Nel's New Day

March 24, 2020

Idiocy, Practicality for the Covid-19 Crisis

The FDA has granted Gilead pharmaceutical corporation “orphan drug status,” almost always reserved for drugs treating rare illnesses affecting fewer than 200,000 people, for remdesivir, a possible cure for covid-19. The company now has a seven-year monopoly for the drug and can block manufacturers from developing generic versions of the drug which could be cheaper and more accessible. In addition, Gilead can establish price controls and benefit from grants and tax credits on a drug which the federal government funded with at least $79 million. Joe Grogan, one of DDT’s “coronavirus task force,” worked as a lobbyist for Gilead from 2011 to 2017.

John Fea describes the U.S. as a dystopia: the so-called “pro-life” Republicans now want to kill off old people so that the stock market will go up. Lt. Gov. Dan Patrick (R-TX), an evangelical Christian who said his faith influences his political decisions, told Tucker Carlson that grandparents should be willing to die to save the economy for their children and grandchildren. And his commentary, Patrick said that he talked to a number of the elderly who agree with him. Responses described in the media disagree. Patrick has this fantasy of the U.S. immediately returning to the nation of his dreams as soon as all those old people die, but he forgets that young people with covid-19 will also need lots of care and may also die.

Like other situations that he can’t handle, DDT said “nobody in their wildest dreams would have ever thought that we’d need tens of thousands of ventilators.” And like other situations, he lies. Almost every agency warns about shortages. In 2005, HHS published an explicit 400-page Pandemic Influenza Plan addressing the possibility of over 900,000 hospitalizations under a scenario presently confronting the United States. The plan suggested that 742,500 ventilators might be needed. The plan was updated in 2006, 2009, and as recently as 2017 after DDT was inaugurated. He ignored increasingly alarming reports from the U.S. intelligence community about the coming epidemic. Whenever DDT is asked about shortages, he falsely repeats the word “unprecedented.”

For the H1N1 pandemic of 2009, development of tests that were immediately mass produced and distributed throughout the U.S. took only 15 days from the first case. Federal emergency declarations and measures were quickly taken, hundreds of schools were closed, and measures for the federal emergency declarations were rapidly followed. The first confirmed case of covid-19 in the U.S. was on January 20, the same day as in South Korea. In the first 50 days, the U.S. tested 8,554 people while South Korea tested 210,144. As of today, the U.S. has six times the number of confirmed cases as South Korea and over seven times the number of deaths.

Another evidence of U.S. federal incompetence, the lack of supplies, is demonstrated by California’s need to charter planes to China to get equipment. The same problems happened with drug prices. Utah pays state employees to fly to Mexico to buy medications for themselves.

As of today, the state of Louisiana has 1,388 confirmed cases and 46 deaths from covid-19. Opposing a shutdown of businesses in the state to reduce the spread of the virus, Sen. John Kennedy (R-LA) claimed that the covid-19 crisis in his state came from one or two people at Mardi Gras who weakened their immune systems by drinking. He also followed the party line that China “sat on the news,” despite the U.S. knowing about the disease almost two months before he seemed to take the health crisis seriously.

Practical ideas to help the covid-19 crisis:

Include local media in the stimulus package – Suzanne Nossel and Viktorya Vilk

Local news outlets providing essential, up-to-the minute information to keep communities safe have lost revenue from social media advertising. One in five local newspapers has closed in the past 15 years, and even large city newspapers have been purchased by conservative conglomerates. This “essential service” deserves help to keep people informed and connected. [Nossel is chief executive of PEN America, and Vilk is the director of digital safety and free expression programs at PEN America.]

Lift tariffs on Chinese medical equipment – Susan Shirk and Yanzhong Huang

The epidemic in China seems to have peaked, and the nation has a surplus of protective medical gear—including masks, gloves and gowns—ready to export. Over 80 countries are benefiting from these supplies while, U.S. healthcare workers must resort to bandanas, underwear fabric, and substitutes made by nine-year-old for masks. DDT’s tariffs include these supplies as well as protective goggles and thermometers. The administration might lift the tariffs on June 25, three months from now. [Shirk is research professor and chair of the 21st Century China Center School of Global Policy and Strategy at University of California, San Diego, and Huang is a senior fellow of global health at the Council on Foreign Relations and a professor at Seton Hall University’s School of Diplomacy and International Relations.]

Let foreign-born health-care workers live in peace – Christopher Richardson

More than 1 in 6 of U.S. health-care workers are immigrants; 25 percent are physicians.  For U.S. doctors, the statistic is even more pronounced, at 1 in 4. In states hardest hit by coronavirus, California and New York, more than a third of all health-care workers are immigrants. They also face DDT’s unfair immigration provisions such as his travel ban, administrative processing roadblocks, arbitrary green card caps, and the new public charge rule. Almost 30,000 DACA recipients are health-care workers, including 200 who are slated to be doctors, but DDT’s Supreme Court will probably throw them out of the country, maybe before that because DHS could be planning raids and deportations against these healthcare workers. DDT should exempt healthcare workers from any immigration caps and set up task forces within DHS and the State Department to expedite their current cases, no matter what they are. [Richardson is a former U.S. diplomat and immigration attorney.]

Unleash fourth-year medical students – Donald W. Landry

About 20,000 fourth-year U.S. medical students have been assigned hospitals and are scheduled to being in July. Fourth-year students have completed all the clinical rotations required for the MD degree.  Immediately conferring MD degrees instead of waiting until the end of the semester would allow 20,000 doctors to free more experienced physicians who could care for covid-19 patients. [Landry is physician-in-chief, chair of the Department of Medicine and director of the Division of Experimental Therapeutics at New York-Presbyterian Hospital/Columbia University Medical Center.]

House mild cases in hotels – Jeremy Samuel Faust and Cass Sunstein

The large majority of cases that are mild or symptom free need to be isolated to reduce spread, but the infected people don’t need a hospital bed. Sending them home to self-isolate has risks and may not be feasible. The federal government could temporarily convert large hotels, suffering from the current economic situation, into isolation facilities. [Faust is an emergency physician at Brigham and Women’s Hospital in the Division of Health Policy and Public Health and an instructor at Harvard Medical School, and Sunstein is Robert Walmsley University Professor at Harvard and a former administrator of the White House Office of Information and Regulatory Affairs.]

Forget stimulus checks. Send prepaid cards instead. – Herbert Lin

To guarantee that the money sent from the stimulus moves into the U.S. economy, prepaid Mastercard or Visa cards that expire within a few months rather than a check would ensure an expenditure. They can be used immediately instead of waiting for deposits, and some people don’t have bank accounts. Going to the bank could also violate state rulings to reduce the virus. Unused cards can revert to the U.S. Treasury. [Lin is a senior research scholar and the Hank J. Holland Fellow at Stanford University.]

Provide health care at the neighborhood level – Stephen Grill

With organization and some medical supplies, doctors practicing telehealth from home offices could help with screenings for neighbors in their specialty, for example visiting someone concerned that facial that a facial weakness might be a stroke or Bell’s palsy. Social-networking services could indicate expertise, availability, and selected responsibilities. [Grill is a neurologist at the Parkinson’s & Movement Disorders Center of Maryland.]

Let patients test themselves at home – Shantanu Nundy and Marty Makary

People could test themselves at home through telemedicine under the direction of a doctor by being sent a testing kit. They would then self-swab according to an instructional video or a virtual healthcare professional and drop off the sample to a testing facility or mail it. [Nundy is a primary-care physician and chief medical officer at Accolade Inc., and Makary is a professor at the Johns Hopkins School of Public Health, editor-in-chief of MedPage Today and author of The Price We Pay.

As of today, the U.S. has 54,867 confirmed cases, 12,424 more than yesterday, and 782 deaths, 265 more than yesterday. The world has 422,943 confirmed cases and 18,907 deaths.

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