“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.””
“Cuba’s economic problems largely predate the pandemic, but the coronavirus sharpened them. It decimated Cuba’s tourism industry, a huge slice of the island’s economy. Trump-era sanctions — which the Biden administration has not rolled back — have added to the pressure. And the pandemic itself is taking a toll: Cuba is currently experiencing a record surge in cases and deaths.”
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“Biden said the US supports Cuba’s “clarion call for freedom and relief.” Both Democrats and Republicans have backed the protests, but US lawmakers are split over how to approach the demonstrations and acute humanitarian crisis on the island.
Biden promised during his 2020 campaign to roll back Trump’s sanctions on Cuba, but he hasn’t acted. Now, the issue is urgent — both for those who want to see the sanctions gone and for those who feel Biden must keep them in place to continue pressuring the regime.
Biden’s best-laid plans on foreign policy didn’t include Cuba as a priority. But now a crisis in Cuba is here. What the US should do is always a complicated decision, but it’s clear Biden can’t just ignore Cuba.”
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“After the protests, Cuban President Miguel Díaz-Canel blamed much of the unrest on the United States, claiming US-backed mercenaries caused the unrest. He called on supporters to also go to the streets and “defend the revolution.” About 100 people were arrested, according to human rights groups.”
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“The specter of United States interference remains powerful in Cuba, given, well, a very long history of US intervention there. Fast-forwarding to the Cuban Revolution in 1959, communist revolutionary Fidel Castro overthrew the US-backed dictator and began to pursue closer ties with the Soviet Union — an absolute no-no for the US during the Cold War.
The US tried to overthrow Castro during the Bay of Pigs invasion in the 1960s, but after that failure, the US strengthened an economic embargo that largely blocked Americans from doing business or trade with Cuba. There have been tweaks on the margins since, but the embargo has long outlasted the Cold War.
In 2014, then-President Barack Obama began a historic diplomatic opening with Cuba, and as a result of the process, rolled back some economic restrictions tied to the Cold War-era US embargo and opened up travel.
Trump, as president, vowed to reverse those policies; he did throughout his time in office, significantly stepping up the pressure starting in 2019. He imposed renewed travel restrictions and other sanctions, including designating Cuba as a “state sponsor of terror” in his final days in office. A key pillar of Trump’s sanctions severely limited remittances to the island, which cut off another economic spigot.
As experts said, Cuba’s problems are deeper than US sanctions alone, but the Trump-era policy, especially coming during the pandemic, is adding to the strain. And that is creating a dilemma for Washington.”
“Alabama Gov. Kay Ivey issued an impassioned plea for residents of her state to get vaccinated against Covid-19, arguing it was “time to start blaming the unvaccinated folks” for the disease’s continued spread.
“I want folks to get vaccinated. That’s the cure. That prevents everything,” Ivey, a Republican, told reporters in Birmingham, Ala., on Thursday.”
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“Alabama remains the state with perhaps the lowest vaccination rate in the country, according to the CDC: Only 39.6 percent of its residents 12 and older have been fully vaccinated, compared to the 48.8 percent of Americans nationally who have gotten their shots.”
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“The Delta variant now represents more than 83 percent of the virus circulating in the United States, according to the CDC, and unvaccinated people account for 97 percent of coronavirus-related hospitalizations and deaths nationally.”
“For some reason, despite the risks, millions of Russians are unhappy enough with Putin to go out in the streets and protest. The question is—why? And will it matter?”
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“Why did he think Russians were turning out like never before? Davidoff said that everyone he asked began with the phrase: “Well, I don’t agree with Navalny about everything, but …” I had heard similar comments. Then the speakers would continue with phrases like these: “But if they can treat Navalny this way, they can treat me this way.” “But it’s a matter of self-respect.” “But the corruption is out of control.” “But my bills keep going up and my pension stays the same.” “But my salary just disappears.” “But I’ve got to help support my parents.”
Whatever the motivation for each person, it was strong enough for them to risk physical harm, detention or even imprisonment to express discontent with the country and their lives.”
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“Russians really are having a hard time making ends meet. In Moscow, with its shopping malls, elegantly dressed population and boom of elite housing, it’s easy to miss.
It’s also not easy to see on paper. All the statistics seemed to indicate that Russia weathered the Covid storm better than most countries. At the beginning of 2021, data showed that the economies of European countries contracted about 7.4 percent in 2020 and the world economy was down 3.5 percent, while Russia’s economy contracted by only about 3.1 percent. Analysts at Moscow’s Higher School of Economics noted cheerfully that this was the first time in history Russia did better than the world average. This appears to be in part because the segments of the economy hit hardest by the pandemic—service sectors—are relatively small in Russia. The price of oil, Russia’s main source of income, did plummet for a while, but then it began to edge up again. Today it’s almost $70 a barrel, while the state budget is based on revenues of $42 per barrel.
But on the micro level it’s a different story. Household incomes are down 3.5 percent in the past year, and this is a deeper dip in a downward trend: Households are making 11 percent less in real terms than in 2013. From Dec. 1 to March 17 the price of gas jumped 18.5 percent. Food prices have risen by almost 8 percent from April 2020 to April 2021, and the government is paying 3 billion rubles (about $40 million) to subsidize the price of sugar. The government has even banned the export of buckwheat groats, a staple for Russian families in hard times, to keep the price affordable.
All of this means that none of my retired friends can live on their monthly pensions of 12,000 rubles ($164) without working or getting help from their children and families. And it explains why all of us have been living paycheck to paycheck.”
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“Corruption in Russia has always been a problem, but the conventional wisdom is that it seems to have gotten worse in the past two decades. First, my friends would tell me, they had to pay 15 percent in kickbacks on state contracts, but now it’s 35 or 50 percent. The saleswoman in a local household goods store told me how she and her husband had saved up enough money to buy the rights to a small press kiosk, but since it was at a bus stop and owned by the city, he had to get an official’s signature. Dressed in his best suit, her husband went into the office and explained what he needed. The bureaucrat replied, “Well?” My friend’s husband didn’t understand, and after a few questions back and forth at cross purposes, the official finally said, “Didn’t anyone tell you? My signature costs $50,000.”
Businesspeople also run the risk that a competitor will pay off someone in law enforcement to bring charges against them—and watch as the competitor takes over their business. Everyone resents the day-to-day corruption that makes life difficult, the money you pay in taxes or fees that disappears into someone’s pockets. You pay your apartment fees, but the management company doesn’t shovel the snow or wash the floor in the entryway or fix the hole in the roof. You watch workers change the curbstones on your street four times in three months. The trash cans in parks are overflowing. Getting your kids in the right school or right class costs extra.”
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“The government crackdown in recent weeks means life has changed dramatically for independent media and opposition political figures and activists. Dmitry Gudkov, once a member of the parliament who formed the opposition Party of Changes, packed up and left Russia on June 6 after being warned by sources in the presidential administration that otherwise a “fake criminal case would continue until his arrest.” On June 9, the Anti-Corruption Foundation was declared an extremist group, thus making all its employees ineligible for elections for at least three years—including, of course, in the upcoming parliamentary elections scheduled for September. For Russians who hoped for change through open media and elections, it felt like the end of an era in Russia’s political life.”
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“Albats points out that throughout Russian history, autocrats have been forced out only when they lose the support of the “elites”—which these days means the billionaires around Putin.
Which suggests that a crusader like Navalny, no matter how charismatic, and ordinary Russians, no matter how discontented, are unlikely to change that pattern.”
“”Defining ‘misinformation’ is a challenging task, and any definition has limitations,” Murthy concedes. “One key issue is whether there can be an objective benchmark for whether something qualifies as misinformation. Some researchers argue that for something to be considered misinformation, it has to go against ‘scientific consensus.’ Others consider misinformation to be information that is contrary to the ‘best available evidence.’ Both approaches recognize that what counts as misinformation can change over time with new evidence and scientific consensus. This Advisory prefers the ‘best available evidence’ benchmark since claims can be highly misleading and harmful even if the science on an issue isn’t yet settled.”
Who decides what the “best available evidence” indicates? Trusting government-appointed experts with that job seems risky, to say the least.”
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“If those recommendations become commands, they would clearly impinge on the First Amendment rights of social media companies and people who use their platforms. But even if such regulations could pass constitutional muster, they would face the same basic problem as voluntary efforts to curb “misinformation”: Once you get beyond clear examples like warnings about vaccine-induced mass sterility, misinformation is in the eye of the beholder.”
“while some circumstantial evidence supports the lab leak theory, there is still no scientific consensus on whether COVID-19 emerged from a research facility, a wet market, or somewhere else.”
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“Facebook made a quiet but dramatic reversal..: It no longer forbids users from touting the theory that COVID-19 came from a laboratory.
“In light of ongoing investigations into the origin of COVID-19 and in consultation with public health experts, we will no longer remove the claim that COVID-19 is man-made or manufactured from our apps,” the social media platform declared in a statement.”
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“the lab leak theory—the idea that COVID-19 inadvertently escaped from a laboratory, possibly the Wuhan Institute of Virology—has gained some public support among experts. In March, former Centers for Disease Control and Prevention (CDC) chief Robert Redfield said that he bought the theory. (His admission earned him death threats; most of them came from fellow scientists.) Nicholson Baker, writing in New York, and Nicholas Wade, formerly of The New York Times, both wrote articles that accepted the lab leak as equally if not more plausible than the idea that COVID-19 jumped from animals to humans in the wild (or at a wet market). Even Anthony Fauci, the White House’s coronavirus advisor and an early critic of the lab leak theory, now concedes it shouldn’t be ruled out as a possibility.
This has forced many in the media to eat crow. Matthew Yglesias, formerly of Vox, assailed mainstream journalism’s approach to lab leak as a “fiasco.” The Post rewrote its February headline, which now refers to the lab leak as a “fringe theory that scientists have disputed” rather than as a debunked conspiracy theory. New York magazine’s Jonathan Chait noted that a few ardent opponents of lab leak “with unusually robust social-media profiles” had used Twitter—the preferred medium of progressive politicos and journalists—to promote the idea that any dissent on this subject was both wrong and a sign of racial bias against Asian people.”
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“Big Tech takes its cues from the mainstream media, making decisions about which articles to boost or suppress based on the prevailing wisdom coming from The New York Times, The Washington Post, and elite media fact-checkers. (That’s according to information I obtained from insiders at Facebook during research for my forthcoming book, Tech Panic.)”