Age is a moveable number determined by our internal joie de vivre quotient, or so we are often told. According to this premise, we are just as old as we feel. Our true age may be 75 or 85, but we might still prefer to be 50 or 60 in our mind’s eye.

The Internet is awash in pages that celebrate aging well. You can find the

35 Best Age Quotes, 14 of the Best Quotes About Aging, 70 Best Getting Older Quotes About Aging Gracefully and so on and so forth. Amazon has no end of books that want us to get the most out of our later years. Successful Aging: A Neuroscientist Explores the Power and Potential of Our Lives is one. Lifespan: Why We Age―and Why We Don’t Have To is another. It turns out that aging may be the only thing that unites all of us living on Planet Earth at any given moment. Each and every one of us here today will be one day older tomorrow if we are blessed to open our eyes in the morning. Or as Eleanor Roosevelt once put it, “Today is the oldest you’ve ever been, and the youngest you’ll ever be again.”

Albert Einstein admonished us: “Do not grow old, no matter how long you live.”  No other than Benjamin Franklin told us that Life’s tragedy is that we get old too soon and wise too late. On aging, Gabriel García Márquez knowingly wrote What happens is that you don’t feel it on the inside, but from the outside everybody can see it.

There is no wealth of opinion zeroed in on aging.

No other than Sophia Loren has had her say: “There is a fountain of youth: it is your mind, your talents, the creativity you bring to your life and the lives of people you love. When you learn to tap this source, you will truly have defeated age.”  Sorry, Sophia, no matter how well felt your observations, I don’t believe any of us ever defeats age. I prefer Golda Meir’s insight, “Old age is like a plane flying through a storm. Once you are aboard there is nothing you can do about it.”

We all age, whether we like it or not. Sooner of later, thoughts of aging will come home to roost for even the youngest of us alive today.

Many of us, getting older, are happy to share our later years with our family and long established, or even new, friends. We are ready to put our energy to work in the effort of reflection, contributing where we can, thoughtfulness and winding down. We never quite put it in terms of letting go, but yeah we are learning to let go.

Many of us, as I said, but not all.

These days, there are still music stars going strong well on in years – Cher is 76, Streisand 80, Dolly Parton 75, Bob Dylan 80, Ringo Starr 81. Yet, no other than Mike Jagger 78, recently had this to say, Rock ’n’ roll, or any kind of pop music honestly, isn’t supposed to be done when you’re in your 70s. It wasn’t designed for that.

A lot of life, in fact, was never designed for doing in our 70’s or 80’s. Of course, we have never turned to our rock stars to lead us. They get on with their business in the background of our lives. We don’t check in with them on a daily basis. A new song, a new record, drops whenever they have something new to share, every year, every 5 or 10.

We do check in, however, with those we have voted or not voted for, with those in charge of the leadership of our future more often than we should, perhaps, those who have chosen to represent, to influence or to channel their wisdom into setting the best path forward for our children, grandchildren and their grandchildren.

The desire for the glory of leadership in later life, it turns out, is distributed only among a certain few, but that certain few influence, and how, our daily lives to an inordinate degree.

Putin is on the cusp of his 70’s, younger – even if more delusional – than many of his peers. Not far behind him at all, Trump came to office in January 2017, the oldest ever US President at the time, sworn in at the age of 70. If he were to come back to haunt us and win in 2024, he would be 77 on election day and 81 when leaving office. Biden does him one better. Our current President took office when he was 78. If he runs again, wins and completes a second term, he would be 86 by the time 2028 comes round.

Here are a couple of excerpts from a recent New York Times piece on a Biden second term:

To nearly all the Democrats interviewed, the president’s age — 79 now, 82 by the time the winner of the 2024 election is inaugurated — is a deep concern about his political viability. They have watched as a commander in chief who built a reputation for gaffes has repeatedly rattled global diplomacy with unexpected remarks that were later walked back by his White House staff, and as he has sat for fewer interviews than any of his recent predecessors.

… The presidency is a monstrously taxing job and the stark reality is the president would be closer to 90 than 80 at the end of a second term, and that would be a major issue,” said David Axelrod, the chief strategist for Barack Obama’s two winning presidential campaigns.

Trump and Biden are not the only US or world leaders not yet ready to let go.

Queen Elizabeth II is the longest-reigning monarch in the history of the United Kingdom. She recently celebrated he 96th birthday and announced no date to relinquish her powers.

Nicaragua’s dictator, Daniel Ortega, is 76. His accompice wife, Rosario Murillo, is 70.

Republican Mitch McConnell, Senate minority leader, is 80. Nancy Pelosi, Speaker of the House, is 82.

Ruth Bader Ginsburg was still a Supreme Court Justice when she died at the age of 87.

Diane Feinstein, 88, is at a crossroads. Once again the Times offers insight. Feinstein, the Times reports is far from the towering presence she once was on the American political stage. The Times continues:

At 88, Ms. Feinstein sometimes struggles to recall the names of colleagues, frequently has little recollection of meetings or telephone conversations, and at times walks around in a state of befuddlement — including about why she is increasingly dogged by questions about whether she is fit to serve in the Senate representing the 40 million residents of California, according to half a dozen lawmakers and aides who spoke about the situation on the condition of anonymity.

To age is human. Aging is real. As much as we might try, we cannot deny it. We lose some of our abilities as we get older. Yes, some of us can still do bungee jumps. I can assure you that those are the few and far between. The World Health Organization defines aging thus:

 At the biological level, ageing results from the impact of the accumulation of a wide variety of molecular and cellular damage over time. This leads to a gradual decrease in physical and mental capacity, a growing risk of disease and ultimately death.

Getting older, it turns out, is really a thing.

Benedict XVI ruled his Catholic flock until he resigned as Pope, aged 85, in 2013. He cited a lack of strength of mind and body in annoucing his decision. The present Pope, Francis 85 is ailing in health, and if rumors are true, also on the cusp of announcing his resignation. We should applaud him if that is the case. Knowing when to step down and when to bow out is not only admirable and counter-cultural to a certain extent, but at times necessary.

We set limits for those wanting to enter our leadership roles. To be President of the United States, you have to be at least 35. To be a Senator, you need to be 30. To be a Representative in the House, 25.

Perhaps it’s time to contemplate upper limits for those in power. We don’t have any in place. Life expectancy was not the same when our Constitution, rules and regulations were written. The World Health Organization, again, reminds us that:

People worldwide are living longer. Today most people can expect to live into their sixties and beyond. Every country in the world is experiencing growth in both the size and the proportion of older persons in the population.

… By 2030, 1 in 6 people in the world will be aged 60 years or over. At this time the share of the population aged 60 years and over will increase from 1 billion in 2020 to 1.4 billion. By 2050, the world’s population of people aged 60 years and older will double (2.1 billion). The number of persons aged 80 years or older is expected to triple between 2020 and 2050 to reach 426 million.

The Social Security Agency defines eligibility for full retirement as 66 if you were born from 1943 to 1954. Biden was born in 1942, Trump in 1946. They could both easily step back from the public arena right now with a robust pension if only humility would allow them to do so.

Is that ever going to to happen.

Of course not.

In the meantime, the internet is overflowing with positive sentiment on the plus side of retirement. AAG, (Retire Better) has the 60 Best Inspirational and Funny Retirement Sayings. Senior Living has 30 retirement quotes. Southern Living has its 50 Retirement Quotes That Will Resonate With Any Retiree.

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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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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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Donald Trump is making us sick—and I mean that literally. Some food experts are claiming that the recent outbreak of E.Coli contamination in Romaine lettuce may be directly linked to the Trump administration’s disdain for the Food and Drug Administration,  and particularly its health-ensuring regulations.

Specifically, the regulations in play in the Romaine lettuce issue are the ones pertaining to the safety of water used to irrigate and wash crops. Okay, I’m just going to say it: This is about poop, feces, pig shit, horse manure and other animal excreta — the sources of the E. Coli bacteria that have rendered Caesar salad an outcast in American kitchens and restaurants in 2018 and caused hundreds–maybe thousands–of people to vomit, have diarrhea even come close to death. .

It’s all happening, some food-safety experts say, because last year, Trump overturned Obama-era rules to test farm water for E. coli as well as for pesticides and other contaminants.

Let’s review.

According to EcoWatch, in 2006, a major outbreak of E. coli linked to Dole baby spinach was eventually traced back to water contaminated with cattle and wild pig feces. By that year, foodborne illness had become a full-blown epidemic, affecting 1 in 6 Americans. In response to that and many other outbreaks connected to foods such as peanuts, fruit and vegetables, Congress passed the landmark 2011 Food Safety Modernization Act (FSMA). The law includes requirements that the FDA develop rules governing produce safety, including the water quality used to grow, harvest and pack produce.

But the FDA dragged its feet in implementing the rules. After numerous lawsuits from food-safety groups, the FDA decided to allow growers to phase in water quality and testing requirements between 2018 and 2022.

That sounded like progress. But then, Trump came along—Trump and his anti-regulatory business cronies and Big Agriculture political donors. That’s when things started going south for food safety, turning us backward, toward the good old golden, anything-goes days of the unregulated food industry of 100+ years ago.

Ecowatch reports that, “in March 2017, Trump announced billions in dollars of cuts to USDA and FDA, undermining their ability to keep our food safe. In November 2017, the Trump administration proposed a delay in enforcement of urgently needed rules aimed at keeping produce free from fecal contamination. Under the Trump administration’s delay, growers would not have to test water for E. coli contamination until between 2022 and 2014—11 to 13 years after FSMA’s passage.”

The Center for Food Safety says that, based on FDA estimates, delaying enforcement of the rule could lead to more than 730,000 additional cases of foodborne illness and countless deaths.

FDA’s own economic analysis estimates that those illnesses and deaths would cost consumers between $96 million and $822 million more than the industry would save from a delay in enforcing the rule. The groups point to at least seven deadly outbreaks of foodborne illness linked to produce, including cantaloupes, apples, cucumbers, and papayas, since the passage of FSMA in 2011. Some of those outbreaks might have been prevented if the water safety rule had been in effect.

At the Center for Science in the Public Interest, deputy director for legislative affairs Sarah Sorcher said:

“Americans deserve to know that their produce wasn’t grown or rinsed in water contaminated with animal feces. Testing water that is used to grow and harvest produce for E. coli will save both lives and money. Consumers should be outraged that the Trump administration intends to defy Congress by delaying enforcement of these safeguards for many years more.”

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The misinformation about legal immigration peddled by the Trump administration is going to get up close and personal for many of us rather quickly. Unfortunately, Trump and the anti-immigrant faction in the White House, led by Stephen Miller and the former attorney general, Jeff Sessions, has prevailed in their nativist project to grant fewer visas and approve fewer numbers of refugees. These mostly under-the-radar measures ultimately will trickle down to our health care system’s ability to provide adequate staffing and timely access to medical care.

We know that the Trump administration is, to put it mildly, fact challenged. But no matter what Trump and his merry band of alternate-reality enablers claim, objective facts about immigrants and their essential role in keeping the American health care system staffed is right before our eyes. You don’t have to go looking online, or search for the data, or Google the facts. Just take a moment to look around your local hospital, your local doctors’ offices, or your local walk-in clinics, dental offices, or urgent-care facilities. You’ll find foreign-born and educated doctors, surgeons, technicians, dentists and dental assistants, nurses, nurses’ assistants, and home health aids from across the globe who are laboring on the frontlines of delivering quality care across the country.

Facts

The numbers belie the claims that foreign-born workers, particularly in the health care industry, are taking away jobs from Americans.

• Foreign-born and foreign-educated health care professionals have actually become an essential part of America’s health care delivery system, particularly in smaller cities, rural areas, and underserved low-income communities shunned by American-educated health care workers chasing the highest wages in specialty practices in urban centers.

In a letter written to the Department of Homeland Security in 2017—during the time when the fever of executive orders banning individuals from Muslim countries was at its highest—the American Medical Association sounded the alarm about the negative impacts to America’s health care system of limiting or curtailing immigration numbers.

“To date, one our of every four physicians practicing in the United States is an international medical graduate. . . .They are more likely to practice in underserved and poor communities, and to fill training positions in primary care and other specialties that face significant workforce shortages [editor’s emphasis].”

• Internationally trained health care workers’ role in U.S. health care has steadily grown over recent decades. The foreign-born share of health care workers jumped as high as 30 percent in the 1990s, up from 5 percent in the 1960s, according to a 2014 study from Georgetown University’s Center on Education and the Workforce. Studies have found that the health care industry now has the largest percentage of foreign-born and foreign-trained workers of any industry in the country – beating out even the tech industry.
• According to the Bureau of Labor Statistics, between 2006 and 2010, the number of foreign-born health care workers increased from 1.5 million to 1.8 million. Those numbers are staggering and should be setting off alarm bells for what might happen to the health care industry and Americans’ health if the Trump/Miller immigration model prevails.
• More than one-quarter of physicians and surgeons, or 27%, were born outside the U.S. and more than one out of every five, or 22%, of individuals working in support jobs like nursing, psychiatric, home health, and janitorial services also are foreign born.

Facts are facts. Contrary to Trump and his administration’s claims that the U.S. would be better off with fewer legal immigrants, in the health care sector the reality is that Americans’ access to medical care depends on immigrants.

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Regardless of party affiliation or which party’s candidates voters cast their ballots for on November 6, the big winners in the midterm elections are all Americans with pre-existing medical conditions.

That’s because as of January 3, 2019, when the 116^th Congress convenes, Republican-led efforts to repeal the Affordable Care Act will be blocked by a Democratic majority in the House. For at least the next two years, Americans can sleep more soundly and stop worrying about being denied healthcare insurance coverage because of a pre-existing condition, or being charged more for coverage because of one or more pre-existing conditions, or discovering that their insurance denies coverage for services or treatments associated with a pre-existing condition.

Unfortunately, the news media and party pundits continue to waste valuable reporting time on which party was the biggest winner – Democrats for taking back the House or Republicans for holding on to the majority in the Senate. As the pundits continue to push the winner/loser line and who is up and who is down in the polls, they’re giving scant air time to the most important story that touches the lives of all Americans—affordable and dependable access to healthcare.

Democrats, in particular, are missing the opportunity to trumpet what might be the most consequential result of the midterm elections and drive home the message that Democrats have just won a victory that protects all Americans and their families. Incredibly, Democrats once again are failing to craft a unified message that reminds voters that Democrats belong to the party that conceived of and committed itself for more than eighty years to compassionate, life-saving, and family-affirming programs like Social Security, Medicare, Medicaid, and the Affordable Care Act.

A new message for Democrats

Democrats, if you’re paying attention, here’s my suggestion for the most important message to drive home from now until 2020:

America, because of our steadfast commitment to your health and well-being, you can stop worrying about being denied health coverage if

• You are one of the 82 million Americans with a pre-existing condition with employer-based coverage.
• You are one of the 50 to 130 million, or 19 to 50 percent of non-elderly Americans, with some type of pre-existing condition.
• You are one of the 44 million Americans with high blood pressure or high cholesterol.
• You are one of the 34 million individuals suffering from asthma or chronic lung disease.
• You are in the group of the 34 million people who have osteoarthritis and other joint disorders.
• You are a parent with a child who is suffering from a childhood illness, because 1 in 4 children might have been denied coverage if the protections of the Affordable Care Act had been eliminated.

And what are those pre-existing conditions? The list is long and encompasses most of the most common ailments. According to the nonprofit Kaiser Family Foundation, here are just some of the pre-existing conditions that insurers used to routinely deny coverage for prior to enactment in 2014 of the Affordable Care Act:

• HIV/AIDS
• Lupus
• Alcohol abuse/drug abuse with recent treatment
• Mental disorders
• Alzheimer’s/dementia
• Multiple sclerosis
• Rheumatoid arthritis, fibromyalgia, and other inflammatory joint disease
• Muscular dystrophy
• Cancer within some period of time (e.g. 10 years)
• Severe obesity
• Cerebral palsy
• Organ transplant
• Congestive heart failure
• Paraplegia
• Coronary artery/heart disease, bypass surgery
• Paralysis
• Chrohn’s disease/ulcerative colitis
• Parkinson’s disease
• Chronic obstructive pulmonary disease/emphysema
• Pending surgery or hospitalization
• Diabetes mellitus
• Penumocystic pneumonia
• Epilepsy
• Pregnancy or expectant parent
• Hemophilia
• Sleep apnea
• Hepatitis C
• Stroke
• Kidney disease, renal failure
• Transsexualism

The post Big winners in 2018 midterms? Every American with a pre-existing condition appeared first on Occasional Planet.

The first thing I noticed when the doctor sat down in the examining room were the socks. Tucked into a pair of worn, brown-leather shoes, the socks were juniper green, dotted with a pattern of cartoonish chartreuse-colored frog heads. I couldn’t keep my eyes off of them. They looked exactly like the tacky, unsold socks you’d find in the bargain bin at the back of your local bargain store. If those socks were intended to break the levity of the moment of one of the most consequential doctor’s consultations I would ever have, they were more than up to the task.

“Wow,” I said, “great socks.” With a nod and just the faintest hint of a smile, the doctor lifted up one of his pants’ legs to show off the full display of downright silliness. Playing along with my nervous banter and my obvious delaying tactic, the doctor explained his sartorial choice. “Since I no longer wear a tie,” he explained, “I like to shake things up and have a bit of fun.”

Hoping to extend the light-hearted moment a bit longer and trying with everything I could muster to stave off the inevitable discussion of my medical condition, I asked, “So why don’t you wear a tie?”

The answer was simple but, I have to admit, unexpected. Ties harbor bacteria.

Following that office visit, I decided to delve deeper into the necktie mystery. What I discovered is that recent studies in the United States and Britain have concluded that ties harbor dangerous bacteria and fungus that can be transmitted from patient to patient during the examining process.

The bacteria and fungus found on doctors’ ties in recent research studies are hardly household names, but they can cause serious illness. There’s Klebsiella pneumoniae, which causes pneumonia and can also cause infections in the urinary tract, the lower biliary tract, and infections to surgical wound sites. There’s Pseudomonas aeruginosa, a potentially multi-drug resistant bacteria that is documented to cause more than 50,000 healthcare-associated infections in the U.S. each year. There’s Staphylococcus aureaus, the leading cause of skin and soft-tissue infections. And then there’s the fungus Aspergillus, which causes allergic diseases, respiratory illnesses, and infections of the bloodstream.

To tell the truth, I was shocked by what I read. The list of bacteria and fungus found on a sampling of neckties sounded more like a compendium of disease-causing agents lurking on the filthy surfaces in the toxic swamp of a New York City subway car rather than something hitching a free ride on a doctor’s shirt. As it turns out, there they are—sometimes life-threatening bacteria and fungus— hiding in plain sight in the pseudo-sterile environment of the doctor’s examining room or the hospital room. These hidden bogeymen, lurking in the toxic fibers of the seldom-laundered necktie, can cause infection that is sometimes even life threatening, particularly in patients who are already ill. Who knew?

Unnoticed by most patients, the fact is that doctors and neckties are breaking up. Old ideas of professional attire—for both male and female professionals—are changing. Neckties, which along with the white coat have been de rigueur at least for the male contingent of the medical profession throughout the twentieth century, gradually are disappearing in the workplace. As an accessory of choice, as a traditional symbol of white-collar work, and as a potent symbol of individuality, I understand why doctors’ are reluctant to give up the tie.

But now I also understand how significant and responsible was the choice by my doctor that day to demur on the necktie and to choose instead to wear colorful, frog-printed socks.

The post What I learned about killer bacteria from my doctor’s socks appeared first on Occasional Planet.

Two years ago, the  Guardian described how Venezuela’s devastating economic downturn was ravaging its hospitals. Since then, things have only gotten worse. Much worse.

The New York Times reported at the end of last year that in Venezuela today,  hunger is killing the nation’s children at an alarming rate. The Times team tracked 21 public hospitals in Venezuela. The paper reported that doctors were seeing record numbers of children with severe malnutrition. More alarmingly, in the same piece, the Times reported that hundreds of children had already died. And children continue to die.

The most needed medicines have disappeared in Venezuela. Millions of Venezuelan citizens have had to flee their country, and as the diaspora widens, Venezuelans in their thousands continue to exit Venezuela daily. Venezuelans are walking to cities and towns in Colombia, journeys of hundreds of miles, wearing nothing more than flip-flops on their feet.

Meanwhile, Venezuelan President Maduro was videotaped and photographed last week living high on the hog in Istanbul, Turkey, smoking a cigar, enjoying $400 beef and chitchatting with and cozying up to the executive chef Salt Bae at one of the most expensive restaurants in the world. The video went viral, and immediately, not just in Venezuela, but around the world garnered the indignation that it deserved.

Just in August of this year, Maduro – and economist he is not – announced an unprecedented increase in the minimum wage to 180 of his newly invented currency, Bolívares soberanos (Sovereign Bolivars). In his attempt to keep pace with the hyperinflation that he himself has created (this is his 23rd or 24th – it’s hard to keep track – increase in the minimum wage over the past 6 years), Maduro announced that from September 1st of this year the minimum wage in Venezuela would now be the equivalent of $18 US per month.

Maduro is pegging his new currency to something called the Petro – a crypto currency tied to Venezuela’s oil reserves in the marketplace going forward, a complete unknown. On the introduction of the Petro, Maduro on national television described his new initiatives as “a really impressive, magic formula that we discovered while studying with our own, Venezuelan, Latin American-rooted thinking.”

Forget Venezuelan, Latin American-rooted thinking in the above sentence for just a minute. Magic formula is the pivotal key concept in his pronouncement.

The President of a 30 million+ population is trying to sell his citizens on the miracle of snake oil, on a medicine show that was commonplace centuries ago and whose overenthusiastic misstatements have been disgraced thousands of times since. Maduro wants no more and no less than that his citizens buy into a false cure of what ails Venezuela.

$18 per month is a 35-fold increase from the 50¢ conversion-rate adjusted minimum monthly wage that Venezuelans were guaranteed in just August of this year. It sounds like a huge increment, until you realize that the International Monetary Fund is predicting a 1,000,000 percent increase in the inflation rate in Venezuela by December. And a one-million percent inflation rate applied to $18 is such an infinitesimal amount that it won’t even show up on your calculator. Rest assured that there will be a 25th and a 26th, and perhaps even a 27th and 28th increase in the minimum wage before the end of this year. If it happens, it means nothing. And if it doesn’t happen, $18 per month is still just $18 per month for life’s necessities.

Unable to pay a 35-time increase in the minimum wage for their employees, business owners across Venezuela have reacted to Maduro’s latest proposal by letting longtime employees go, and by closing down their stores or businesses completely.

The result of this new Maduro policy is that there are now many more Venezuelans out of work and without the basic resources for daily life in Venezuela than there were just 30 or so days ago. With Maduro’s latest initiatives, the number of Venezuelans needing to leave Venezuela and take their chances in a completely unknown life abroad has increased exponentially.

How to help

Those of us who live outside Venezuela are observers of a situation that is inhumane and cruel beyond belief. We are witnessing a humanitarian crisis unfold in the Americas like none before. And we have to ask ourselves What can be done? How can we help?

Here are some suggestions as to how we can help our neighbors just south of Key West right now.

The Venezuelan Society of Palliative Medicine collects medicines to help those in Venezuela without resources. The specific goal is to help in the treatment of patients with chronic diseases.

Programa de Ayuda Humanitaria para Venezuela accepts financial donations via PayPal, and also accepts donations of medicines and food in Florida and Puerto Rico. You can see a complete list of drop-off locations or contact numbers here – and scrolling down the page you will find a useful list of hard-to-find medicines in Venezuela.

Cuatro por Venezuela works to provide help in the areas of health, nutrition and education. The organization partners with 74 hospitals and institutions in more than 14 Venezuelan states to help provide food to senior citizens and children facing hunger.

Chamos is a UK-based non-profit focused on the needs of Venezuelan children through education and healthcare programs going forward.

In July 2018, WPLG in Miami ran a piece on how to be more immediately involved with the Catholic organizations offering assistance to those arriving in Cúcuta, Colombia daily. Cúcuta, Colombia is the gateway to the world for the vast majority of Venezuelans leaving Venezuela. Among WPLG’s suggestions are these:

The Casa de Paso Divina Providencia provides healthcare and food to Venezuelan refugees. Rev. José David Cañas, 57, has distributed some 500,000 lunches since the house opened June 14, 2017.

The Scalabrini International Migration Network runs a center, or “casa del migrante,” in Cúcuta. They manage several programs including a kitchen responsible for a regular distribution of breakfasts and lunches and a school. For more information, call 011-57-7-573-5533 or email scalabrinicucuta@gmail.com.

The post Venezuela’s sick economy is killing its citizens. Here’s how to help them. appeared first on Occasional Planet.

And now, a word about the brown marmorated stink bug. If you haven’t heard of it, count yourself lucky. This autumn the stink bug, or Halyomorpha halys, has rocketed to the top of the most-hated invasive list. The stink bug is an insect that makes the skin of even the most bug tolerant crawl. Here in the Northeast, this fall’s quasi-biblical invasion is in full swing. And we’re not alone. This noxious Asian native has migrated across the continent, and farmers, homeowners, and agricultural researchers are desperately searching for effective measures to eliminate this wily enemy.

Who and what is this prehistoric-appearing nemesis that spreads fear and loathing wherever it’s found? Out in the fields, stink bugs are causing millions of dollars of damage to a variety of crops. In homes, the stink bug clings to sun-drenched exterior walls and speckles the insides and outsides of window screens. Seeking shelter to hibernate for winter, the bug finds its way indoors through the tiniest of cracks. It clings to window shades. It hides in air-conditioning filters. It snuggles down in the folds of pillowcases, window blinds, and blankets. It drops from the ceiling onto unsuspecting sleepers, awakening them to paroxysms of fight-or-flight. Capture or squash them at the risk of having their stomach-churning coriander-like odor pervading fingers or rooms for days. And their sound in flight—a spine-chilling, buzz-saw sound that far outstrips what one might expect for their one-half-inch-size—is the stuff of insectophobes’ worst nightmares.

Connecting the dots

Is there a lesson in the destructive tale of the stink bug? Of course there is, and it’s important that we connect the dots and acknowledge the larger picture. Without much irony, you might declare that “stink bugs are us.”  That’s because the bug’s presence here in the U.S. is just one of many examples of the negative environmental impacts of a global market fed by our voracious appetite for low-cost consumer goods. In other words, the stink bug established a beachhead in our homes and on our farms as a direct result of our preference for low-cost t-shirts, pants, shoes, and small appliances produced in factories located in low-wage markets far from these shores.

So how did the stink bug, a native of China and Japan, establish a comfortable niche here on the American continent? Researchers believe that the bugs made their first inroads in Pennsylvania, where the first sightings occurred in Allentown in 1998. Speculation is that the stink bug stowed away in wooden shipping crates transporting either manufactured or agricultural goods from Asia. Over the next two decades, their territory spread to twenty-eight states. Today the number of states in which they’ve found a cozy haven stands at forty-one.

This is not a joke

Regardless of its humorous-sounding name, the stink bug is no joke. For home owners, the stink bug is a seasonal nuisance, but for farmers the impact is far more serious.

Just how dire is the stink-bug threat to agricultural production? Unfortunately, the average stink bug isn’t a fussy eater, feeding on both fruit and vegetable crops. The stink bug consumes peaches, apples, cherries, grapes, pears, tomatoes, peppers, corn, soybeans, and green beans, and more.

To understand the stink bugs’ spreading economic impact, consider the travails of two agricultural sectors: the apple and wine industries. In 2010, apple growers in the mid-Atlantic states reported losing 18% of their crop at a cost of $37 million due to stink-bug damage.  Think about the experience of wine producers in the Northwest. Stink bugs feed on the grapevines and then hitch a ride on the harvested grapes as they make their way through the wine-making process. During the process, the stink bug’s musty stink, or in more scientific terms, the stress compound identified as (E)-2-decenal, fouls the aroma of the fermented grapes. And unless wine drinkers’ olfactory expectations change dramatically, the dire economic consequences to the wine industry are obvious.

The stink bug problem is, in fact, so dire that the USDA’s Specialty Crop Research Initiative now has fifty researchers rushing to look into ways to combat this stinky destructor. Right now those researchers believe that weaponizing another Asian invasive pest, the tiny, parasitoid Trissolcus japonicus—or, as they are more affectionately known, the samurai wasp—will help control and decrease the population of stink bugs. How does the samurai wasp accomplish biologically what other measures do not? In one of the cruelties of nature, the samurai wasp lays its eggs inside the eggs of the brown marmorated stink bug, thereby destroying the stink bug’s brood.

Doing even a cursory search online about stick bugs reveals that researchers and agricultural agencies are so alarmed about the stink bug problem that the bug has the distinction of having has its own website dedicated to educating the public and reporting on advancements in management strategies. (www.stopbmsb) The stink bug also has its own online early-detection and distribution mapping system, hosted by the Center for Invasive Species and Ecosystem Health, that encourages the public to report stink bug sitings.

The post Invasion of the stink bug: Icky and economically dangerous appeared first on Occasional Planet.