as China increases its influence?

2020-07-08

photo by Einfach-Eve courtesy of pixabay.com

After World War Two, the United States was the strongest country.  China was just finishing up a bloody civil war that left the entire country in ruins.  Europe had been bombed back into the Stone Age.  The Soviet Union (Russia) had lost millions of soldiers and civilians to the war against the Nazis.  Japan had been hit with two atomic bombs, after firebombs had killed hundreds of thousands in cities.

Now, after almost four years of destruction by he-who-must-not-be-named, the US has withdrawn from its involvement with the rest of the world.  After over 70 years of rebuilding, the world is totally different, but until four years ago, the US was still the country with the most involvement in other countries.  We gave the most support for democracy and human rights.  Today, we have given up our role in the world and are in danger of ceding our power to China.

This is a very dangerous thing, because the Chinese government has no interest in democracy or human rights.  The government is a product of its leaders, who from the beginning of the Chinese Revolution have been interested only in amassing power, first to overthrow the warlords, then to rebuild the country.  They have always looked on democratic government as a weakness.  They have never been interested in protecting freedom of expression or allowing cultures to continue their indigenous growth.  Their leader, Mao, had a similar personality to our current leader, and he set the tone for the current Chinese government.

The US has long been an aspirant to democracy and to the rights of all humans.  All the injustices and oppression that have taken place in the US have been opposed by the arc of its aspirational self-governance.  Just when the equality of peoples has been nearly approached, it is in danger of being snatched away by the disinterest and active sabotage of our current leaders.

Drawing away from leadership towards equal representation in other countries, the administration in this country has turned towards re-oppressing its own peoples.  Corruption and malfeasance in our government has not only encouraged state violence against our own people, but allowed tyrannical leaders in other countries to oppress their own people without fear of disapproval from our leaders.  We must fight to return our country to a path towards equality and freedom for everyone by ending the current leadership and electing new leaders.  We need leaders who respect everyone’s rights in this country and fight for the rights of peoples in other countries.

Persistent shortage of masks and other personal protective equipment hinders medicine and dentistry during pandemic: NYT

2020-07-08

photo by Juraj Varga courtesy of pixabay.com

This report in the New York Times July 8 details a persistent shortage of personal protective equipment like N95 masks, gloves, and gowns that is preventing medical offices and dentists from seeing patients during the pandemic.  Hospitals are able to obtain protective gear to cover most of their needs, but smaller groups are still struggling to obtain essential equipment.  From the article:

 Neurologists, cardiologists and cancer specialists around the country have been unable to reopen their offices in recent weeks, leaving many patients without care, according to the American Medical Association and other doctor groups.

Lubbock Kids Dental of Lubbock, Texas, which serves low-income children, has been unable to obtain masks and gloves for dental surgery and has a list of over 50 children with abscesses waiting for care.  Treatment with antibiotics has not relieved the need for surgical drainage, and these patients are at risk of developing septicemia if the bacteria enter the bloodstream.

Other outpatient clinics also cannot obtain sufficient masks to re-open.  Many hospitals are forcing their staff to re-use N95 masks, and some staff dealing with coronavirus patients can’t get the N95 masks at all.  The article describes numerous cases of re-use and shortages.

The US is dependent on foreign manufacturers for most of its protective equipment; domestic companies are unable to make sufficient supplies to meet demand.  The federal government could help by invoking the Defense Production Act, but it has done nothing to encourage or mandate supply improvements.  Small amounts of PPE are being distributed by the Federal Emergency Management Administration (FEMA), but nowhere near enough to meet demand.

The shortage is felt most at the level of individual medical and dental practitioners, who cannot band together to order PPE supplies.  The federal government is still doing nothing to help, and spokesmen like the Vice President are lying about the situation.  From the article:

In a coronavirus briefing on Wednesday, Vice President Mike Pence downplayed the shortages, but said the government was preparing to issue new guidance on the preservation and reuse of protective gear. “P.P.E., we hear, remains very strong,” he said.

With the pandemic worsening every day in the South and West, this situation is critical and unconscionable, especially in a supposedly affluent country.  The resulting suffering and deaths are entirely the responsibility of our leaders, especially he-who-must-not-be-named.

COVID-19 Pandemic Continues to Rage, especially in US: 60,000 New Cases Reported as federal government dithers and White House Lies

2020-07-08

Electron micrograph of SARS-COV-2 virions in vitro

CNN reports that the US had 60,000 new cases on Tuesday, according to Johns Hopkins University.  Other daily tracking reports are smaller.  For example, worldometer says that there were 55,442 new cases yesterday.  Ourworldindata reports 57,473.

The White House is openly pressuring both elementary/secondary and college-level schools to open for in-person classes this fall.  They stated that the CDC’s guidelines were too expensive and convoluted to follow.  All administration spokesmen are claiming that everything is under control.  Even Dr. Birx claims that she has seen “encouraging signs” in Texas, Arizona, and Florida.   Dr. Fauci has contradicted this happy talk, but he has been prevented from giving interviews to most media.  I won’t repeat the other lies coming from the administration.

The White House has formally notified the World Health Organization (WHO) that it plans to withdraw from membership, effective in a year from now.  There has no word on whether the US will pay the dues that it currently owes, although the US contributed the largest individual share of WHO’s budget last year.  There have already been changes that have reduced the US participation in WHO.  China will probably take the opportunity to increase its involvement in, and control over WHO because of the US withdrawal.

Miami-Dade County reported that 28% of its antigen tests are coming back positive.  42 Florida hospitals have completely full intensive care units (ICU) and a field hospital with 450 beds has been established at the Miami Convention Center.  Miami-Dade and Broward County schools may not open this fall if conditions continue to deteriorate, despite the Florida state-wide “order” to re-open.  The caveats included with the re-opening order make it possible for local officials to overrule the plans to open.

According to CNN, “In the past 13 days, Florida’s Miami-Dade County has seen a 70% increase in the number of Covid-19 patients being hospitalized.  The number of intensive care unit beds being used has risen to 84% and the use of ventilators is at 116%, according to the latest data released by Miami-Dade County government.””

New Jersey, New York, and Connecticut have ordered travelers from at least 19 other states to self-quarantine for two weeks if they enter the state.  Canada has seen a marked improvement in their daily case counts, and Prime Minister Trudeau decided not to travel to the White House for ceremonies marking the start of the new US-Canada-Mexico trade agreement.

Brazil continues to record increases in their daily case counts, with at least 45,000 new cases yesterday.  Over 1,668,000 cases have been reported in that country.  Their head, Jair Bolsonaro, reported that he has had a positive test, with symptoms, after refusing to wear a mask and exposing himself repeatedly.  Brazil’s reaction to the virus has been chaotic and most of the population is unable to isolate because of poverty.  All of South America is suffering greatly from the pandemic.

For additional minute-to-minute coronavirus updates, see the CNN website.

 

Acute Neurological Syndromes Associated with COVID-19: A report of 40 patients with strokes, paralysis, encephalomyelitis, and other syndromes: Brain Journal

2020-07-08

EM of sars-cov-2 budding from apoptotic (dying) cells–NIAID

This report in Brain Neurology Journal on July 8 gives details of 40 patients with acute neurological syndromes related to COVID-19.  The first group is those with stroke, patients with large blood clots in major arteries leading to the brain; most have made only minimal recoveries.  Another group had acute encephalomyelitis– some responded to corticosteroids and made partial recoveries.  A third had acute encephalopathies with delirium or psychosis but no findings on MRI scans– most of these recovered.  A fourth group had peripheral nerve disorders, some similar to Guillain-Barre Syndrome, with paralysis.  A fifth group had difficult-to-categorize problems.

From the abstract: “SARS-CoV-2 infection is associated with a wide spectrum of neurological syndromes affecting the whole neuraxis, including the cerebral vasculature…”

This is an abstruse academic paper with many details for neurologists and other involved disciplines.  The point of the paper for amateurs is that COVID-19 often affects the brain and nerves as well as the lungs.  There are many cases, even in relatively mild illnesses, in which cough and fever are not the only problems.  Patients who have mental symptoms or nerve problems should not feel that they are imagining things.

Many patients with apparently mild illness find that their reflexes are off, they have weakness, or they have clumsiness, even difficulty walking.  There are also frequent reports of hallucinations, often worse at night.  These symptoms are due to an as-yet unexplained effect of the virus on brain and nerves– not a direct infection, apparently, but an immune response.

Another issue is that many of these symptoms appear after the acute illness or persist long after one would expect to have recovered.  The vast majority of illnesses have occurred in the last three months, and many of those affected have still not fully recovered.  It remains to be seen how long these symptoms will last, or even if some of them may be permanent.  We have a great deal to learn about this virus.

Statin use (cholesterol-lowering drugs) lowered all-cause and cardiovascular mortality in US veterans: JAMA

2020-07-08

photo courtesy of qimono (Arek Socha) via pixabay.com

A retrospective study of over 300,000 elderly veterans (almost all men) showed a 25% reduction in mortality rates over seven years in a study reported in the Journal of the American Medical Association.  This study is believable because it included a very large cohort of men observed over a long period of time.  Here are the results:

Results  Of 326 981 eligible veterans (mean [SD] age, 81.1 [4.1] years; 97% men; 91% white), 57 178 (17.5%) newly initiated statins during the study period. During a mean follow-up of 6.8 (SD, 3.9) years, a total 206 902 deaths occurred including 53 296 cardiovascular deaths, with 78.7 and 98.2 total deaths/1000 person-years among statin users and nonusers, respectively (weighted incidence rate difference [IRD]/1000 person-years, –19.5 [95% CI, –20.4 to –18.5]). There were 22.6 and 25.7 cardiovascular deaths per 1000 person-years among statin users and nonusers, respectively (weighted IRD/1000 person-years, –3.1 [95 CI, –3.6 to –2.6]). For the composite ASCVD outcome there were 123 379 events, with 66.3 and 70.4 events/1000 person-years among statin users and nonusers, respectively (weighted IRD/1000 person-years, –4.1 [95% CI, –5.1 to –3.0]). After propensity score overlap weighting was applied, the hazard ratio was 0.75 (95% CI, 0.74-0.76) for all-cause mortality, 0.80 (95% CI, 0.78-0.81) for cardiovascular mortality, and 0.92 (95% CI, 0.91-0.94) for a composite of ASCVD events when comparing statin users with nonusers.

(bolding applied to emphasize key points)

This study suggests that elderly men, regardless of their cholesterol levels, benefit from taking statins to improve their life expectancy.  Two-thirds of the men, who were around 80 years old at the start of the study, died over the 6.8 years that it ran.  17.5% of the men started taking statins during the study, and of these men, there was an all-cause death hazard ratio of 0.75– meaning that men were 25% less likely to die if they took a statin drug.

The statins most widely used are atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor), among many others.  The results of this study are no surprise and confirm the wide acceptance of these drugs among doctors.

The only limitations of the study are that it only includes men, mainly white men, and doesn’t address costs.  Despite this, women should probably take statins as well after menopause, when their risk of cardiovascular disease rises to nearly the same level as men.  The costs are now quite reasonable for these drugs, and Medicare pays the entire bill.

Non-white men, especially those with African-American or Caribbean-American heritage, should take statins as well, because their risks are higher than those of white men.  Black men should also carefully control their blood pressure, partly because discrimination has been shown to raise one’s blood pressure (sorry, I don’t have the citation, but it’s out there.)  High blood pressure also dramatically increases one’s risk of stroke, and the incidence of stroke is much higher in Black men.

What’s happening now: “We are in freefall.” Uncontrolled virus transmission has led to a doubling of Florida’s new cases in the last ten days. Contact tracing can’t catch up.

2020-07-07

Be Here Now– photo by Harald Lepisk courtesy of pixabay.com

Dr. Rochelle Walensky, chief of infectious diseases at Massachusetts General Hospital, said on Monday that “We are in free fall” but she wasn’t referring to Massachusetts, one of the few states with stable or declining new case numbers.  She was referring to pictures of people on the beach over the weekend.  Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, said “free fall” was accurate for Texas.

The New York Times daily case counts for Florida show newly reported COVID-19 cases roughly doubled between June 24 and July 4. Idaho’s case counts have doubled, from 219 on June 25 (with a rolling 7-day average of 161) to 368 on July 5 (7-day average: 322) and 423 (7-day average: 350) on July 6.  For Texas, the 7-day rolling average quadrupled from 1607 on June 5 to 6814 on July 5, and 9181 new cases were reported for July 6.

Numerous public testing sites have recently closed, either temporarily or permanently.  The site at Los Angeles’ Dodger Stadium was closed for four days over the Independence Day holiday weekend, but is expected to re-open today (July 7.)  Appointments for tests today are already fully booked, so if you call, you might get an appointment for tomorrow or Thursday.  This site will be able to run 6,500 tests a day (up from 6000 last week), half of Los Angeles County’s public testing.  Closures at some public testing sites will dramatically reduce daily case counts in their areas because they represent such a large proportion of overall tests in that area.

Those testing sites that have not closed are overwhelmed and have repeatedly run out of supplies with which to perform tests.  (One thing that might help with supplies is to switch to a saliva test, where you just spit into a vial.  No swab, no technician, and no intrusive deep intranasal swabbing is required.  The saliva test could be sent out and returned via mail, to be done in the home.  The saliva test is being evaluated in Southampton, United Kingdom currently.   Tests have shown the saliva test is not quite as sensitive as the swab, but this could be improved by “hacking” and coughing, and running your tongue around your mouth to collect cheek cells.)

The alternative to a public site (which is often free) is for an individual to visit their doctor for a written order to test, which can then be carried out by a lab– assuming that the lab has the needed supplies.  When performing a test under a doctor’s order, the patient will have to pay something, either out of pocket or with the help of an insurance company.  The test itself is reimbursed up to $100 by Medicare and Medicaid (cms.gov, April 15); it’s supposed to be free to the patient under the new law.  Private insurers probably pay more, and cash patients may pay $229, according to one web site.

For example (npr.org), a 25 year old woman who on March 11 visited her primary care physician with a persistent sore throat (a common and not particularly serious complaint, except that she had lupus) under her Aetna insurance was charged $2.121 (of which she was responsible for $536.46.)  She was tested for more than a dozen respiratory diseases.  She was positive for influenza B, so the lab did not run a test for SARS-COV-2.  On her doctor’s advice, however, she had a test done ten days later at a drive-thru site; the doctor reasoned that people could be co-infected with both SARS-COV-2 and influenza B.  She was negative for SARS-COV-2, the causative agent for COVID-19, and the test was free.

The federal government passed a law in March making coronavirus tests and some other associated care available at no cost to the patient (although insurance companies are on the hook) but this patient visited her health care provider before the law went into effect.  Her insurer, however, had already promised to provide the test at no patient fee.  Because of the limited availability of the test at that time, patients were required to have other conditions ruled out before running the COVID-19 test.  After being notified by a reporter of the circumstances surrounding the case, Aetna waived the patient’s portion of the bill.

What comes after being tested?  If your test is positive, you are supposed to receive a call from a contact tracer.  News reports indicate this is not happening in Florida.  To be sure, some people are not cooperating when they are contacted; one particularly recalcitrant group received subpoenas.  The bottom line, though, is that there are too many new cases for the present group of contact tracers to follow up.  This was true a month ago, and even with attempts to hire more people, it is even more true today.  This from CNN and WMUR:

“The cases are rising so rapidly, that we cannot even do contact tracing anymore. I don’t see how it’s possible to even do that,” Dr. Peter Hotez, dean of tropical medicine at Baylor College of Medicine, told CNN Monday.

The Republican governor of Florida, Ron DeSantis, who has been criticized in the past for his actions in relation to the coronavirus crisis in his state, said in an interview on July 7, “Contact tracing is not going to be enough”, although he did not give clear indications of what additional measures the state government would take to address the problem.  He did say that $138 million has been allocated to the State Department of Health but claimed that individual counties could hire contact tracers with CARES Act funding, so apparently the State would not be doing so.  He stated that young people with no symptoms are driving the increased infection rate and that they often didn’t cooperate with contact tracers.  He also stated that the virus is transmitted more easily by people talking loudly over music.  All these things are true, but he didn’t say how the state government was going to respond to them.   There is little or no apparent state-level direction to the fight against the virus in Florida.

(PS: there are many good articles about the novel coronavirus in “The Conversation”, a website that is supported by a number of academic institutions.  In “Who We Are”, it states, “The Conversation US arose out of deep-seated concerns for the fading quality of our public discourse – and recognition of the vital role that academic experts can play in the public arena.”)

 

What the coronavirus reveals about the US healthcare system: New Yorker. Our medical system is controlled by profit-hungry investors and costs twice as much as it should.

2020-07-06

em coronavirus from NIAID– CC license

This article in the New Yorker is actually “old”– it’s from April 27– but it’s still highly relevant.  It was pushed to the back burner by the crush of news about the novel coronavirus, but it seems it’s on the front again with the crisis in Texas, Florida, and elsewhere in the South and West.

I won’t go into all the details of the article, just a quick summary– you should read it yourself if you care about fixing the problems we have in this country.  But you should be very pessimistic about the chances for changing anything.

The article explains that there are certain problems that can be fixed.  One is the way the system is organized.  There is a supply line that has too many choke-points: if one factory’s output is lost, there are no other factories that can make up for the lack of the components that it produces.

Chinese factories made most of the masks that we needed.  When they started hoarding them in January because they had to shut down, there was no-one else who could make up for the shortage.  Price competition had caused all the competitors to quit making masks and dismantle their production lines.

The National Strategic Stockpile was supposed to have a lot of masks.  It was depleted during the last crisis, and when the Obama administration requested the money to replenish it, they were turned down by Congress.  When the new administration came in, the Stockpile had only some old masks that had deteriorated over the years to the point where the elastic bands broke when they were put on.

These old masks were not replaced.  The new administration wasn’t interested in replenishing the stockpile because they didn’t realize that another pandemic was coming and didn’t think they needed to spend the money.

The information systems that support clinical medicine are broken.  Electronic health records were supposed to revolutionize medicine, but instead, they have become separate islands with no method for intercommunication between hospitals or between doctors.

The records are used for billing insurance companies, not for communication of medical findings between providers or coordination of treatment approaches.  Instead of helping doctors to advance medicine, they have become another time-consuming headache: filling out charts.

Shortages of specific medicines have been occurring more frequently over the past few years.  This is because pharmaceutical companies have shut down production lines for products that are not profitable.  Some products were left with only one supplier, and if that one’s production was shut down (for example, by quality control problems) then the product became unavailable.

Business practices that make sense for individual firms– to save money– cause major problems when they are followed by every firm.  Tightening up supply chains, with “just in time” manufacturing, leads to sudden shortages when a link in the chain is broken.  Squeezing the inefficiencies out of production leads to breakdowns when emergencies occur because all the resiliency is removed from the system.

The same applies to research capabilities.  Squeezing all the inefficiencies out of our research programs leads to not having any excess capabilities when emergencies hit.  Having enough slack in the system makes it resilient to sudden changes in demand and to having capabilities that are currently unused but might be needed in an emergency.  That costs more money, which eats into profits.

My conclusion, even after reading this article, is that there are too many basic deficiencies in the US healthcare system.  The most important deficiency, the one at the root of the worst problems, is that the system is entirely dedicated to producing a profit for certain participants– those who invest in producing all the components of health care.

Instead, the system should be geared to producing the most health improvements to the largest number of people (“the greatest good to the greatest number”– Mr. Spock.)

Right now, the investors are the ones who make all the decisions.  In order to change all the bad things about the system, it would be necessary to remove the investor.  Instead, the US federal government should be the primary payor.  All the other components will have to be changed to make this work.  That means that the people who are making money off the system the way it is would have to be removed by buying them out.

Only when the profit motive is secondary will there be room to build in excess capabilities that are not currently needed and which cost a little more money.

This is impossible.  Too many investors are making money off the backs of the American people.  We are paying twice as much as our peers in Europe for health care, and the money is going into the pockets of the people who own insurance companies, hospitals, clinical laboratories, and other expensive parts of the system.

The government would have to buy out all these people– pay them off for their investments.  Why should they sell out?  They see their way clear to continued profits at the expense of the average American.

The system is crashing.  Too much demand for medical care is leading to critical shortages of medicine, providers, and bed space.  When the system is unable to provide for the needs of people who have the capability to pay, there will be irresistible demands for change.  Even then, the basic profit motive will continue to rule.

The only fair way to remove the profit motive is to have the federal government buy out the system.  That will take a revolution, which will only happen when too many people are suffering to hold back the changes that are needed.  Revolution will cause even more suffering because there won’t be fair changes– someone will get hurt.

 

Daily New COVID-19 Cases in the US: 52,228 as of July 5 (or 6) per CDC; 46,042 per Worldometer; 49,093 per OurWorldInData; 45,157 per NYT; 57,186 per WHO. It may already be too late to stop.

2020-07-06

photo by Juraj Varga courtesy of pixabay.com

New cases of coronavirus continue their daily increase  (per New York Times live updates) since mid-June, with different organizations reporting different totals but all showing rises. Arizona, California, Florida, and Texas are seeing the greatest increases, with hospitals filling up and intensive care units (ICU) showing the strain.  Florida has reported more than 10,000 new cases a day for almost a week.  Public testing sites are overwhelmed with patients waiting hours in their cars, only to be turned away when testing supplies run out.  Yet the death rate has not increased, and in fact is much lower than two months ago.

Public health officials warn that the death rate could still increase, as the rise in cases dates only to mid-June, and it takes three weeks for death rates to catch up.  There are indications, though, that deaths may be lower because younger people are getting infected.  In addition, the use of anti-inflammatory steroids like dexamethasone is reducing deaths in seriously ill patients.

Remdesivir is still in short supply, with only 500,000 courses total being distributed by the federal government to the neediest hospitals.  When it is used, remdesivir may reduce the death rate (although the study showing a 1/3 reduction in deaths wasn’t big enough to reach statistical significance.)  Most of the world’s supply from Gilead was snapped up by the US government, although generic companies are beginning to produce it overseas.

The World Health Organization (WHO) has downplayed the importance of SARS-COV-2 aerosol transmission, insisting that large droplets (produced by coughs and sneezes) are the main vector.  According to the New York Times, a group of 239 scientists has written an open letter to WHO pleading for the recognition of aerosols as an important factor.  The reason for this: they argue that medical personnel should wear N95 masks whenever they are in the same room with COVID-19 patients; and that air filtering and decontamination for indoor areas where people gather should play a more important role.

The scientists say that WHO’s decision-making is too slow (see also this article from Washington Post on July 5) and conservative to accommodate fast-moving scientific discoveries about the coronavirus.  The WHO didn’t endorse the use of face-masks until early June, partly because of a shortage and partly because they didn’t accept the evidence that aerosol transmission was a major factor.  They still emphasize hand-washing as a primary preventive measure.  They also don’t recognize the fact that asymptomatic patients account for a large proportion of person-to-person transmission events.

WHO has come in for a great deal of criticism, even from its associated scientists, who prefer to remain anonymous to avoid jeopardizing their contracts.  The New York Times story reports complaints by scientists about the bureaucratic nature of WHO’s decision-making.

Contact tracing and isolation, procedures that have been so successful in South Korea and some other countries, are lacking in the US.  San Francisco has a well-organized program, but they are the exception.  States like Florida have not recruited enough contact tracers and the suddenly increased workload has overwhelmed them.  Test results are taking too long, frequently from four days to a week, to make contact tracing useful for interrupting chains of transmission.

There is no place to send people for isolation in most states; empty hotel rooms have not been organized, even though they are widely available.  Isolating at home is impossible for poor people living in overcrowded conditions.  Services like food delivery that make isolation more possible have not been organized either.  Forbes has an article on July 5 explaining why ten simple steps to respond to coronavirus may be impossible for poor and elderly people.

Without well-organized contact tracing and isolation procedures, controlling the spread of the coronavirus is next to impossible.  It may already be too late for the US to stop the virus.

 

The Vedic Period in northern India: Part Five: concepts: Atman

2020-07-05

photo by Manfred Antranias Zimmer courtesy of pixabay.com

In Hindu philosophy, Atman is defined as the Self, that is, the True self, as opposed to a self which is part of some phenomenon of existence such as that of an individual human personality, or an elephant.  Depending on one’s position as to duality, the Self is either identical with Brahman (the ultimate reality) (which is called advaita, non-duality, or monism), entirely separate from Brahman (dvaita, duality), or both separate and the same (bhedabheda, dual and non-dual.)  The six orthodox schools of Hinduism all agree that there is atman in every living being, human and animal.

To the advaita school of Hinduism, the atman is the same as the brahman.  In a sense, this is monotheism; here, Brahman and Vishnu are the same, as are all gods and avatars.  Vishnu, the Supreme Being, the Controller of the Entire Universe, Parabrahman, all are one and the same.  This includes the trinity (Trimurti) of Vishnu: Brahma (Rajas), creation or passion; Vishnu (Sattva), preservation or goodness; and Shiva (Tamas), destruction or darkness.  There are over a thousand names for Vishnu, representing different qualities, but in the advaita school they are all fundamentally the same.  Likewise, Vishnu has many avatars, all from the same source.

In the dvaita (dualist) school, Brahman is distinct from atman.  This distinction means that one cannot achieve union with Brahman or liberation during one’s lifetime, only after death.  Brahman is synonymous with Vishnu but separate from the individual atman of each living soul.  The best one can do during one’s lifetime is to reduce the separation to an infinitesimally small distance from Brahman.

Regardless of whether the atman is identical to Brahman or not, the atman is distinct from the ego (what we think of as the individual self.)  The atman does not have an individual personality and feels neither pleasure nor pain.  It is up to the ego to feel.  The ego is referred to as “ahamkara”, which is a combination of “I” and “to do”– meaning that the ego is inseparable from actions.  “Aham” is also translated as “spirit” which may be confusing.  There is a separate web page in Wikipedia for “ahamkara” and, in one section, it refers to the ways in which a person can become confused when bound up in personal possessions or in philosophies.

The ahamkara is distinct from the atman in the sense that the atman is the real owner of consciousness while the ahamkara is the expression of individuality.  This duality (not dvaita, which is different) causes people to misidentify their inner selves with their outer selves, to take their sense of personhood from their possessions, or to mistake their true philosophy as being less important than their defense of their viewpoints.  For example, (as described in Wikipedia) a man may buy a sports car and drive like a racer, even though he is not trained as a race car driver.  Or a woman may receive a diamond tiara and act like a queen, even though she is not of royal blood.

Another example would be someone who comes to believe in pacifism, goes to a demonstration, and gets in a fight with someone who supports the war.  Instead of applying the philosophy of pacifism to their personal life, the person will engage in violence to defend their point of view from counter-demonstrators.  Here the general philosophy is confused with the personal commitment.

The ahamkara is an illusion, but it is a necessary place to start on the path to enlightenment.  One must cultivate patience and forbearance in order to separate oneself from the manifestations of a turbulent world.

This verse comes from the Bhagavad Gita (4.7-8); it describes how Vishnu creates an avatar and sends it into the world to conquer evil whenever it becomes manifest:

Whenever righteousness wanes and unrighteousness increases I send myself forth.
For the protection of the good and for the destruction of evil,
and for the establishment of righteousness,
I come into being age after age.

The doctrine of “ahimsa” (non-harm to all living beings) is credited to the monistic idea that all living things possess atman in common and thus should not be harmed.  It dates to one of the earliest Vedas, the Isha Upanishad, which is thought to have been composed some time in the early part of the first millenium BCE.  Wikipedia quotes these verses from the Isha Upanishad (hymns 6-8):

And he who sees everything in his atman, and his atman in everything, does not seek to hide himself from that.
In whom all beings have become one with his own atman, what perplexity, what sorrow, is there when he sees this oneness?
He [the self] pervades  all, resplendent, bodiless, woundless, without muscles, pure, untouched by evil; far-seeing, transcendent, self-being, disposing ends through perpetual ages.

The Isha Upanishad predates the Buddha and ahimsa was incorporated into Buddhism.

In Buddhist philosophy, there is no atman.  Buddhists call the concept of atman an illusion (“maya”) and state that “nirvana” is that state of bliss achieved when one realizes that there is no self.  This was an area of active debate between Buddhists and Hindus in the Vedic period and after.  The Hindus believe that “moksha” (liberation) from the cycle of birth and rebirth (whether it is attainable in this life or not until after death) depends on realizing true self-knowledge and self-realization– the understanding that the inner soul is attached to, or part of, the universal soul or Brahman.   Buddhists believe that there is no permanent self.

This is another good place to stop.  I hope that this gives you some relief from thoughts about the pandemic.