“Hospitals and lawmakers in states gripped by the Delta variant are offering nurses tens of thousands of dollars in signing bonuses, rewriting job descriptions so paramedics can care for patients and pleading for federal help to beef up their crisis-fatigued health care workforces.
The alarming spread of new cases is draining the pool of available health workers in ways not seen since the pandemic’s winter peak, forcing officials to improvise and tear up rules dictating who cares for whom. Governors and hospital directors warn that the staffing crisis is so acute that patients, whether suffering from Covid-19, a heart attack or the effects of a car accident, can no longer expect the level of care that might have been available six weeks ago.”
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” Hospitals can respond by adding beds and ordering more protective gear. But they’re stuck fighting over the same finite pool of nurses, lab techs, nurse assistants and front desk workers, whose ranks have already been depleted by retirements and resignations. The Delta variant’s transmissibility — the U.S. is averaging 140,000 cases per day, up from 12,000 six weeks ago — is leaving few regions untouched, making it harder to call for reinforcements.”
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“Some nurses say hospitals facing surges are paying more to recruit new nurses, or hire temps from a staffing agency, than to retain the current staff. Some new hires can receive $20,000 signing bonuses while current staff get a $500 retention bonus, said Jamie Lucas, the executive director of the Wisconsin Federation of Nurses and Health Professionals, which is bargaining with multiple hospitals for bigger retention bonuses.”
“That polarization has now opened political rifts in vaccination rates, with people’s decision to get a shot or not today a better predictor of states’ electoral outcomes than their votes in prior elections. It’s led the US’s vaccination campaign to hit a wall, missing President Joe Biden’s July 4 goal. Meanwhile, the more infectious delta variant is spreading, raising the risk of infections, hospitalizations, and deaths in unvaccinated — and often heavily Republican — areas.
To put it bluntly: Polarization is killing people.”
“there is ample evidence that vaccines sharply reduce the risk of infection and are even more effective at preventing life-threatening symptoms. Furthermore, schools have a long history of requiring that students be vaccinated against other diseases. Abbott’s order nevertheless says “state agencies and political subdivisions shall not adopt or enforce any order, ordinance, policy, regulation. rule, or similar measure that requires an individual to provide, as a condition of receiving any service or entering any place, documentation regarding the individual’s vaccination status for any COVID-19 vaccine administered under an emergency use authorization.” That prohibition also applies to “any public or private entity that is receiving or will receive public funds through any means, including grants, contracts, loans, or other disbursements of taxpayer money.””
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“a state law that Abbott signed on June 16 goes further, saying “a business in this state may not require a customer to provide any documentation certifying the customer’s COVID-19 vaccination or post-transmission recovery on entry to, to gain access to, or to receive service from the business.” It says any business that violates this provision is ineligible for state contracts, and it allows state agencies to “require compliance with that subsection as a condition for a license, permit, or other state authorization necessary for conducting business in this state.””
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“”Texas is open 100 percent, and we want to make sure that you have the freedom to go where you want without limits,” Abbott declared after signing the law banning proof-of-vaccination requirements. That position sacrifices private property rights and freedom of association in the name of an unlimited “freedom” that has never been legally recognized: the freedom of any given customer to dictate the terms on which businesses offer products or services.”
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“assuming that school vaccine mandates are justified with respect to other communicable diseases, it is hard to see why COVID-19 should be treated differently—leaving aside the lack of full FDA approval, which is expected to be remedied soon. One counterargument is that COVID-19, which rarely causes life-threatening symptoms in children and teenagers, poses a less serious danger to them than other diseases for which vaccination is required.* Still, requiring teachers and students to be vaccinated certainly seems like a more cost-effective policy than requiring them to wear masks all day.”
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“it hardly makes sense to say that private businesses should be free to require face masks, on the theory that customers who don’t like that rule can go elsewhere, while prohibiting them from requiring proof of vaccination, which likewise is not tantamount to a legal requirement.”
“It’s been 10 days since Joel Valdez was shot outside of a Houston grocery store, and he still hasn’t been able to undergo surgery, due to his hospital being overcrowded with COVID-19 patients.”
“That’s the problem with almost all government bail-out schemes. You gotta be in the room where it happens—metaphorically, at least. Successful businesses will always have an advantage over those who lack the lobbyists, name recognition, or culture cachet required to cash in.
On the other hand, the federal government’s firehose of COVID relief spending—$5.9 trillion and counting—means it is easier than ever to get bailed out. So far, the government has responded to the pandemic by sending money to people who earn six-figure paychecks, paying fully vaccinated people not to work even though there are millions of available jobs, bailing out state governments that are running huge surpluses, and using the pandemic as cover for a massive bailout of union-run pension funds, among other things.
Like with Hamilton, there doesn’t seem to be any consideration of when or how much government aid is necessary. We’ve pumped so much money into the system—nearly all of it borrowed and added to the country’s long-term debt problems—and it has to go somewhere.
Did a bunch of fake celebrities whose only claim to fame is being former contestants on The Bachelor need the federal government to dump as much as $20,000 apiece into their bank accounts? Nope, but they got the cash anyway, according to data gathered by ProPublica and reported in a variety of media outlets.”
“States and localities continue to struggle with getting billions in federal rent relief funds out the door, frustrating both tenants and property owners while fueling demands for continued eviction moratoriums.
On Friday, the U.S. Treasury Department released new data showing that as of May 31, recipient jurisdictions have spent only about $1.3 billion, or 6 percent, of the $25 billion in Emergency Rental Assistance (ERA) funds approved by Congress in December 2020 to help renters cover rent, rent debt, and utilities.
That federal money was given in the form of grants to states and territories and to local governments with populations over 200,000.
That number obscures a lot of variation between states. Virginia has spent about 30 percent of its ERA award, compared to California’s 2 percent. The pace of spending is also increasing. States and localities spent $774 million in May, compared to the $443 million spent in April, and the $272 million spent from January to March. About 345,000 families have received ERA-funded assistance.
That’s far short of the 1.3 million households who self-report that they’re “very likely” to be evicted in the next two months in Census surveys, reports Politico.”
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“The dispersal of funds has faced a number of problems. For starters, most state and local governments have had to set up their own rent relief programs from scratch.”
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“Some 60 percent of respondents in a recent survey of ERA administrators said that a lack of staff was preventing them from dispersing rental aid. Another 49 percent said that their technical ability to scale up programs was responsible for the trickle of relief provided thus far.
Nevertheless, housing advocates say that even with these front-end logistical difficulties, ERA grantees should still be managing to spend emergency rental assistance like there’s actually an emergency on.”
“The federal government created the stockpile, originally the National Pharmaceutical Stockpile, in 1999 to counter potential biological, disease and chemical threats to civilian populations. It was eventually renamed the Strategic National Stockpile in 2003, and the Department of Defense was given a role in its management alongside HHS. The stockpile was designed as a stopgap that would allow the federal government to surge supplies to specific areas experiencing disasters or threats, supplementing local procurement efforts. It was not meant to be the sole source for private and public institutions to obtain medical supplies in emergency settings.
Hospitals, public health departments and other health care facilities are supposed to maintain their own stocks of masks, gowns, drugs and ventilators. But during the first months of the Covid-19 pandemic in 2020, they ran out of those basic supplies. The overwhelming number of Covid-19 patients forced both private and public institutions to search for personal protective equipment and therapeutics on the open market.”
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“A year and a half into the pandemic, the U.S. still does not have a good way to quickly scale production of drugs and medical supplies needed to help supplement the strategic national stockpile, in part because manufacturers operate on just-in-time principals. Those standards are supposed to minimize inventory and maximize efficiency, but struggle to account for swings in demand.
“Everybody — shippers, hospitals, pharmacy chains — no one wants to hold inventory. Who is going to pay for those expensive medicines sitting there month after month?” O’Toole said. “This is why hospital stockpiles have dwindled.”
The federal government is beginning to work with the private sector to ensure manufacturers have the ability to scale production quickly during large-scale disease outbreaks.
The Biomedical Advanced Research and Development Authority (BARDA) is working with its parent, HHS, to find companies willing to alter their standard manufacturing practices to scale up production of therapeutics and other medical supplies to better prepare for the next pandemic. But expanding manufacturing capacity in the U.S. is not easy, one former Trump administration official who worked with BARDA told POLITICO. It will take years to build facilities, manufacturing lines and hire staff to oversee production, the former official said.”
“The vast majority of Americans want to age in their home and community, spending their twilight years in a familiar and comfortable setting. But the choice is not always their own.
The US long-term care system — such as it is — is broken. Hundreds of thousands of Americans are on waiting lists for home-based care. More than 40 million people report that they have cared for a loved one over 50 without any pay in the last year. The United States ranks near the bottom of developed economies in the number of older adults who receive long-term care at home. Meanwhile, America’s nursing homes are staffed by overwhelmed and underpaid workers, and for-profit takeovers of those facilities have led to worse care for patients.
Covid-19 has made this long-term care crisis impossible to ignore. More than 130,000 nursing home residents have died in the pandemic, accounting for nearly one in four US deaths. Residents of large institutions died at higher rates than those who live in the community.
In America, aging people who need care — in a nursing facility or at home — either must be wealthy enough to pay for it themselves or must deplete their income and assets enough that they qualify for Medicaid. Almost by accident, the health insurance program for low-income Americans has become the main payer for nursing home and home-based care. Experts describe long-term care in the US with a sense of disbelief.
“If you were starting from scratch, you would never design a system this way,” David Grabowski, a Harvard professor who studies the economics of long-term care, told me.
Tricia Neuman, who studies long-term care at the Kaiser Family Foundation, put it even more baldly: “We do not have a system of long-term care in our country.”
America has been struggling for decades to figure out a balance between having people age in long-term care facilities and age at home. President Joe Biden has proposed a massive infusion of federal spending on home-based care. Experts say it should start to address these structural problems — but it’s only a start.”
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“More than three in four people over the age of 50 said in a 2018 AARP survey they want to stay in their community as long they can. But fewer than half thought that would be possible — and many of them may end up being right, as the long waiting lists for home- and community-based services attest. As of February 2020, more than 820,000 Americans were stuck on their state Medicaid program’s waiting list for home- and community-based services, according to the Kaiser Family Foundation, and their average wait time is longer than three years.
Even for those lucky enough to be able to afford in-home care, the US long-term care system hasn’t done them any favors. Virginia Veliz, a 70-year-old in Santa Clarita, California, has been coordinating care for her 90-year-old mother, who has Lewy body dementia and Parkison’s disease, for the past five years.
“You really have to treat it like a job,” she said.”
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“There are some people for whom institutional care makes sense — those with severe cognitive decline, for example. Others might simply prefer to live in a nursing home with other people instead of living alone at home.
But the idea is that it should be the patient’s choice. The US still has not found a way to put that decision entirely in the patient’s hands.”
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“Prioritizing home-based care appears to be the preferred solution for both patients and policymakers. But it will cost money. The Netherlands, Norway, and Sweden are considered global leaders in providing community-based services, but they also spend a substantially higher share of their GDPs on long-term care (around 3 percent) than the US (0.5 percent).”
“Do you know who is back in the office, unlike State Dept. employees who’ve had access to COVID vaccines longer than most of the rest of us? Scores of millions of Americans, including many who would like to visit their relatives for the first time in a year and a half. Compounding that failure to put asses back in office chairs is the fact that, as Arndt says, “passport specialists need to be physically present in the office to process the passports. They are not processing remotely or from home.””