“Data shows that more than 90 percent of US surgeries are considered elective or nonessential. Collectively, they bring the nation’s health care system between $48 billion and $64 billion of revenue per year. This is why so many hospital systems struggled financially in the early days of the pandemic: While beds filled with Covid-19 patients, many profitable services ground to a halt.
Yet the definition of essential care has varied not only by health care provider, insurance company, and hospital system, but also by the state, city, or town that a person happens to live in. Some conditions are clearly emergencies, such as a rupturing appendix. But “nonessential” does not necessarily mean something purely cosmetic like a rhinoplasty or tummy tuck. During the pandemic, Sakran said, he has had to postpone surgeries to repair hernias that impede people from comfortably eating or walking.
The logistical difficulty of defining essential care has been “an ongoing challenge for insurance companies,” said Jesse Ehrenfeld, a physician and LGBTQ health advocate who chairs the American Medical Association board of trustees. It “leads to a lot of individual decision-making happening that is inconsistent.””
“In the near future, the energy made in the US is going to be much greener. The country’s current goal is for solar plants alone to make nearly half of US electricity by 2050. But we can’t just build solar plants where coal and gas plants used to be. They have to be built where it’s … sunny. And wind turbines have to be built where it’s windy. But that’s not always where the people who need the power are.
The distance from energy source to energy need is about to get a lot bigger. And the US is going to need more high-voltage transmission lines. A lot more. As soon as possible. While solar plants can be built relatively fast, high-voltage transmission projects can take up to 10 years. So experts say we need to start proactively building them, right now.”
“One Texas patient who was taking birth control had no idea she was pregnant until it was too late. Others came in for their state-mandated ultrasounds but had their abortion appointments delayed by Tropical Storm Nicholas. They, just like the first patient, will now have to travel hundreds or even thousands of miles in order to end their pregnancies — if they can get together the money, time off work, and child care necessary to do so.
This is what it looks like to try to get an abortion in Texas since the passage of SB 8, a law that bans nearly all abortions after six weeks, before many people know they are pregnant. For the few patients who do realize it in time, it’s a race against the clock to schedule an appointment and get the money for the procedure — which costs an average of about $500 and typically isn’t covered by insurance. “There’s a sense of urgency that’s causing a devastation among our callers,” said Shae Ward, hotline program coordinator at the Lilith Fund, which funds abortions in Texas. “They just are like, ‘If it’s not done by then, I don’t know what I’m gonna do.’”
The options aren’t good. While one Texas doctor, Alan Braid, has been vocal about performing an abortion in defiance of the new law, providers generally say they are complying. That means patients who aren’t able to get an abortion before six weeks, or who don’t realize they’re pregnant before then, have to make what’s often a multi-day journey to a clinic in Oklahoma, Kansas, or even as far away as Michigan or New Jersey. Such a trip is simply out of reach for a lot of Texans. “If you can’t afford the $500 to get seen in-state,” Ward said, “then you definitely can’t afford the $500 to get your procedure somewhere else, and then also a flight and also a hotel.””
“Solving a problem as vast as climate change or biodiversity loss is never as straightforward as planting lots of trees. People often think, “We’ll just plant trees and call that a restoration project, and we’ll exonerate our carbon sins,” said Robin Chazdon, a forest researcher at the University of the Sunshine Coast. Usually, she said, “that fails.”
Buzzy tree-planting programs tend to obscure the fact that restoration requires a long-term commitment of resources and many years of monitoring. “We should just stop thinking about only tree-planting,” as climate scientist Lalisa Duguma has said. “It has to be tree-growing.” Even fast-growing trees take at least three years to mature, he added, while others can require eight years or more. “If our thinking of growing trees is downgraded to planting trees, we miss that big part of the investment that is required,” Duguma said.”
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” A bigger problem still is that many large planting campaigns don’t account for the underlying social or economic conditions that fuel deforestation in the first place. People may cut down trees to collect firewood or carve out land for their animals. In those cases, putting seedlings in the ground won’t do much to end deforestation. “Planting trees might not be the intervention,” Fleischman said. “The intervention might be giving people a substitute for firewood.””
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“there are plenty of successful restoration programs — and they’re getting better, said Chazdon, who’s also an adviser for the WEF trillion trees campaign. “There is ample evidence that when restoration is done properly, it works,” she said.”
“The US has made a distinction between Afghan refugees and the other vulnerable populations arriving at America’s doorstep. And it’s a false one.
Afghans fleeing Taliban rule have so far occupied a unique space in the immigration policy debate. In a climate where immigration has become a political wedge, there has been overwhelming bipartisan support for resettling at least some of them in the US: Polling has shown that 76 percent of Republicans and 90 percent of Democrats back resettlement efforts for Afghans who aided US troops. When it comes to other asylum seekers, the numbers are starkly different. For example, 64 percent of registered voters believe Biden needs to institute stricter policies at the southern border.
What makes Americans sympathetic to Afghan refugees compared to other people seeking protection? Some rightly feel a moral responsibility to protect those who were forced to leave their home due to their government’s ill-conceived and failed nation-building efforts, especially those who worked alongside American forces.
But what may also be a factor is that the Afghan war was also the kind of faraway conflict typically associated with the sort of refugees the US has historically admitted, like Somalis fleeing ongoing civil war in their home country.
Complicating this idea, however, is the fact that the kind of persecution and peril Afghans face in their home country is markedly similar to that faced by asylum seekers arriving on the US-Mexico border. Those from Central America’s Northern Triangle — Honduras, El Salvador, and Guatemala — are fleeing brutal gang violence, extortion, and government corruption, which are compounded by poverty, lack of economic opportunity, and climate-related issues. The same is true of many other groups as well, like the thousands of Haitians gathered in Del Rio, Texas.
Though the US has not fought a 20-year war in the Northern Triangle or in Haiti, it has played a direct role in creating the societal ills people are running away from, meaning the moral obligation many feel America has toward Afghans ought to extend to migrants from those countries as well.
That, of course, hasn’t been the case. Often invoking racist dog whistles, Republicans have falsely painted them as criminals who threaten public safety, carriers of disease, or economic migrants who want to skip “the line” of legal US immigration. Democrats have not necessarily been much better: The Obama administration detained migrant families on a large scale and told them “don’t come” while the Biden administration has maintained Trump-era policies, effectively blocking all asylum seekers from gaining access to protection amid the pandemic despite claiming to take a more humane approach.
Afghan refugees deserve protection. But so do the other vulnerable populations arriving at America’s doorstep. The Afghan refugee crisis has clarified this in a way other recent mass migration movements have not, and it also presents a unique opportunity for the US to recalibrate its policy about who is worthy of American protection.”
“Toward the end of the summer, Florida became the epicenter for America’s recent Covid-19 wave — reporting more hospitalizations and deaths than any other state in the country. But there was and still is surprisingly little certainty, among experts, over one question about Florida’s surge: Why did it happen?
The most common explanation for the outbreaks in the South that we saw over the recent summer was the low vaccination rates across the region. It’s true vaccination rates are low across the South: Seven of the 10 states with the lowest vaccination rates are in the region. And lower vaccine rates do correlate with more Covid-19 cases and deaths.
But Florida defies the regional trend. The state ranks 20th for full vaccination in the US, with 56 percent of people fully vaccinated — not great, but a little above the national rate. At the peak of its outbreak in mid-August, Florida had fully vaccinated about 51 percent of its population — again, not great, but in line with the national rate.
Maybe Florida loosened restrictions too quickly and more aggressively? It’s certainly true that Gov. Ron DeSantis has taken a more hands-off approach than leaders in blue states, but it’s not clear if this actually led to differences in how the public behaved.
According to Google’s mobility data, Floridians around mid-August were about 14 percent less likely to travel to retail and recreational outlets compared to pre-pandemic times. That’s almost the same as Californians, and actually lower than New Yorkers. Neither New York (about 59 percent fully vaccinated at the time) nor California (about 54 percent fully vaccinated at the time — not much higher than Florida) saw surges anywhere as bad as Florida’s in August.
The same trend holds for other metrics that measure precaution. Based on Carnegie Mellon University’s COVIDcast, through August, Floridians were more likely to mask up than New Yorkers or residents in other states that didn’t see nearly as big Covid-19 surges.
Based on OpenTable’s restaurant reservation data, Florida was back to pre-pandemic numbers for restaurant reservations around mid-August, but that wasn’t too different from the US as a whole. Some states, like New Jersey and Connecticut, equaled or surpassed their pre-pandemic baseline for restaurant reservations and didn’t see anywhere near the surge that Florida did (although both benefited from significantly higher vaccination rates than Florida).”
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“We don’t know everything about why Covid-19 cases rise, and we don’t know everything about why they fall, either. David Leonhardt and Ashley Wu at the New York Times recently demonstrated that the coronavirus appears to follow two-month cycles in its rises and falls.”
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“This isn’t to say that nothing matters in the fight against Covid-19. We know vaccines work to protect people from severe illness, including against the delta variant. Social distancing, masking, and restrictions do, too. Chances are Florida’s surge would have been much smaller if it had done better on all these fronts.
But Florida’s example complicates any story of recent Covid-19 surges that focuses solely on reopenings and vaccinations. Something else seems to be going on, and experts aren’t totally sure what. “There are things that, to be honest, we don’t fully understand,” Ashish Jha, dean of the Brown University School of Public Health, told me.”
“The sheer number of bills — both enacted and proposed — really emphasizes what a big priority tightening election laws has become for the GOP since the 2020 election. But it’s also important to remember that a single law can contain numerous far-reaching voting restrictions. And as such, Texas’s Senate Bill 1 is probably the most comprehensive voting-restriction law passed since Florida’s SB 90.
SB 1 requires absentee voters to provide their driver’s license number or the last four digits of their Social Security number on both their absentee-ballot application and absentee-ballot envelope; gives partisan poll watchers “free movement” around polling places; requires the secretary of state to check the voting rolls for noncitizens; and creates more paperwork for people who help other people fill out their ballots. It also bans specific ways of encouraging voting that were used by heavily Democratic counties, such as Harris, in last year’s election — including automatically mailing absentee-ballot applications to voters, drive-through voting and 24-hour early voting. The law does, however, include some provisions supported by Democrats, such as allowing voters to fix, or “cure,” mistakes on their absentee ballots and requiring training for poll watchers.”
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“both the severity and quantity of voting restrictions has increased dramatically in 2021. While we don’t know whether these changes will actually affect the outcomes of elections (as many Democrats fear and at least a few Republicans hope), it will undoubtedly be harder to vote in 2022 in many states than it was in 2020.”
“So what do researchers know about the effectiveness of ivermectin, approved for human use but best known as a horse deworming medicine, in treating COVID-19? At the beginning of the pandemic, scientists around the globe began testing thousands of existing medications in test tubes to see if they could be repurposed to fight against the novel coronavirus. In very preliminary research, researchers found that ivermectin significantly inhibited COVID-19 coronaviruses in cell cultures.
Encouraged by these petri dish findings, some desperate clinicians began administering ivermectin to their COVID-19 patients. The result was a number of hopeful observational studies by clinicians reporting that ivermectin appeared to be effective—in some cases, highly effective—in preventing COVID deaths. Observational studies are notoriously subject to researcher biases and confounders that can mislead clinicians into thinking an intervention works when actually a third factor is responsible.
Nevertheless, a prominent group of American physicians calling themselves the Front Line COVID-19 Critical Care Alliance (FLCCC) combined these preliminary observational and epidemiological studies into a November 13, 2020, preprint meta-analysis asserting that ivermectin “has highly potent real-world, anti-viral, and anti-inflammatory properties against SARS-CoV-2 and COVID-19.” Among other findings, the FLCCC pointed to reports that widespread distribution of ivermectin in Peru had correlated with steep declines in COVID-19 cases and mortality there. According to the group, cases and deaths began to rise dramatically in the same country after the government ceased distributing the drug.”
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“research on ivermectin’s efficacy in treating COVID-19 has been ongoing. Has this subsequent research validated Kory’s claim that ivermectin is a miracle drug against COVID-19? It’s complicated, but the answer is largely no.
First: Those dramatic Peruvian results are highly confounded. The steep rise in COVID-19 cases and deaths in that country can most likely be blamed on the breakout of the highly infectious lambda variant rather than to a halt in ivermectin distribution. Meanwhile, the newly reported results of a highly anticipated randomized controlled study of ivermectin in next door Brazil finds that the medicine had “no effect whatsoever” on the disease.
A lot of the hope that ivermectin would be a COVID-19 silver bullet arose from the findings of various meta-analyses, including the one conducted by the FLCCC, that combined the results of various observational studies and small randomized controlled trials. One of the more prominent recent ones was posted as a preprint in May by a team of British public health researchers led by the Newcastle University statistician Andrew Bryant. But other scientists have faulted that study for significant methodological failures.
Also, though it’s not the preprint’s researchers fault, one of the most important studies bolstering their conclusion has been withdrawn because its results appear to be fraudulent. Once the data from that study are removed, the Bryant meta-analysis finds essentially no efficacy for treating COVID-19 with ivermectin.
On July 28, 2021, the authors of a more painstaking meta-analysis of ivermectin COVID-19 treatment studies, published by the Cochrane Library, concluded:
“Based on the current very low‐ to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID‐19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.”
The FLCCC folks are surely sincere, but the best evidence suggests that they are sincerely wrong. The bottom line is that while ivermectin might have some marginal efficacy, it is certainly not a “miracle drug” when it comes to treating COVID-19.”