“Arizona is one of 12 states seeing a rise in hospitalizations from Covid-19 and one of eight states that experts say are the new hot spots for the virus. The relatively fast rise in new cases in Arizona makes it one of the most concerning outbreaks because its health care system could soon be overwhelmed. Hospital capacity was at 83 percent as of Tuesday, the Associated Press reported.
It’s not entirely clear what’s driving the rise in new cases, but on May 15 Arizona Gov. Doug Ducey lifted the stay-at-home order enacted on March 31. The state’s reopening is guided by an executive order that “allows businesses to gradually and safely open in compliance with federal guidelines as the state continues to mitigate and prevent the spread of Covid-19.””
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“the state issued protocols for public health measures like physical distancing, hygiene, and wearing masks, the executive order didn’t provide a way to enforce them or to ensure compliance. (Many experts believe masks should be mandatory in crowded public spaces to reduce transmission, and several other states have made them so.)
“They were ‘recommendations’ instead of ‘requirements,’” said Will Humble, executive director of the Arizona Public Health Association and the former director of the ADHS.
Three weeks later, infections are spiking.
“If you do a root cause analysis of what’s going on and what’s wrong, it’s that word [recommendations],” said Humble.”
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“Meanwhile, countries like Italy that have lifted their restrictions have not seen a resurgence of the virus. Experts aren’t sure why. It may be due to changes in habits and hygiene that have stuck. The difference in outcomes highlights the importance of early action and vigilance. States like Arizona meanwhile are launching a real-world experiment, and an extremely risky one at that.”
“While it is true that the majority of drugs Americans consume are imported, just 13 percent of the facilities certified by the FDA to make drugs for the United States are located in China. Last year, less than 1 percent of the finished drugs imported into the United States came from China—compared to 23 percent from Ireland.”
“the WHO did make some mistakes early on in the pandemic, such as not pushing China to allow international inspectors into the country as the coronavirus outbreak grew, and falsely asserting in January that “Chinese authorities have found no clear evidence of human-to-human transmission” of Covid-19.
But that’s a far cry from proof of some special WHO-China conspiracy, and serves as a convenient excuse to distract from Trump’s lacking coronavirus response in the US — including ignoring months of US intelligence warning of an imminent threat to the country from the virus.”
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“the president’s decision will be a major blow to the WHO. America’s withdrawal means the health body will lose nearly $900 million in US contributions every two years, by far the most the body receives from any nation. Trump had already frozen about $400 million of that money last month when he first froze funding during a review of US-WHO relations.
The US will now be “redirecting those funds to other worldwide and deserving urgent global public health needs,” Trump said, without naming what those might be.
In one fell swoop, Trump is making the global coronavirus response harder to coordinate, has possibly ignited a congressional firestorm, and almost surely worsened the world’s perceptions of America.”
“conspicuously absent is the policy that would do the most to guarantee — or at least support — ongoing recovery: automatic stabilizers.
The idea is simple, and backed by an array of economists. We’re in a depression. The support people need should be tied to the economic conditions they face, not arbitrary expiration dates.”
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“There are various proposals for how to do it. Rep. Don Beyer’s (D-VA) Worker Relief and Security Act is a good place to start. It groups states into tiers based on their unemployment rates, and ties both extensions and expansions of unemployment insurance to those tiers. The support doesn’t end until the economic emergency ends.”
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” Automatic stabilizers are, if anything, cheaper than the alternative. They ensure the money is spent as soon as it’s needed. “The faster you act, the more effective the relief will be at fighting the recession,””
“the states that have reopened have seen anemic economic recoveries at best.
Slate’s Jordan Weissman, using data from the app Open Table, notes that restaurant reservations are down as much as 92 percent from last year in those states that have allowed dining rooms to reopen.
A ranking of state jobless claims released yesterday by the personal finance website Wallethub finds that the number of people applying for unemployment is especially high in Connecticut, which had a bad COVID-19 outbreaks and a strict shutdown order, but also in Georgia and South Dakota. The former is lifting its shutdown order, and the latter never imposed one.
This matches with new research showing that economic activity declined at similar rates regardless of when states issued formal lockdown orders. Individuals, not the government, shut the economy down. They’ll also decide when, or if, it reopens.”
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“if we can’t expect much of the pre-pandemic economic activity to return, that dramatically weakens the case for propping up businesses as Jayapal and Hawley want to do, or paying workers to stay jobless like the HEROES Act does. Both policies stymie markets’ ability to adjust to COVID-19 while shifting resources from those parts of the economy that can be productive during a pandemic to those that can’t. If there’s no demand for air travel, we’d be better off seeing baggage handlers shift to being warehouse workers or grocery delivery drivers. We want cooks and cashiers to move to restaurants that can figure out a way to stay profitable without dining service.
That doesn’t mean the government can’t provide relief. Even if we allow those readjustments to happen, we’ll still probably have a less productive economy for a while, and the negative effects of that will be concentrated on people who aren’t in a position to adapt. So there’s a reasonable case for cash transfers targeting the poorest Americans. But they shouldn’t be conditioned on staying at their current jobs, and—unlike unemployment benefits—they shouldn’t be conditioned on staying out of the labor force altogether.”
“Herd immunity is the resistance to the spread of a contagious disease that results if a sufficiently high proportion of a population is immune to the illness. Some people are still susceptible, but they are surrounded by immune individuals, who serve as a barrier preventing the microbes from reaching them. You can achieve this through either mass infection or mass vaccination.”
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“Most the evidence so far suggests that people who recover from a COVID-19 coronavirus infection do, at least for a time, develop immunity to the microbe. If that’s true, what is the disease-induced herd immunity threshold for the COVID-19 coronavirus? Various epidemiologists offer different answers, depending upon their estimates for the disease’s R0 and other variables, but most have converged on a threshold at around 60 to 70 percent.
More recently, some researchers have suggested that this threshold may be too high. In a new preprint, three mathematicians from Sweden and the United Kingdom, using an R0 of 2.5, calculate a reduction in the herd immunity threshold from 60 percent to 43 percent by incorporating some assumptions with respect to populations’ social activity levels and age structures.
A couple of new reports speculatively lower the possible herd immunity threshold for the coronavirus to just 10 to 20 percent of the population. This conjecture depends chiefly on assumptions about just how susceptible and connected members of the herd are.”
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“There are no solid estimates for the percentage of the U.S. population that has already been infected by the coronavirus, but Youyang Gu and his team at COVID19-Projections estimate that right now the number is between 2.2 to 4.7 percent. That would mean that somewhere between 7.3 and 15.5 million Americans have been infected. A similar result emerges from a very rough calculation that multiplies the number of confirmed cases at 1.4 million by a 10-fold factor of undiagnosed cases and infections. (The 10-fold factor is derived from data recently reported by Indiana University researchers.)
The upshot: The U.S. as a whole is not yet close to achieving even the speculatively low estimate of the herd immunity threshold.”
“If COVID-19 precautions are mandatory, they must at some point be legally enforced, with all the risks that entails, including violence and racial discrimination. The public health payoff might justify those risks in certain contexts—if a dense crowd happens to gather in Central Park, for instance, or if subway riders refuse to wear masks (although that was the situation in the video that the Times cites as evidence of overkill). But the risks cannot be eliminated if voluntary compliance is less than perfect, as it always will be.”
“the attention and resources dedicated to repurposing old drugs detracts from the pursuit of new therapies that would be true breakthroughs, exponential advancements in science. Feldman describes such innovation as “value beyond pearls.”
“It’s rare, it’s beautiful, it’s startling, it’s a thing of beauty,” she said.
But that kind of innovation takes time and money with no certain payoff. It’s simpler and cheaper to modify existing products to somewhat improve their efficacy or to tweak them to treat a different condition.
“I worry that our system is not well primed for it,” she said. “It’s all about the incentives. Our incentives aren’t directed properly.”
She pointed to the shift away from antibacterial resistance research and drug development, even though researchers anticipate millions of global deaths annually within the next few decades because bacteria have become resistant to the drugs that we already have to fight them.
Drug makers currently devote a lot of their attention to end-stage cancers, because they can benefit from “orphan drug” designation and other competitively advantageous policies, while Feldman argued that chronic conditions have been underserved. Looking at it from a societal perspective, the latter obviously has more value than the former — and yet that is not necessarily what our innovation system has been designed to reward.
Or look at the antiviral space, which is the most relevant to the coronavirus response.
Antiviral research investment historically has not been a priority for the major drugmakers. The Wall Street Journal reported Pfizer had to reestablish its antiviral research department for its Covid-19 work because the unit was disbanded in 2009. Novartis ended its antiviral and antibacterial research in 2018. One systemic review of the past 30 years of antiviral research found “only a few drugs were approved to treat acute viral infections” in that time.
“Antibiotics and antivirals are both areas that haven’t seen a tremendous amount of new drug development because the economic incentives haven’t justified significant R&D in this area,” Caroline Pearson, senior fellow with NORC-University of Chicago, told me recently.
So long as these incentive structures remain in place, Feldman warned, we will never be ahead of the curve in fighting off the next pandemic. She said that the US should be asking: “What’s of value and what should we incentivize people to do?””
“The recent spike in Covid-19 cases in some of the countries thought to have best contained the virus — first Singapore, now South Korea and, potentially, Germany — is a glimpse into America’s possible future as states start reopening businesses and public activities after several months of lockdown.
All it can take to reverse the positive trends is a single undetected case. As Vox’s Alex Ward reported this week, one South Korean man who went out for a night on the town at several Seoul dance clubs has been linked to nearly 80 new cases there. Suddenly the country’s curve is rising again and the local government ordered bars and restaurants to be closed, an abrupt reversal of its reopening plans.”