The Daily Parker

The Atlantic makes a solid case for treating Covid-19 as a behavior problem, not a virus:

The “new normal” will arrive when we acknowledge that COVID’s risks have become more in line with those of smoking cigarettes—and that many COVID deaths, like many smoking-related deaths, could be prevented with a single intervention.

The pandemic’s greatest source of danger has transformed from a pathogen into a behavior. Choosing not to get vaccinated against COVID is, right now, a modifiable health risk on par with smoking, which kills more than 400,000 people each year in the United States.

The COVID vaccines are, without exaggeration, among the safest and most effective therapies in all of modern medicine. An unvaccinated adult is an astonishing 68 times more likely to die from COVID than a boosted one. Yet widespread vaccine hesitancy in the United States has caused more than 163,000 preventable deaths and counting. Because too few people are vaccinated, COVID surges still overwhelm hospitals—interfering with routine medical services and leading to thousands of lives lost from other conditions. If everyone who is eligible were triply vaccinated, our health-care system would be functioning normally again.

We haven’t banned tobacco outright—in fact, most states protect smokers from job discrimination—but we have embarked on a permanent, society-wide campaign of disincentivizing its use. Long-term actions for COVID might include charging the unvaccinated a premium on their health insurance, just as we do for smokers, or distributing frightening health warnings about the perils of remaining uninoculated. And once the political furor dies down, COVID shots will probably be added to the lists of required vaccinations for many more schools and workplaces.

It's time to cough up a better strategy for getting people jabbed.

The temperature dropped 17.7°C between 2:30 pm yesterday and 7:45 this morning, from 6.5°C to -10.2°C, as measured at Inner Drive Technology World Headquarters. So far it's recovered to -5.5°C, almost warm enough to take my lazy dog on a hike. She got a talking-to from HR about not pulling her weight in the office, so this morning she worked away at a bone for a good stretch:

Alas, the sun came out, a beam hit her head, and she decided the bone could wait:

Meanwhile, in the rest of the world:

• Julia Ioffe interviews Russian diplomat Dr Andrey Sushentsov about Russia's views of the Ukraine crisis. tl;dr: the US and Russia don't even have a common set of facts to discuss, let alone a common interpretation of them.
• In Beijing, former Olympic figure skater Adam Rippon blasts the Russian team for once again crapping on their own performance with yet another doping scandal.
• The government of Ontario secured a court order last night allowing the Windsor Police and OPP to start clearing the Ambassador Bridge. So far, they have managed to do so without violence, but a few extremists haven't yet budged.
• James Fallows updates his earlier post on how framing outrageous actions as "that's just Trump" is an abrogation of the press's responsibility to its consumers. "For perspective here: the late Sandy Berger, who had been Bill Clinton’s National Security Advisor, was investigated, charged, fined $50,000, and sentenced to two years of probation for stuffing copies of a classified document into his socks, and sneaking them out from the National Archives. The story of his downfall was a major news feature back in the mid-2000s."
• The UK now allows fully-vaccinated travelers from most countries to arrive and depart without getting a swab stuck up their nose.
• Comedian Bob Saget died of blunt head trauma, consistent with a slip and fall, according to an autopsy. It also found his heart had a 95% blockage, which might have killed him even without the fall.

Finally, in 2018 Rebecca Mead returned to London after living in New York for 30 years. Her 15-year-old son now speaks with a unique accent Mead says has become the new standard "Multicultural London English."

Josh Marshall lays out the evidence that the Omicron Covid variant hit hard and fast, but as in South Africa, appears to have a short life-span:

New York City was one of the first parts of the United States hit by the Omicron variant. The trajectory of the city’s surge now appears remarkably similar to the pattern we saw earlier in South Africa and other countries.

Data out of South Africa showed a roughly four week interval between the start of the Omicron surge and its peak. “Peak in four weeks and precipitous decline in another two,” said Fareed Abdullah of the South African Medical Research Council. “It was a flash flood more than a wave.”

New York City numbers appear to match this pattern almost exactly.

It looks like we may have much lower Covid numbers by the end of January here in Chicago. That said, not that it surprised anyone, but the way the city and State of Illinois have managed testing here seems a bit...hinky:

As Omicron cases surged, Chicagoans were told repeatedly by city, state and federal officials to get tested for COVID-19 — but few testing options were available.

The city previously shut down many of the free testing sites it ran, and the few government-run sites and health clinics still open were booked up. At-home tests sold out. Thousands of people turned to pop-ups that promised quick results, especially as they tried to keep family and friends safe during the holidays.

Now, many who tested at pop-ups are questioning if they got accurate results — and wondering where they can go to for trusted testing. Some have said they’re frustrated the government hasn’t done more to provide legitimate testing options, stockpile testing supplies and shut down bad actors.

Last week, Block Club highlighted how one locally based chain — the Center for COVID Control, with 300 locations across the United States — is now the subject of federal and state investigations after numerous people filed complaints about not getting results or getting delayed results. Authorities said the chain wasted more than 40,000 PCR tests and didn’t properly process rapid tests in multiple instances, among other concerns.

Officials are also beginning to crack down on the pop-ups. The Illinois Attorney General’s office and other agencies are investigating the Center for COVID Control, and the Attorney General’s Office has warned people to be cautious around pop-ups in general.

So, some opportunists predicted a Covid surge in December, bought up all the rapid tests, then opened pop-up stores to bilk the government and the people out of hundreds for "free" tests they could have gotten without "help" from the pop-ups.

The only people who could have predicted this turn of events were millions of us who grew up in Chicago.

New Republic Natalie Shure points out the absolute, crashing idiocy of getting private health insurance companies involved in procuring free Covid testing, because their whole reason for being is to prevent the efficient procurement of health care:

This rollout will be a disaster. And really, that should have been obvious: There’s a reason that the Covid-19 vaccines, monoclonal antibody treatments and antiviral drugs have been made free at the point of use, rather than routed through private insurers. It’s because the insurance industry is structurally incapable of achieving anything universally or efficiently.

That’s not hyperbole, it is by design: The role of private insurers within a for-profit multi-payer system is to restrict access as a gatekeeper, determining who is entitled to use which healthcare services and how much they pay for this. To keep these obligations profitable, they employ an army of claims assessors to argue with you, erect arbitrary hoops for providers and patients to jump through to prove you actually need certain care, raise copays and deductibles as high as possible, and foist as much of the paperwork as possible onto patients.

Insurance companies play the single ghastliest role in a legendarily ghastly healthcare system: Whatever invective you can hurl in Big Pharma’s direction, they at least produce something we actually need. Health insurers offer no value whatsoever; they have nothing to do with care itself and if the industry vaporized completely tomorrow, no one would mourn its demise—we’d all be better off. We’re maddeningly stuck with them for now, owing to a host of reasons ranging from inertia to political capture by industry.

[T]his is an object lesson: We’re in the hands of an industry that was never built to serve patients, a problem which no regulatory tweak will ever fix.

Yes, this is true. I learned that early in my career, leading to a long-standing policy of never working for a health insurer in any capacity.

Let me catalog some of my own experiences when big health-insurance companies have claimed to pay me to write software:

• The first time, a major health-insurance company hired me to write software using a then-current technology, but the project wasn't ready to start, so they involuntarily put me on a team working with obsolete technology and a process so stultifying I didn't actually get to write code. I literally picked up my signing bonus on the way to several interviews in New York, and quit the day I got back. The entire division got dissolved about a year later.
• Well into my professional career, I went to another major health-insurance company along with 8 other developers and managers, but under the aegis of a moderately-big consulting firm. The on-site project cost the client of about $150,000 per week. Of course, they couldn't get us network access or even a project charter. After about a month and about $750,000 spent, the company cancelled the project. I never even found out what software they proposed to build, had they gone through with, you know, building it.
• More recently, a major health-insurance company hired me through a recently-acquired subsidiary as the 6th member of a team writing software in a language less than 3% of software developers ever use. I only took the gig because the subsidiary claimed a level of autonomy from the parent company it did not, in fact, enjoy. It occurred to me less than a week after starting that if the product we were building worked, it would undermine one of the key revenue streams of the parent company. Nevertheless, they hired a new developer to the team about every three weeks (despite an admitted 6-month ramp-up time in the language and product), at an average all-in cost of $18,000 per month per developer. I left after three months, as the team grew past 12 people and yet only completed about 5 function points a week.
  The parent company killed not only the project but also the entire acquired company about two years later. The software never shipped, though I did hear they had completed about half of the planned function points.
  On my way out the door I asked my manager what it said to him that the parent company didn't care about burning $200,000 a month on software that he and I both knew a couple of us could build in a garage in four months. He didn't say anything, but Upton Sinclair did*.

You may not see the connection between these failures, or why I jumped ship so quickly the third time, but it's actually really simple. In all three cases, the companies needed to show their shareholders ongoing investments in technology, and needed to show the general public plans for really great tools to make people's lives better any day now. But the best way any of these companies could have made anyone's lives better would be for the US government to obviate their health divisions by paying for our health care directly.

According to the World Bank, the US spends 17% of GDP on health care, behind only Tuvalu and the Marshall Islands (combined populations: 72,000). The first OECD countries on the list are Switzerland (11.9%), Germany (11.4%), and France (11.3%), all of which have vastly better outcomes than the US. How do they achieve this? By not having fat, bloody leeches draining their health spending on useless bullshit. Example: the National Institutes of Health found in a 2020 study that a staggering 34.2% of health-care expenditures in the US went into administration, compared with just 17% in Canada—and Canada has better health-care outcomes overall than we do.

Shure ends her column with an inescapable truth:

[I]t’s pretty telling that the very moment a life-threatening pandemic necessitated mass vaccination, the idea of involving private health insurance companies with that project was absolutely unthinkable. Who in their right mind would attempt to involve them in something urgent? And if they’re such a dismal way to confer access to Covid-19 testing to anyone who needs it, why the hell are they still playing the role they do in the healthcare system writ large?

Let's end this farce and get real single-payer health care in the US, so we can finally enter the 21st century with the rest of the OECD.

* "It is difficult to get a man to understand a thing when his salary depends on him not understanding it."

Every so often in the winter, a cold front pushes in overnight, giving us the warmest temperature of the day at midnight. Welcome to my morning:

The sun actually came out a few minutes ago—right around the time the temperature started dropping faster.

The forecast says temperatures will continue falling to about -12°C by 3pm, rise ever so slightly overnight and tomorrow, then slide on down to -17° from 3pm tomorrow to 6am Friday. And, because it's Chicago, and because the circumpolar jet stream looks like Charlie Brown's shirt right now, between 6am Friday and 9pm Saturday the temperature will steadily rise more than 20°C (that's 36°F to the luddites out there), peaking at 3°C around 9pm Saturday.

Before the cold front hit last night, the Chicago Teachers Union voted to halt in-person teaching, citing alarming Covid numbers. The Chicago Public Schools promptly locked them out of virtual teaching, giving about 100,000 nothing to do and nowhere to go. (Some CPS staff have at least opened the school buildings so kids can get lunches and stay warm, but the SEIU won't cross what it sees as a picket line, so...)

Since most of the area's colleges and universities have moved back to virtual instruction for the next two weeks, I have trouble understanding the CPS position here, or why CPS locked the teachers out. Sure, the teachers may lose a day's pay, but the kids will suffer more harm than either organization.

Chicago's public health officials say the schools are safe, with Chicago Mayor Lori Lightfoot complaining that "There’s no reason to shut down the entire system, particularly given the catastrophic consequences that will flow." But the CTU didn't call a work stoppage; they called for virtual classes, something CPS has done for almost two years. That leaves me with the impression that Lightfoot and CPS want to stand up to the CTU more than they want to find a solution.

Frankly, both sides look bad here. And again: the kids get the worst of it.

Hard to imagine why Illinois recreational marijuana sales doubled to $1.38 billion in 2021.

Cassie and I both love these crystal-clear autumn days in Chicago, though as far as I know she spent her first two autumns in Tennessee. Does Nashville have crisp fall mornings? I don't know for sure, and Cassie won't say.

I meant to highlight these stories yesterday but got into the deep flow of refactoring:

• People who adopted dogs during the pandemic have discovered that dogs cost money. No kidding.
• Also, living alone costs more than living with a partner, even though singles have more social contacts and tend to be happier. Again, no kidding.
• It turns out that online "wellness" communities spread huge amounts of anti-vaccine bullshit.
• “This idea of intellectual debate and rigor as the pinnacle of intellectualism comes from a world in which white men dominated,” said the geosciences department chair at Williams College, causing me to react loudly enough to alarm Cassie.
• The worst airline in the history of the world died pathetically a week ago, and its successor airline managed to launch with truly ugly livery.

I will now make Cassie drool buckets by using salmon skin as a training tool.

Former Chicago Fraternal Order of Police president Dean Angelo died yesterday of Covid-19. And yet the current FOP president, John Catanzara, has promised to sue the City over the requirement that police officers either show proof of vaccination by Friday or go on a twice-a-week testing regimen if they want to keep getting paid:

"It literally has been like everything else with this mayor the last two and a half years," said FOP President John Catanzara. "Do it or else because I said so."

In a social media post Tuesday, Catanzara urged his members to not comply with the vaccine mandate.

"We're notifying the city the demand for expedited arbitration along with filing unfair labor practice with the labor board," he said Tuesday. "Tomorrow we'll be filing court paperwork for a temporary restraining order."

The dispute comes as a new report from the National Law Enforcement Museum reveals that a full 62% of all line-of-duty law enforcement deaths across the country last year were from COVID-19.

(Emphasis mine.)

In related news, I'm about a quarter through Ruth Ben-Ghiat's Strongmen: Mussolini to the Present, in which she details the patterns of authoritarians throughout the last century. In almost every case, the authoritarian leader demands his followers show loyalty by embracing lies, even when those lies kill them.

Ben-Ghiat's book, like the story today of Angelo's death, frustrate the hell out of me. We make the same mistakes over and over and over. Ultimately, though, we haven't had enough time away from the savannahs of Africa to stop acting like frightened apes half the time.

About 7,000 a day, though it won't hurt to do 10,000:

[T]wo studies, which, together, followed more than 10,000 men and women for decades, show that the right types and amounts of physical activity reduce the risk of premature death by as much as 70 percent.

But they also suggest that there can be an upper limit to the longevity benefits of being active, and pushing beyond that ceiling is unlikely to add years to our life spans and, in extreme cases, might be detrimental.

[A]t 10,000 steps, the benefits leveled off. “There was a point of diminishing returns,” said Amanda Paluch, an assistant professor of kinesiology at the University of Massachusetts Amherst, who led the new study. People taking more than 10,000 steps per day, even plenty more, rarely outlived those taking at least 7,000.

Both studies pinpoint the sweet spot for activity and longevity at somewhere around 7,000 to 8,000 daily steps or about 30 to 45 minutes of exercise most days. Doing more may marginally improve your odds of a long life, Dr. O’Keefe said, but not by much, and doing far more might, at some point, be counterproductive.

I get about 13,000 per day, in part because of Cassie. Which seems fine, according to the report. Note that neither study actually found a causal link between steps and health; the effects only appear related.

Religious extremists, emboldened by lucky tactical and political successes over the past few years despite declining popular support, today won a major victory in their campaign to return women to a state of subjugation that they had only recently escaped. Supporters and allies of the religious leaders imposing the harsh new laws against women celebrated, driving around in pickup trucks while displaying traditional symbols of oppression.

Afghanistan? Iran? Saudi Arabia?

Nope. Texas:

[T]he Supreme Court on Wednesday confirmed what it had previously only implied through its failure to act the night before: The court rejected a request to block enforcement of the law, which abortion providers say will bar at least 85% of abortions in the state and will likely cause many clinics to close, while a challenge to its constitutionality is litigated in the lower courts. The vote was 5-4, with Chief Justice John Roberts joining the court’s three liberal justices – Stephen Breyer, Sonia Sotomayor and Elena Kagan – in dissent.

The case, Whole Woman’s Health v. Jackson, had come to the court on an emergency basis on Monday, with a group of abortion providers asking the justices to intervene. It was the first major test on abortion rights for the Roberts court since the death of Justice Ruth Bader Ginsburg in September 2020, and Ginsburg’s replacement by the conservative Justice Amy Coney Barrett was likely decisive in the outcome.

The court’s inaction on Tuesday night that allowed the Texas law to go into effect and its brief order on Wednesday night denying any relief to the abortion providers unquestionably represented a victory for abortion foes, but the five-justice majority emphasized (and Roberts in his dissent reiterated) that the court was not endorsing the constitutionality of the law. The ruling also revealed a court that is deeply divided, not only on the merits of the case but also on the procedures that the court uses to resolve these kinds of emergency appeals.

Justice Sotomayor pulled no punches:

The Court’s order is stunning. Presented with an application to enjoin a flagrantly unconstitutional law engineered to prohibit women from exercising their constitutional rights and evade judicial scrutiny, a majority of Justices have opted to bury their heads in the sand. Last night, the Court silently acquiesced in a State’s enactment of a law that flouts nearly 50 years of federal precedents. Today, the Court belatedly explains that it declined to grant relief because of procedural complexities of the State’s own invention.

[T]he Act is a breathtaking act of defiance—of the Constitution, of this Court’s precedents, and of the rights of women seeking abortions throughout Texas.

The Court's two conservative justices (Roberts and Breyer) joined with the Court's two liberals (Kagan and Sotomayor) but could not overcome the five Republican justices demonstrating their true loyalties.

The immediate effect of the Court's shadow-docket lawmaking is that about half of all abortion services in Texas have closed as of this afternoon.

The Tennessee Dept of Health will stop telling adolescents about vaccines—especially about the HPV vaccine:

The Tennessee Department of Health will halt all adolescent vaccine outreach – not just for coronavirus, but all diseases – amid pressure from Republican state lawmakers, according to an internal report and agency emails obtained by the Tennessean. If the health department must issue any information about vaccines, staff are instructed to strip the agency logo off the documents.

The health department will also stop all COVID-19 vaccine events on school property, despite holding at least one such event this month. The decisions to end vaccine outreach and school events come directly from Health Commissioner Dr. Lisa Piercey, the internal report states.

After the health department's internal COVID-19 report was circulated on Friday, the rollback of vaccine outreach was further detailed in a Monday email from agency Chief Medical Officer Dr. Tim Jones.

Jones told staff they should conduct "no proactive outreach regarding routine vaccines" and "no outreach whatsoever regarding the HPV vaccine." 

Staff were also told not to do any "pre-planning" for flu shots events at schools. Any information released about back-to-school vaccinations should come from the Tennessee Department of Education, not the Tennessee Department of Health, Jones wrote.

Decisions to ratchet back outreach comes amid pressure from conservative lawmakers, who have embraced misinformation about the coronavirus vaccine, said Dr. Michelle Fiscus, Tennessee's former top vaccine official.

Despite being Cassie's birthplace, not to mention the state other close friends come from, we must remember that it also hosted the Scopes trial in 1925. The state government has a long history of anti-science legislation. This mandate seems particularly idiotic, but we also have to remember that with the modern Republican Party, the cruelty is the point.