Why the US nursing crisis is getting worse
https://www.vox.com/coronavirus-covid19/22763417/us-covid-19-hospitals-nurses-shortage
Lone Candle
Champion of Truth
https://www.vox.com/coronavirus-covid19/22763417/us-covid-19-hospitals-nurses-shortage
“Vaccines aren’t distributed equally: Rich countries have about twice the population of low-income countries, yet they have received about 50 times as many Covid-19 vaccine doses”
…
“Hoarding and production constraints are part of the story, but so are less-appreciated obstacles like clogged supply chains and breakdowns in communication between vaccine makers, donors, and recipients. These problems are solvable, however, and countries like the United States are uniquely positioned to contribute.”
…
“Countries that are counting on Covid-19 vaccine imports, whether through donations or purchases, are often in the dark about when and where rich countries and pharmaceutical companies will ship their doses”
…
“the United Kingdom donated 9 million Covid-19 vaccine doses to low-income countries this summer, but several of the countries receiving them warned that they would not be able to distribute most of them in time. Many vaccines have a limited shelf life, and donated vaccines are often close to expiration. In May, Malawi was forced to discard 20,000 doses of Covid-19 vaccines because the country’s health system could not administer them before the shots expired.”
“Many had expected people to return to the workforce en masse after federal unemployment benefits expired in September. While that’s happened to some degree — the economy added more than half a million jobs last month — there are still many more Americans holding out, thanks to a variety of reasons, from savings to lack of child care to the ongoing risks of the pandemic.
Importantly, the pandemic — as well as government social safety nets like extended unemployment benefits — gave people the time, distance, and perspective to reevaluate the place of work in their lives.”
…
“There are still more than 4 million fewer people in the workforce than there would be if labor force participation were at pre-pandemic levels. There are 10.4 million open jobs and just 7.4 million unemployed, according to the latest data. Of course, many of these open jobs are bad: They have bad pay, dangerous working conditions, or just aren’t remote (remote positions on LinkedIn get 2.5 times more applications than non-remote, according to the company).
The result is a situation where many employers — especially those in industries with notoriously bad pay and conditions — are having difficulty finding and retaining workers. To counter it, they’re raising wages, offering better benefits, and even altering the nature of their work. Depending on their strength and duration, these various actions could have long-lasting impacts on the future of work for all Americans.”
…
“In September, a high of 4.4 million people quit their jobs, according to the latest data from the Bureau of Labor Statistics, which has been tracking this data since 2000. That’s 3 percent of all employment and follows a summer of record quit numbers. Quitting has been especially prevalent in lower-paying, lower-status jobs like those in leisure, hospitality, and retail.”
…
“In 2021, approval of labor unions grew to 68 percent of Americans, its highest rate in more than 50 years. This is happening as many American workers are attempting to unionize their workplaces. Recent unionization efforts include Starbucks, Amazon, and meal-kit delivery service HelloFresh. Last month was dubbed “Striketober,” as more than 100,000 workers across industries, including workers at John Deere and in film and TV crews, participated in various labor actions. This is one of the many worker trends bulwarked by social media, which is rampant with support for unions.”
“Israeli presenters provided slide after slide showing the power of booster shots. But not all of the FDA advisors were convinced. “What they’re seeing in Israel is not necessarily what we’re seeing here in the U.S.,” said Dr. Archana Chatterjee, dean of Chicago Medical School and member of the advisory committee, during the meeting. In an interview with FiveThirtyEight, she explained that Israel’s data is “interesting and very compelling,” but that Israel differs from the U.S. on key characteristics: Namely, a higher share of the Israeli population is inoculated, and a larger proportion of breakthrough cases in Israel led to hospitalization prior to the booster shot rollout. As a result, she said, Israel had a clear need for additional shots to bump up immunity. In the U.S., meanwhile, the vaccines were still highly protective against severe COVID-19 disease and death.
Chatterjee said that her eventual votes — in favor of booster shots — were not based on data from Israel. Still, the Israeli scientists’ very presence at the meeting demonstrated the shortcomings of the U.S. health system. If the U.S. doesn’t comprehensively track its own data, it has to rely on other countries to tell it how to keep Americans safe. Meanwhile, without clear evidence that they can refer to in making their own COVID-19 decisions, many Americans have been confused about whether they are eligible for — or even need — a booster shot.
Israel has a universal health care system for all citizens and permanent residents. So does the U.K., another country that the U.S. looks to for COVID-19 data. Beyond the health care benefits that such policies provide to residents, universal health care has a clear advantage for data scientists seeking to answer medical questions. When every person in the country is plugged into the same health care system, it’s very easy to standardize your data.”
…
“In the U.S., vaccine research is far more complicated. Rather than one singular, standardized system housing health care data, 50 different states have their own systems, along with hundreds of local health departments and thousands of hospitals. “In the U.S., everything is incredibly fragmented,” said Zoë McLaren, a health economist at the University of Maryland Baltimore County. “And so you get a very fragmented view of what’s going on in the country.””
…
“Without a unified dataset allowing U.S. researchers to analyze how well the vaccines are working, policymakers are left with limited information to make crucial decisions, such as determining who should be first in line for a booster shot.”
“The effects of mass death on the economic fortunes of workers were profound. On the eve of the Black Death, Europe was characterized by feudalism, a hierarchical social and economic system with military aristocrats (and the clergy) at the top and a large mass of peasant laborers at the bottom. Because the economy was overwhelmingly agricultural, the elite’s capital was held almost exclusively as land. Peasants were tied to this land through a highly exploitative system of forced labor called serfdom, which demanded the uncompensated provision of labor and greatly restricted workers’ mobility.
The demographic collapse wrought by the Black Death was a fundamental shock to this system — at least it was in the areas where the toll of the plague was high. The basic laws of supply and demand explain why. In areas where the plague hit hard, it decimated the labor force. At the same time, the disease left the upper classes’ main capital asset, land, completely untouched. Thus, one factor of economic production, labor, suddenly became scarce and expensive, while the other, land, became abundant and cheap. The result was a massive increase in peasants’ bargaining power. Thus, workers were able to demand better working conditions, improve their access to land and, given the challenges elites faced in policing their movement, migrate to the cities. In the years immediately following the Black Death, serfdom collapsed and was replaced by a wage economy based on free labor.
Yet this reaction to the Black Death did not take place across the whole of Europe. Although much of Western Europe (including some western areas of what we now think of as Germany) suffered from the plague with particularly high intensity, leading to those massive changes to the bargaining power of labor, Eastern Europe, which was less exposed to trade and had sparser human settlement, saw significantly less death. Consequently, in the eastern parts of Europe, including the east of German-speaking Central Europe, the system of serfdom persisted for centuries longer than it did in the West.
These differences in labor freedom had important consequences for local politics and institutions. We find that areas of Central Europe that experienced high mortality from the Black Death — leading to an early end for serfdom — developed more inclusive political institutions at the local level, such as the use of elections to select city councils. These changes initially resulted from shifts in the organization of agriculture. In areas where the Black Death hit hard, elites were forced to decentralize much of the everyday control over agricultural management to the peasants themselves. This created a local need for coordination, since agricultural production at the village-level could only be successful if peasants agreed on the crops to be harvested and the division of labor in the agricultural round. As a consequence of these early experiences with self-governance, peasant villages began to demand the right to elect their own officials. Over time, this led to wider and wider participation in collective self-governance at the local level. Such experiences fostered a lasting culture of civic engagement and cooperation that proved essential for safeguarding the freedoms of laborers from future attempts by elites to roll back the gains won in the wake of the Black Death.”
“Outside experts have estimated that as much as $75 billion should be spent over 10 years on public health infrastructure, preparedness, and prevention.
The revised Build Back Better legislation totals roughly $10 billion in public health infrastructure and pandemic preparedness funding over the next few years — a down payment on better readiness, in Democrats’ view, but one without assurance of future installations.
“All too often, when there’s a crisis, the reaction is to put money into public health. Once the crisis subsides, the funding tends to dry up,” Ron Bialek, president of the Public Health Foundation, told me. “This is not a recipe for success.””
“under Gorsuch’s approach, the state must exempt religious objectors because it has a single exemption — again, for people who could suffer serious health consequences if they receive the vaccine.
Had Gorsuch’s approach prevailed, it’s likely that religious objectors would be exempted from nearly any law. Speed limits, for example, typically exempt police, ambulances, and other emergency vehicles responding to an emergency. Even laws banning homicide typically contain exemptions for self-defense. (Although, in fairness, Gorsuch concedes that a religious exemption is inappropriate when the “challenged law serves a compelling interest and represents the least restrictive means for doing so.” So Gorsuch probably would not allow religiously motivated murder.)
In any event, Gorsuch’s view did not prevail — though it is far from clear that it will not receive five votes in a future case. Though Justice Barrett joined a majority of the Court in allowing Maine’s vaccine mandate to take effect, her opinion (which is joined by Justice Brett Kavanaugh) clarifies that she did so on exceedingly narrow grounds.
Essentially, Barrett argues that the Supreme Court has discretion to decide which cases it wants to hear. And her opinion suggests that she would exercise her discretion to not hear this particular case.”
…
“For now, at least, the bottom line is that Maine’s vaccine mandate is in effect. Public-facing health care workers will need to receive the Covid-19 vaccine unless they have a medical excuse.”
…
“it’s not a huge loss for the religious right. But the decision in Does suggests that there is, at least, some limit to the Court’s willingness to carve out legal exemptions for religious conservatives.”
“According to a new survey from the Kaiser Family Foundation, as the rate of U.S. adults who report having received at least one dose of the COVID-19 vaccines continues to climb, the rates among racial groups are now basically identical, comprising 71 percent of white adults, 70 percent of black adults, and 73 percent of Hispanic adults.”
“The federal government sent around $190 billion in aid to public schools across the nation during the COVID-19 pandemic. That is a lot of money by any standards, but in terms of federal spending on primary education, it is a shockingly large amount: as Reason’s Matt Welch explained when surveying the Biden administration’s weak moves toward promoting public school reopening back in February, that’s more than four times as much as the federal government tended to push toward K-12 education a year in pre-COVID times.
Is the money being diligently used for its intended purpose? Of course not. A survey by ProPublica found, when examining some of the “provisional annual reports…by state education agencies” for about $3 billion worth of the aid from March to September of 2020, that “just over half of the $3 billion in aid was categorized as ‘other,’ providing no insight into how the funds were allocated.”
Over the last school year, 15 states constituting around a quarter of the total U.S. population didn’t even manage to achieve 50 percent effective in-person education, the alleged purpose of all that federal COVID money.”
…
“”The law places few restrictions on how districts can spend the federal aid, as long as the investments are loosely connected to the effects of the pandemic,” ProPublica explains, while noting that various districts, as reported by the Associated Press, are diverting the cash to athletics. The schools are supposed to spend all the money by 2024. The Associated Press reports that although schools “are required to tell states how they’re spending the money…some schools are using local funding for sports projects and then replacing it with the federal relief—a maneuver that skirts reporting requirements.””