Can one person change the course of life for millions of others?

Radically.

We have Putin as our most conspicuous contemporary example.

Just a few moments ago in our elastic present-day concept of time here at home, we had the hotel magnate, Trump, as our elected leader, influencing our daily lives like a twin Putin autocrat.

Thanks to that very same hotelier, we now have Brett M. Kavanaugh, and Amy Coney Barrett firmly ensconced on our Highest Court, pretending to be impartial, damaging lives left, right and center.

So let me reframe the question.

Can one person change the course of life for the good of millions of others?

Right away, all of the above are disqualified.

Putin, apparently whimsically – and just because as a simple Russian bureaucrat elevated to the highest post of his land well beyond his abilities – misunderstood the zeitgeist and ordered Russian troops to invade and decimate neighboring Ukraine. Unwittingly, he relegated Russia to minor player status on the world stage going forward.

His US counterpart, Trump, tried to upend the real world here at home and declare his opponent’s election invalid. Unlike in Nicaragua, where a Trump think-alike, Ortega, has been able to maintain and enhance his power through manipulating elections since 1979, Trump failed to falsify Biden’s Presidential triumph. At least for now. Fingers crossed.

There are now six Catholic justices on the U.S. Supreme Court, 6 out of 9. That might be par for the course in Italy or France; not here in the United States. Immigration from largely Catholic Latin America has given us a Catholic population in our 50 states of about 20%. Yet according to the Pew Research Center, we identify ourselves as a country predominently Protestant, 43%, unaffiliated, 26% and Jewish, 2%. Six Catholics on the highest Court of the land is way out of proportion to our religous identity as a nation.

Brett Kavanaugh and Amy Coney Barrett, the most recent Catholic arrivals to the Supreme Court, gave us ample reason to doubt their true personas in their Congressional hearings. A psychology professor, Christine Blasey Ford, accused Kavanaugh of sexual assault years before. Our elected Republican senators shut their ears. They voted him in anyway. OK, they seemed to say, Boys will be boys. They were fast to overlook the implications of his traditional conservative Catholicism, or perhaps eager to espouse it.

In 2020, the Washington Post reported that, while in law school, Coney Barrett

lived at the South Bend home of People of Praise’s influential co-founder Kevin Ranaghan and his wife, Dorothy, who together helped establish the group’s male-dominated hierarchy and view of gender roles.

In June of this year, London’s Guardian had this to say on the very same People of Praise co-founder:

… the People of Praise, a secretive charismatic Christian group that counts the supreme court justice Amy Coney Barrett as a member, was described in a sworn affidavit filed in the 1990s as exerting almost total control over one of the group’s female members, including making all decisions about her finances and dating relationships.

Were our elected Republican senators interested in any of this? Did they care? Not at all. Coney Barret was confirmed as a Supreme Court Justice on Oct 26, 2020 with 52 of 53 Republicans voting in favor. Maine’s Susan Collins was the sole dissenting Republican.

Could we now, just possibly, be seeing People of Praise influencing a Supreme Court decision on abortion? Yes, we could.

You are totally within your rights to shout out loud about that right now. As Marcellus once said in in William Shakespeare’s Hamlet, “Something is rotten in the state of Denmark.”

Back to the original question.

Can one person change the course of life for the good of millions of others?

Lest we forget, the answer is yes, yes and yes again.

There are still some Americans who might fit the bill. Franklin D. Roosevelt comes to mind. How about our 16th President, Abraham Lincoln? Or our 44th, Barack Obama?

Franklin Delano Roosevelt, our 32nd President, was elected to the office four times, something no longer possible. He led us through the Great Depression and World War 2. He launched the New Deal, a transformation of American society that included the creation of the Social Security Administration, which today continues to provide essential daily benefits for more than 70 million Americans.

Abraham Lincoln was our President during our first and only – up to now – Civil War. Not only did he preserve our Union – an achievement that continues to reverberate for all 330 million + of us living in the United States today, but he also just happens to be the President who abolished slavery. At the time, the ending of slavery immediately affected the lives of four million African-Americans living in servitude. Since then, the abolition of slavery has daily touched the lives of millions and millions of others, as a constant reminder of our need, and necessity, to acknowledge and embrace each other, and to celebrate our similarities and differences.

So how many lives did Abraham Lincoln impact for the good? The number in incalculable and uncountable.

Oh and by the way, Abraham Lincoln was something called a moderate Republican, a species now apparently extinct.

Barack Obama served as our President from 2009 to 2017. In our lifetime, we have been witness to Obama’s supreme gift to our nation, the establishment of Obamacare. Thanks to Barack Obama, the U.S. Department of Health & Human Services reports that we have:

35 Million People enrolled in Coverage Related to the Affordable Care Act, with a historic number of 21 Million people enrolled in Medicaid Expansion Coverage.

In terms of doing good for the greater benefit of society, that counts.

It would seem that we are in a constant back-and-forth between those who want to do good to the benefit of all of us alive on earth, and those who are equipped with an aberrant gene that is programmed to do us harm.

Unfortunately for those of us living in the United States today, we are confronted with, and confounded by, a hotelier equipped with the aberrant gene, a hotelier who would seem to be planning further assaults on our democracy.

See fingers crossed above.

Our DT, our Wizard of Doom to democracy, is still with us.

At any moment, he could rise from the ashes.  At any moment, he could still consume us, devour us, and swallow our collective notion of peaceful coexistence in one night-sweat gulp.

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The Political Playbook of Tuesday, January 25, 2022 includes a lengthy description of how Senate Majority Leader Chuck Schumer’s leadership strategy has led to considerable simmering among Democrats.

Reporters Rachel Bade and Tara Palmeri spoke with a half-dozen Democratic staffers in both houses of Congress Monday night and heard frustration with how Schumer and other Democratic leaders are treating Senators Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ).

Apparently, Manchin continues to be furious at how he has been treated. Other Democrats are now upset with Schumer, House Speaker Nancy Pelosi and others for having stated the obvious. For either the Build Back Better Act or the Voting Rights Acts to have passed, the votes of both Manchin and Sinema were needed. Obviously, that didn’t happen with the voting rights proposals and a Senate vote on BBB has been indefinitely postponed because of a lack of affirmative votes.

In an earlier iteration of Manchin saying that he would not vote to change the filibuster rule, he implied on Fox News Sunday that the Biden Administration was not working respectfully enough with him. It may indeed be possible that some staff members in the White House were expressing their exasperation with Manchin either to him directly or to outside sources.

Manchin and Sinema are entitled to view issues differently than the other 48 members of the Senate Democratic caucus. What they don’t have a right to do is to get upset with other Democrats who have increasingly been frustrated with them.

Had Manchin and Sinema joined the other 48:

1. Two voting rights bills would have passed and the discriminatory election and voting laws that Republicans have passed in nineteen states would either be negated, or involved in court cases, the types of which the federal government has traditionally won.
2. The Build Back Better Act would be law meaning child tax credits would be expanded, there would be child care subsidies, free universal preschool, health care subsidies, paid family leave and a host of other provisions that would help families and bring the American economic and social safety web closer to those in other industrial countries.
3. President Biden’s popularity would be much higher and the prospects for Democrats in the 2022 and 2024 elections would be much better.

Who could blame Democrats for being upset that these two senators have greatly damaged their party politically, and deprived the country of perhaps the two most necessary pieces of legislation currently being considered?

Manchin could whine and pout about how he is being treated, but other Democrats were not entitled to express frustration over how two senators are using antiquated rules to hold the country hostage.

Strictly speaking, the reporting in of Bade and Palmeri is accurate. Democrats other than Manchin and Sinema are expressing their frustration with other Democrats. But the reporting is not in context, with inclusion of how Manchin and Sinema set off a chain of bad feelings within the party.

It seems that the two wayward Democratic senators have the same privilege as Mitch McConnell and essentially the entire Republican caucus. They can speak of hurt feelings as if they are righteous victims and have been unjustly attacked, while other Democrats cannot say “ouch” for fear of being called wimps. The press needs to take a leading role in not perpetuating this unfair and false equivalency.

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On Tuesday, Jan. 11, there were three examples of a public officials being unfairly reamed or slighted by another official. The highly bizarre attacks on Dr. Anthony Fauci by Sen. Rand Paul showed a complete lack of civility, and rational thinking. In some ways, it was understandable, because through the years, we have seen a continuous flow of bizarre and far-fetched behavior from the junior senator from Kentucky. All the same, it was completely unwarranted, especially since Paul’s diatribes have contributed to vicious threats of violence directed at Dr. Fauci and his family.

Groups such as Black Voters Matter boycotted President Joe Biden’s major speech on civil rights in Atlanta. Perhaps the most prominent individual who would have been expected to attend but didn’t was Stacy Abrams. She is founder of Fair Fight Action and the likely Democratic nominee for Georgia governor this coming November as she was in 2018. She, and others, thought that the Biden speech was too little too late. They may have been on target about too late, but in retrospect, it is difficult to call the powerful speech too little.

The third case involves government response to COVID, but nothing involving vitriolic senators like Rand Paul or Roger Marshall from Kansas.

Dr. Fauci and Centers for Disease Control director Dr. Rochelle Walensky were grilled about the often confusing and even contradictory recommendations that government officials have given re. COVID. Policies on masks, vaccinations, testing and more continue to change frequently and sometimes unexpectedly.

There is no question that mistakes have been made. But consider the complexity of the problems. Fighting COVID is somewhat like whack-a-mole; when you find solutions to one kind of problem, or variant, then another one pops up.

What to recommend in the way of vaccinations (other than get them as quickly as you can), is difficult because they involve new science with limited time for testing. What masks to recommend depends on the supplies available, and helping consumers determine which are effective and which are knock-offs. The idea of providing adequate testing for 330 million Americans is overwhelming, considering the scope of the numbers involved. Manufacturing techniques are new and distribution logistics are complicated.

If Drs. Fauci and Walensky were like Donald Trump’s fraudulent advisor, Dr. Scott Atlas, then criticism would be warranted because he was neither serious nor compassionately concerned. Yes, Drs. Fauci and Walensky have made mistakes, but who wouldn’t? So long as they are making good faith efforts with intelligence and concern, they should be given a great deal of slack.

Similarly, Stacy Abrams and others may have been right that President Biden waited to long to give his voting rights speech. But he had good reasons. As someone who served in the U.S. Senate for thirty-six years, he knew how to quietly negotiate. Unfortunately, Sen. Joe Manchin could not be persuaded (hopefully that will change now following the Biden speech and the follow-up).

As we have said before, it is much more difficult for progressives to advance their agendas than it is for conservatives. This is because progressives actually want to do something; not block progress. The Biden Administration is staffed with many outstanding individuals and is working hard to address America’s and the world’s greatest problems. Let’s give them a break!

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In 2021, as summer ebbs into fall, Democrats are concerned with a number of issues, but perhaps most importantly, abortion. It has become a wildcard issue because the Supreme Court has rendered a decision regarding it that neither is supreme nor courtly.

Bullies and cowards often travel together, and that is precisely how Republicans have acted regarding the latest legislation from the hallowed halls of the capitol of Texas. The Lone Star state has enacted the strictest abortion law in the land. Essentially it outlaws any abortion that would be performed approximately six weeks following conception. That’s the bullying part – exercising arbitrary and capricious power to encroach on a basic human right. And, of course, the Republicans chose to place far more restraints on the women of Texas rather than the men. In case you have forgotten, men don’t need abortions.

The cowardice angle is that the state is relieved of any enforcement responsibilities. Rather than have state authorities monitor abortion clinics for alleged crimes, the state “farms out” responsibility for enforcement to the citizens of Texas, or for that matter, the citizens of any other state who might happen to be in Texas. They are empowered to sue any woman in Texas who chooses to have a prohibited abortion.

The “infraction” is not settled in criminal court; rather in civil court where the “apprehender” or bounty hunter can seek to recover as much as $10,000 from a fine levied on the woman seeking the abortion. In further acts of cowardice, the law states that not only can a woman receiving an abortion be sued, but any other person who is “complicit” with her can as well. This could be the receptionist at the abortion clinic, the Uber driver who gives her a lift to the clinic, and any healthcare professional who works or volunteers at the clinic.

Indeed, Americans live in a strange country when the supreme court of the land, operating under the jurisdiction of the world’s oldest and presumed fairest constitution, cannot find one, much less dozens of reasons, to rule this sham of a law unconstitutional.

Almost all conservatives vehemently oppose abortion. Is there anything that draws a similar opposition from progressives?

How about gun control? Just as conservatives see abortion as an issue if life, progressives see unfettered gun rights as a matter of life, and death. Ever since 1973, when abortion became legal in the United States in the Roe v. Wade ruling, conservatives have been successful at chipping away at abortion rights to the point where now in Texas, over 85% of what were legal abortions are now against the law. Dozens of other states are fashioning similarly draconian laws.

During that same forty-eight-year period of time since Roe v. Wade, progressives have been trying to chip away at gun rights in the interest of gun safety. In 1973, Richard Nixon was still hanging on to his presidency with its law and order mantra. The rate of violent crime in the United States was growing rapidly. Conservatives favored stricter laws against gun crimes. Some progressives favored stronger penalties as well, but most wanted to deal with the root of the problem, the presence of guns, legal and illegal, on the streets and in the homes of Americans.

How much progress have progressives made in reducing the number and the of guns in America and the power of the types that are legally permitted? The answer is virtually none. In 1994, with Bill Clinton as president, the Democratic Congress passed a ten-year ban with the Public Safety and Recreational Firearms Use Protection Act. It did outlaw some powerful weapons, but there was the sunset provision, limiting the restrictions to ten years before the law had to be renewed.

Conservatives were outraged that the bill passed. Less than two months after the bill became law, the first nail was hammered into its coffin as Newt Gingrich and the conservative Republicans took over Congress. By the time that the ten-year life of the bill was over in 2004, Republican George W. Bush was president, and he was in a position to veto any extension of the law. Since that period, gun laws have not been strengthened; they have been weakened.

So, suppose that progressives wanted to counter the strength of guns in America in a fashion similar to what Republicans have done with abortion. If there was to be symmetry in their strategy to what Republicans did, they would choose to not have any have any government agencies or officials involved in enforcing the laws.

Instead, they would set up a bounty system similar to what Texas Republicans have done to curtail abortions. Progressives would pass a law that would enable citizens to monitor the presence of weapons, particularly assault weapons, in the streets, workplaces, schools and homes of America.

That way, progressives could try to be like conservatives and bully their foes. They could establish un-armed posses to travel throughout America, to wherever guns are present. They could courteously go to gun stores, gun shows, bars, gang hideouts and wherever else there might be high concentrations of guns and please ask the owners (legal or illegal) to surrender their weapons in return for a summons to appear in court. This method by progressives to deal with guns would have a parallel construction to how conservatives in Texas are currently dealing with abortions.

Conservatives would be pleased with these parallel laws. All that they would have to do would be to take a picture of a woman about to have an abortion, along with anyone assisting her, and issue a warrant for their arrest. They show up in court and their work is done and they are richer.

Progressives would simply take pictures of people with guns and find a way to serve a warrant on the gun owners and be sure to say ‘please’ when they do so.

This is what conservatives call fair. They can act like bullies and prevent a woman from having control of her body while the other side must forcefully try to confiscate powerful firearms.

Yes, the absurdity is very clear to progressives; not at all to conservatives. This is why conservatives are winning so many of the battles these days. They get to use firearms as their weapon of choice; progressives use a basic right on human reproduction. If you can’t see a power imbalance in this conundrum, look again.

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Conventional wisdom says that “in polite company,” we don’t talk about sex, politics, or religion. Of the three, sex is clearly the least comfortable topic to broach.

You see, sex is a ‘hot’ topic; it’s erotic. Some may regard sex as joy; others regard it with shame; and still others with no apparent emotion. While nearly everyone has an opinion about it that does not mean that all are willing to engage in open conversation about sex.

This problem is particularly difficult with the topic of abortion. When abortion is brought up, what is missing is the honesty in the conversation – the honesty about how and why a woman becomes pregnant; what her thinking was before, during and after the act, and how the impregnator (the man) can frequently walk away from an act in which he was either an aggressor or a collaborator or some combination of the two.

Under the best of circumstances, the sex act is a consensual on the part of both individuals. At the time, the two may or may not have desired to pro-create. Under the best of circumstances, this is how the human race commits acts of love and carries on its existence from generation to generation.

But it doesn’t always evolve that way. There are numerous ways for complications or unfortunate circumstances to develop. Following the intercourse, the couple may decide that they are not in love and no longer want to be joint parents to a child.

If both believe in a traditional nuclear family, then the change in their relationship may cause one or both to decide that now is not a good time to give birth to a child. This can be particularly so with the woman who bears major responsibility for the pregnancy and the subsequent child-rearing.

Another dynamic may also be that there are other life changes for one or both progenitors. One is diagnosed with an illness or sustains an injury. It clearly is not a good time to bring a child into the world.

It may also be that as the adults’ lives evolve during the months following the pregnancy, that one or both parties decide that they are not ready to be parents; that they feel a greater compulsion now to pursue a career or avocation. This may seem crass to a strict pro-life advocate, but it is among the myriad of reasons why one or both parties to a pregnancy may want an abortion at a difficult time.

Perhaps the most likely cause of one or both parents not wanting to carry a pregnancy to term is that the process started off informally and then morphed into a “we just want to have a good time” occasion and little or no thought was given to a possible pregnancy during the act of intercourse.

The arguments in favor of abortion for women who have been victims of rape or incest are so compelling that it is hard to fathom why anyone would oppose them. It is often said that many conservatives are mean-spirited; their opposition to abortion following a rape or incest adds clear evidence to that assertion.

All of these reasons are tried and true parts of the ongoing human experience. As you read this, similar scenarios to the ones described above are happening all around the globe, and there is no stopping them.

Because sex is viewed by most as either ‘hot’ or ‘cold,’ most people have reasons to not discuss it in so-called polite company. But it’s too tempting to simply ignore. So rather than pretend that it does not exist, most of us, and especially the news media, either ignore it, or talk about it in code. This is something in which conservatives are exceptionally skilled. They frame issues in a way that do not use literal definitions. Instead, that they are cloaked in verbiage that assuages those conservatives who think that the only way to reference it is to disguise it. They talk about it as life, and what could be more pure. But their big fallacy is that they totally ignore the life of the mother, and the father. The force of the conservatives is so strong that it essentially inundates the mainstream media as well.

Conservatives will continue to dominate the abortion issue and wreak tremendous damage on the civil liberties and economic well-being of non-conservatives. The alternative is for progressives to discuss abortion and sex at the same time, and describe how abortion policy without a realization that “sex happens” will never reflect reality, empathy, and respect for basic civil liberties. Come on, progressives. News organizations now let us use the ‘F’ word as an expletive; why can’t we talk about it for what it really means. It will greatly help the whole country better come to terms with the abortion issue and make more logical and empathetic decisions.

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That we live in an unequal world is nothing new. Now, though, that reality may have unpredictable consequences for all of us. We are living through a pandemic and desperately waiting for vaccines to help us put an end to this endurance marathon we find ourselves running.

As the Pfizer/BioNTech COVID-19 vaccine becomes the first to be approved in the U.S., Canada, the U.K., Saudi Arabia, Mexico and Bahrain, anxiety is spreading in other parts of the world. The world’s capacity for vaccine production is limited, and the buying power of low and middle-income countries cannot match that of wealthier nations. Even though a rallying cry during the pandemic has been that No one is safe until everyone is safe, people in less well-off countries may have to wait until the middle of the decade to be vaccinated. In that scenario, the threat of Covid might not wane for several years despite the approval of vaccines.

As Gavi, the Vaccine Alliance, reminds us:

Only once COVID-19 vaccines are available to priority populations in all countries           around the world will we bring the pandemic under control.

Amnesty International reports that Rich countries have bought up enough doses to vaccinate their entire populations nearly 3 times over. Deutsche Welle (DW,) Germany’s international broadcaster, points out that the claim is somewhat misleading:

The claim assumes that all vaccines will pass clinical trials and be approved. Although more affluent countries have signed agreements with leading vaccination companies, the global scramble to secure doses occurred well before their safety and efficacy were established. While doses have been reserved, this does not necessarily mean that all companies will produce an effective vaccine that is then approved. In short, doses have been reserved for vaccines that are still being tested.

Status of leading vaccine candidates

Johnson & Johnson’s vaccine, which is much desired as it is given in a one-shot dose, is, as of yet, unapproved anywhere. But the U.S. has pre-ordered 200 million doses of the Johnson & Johnson vaccine, Canada has a bid in for 38 million doses, and the U. K. has ordered 30 million doses.

And the US has preordered 100 million doses of Moderna’s vaccine, Canada 56 million doses and the UK 50 million. The Moderna vaccine has the advantage of being 94 percent effective and can be distributed more easily than the Pfizer/BioNTech vaccine, as it remains stable at minus 20 Celsius for up to six months. The vaccine maintains potency in a standard refrigerator for up to a month. And yet, no Latin American country has preordered the Moderna vaccine, even though Brazil, Argentina, Colombia, Peru and Mexico are among the countries most impacted by Covid. Why not? The simple answer is cost. The Moderna vaccine is the most expensive in the marketplace and out of the reach of many.

The European Union had ordered 300 million doses of the Pfizer/BioNTech vaccine, as of Nov. 11. Japan wants 120 million doses, and the U.S. has bought 100 million doses. AstraZeneca/Oxford offered to deliver their vaccine at a no-profit price, which offered hope to developing countries, but their vaccine has run into problems. Released Phase 3 data confused more than assured many, and their trials are being repeated. Countries that had preordered only the AstraZeneca/Oxford vaccine were left scrambling.

Russia’s Sputnik V Vaccine

The Russian Sputnik V is a possibility. Sputnik V, also known as the Gamaleya vaccine, has been given short shrift in higher-income countries. Even though Russia has done pioneering work on vaccines in the past, when Russia fast-forwarded approval of its Sputnik V vaccine before Phase 3 trials were complete, many raised an eyebrow. Even so, early data on the Sputnik V vaccine suggest that it is 92% effective according to the BBC. Russia began offering broad Sputnik V immunizations to its citizens this past week. There were few takers. Distrust of the government is so widespread that 59 percent of Russians say they have no intention of getting a shot, the New York Times reports. Yet, this disparaged vaccine might just be the salvation of millions. Right now, we just don’t know. Just in case, Brazil has ordered 50 million doses, Mexico 32 million, Argentina 25 million and Venezuela 10 million.

Chinese Vaccines

A number of Chinese vaccines are also candidates. The efficacy of the Chinese Sinovac vaccine will not be known until January. Nevertheless, the Sinovac vaccine and Sinopharm, another Chinese vaccine, have been administered under emergency-use orders in China since as early as last July. More than 1 million Chinese have been vaccinated with the Sinopharm vaccine. On December 9, the Sinopharm vaccine was registered in the United Arab Emirates after it was found to be 86% effective in Phase 3 trials there. Bahrain approved the use of the Sinopharm vaccine on Dec 10. Morocco has said that it will initially rely on the Sinopharm vaccine for its plan to vaccinate 80% of its adult population. The Philippines plans to vaccinate 9 million people with the Sinovac vaccine. Chile has ordered 60 million doses of the Sinovac vaccine, and Brazil another 46 million. Mexico has just signed an agreement to buy 35 million doses of another unapproved Chinese product, CanSino Biologics’ COVID-19 vaccine.

It is worth noting that, as of mid-November 2020, no country in sub-Saharan Africa had made any prepurchase agreements for any COVID-19 vaccines in development.

Leveling the Playing Field

COVAX AMC (Advance Market Commitment) is a vaccine purchasing fund led by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI) and the WHO. COVAX was established to support vaccine development and to try to level the playing field of vaccine accessibility worldwide. So far, COVAX has secured 700 million doses of vaccine to distribute among its 92 low-income country members. The EU, the UK and Canada have been key financial contributors to COVAX, as has the Bill & Melinda Gates Foundation. The United States had not participated.

The inequality inherent in the rich country poor country vaccine availability divide has pushed India and South Africa to petition the World Trade Organization to temporarily suspend certain intellectual property rights and medical patents in order to speed up COVID-19 vaccine production in less wealthy areas of the world, at least until herd immunity is achieved. And a group called the People’s Vaccine Alliance, a coalition of organizations including Free the Vaccine, the Yunus Centre, Frontline AIDS, Oxfam, SumOfUs and UNAIDS, is spearheading the call for COVID-19 vaccines free from patents. This group is asking for the fair allocation of vaccines, the prevention of vaccine monopolies, and vaccines available to all, everywhere, free of charge.

The immunity question

In the meantime, in their paper published in the medical journal The Lancet (Nov. 2020), Roy M Anderson, Carolin Vegvari, James Truscott and Benjamin S Collyer remind us of the unwelcome reality of the conundrum we find ourselves in:

Data on immunity to other coronaviruses suggest that immunity to SARS-CoV-2 might be short lived, perhaps 12–18 months in duration. Whether past infection will prevent severe COVID-19 on re-exposure to SARS-CoV-2 is not known at present.

In other words, even after herd immunity is achieved, vaccination against COVID-19 might need to become an annual jab.

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Paul Krugman recently posted a piece in the New York Times, The Deadly Delusions of Mad king Donald. It likened our current state of affairs to being trapped on the Titanic. Definitely worth a read. Krugman writes thoughtful pieces, but one of the commenters, Citizen nicely summed things up with a goody making the internet rounds in April, but still worth repeating.

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800,000 doctors are telling Donald Trump that his “plan” to reopen businesses by Easter is a bad idea. In a letter delivered to Trump on March 27, 2020, organizations representing American physicians in a vast range of specialties voiced their concerns about ending social distancing as COVID-19 continues to spread across the US and has killed at least 1,000 people.

The letter came in response to Trump’s publicly declared preference for ending social distancing and having the economy up and running by Easter, a date he chose because he sees it as  “a beautiful time,” and because, it has been reported, he has grown impatient with being cooped up in the White House and unable to hold the big campaign rallies that he thrives on.

“Federal, state and local governments should only set a date for lifting nationwide social distancing restrictions consistent with assessments by public health and medical experts,” the letter said. “Lifting restrictions sooner will gravely jeopardize the health of all Americans and extend the devastation of the COVID-10 pandemic.”

Here is the full text of the letter and the list of signers.

CMSS Statement on Restrictions to Slow the COVID-19 Pandemic

March 27, 2020

Dear President Trump, Vice President Pence, and Ambassador Birx:

Thank you for actively engaging the health care community—particularly the nation’s physicians and the organizations that represent them—in addressing the COVID-19 pandemic in the United States.

As more than 800,000 physicians across more than 40 specialties in medicine, we continue to support travel and gathering restrictions to slow the transmission of coronavirus disease 2019 (COVID-19). Physicians, other health professionals, and staff are putting themselves in harm’s way without adequate personal protective equipment or necessary tools (such as ventilators) as well as with no proven treatment or vaccine for the virus.

Significant COVID-19 transmission continues across the United States, and we need your leadership in supporting science-based recommendations on social distancing that can slow the virus. Our societies have closely adhered to these measures by moving our staff to fulltime telework and canceling in-person meetings (including annual meetings). These actions have helped to keep physicians and other health professionals in health care facilities, including hospitals, and reduce the risk of spreading COVID-19.

Statewide efforts alone will not sufficiently control this public health crisis. A strong nationwide plan that supports and enforces social distancing—and recognizes that our health and our economy are inextricably linked—should remain in place until public health and medical experts indicate it can be lifted.

Federal, state, and local governments should only set a date for lifting nationwide social distancing restrictions consistent with assessments by public health and medical experts. Lifting restrictions sooner will gravely jeopardize the health of all Americans and extend the devastation of the COVID-19 pandemic.

Again, thank you for actively engaging the nation’s physicians and the organizations that represent them. We appreciate your considering these comments and welcome an opportunity for further dialogue.

Sincerely,

Council of Medical Specialty Societies

American Academy of Allergy, Asthma & Immunology
American Academy of Dermatology
American Academy of Family Physicians
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Orthopaedic Surgeons
American Academy of Pediatrics
American Academy of Physical Medicine and Rehabilitation
American Association of Clinical Endocrinologists
American College of Cardiology
American College of Emergency Physicians
American College of Medical Genetics and Genomics
American College of Obstetricians and Gynecologists
American College of Occupational and Environmental Medicine
American College of Physicians
American College of Preventive Medicine
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Epilepsy Society
American Gastroenterological Association
American Geriatrics Society
American Medical Informatics Association
American Psychiatric Association
American Society of Anesthesiologists
American Society for Clinical Pathology
American Society of Colon and Rectal Surgeons
American Society of Hematology
American Society of Nephrology
American Society for Radiation Oncology
American Society for Reproductive Medicine
American Thoracic Society
American Urological Association
Association for Clinical Oncology
Infectious Diseases Society of America
North American Spine Society
Society of Critical Care Medicine
Society of Gynecologic Oncology
Society of Hospital Medicine
Society of Interventional Radiology
Society of Nuclear Medicine and Molecular Imaging
Society of Thoracic Surgeons
Society for Vascular Surgery

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Picture a nice size orange.  Imagine it cut it in half.  Stick two thin wires into the orange.

Then close your eyes and think of a surgeon placing the orange in the upper left edge of your chest, just below the collarbone, and plugging the wires into your heart.

St. Louis Blue Jay Bouwmeester now has an Implantable Cardioverter Defibrillator, around the size of that orange, monitoring every beat of his heart.  If the processor in the ICD detects an issue it can jolt his heart with electricity to restore proper beat, or, it can act as a pacemaker to restrict or increase his heart beat rate.

Such technology isn’t cheap:  roughly $30,000 to $50,000 for the device, plus installation and monitoring cost.

Still, ICDs have an impressive track record of saving and extending lives.  Best guess is that 800,000 Americans now have ICD’s, with about 120,000 joining JB this year.  (If those numbers don’t seem to match-up, well, many, many ICD owners never have to worry about device durability.)

Like me, Bouwmeester seems to have experienced a bit of Sudden Cardiac Arrest aka Sudden Cardiac Death.  Only the intervention of medical professionals and an Automatic External Defibrillator changed that last word to “arrest,” as happened in my case.

Ironically, ICDs emerged from the Cold War.  Hubert H. Humphrey visited Russia in 1962 and was awed by their efforts to re-start hearts.  “Let’s compete with the U.S.S.R. in research on reversibility of death.”  [Congressional Record, 10/12/62]

By 1985 researchers had prototype ICDs and by the early 1990’s they became available to the public.  Thanks to the level of need and the price point, multiple companies keep improving the product, issuing new generations of devices.  A new recipient such as JB can look forward to a decade of trouble-free service before his ICD needs to be replaced or recharged.  (My 2009 model had a projected life of seven to nine years:  it will hit 11 years this July.)

Yes, an ICD cheats death and offers peace of mind.  Living with it isn’t all fun and games.

In the mass of papers I came home with after my installation was a form for a handicap placard or a disabled drive license plate.  Having a defibrillator, you see, makes you disabled by Missouri Department of Revenue standards.  That ICD exempts you from employment in many professions: while I don’t recall seeing National Hockey League player on the list, I suspect that liability-wary lawyers will keep JB off the ice as a player.  (I’d bet he could coach to his heart’s content.)

And, with an ICD comes a long list of warnings.  The latest list from Boston Scientific (who made my device) is 47 pages including, for example, saying Don’t Tour Hydroelectric Facilities.  Caution is required around other stuff producing electromagnetic fields, including cell phones.  (Hand units should always be used at the ear furthest from the ICD.)  Some store security systems can get an ICD owner’s attention, and, don’t sit an electric car while its charging. [https://www.bostonscientific.com/content/dam/lifebeat-online/en/documents/BSC_Electromagnetic_Compatibility_Guide.pdf ]

The section on airport security keeps changing.  Today it advises that quick exposures to metal detectors shouldn’t cause an issue.  Back around 2010 I had several jolting experiences with TSA equipment, as well as encountering a prevalent bureaucratic disdain for accepting the government’s rules, including my right to a hand search.  To be safe, I still demand a hand pat down – a process which adds anywhere from one to 45 minutes of extra time at the checkpoint.

Sadly, most TSA workers don’t understand how their own equipment works.  For example, the back scatter machines emit very little radiation on the traveler:  that traveler is standing over the guts of the machine which create a helluva electromagnetic field.  Also, if TSA’s equipment miss that metallic orange size bump in a chest we’re all in danger.

Yes, with an ICD comes a formal looking wallet-size ID card to show TSA and other security people…it’s worthless.  Security types either grant the pat-down or refuse, regardless of the card.

I expect that in a few weeks Jay Bouwmeester will be back home.  It will be a changed life but he can still be anywhere with his family, exercise and do as much as 99% of the population.

And, after about a year you get use to that bump in your chest.

The post The ABC’s of ICD’s [the device implanted in Blues player Jay Bouwmeester] appeared first on Occasional Planet.

Elizabeth Warren has proposed a student loan forgiveness program that would cancel up to $50K in student loan debt. Warren says that her plan would totally eliminate student loan debt for 75% of Americans who have that debt and would at least reach 95% of Americans with some debt (there’s even a nifty calculator). Kamala Harris has a student loan forgiveness proposal that would forgive up to $20K in student debt if you received a Pell Grant and start as well as operate a business successfully for 3 years. The business would have to be in an income-disadvantaged neighborhood. Bernie Sanders also has a student loan forgiveness proposal; he wants to forgive all of it. That’s it. There are no formulas, no missives full of technocratic language, and no barrier to entry other than having accumulated student loan debt. To quote democratic strategist James Carville “the less you say, the more you heard”. Simplicity matters, and the broadest policies with the easiest to understand messages typically beat out complexity no matter how much wonkish nerds at think-tanks spend on market testing for whatever candidate they’re writing policy for.

“Build the Wall” was and continues to be more effective at energizing voters than “comprehensive immigration reform.” In 2008, “Universal Coverage” had a much better ring to it than “replacing the tax exemption with a tax credit to be applied to a health savings account.” There’s a separate argument that can be made about messaging and how that can matter when campaigning. As we’ve seen, voters don’t always care too much what actual legislation looks like as long as they can identify it with the campaign message. This would in part explain why Trump voters are satisfied with current policy on immigration despite there being no new wall construction.

However, there are relevant considerations that are obviously more important than messaging such as whether something is good policy. Unequivocally, universal programs are better than means tested programs and that’s why Democrats need to run on them and then fight for them once in government. Whether it’s Medicare-for-All vs. “Medicare-for-All-Who-Want-It” or forgiving all student debt as opposed to forgiving most of it, there are at least 3 reasons why (especially in this campaign) universal programs are better.

1. Universal Programs are More Resistant to Attack from Opposing Interests
   1. Nine states have approved work requirements for Medicaid, and each would have implemented those requirements if not for federal judges blocking implementation. [The Trump Administration is appealing those decisions]. As of 2017, fifteen states have passed legislation to drug test recipients of SNAP or other public assistance programs. Obamacare has been undermined by the failure of 14 states, including 2 of the 3 largest states in the union, have refused to expand Medicaid and have denied millions of people access to healthcare coverage. Meanwhile Medicare benefits have only expanded since its creation in 1965 and has continued to enjoy broad support from voters from both parties. The difference is obvious, Medicare eventually covers everyone while the other programs have formulas for determining coverage and harsh cut-offs. It is easier to oppose a program when it will never benefit you and it’s harder for monied corporate interests to fund opposition to programs that help everyone. That is why privatization of Social Security and Medicare will never become a mainstream right-wing talking point and also serves an effective scare tactic from democratic politicians.
2. Universal Programs Always Help Who They’re Meant To
   1. Hillary Clinton, Pete Buttigieg, and other liberals have made the argument that “we shouldn’t be paying for billionaires’ kids to go to college.” The implication being that public money would be used on the super wealthy to pay for things that they themselves can already afford. That falls apart rather quickly when you go policy by policy. Students take out loans because they can’t afford the cost of school, children of wealthy families are not taking out student loans because they are from wealthy families who can afford tuition and therefore universal student debt forgiveness wouldn’t apply to them in the first place because they have no student debt. The same is true of universal free-public college, most wealthy families send their children to elite private universities and would still pay tuition. When it comes to Medicare-for-All, an argument has been made that we would create a dual-system where the rich are able to afford a higher standard of care under private insurance while the masses must use a public system. That analysis misses two things; we already have the dual-system where wealthy people receive better healthcare and at least in our new paradigm, everyone has healthcare where currently that is not the case. What is most important is that in a universal system, there is no chance that those who need help won’t receive it. Even the best means-tested programs still create incentives for people to work less or stay unmarried or be generally unproductive because without public subsidies they would not be able to afford to live.
3. Politics is About Negotiating, If You Don’t Start High Then You’ve Lost
   1. As anyone who has ever bought a car or home or any product where there isn’t a fixed price knows, you don’t offer the price you’re willing to settle for. If you start with where you’re willing to settle, then you’ll either end up paying more or not buying anything at all because you have to convince the seller that they also received a fair deal. The same is true in politics, we have a bicameral legislature and it will be necessary to deal with conservatives elements in both parties (especially in the Senate) in order to pass any legislation. For Medicare-for-All to be accomplished in the next 4 years a number of extraordinary events would need to happen. Democrats would need to win the Presidency, hold the House, win the Senate, whip every Democratic vote, abolish the filibuster, and appoint a Supreme Court justice to ensure that the law can survive court challenges. That all probably won’t happen, but we can still make sure that we get the best healthcare legislation possible. We may very well end up with Beto’s “Medicare-for-America” or Buttigieg’s “Medicare-for-All-Who-Want-It” or Biden’s “ACA 2.0”. These plans would cover millions more people and make our healthcare system better, but these are plans that we should settle for. We will all be better off if we end up in the middle of Medicare-for-All and our current ineffective system. I don’t know that the same will be true if we’re in the middle of ACA 2.0 and the ACA. By promoting universal programs, we are shifting the Overton window and what is possible in regard to policy which will make it easier to eventually achieve those big progressive ideas.

This country needs big structural change and piecemeal reforms or tinkering around the edges will not make life meaningfully better for most people. Government ought to be viewed as a tool to make people’s lives better and we should not be afraid of unleashing its power to combat the inherent problems present in our political economic system.

It’s time for Democrats to put down the calculators, delete the Brookings Institute from their Rolodex, and embrace big ideas.

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