Pinning hopes on vaccine is not the right coronavirus strategy, expert says

https://www.cnn.com/2020/07/22/health/us-coronavirus-wednesday/index.html

As cases continue to rise, Americans looking to a vaccine as the way out of the coronavirus pandemic should consider a more comprehensive approach, a leading medical expert told CNN on Wednesday.

“Pinning all our hopes on a vaccine that works immediately is not the right strategy,” Dr. William Haseltine, a former professor at Harvard University’s medical and public health schools, told CNN’s Wolf Blitzer.
Haseltine said a broad public health strategy is a better way to contain the spread of the virus along with the help of a vaccine and therapeutic drugs. Mandating masks will help but Haseltine said, “we need a lot more than masks to contain this epidemic that’s running through our country like a freight train.”
Haseltine recommended closing bars and other places where young people congregate at night and ban holding large meetings in the worst-hit regions. Life won’t get better until people make major changes to their behavior and public health services come forward with more resources, he said.
He said a vaccine is still six months away at the earliest and he warned not to underestimate a coronavirus. Haseltine, known for his work on fighting cancer and HIV/AIDS, said it won’t be easy to develop a vaccine.
“These are tricky viruses,” he said. “It’s not as simple as measles or mumps. It’s going to be a lot more complicated”.
Any Covid-19 vaccine that’s sponsored by the US government will be free or affordable for the American public, Health and Human Services Secretary Alex Azar told CNBC on Wednesday.
“For any vaccine that we have bought — so for instance the Pfizer vaccine — those hundred million doses would actually be acquired by the US government, then given for free to Americans,” Azar said.
He said the same would apply with the AstraZeneca and the Novovax vaccines.
“We will ensure that any vaccine that we’re involved in sponsoring is either free to the American people or is affordable,” Azar said.
And while some anti-mask protesters refuse to wear a piece of cloth to help save American lives, enormous signs of altruism have emerged.
More than 100,000 people have volunteered to participate in Covid-19 vaccine clinical trials, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“I think we’ll be fine with regards to getting enough people,” Fauci said during a webinar Wednesday with the TB Alliance.

1 million more cases in two weeks

The US is heading in the wrong direction with Covid-19 numbers, and it’s doing so with astonishing speed.
Just after 1,000 people died in a single day, the country is about to reach 4 million Covid-19 cases.
To put that in perspective, the first reported case came on January 21. After 99 days, 1 million Americans became infected.
It took just 43 days after that to reach 2 million cases.
And 28 days later, on July 8, the US reached 3 million cases. The 4 millionth case could come just two weeks after that.
As of Wednesday night, more than 3.96 million people had been infected across the US, and more than 143,000 have died, according to data from Johns Hopkins University.
Some states are reporting record-breaking numbers of new cases. Johns Hopkins reported at least 68,706 new cases and 1,152 deaths in the US on Wednesday.
More governors are requiring masks, and dozens of hospitals are out of intensive care unit beds.
President Donald Trump said the United States has now conducted more than 50 million coronavirus tests. He told reporters at a White House briefing that people should wear masks, pay attention to social distancing and wash their hands. While hot spots like Florida and Texas have popped up, it’s all going to work out, he said.
“We’re all in this together,” he said.

Covid-19 a leading cause of death in L.A. County

California, the most populous state and the first to shut down months ago, appeared to have Covid-19 under control — only to suffer a massive resurgence and surpass New York with the most coronavirus cases in the nation.
This month, state Gov. Gavin Newsom shut down bars and indoor restaurant services again due to an influx of cases after reopening.
Covid-19 is set to become one of the leading causes of death in Los Angeles County, according to Barbara Ferrer, the county’s health director.
“It’s killing more people than Alzheimer’s disease, other kinds of heart disease, stroke and COPD,” Ferrer said, referring to chronic obstructive pulmonary disease, which causes airflow blockage and breathing issues.
Comparing Covid-19 to the flu, Ferrer said data shows Covid-19 killed twice as many people in six months as the flu did in eight months.

Where cases are surging

Some politicians, including the President, have insisted that much of the soaring case numbers are a reflection of increased testing.
But the surge is new cases has greatly outpaced the increase in testing, with troubling rates of transmission and test positivity in many states.
A CNN analysis of testing data from the Covid Tracking Project reveals the positive test rate — or the average number of positive test results out of 1,000 tests performed — has increased significantly in many of the current hotspots, including Florida, Arizona, Texas and Georgia.
Florida saw an average rate of 35 positive results per 1,000 tests during the month of May. But in June, that number nearly tripled to 105. So far in July, the average rate of test positivity has been 187 out of 1,000.
But Florida Gov. Ron DeSantis said the state is on the “right course” in the fight against the virus.
“I think we will continue to see improvements,” the governor said Tuesday. “We just have to, particularly Floridians, have to continue doing the basic things.”
Over the weekend, nearly 50 Florida hospitals said they were out of ICU beds. Statewide, the ICU bed availability had dwindled to 15.98% on Tuesday, down from about 18.1% on Monday.
And new data from the CDC also show infections could be more than 10 times higher than the number of reported cases in some parts of the US.

More mask mandates lead to decreased death projections

Researchers estimate the US will have 219,864 total Covid-19 deaths by November 1, according to the Institute for Health Metrics at the University of Washington.
That’s actually a decrease of about 5,000 deaths from the IHME’s previous forecast of 224,546 by that date.
The reasons for the slightly better forecast include more face masks mandates, more people wearing masks, and more people practicing social distancing, the researchers said.
“So a mandate is very important and helping, and a national mandate, of course, would do much better,” said Ali Mokdad, a professor of health metrics sciences at the IHME.
If Americans wore masks nationwide, the number of total deaths by November 1 would drop to 185,887, the researchers project. But if the mandates ease more, the US could have 231,012 deaths by November 1.
At least 41 states have some kind of mask requirement in place or planned. Starting Saturday, Minnesota will require people to wear masks inside businesses or indoor public settings. People who have conditions that make “it unreasonable for the individual to maintain a face covering are exempt from the order,” Gov. Tim Walz said.
Trump said Wednesday he would make a decision over the next day on whether to mandate masks on federal property.

Major testing delays make tracing almost useless

With the high transmission levels of the virus, traditional contact tracing has now become “impractical and difficult to do,” said California Health Secretary Dr. Mark Ghaly.
The state is working to refine strategies and continue to work with counties to build up their “tracing army,” but Ghaly warns that “even a very robust contact tracing program will have a hard time reaching out to every single case.”
Contact tracing is now harder all over the nation while testing results take days, Fauci said.
Quest Diagnostics, a leading commercial testing lab, said in a news release Monday that for some patients, testing results can take up to two weeks.
“The time frame from when you get a test to the time you get the results back is sometimes measured in a few days,” Fauci said Tuesday.
“If that’s the case, it kind of negates the purpose of the contract tracing because if you don’t know if that person gets the results back at a period of time that’s reasonable, 24 hours, 48 hours at the most … that kind of really mitigates against getting a good tracing and a good isolation.”

 

 

 

Maps Of The USA That Made Us Say “Whoa”

https://www.ranker.com/list/maps-mash-v1/mel-judson?format=slideshow&slide=1

The Red Area Features A Total Population Greater Than The Grey

Coronavirus cases could reach 150,000 a day this fall, widely followed Morgan Stanley analyst says

https://www.cnbc.com/2020/07/23/coronavirus-cases-could-reach-150000-a-day-this-fall-morgan-stanley-analyst-says.html

KEY POINTS
  • Morgan Stanley’s biotechnology analyst, Matthew Harrison, said 150,000 daily new U.S. coronavirus cases are possible in the fall without better control of the virus.
  • The analyst has gained a wide following on Wall Street for his success in predicting the course of the pandemic and government responses.
  • Harrison previously projected a “second wave” in the fall with daily new cases between 40,000 and 50,000 nationwide.
  • However, the recent hot spots — Arizona, Texas, Florida and California — have shown a high rate of infection, which led the analyst to adjust to a more pessimistic view on the pandemic.

The spread of the coronavirus could be elevated this fall with as many as 150,000 daily cases in the U.S., according to Morgan Stanley’s biotechnology analyst, Matthew Harrison.

“We update our scenarios to account for the higher sustained infection rate,” Harrison said in a note Thursday. “Our bull [most optimistic] case reflects similar virus control to Europe while our base [most likely] case assumes a near-term plateau followed by increased spread in the fall. [About] 150,000 daily new cases are possible without better control of the virus.”

Harrison previously projected a “second wave” in the autumn with daily new cases totaling between 40,000 and 50,000 nationwide. However, the recent emergence of hot spots — Arizona, Texas, Florida and California — has reflected a high rate of infection, which led the analyst to adjust to a more pessimistic view on the pandemic.

The analyst has gained a wide following on Wall Street for his success in predicting the course of the pandemic and government responses. For example, in April, Harrison warned that the reopening of the U.S. economy would be a slow and tedious process.

“Our assumption of a growing reproduction number, and consequently increasing daily cases, throughout the rest of the year is based on the fact that traditionally the spread of viruses is elevated in the fall compared to the summer primarily due to more people in enclosed spaces,” Harrison said.

A recent resurgence in new cases has forced a number of states to roll back their reopening plans, which weighed on the stock market that rallied massively in the second quarter on hopes for a fast economic recovery. 

Texas and Florida hit grim records earlier this week for daily coronavirus deaths based on a seven-day moving average.The virus has infected an average of 66,805 people per day in the U.S. over the past seven days, up more than 7% compared with a week ago, according to a CNBC analysis of data compiled by Johns Hopkins University.

On Wednesday, California reported a record spike in daily infections and passed New York as the U.S. state with the most confirmed infections since the pandemic began. 

To be sure, Harrison said his projection doesn’t take into account any pharmacological intervention such as vaccines or strict lockdown measures that could potentially dampen the infection rate.

There has been a slew of positive news on the vaccine front this week. The U.S. agreed to pay drugmaker Pfizer and German partner BioNTech nearly $2 billion for 100 million coronavirus vaccines if their candidate proves both safe and effective.

Meanwhile, another vaccine candidate from Oxford University and AstraZeneca showed a positive immune response in an early trial. Earlier this week, British pharmaceutical company Synairgen claimed that its new respiratory coronavirus treatment has reduced the number of hospitalized Covid-19 patients needing intensive care in a clinical trial.

Goldman Sachs biotech analyst Salveen Richter said the Covid-19 vaccine market will be similar to the flu vaccine market, which requires an annual or periodic vaccination. The analyst also cited data showing the global vaccine market will grow to at least $40 billion in 2023 from $35 billion in 2018.

 

 

Fauci on coronavirus: ‘I don’t really see us eradicating it’

https://thehill.com/policy/healthcare/public-global-health/508530-fauci-on-coronavirus-i-dont-really-see-us-eradicating?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202020-07-23%20Healthcare%20Dive%20%5Bissue:28659%5D&utm_term=Healthcare%20Dive

Anthony Fauci, the nation’s top infectious diseases expert, said Wednesday he doesn’t think COVID-19 will ever be fully eradicated but noted it can be controlled.

“I don’t see this disappearing the way SARS 1 did,” Fauci said during a livestreamed event hosted by the TB Alliance, a nonprofit focused on finding better tuberculosis treatments.

The SARS outbreak that started in 2003 lasted several months and mostly affected Asian countries before eventually vanishing. But in the process the disease sickened more than 8,000 people in 29 countries and claimed 774 lives.

Because COVID-19 is more contagious, it has had a far greater impact, with more than 15 million cases worldwide, including 618,000 deaths.

“It is so efficient in its ability to transmit from human to human that I think we ultimately will get control of it. I don’t really see us eradicating it,” Fauci said.

President Trump has repeatedly said the virus will eventually disappear, even though that is rare for most infectious diseases.

Fauci, who is a member of the White House coronavirus task force, recently responded to Trump’s characterization of him as “a little bit of an alarmist” on the pandemic by saying he prefers to think of himself as “a realist.”

During Wednesday’s interview, Fauci described ways that the U.S. can get the coronavirus under control.

“I think with a good combination of good public health measures, a degree of global herd immunity and a good vaccine, which I do hope and feel cautiously optimistic we will get, I think when you put all three of those together we will get very good control of this. Whether it’s this year or next year, I’m not certain,” he added.

“We’ll bring it down to such a low level that we will not be in the position we are right now for an extended period of time.”

 

 

 

New unemployment insurance claims rise for the first time since March

https://www.washingtonpost.com/business/2020/07/23/another-14-million-workers-filed-unemployment-benefits-last-week-pandemic-continues-weigh-labor-market/

 

Some 1.4 million workers filed for unemployment last week, the first increase in months, as the pandemic continues to weigh on the labor market

The number of new unemployment claims rose for the first time in months last week, to 1.4 million — a troubling sign for the labor market that’s weathering a new round of closures as the pandemic spreads.

For the week ending July 18, about 109,000 more jobless claims were filed compared to the week prior, according to the Department of Labor.

“What you’re seeing is that, as the economy slows, the pace of claims picks back up — which really puts at risk the monthly jobs report over the next few months,” said Joseph Brusuelas, the chief economist at RSM. “The July numbers are going to be tenuous, but it’s August that I’m worried about.”

The number of workers continually claiming unemployment insurance went down, however, a statistic that lags by a week, to 16.1 million workers for the week ending July 11, from 17.4 million for the week ending July 4.

In addition to the 1.4 million seeking unemployment nationwide last week, another 980,000 new Pandemic Unemployment Assistance claims were filed, the benefits offered to self-employed and gig workers.

The numbers come as millions of unemployed workers are about to exhaust stimulus payments from two federal benefits programs whose expiration economists have warned could have dire effects on the economy.

Brusuelas said the numbers are a sign that the burst of economic activity that marked the country’s reopening has waned, and that shrinking consumer demand remained a significant risk for businesses and the workers they employ across the country.

“We are going to see a much slower pace of growth the reset of the year,” he said. “While we still are retaining our call for a swoosh-shaped recovery, one has to acknowledge a w-shaped recovery is possible.”

The extra $600 a week in unemployment benefits that the federal government has offered to supplement more modest state unemployment benefits will end this week, as lawmakers wrangle over legislation that could extend it.

Including the new benefits available to gig workers and the self-employed, more than 53 million applications have been filed for some form of unemployment insurance during the pandemic.

 

 

5 COVID-19 myths politicians have repeated that just aren’t true

https://theconversation.com/5-covid-19-myths-politicians-have-repeated-that-just-arent-true-141972

5 COVID-19 myths politicians have repeated that just aren't true ...

The number of new COVID-19 cases in the U.S. has jumped to around 50,000 a day, and the virus has killed more than 130,000 Americans. Yet, I still hear myths about the infection that has created the worst public health crisis in America in a century.

The purveyors of these myths, including politicians who have been soft peddling the impact of the coronavirus, aren’t doing the country any favors.

Here are five myths I hear as director of health policy at the University of Southern California’s Schaeffer Center that I would like to put to rest.

Myth: COVID-19 is not much worse than the flu

President Donald Trump and plenty of pundits predicted early on that COVID-19 would prove no more lethal than a bad flu. Some used that claim to argue that stay-at-home orders and government-imposed lockdowns were un-American and a gross overreaction that would cost more lives than they saved.

By the end of June, however, the director of the Centers for Disease Control and Prevention announced that national antibody testing indicated 5% to 8% of Americans had already been infected with the virus. With over 130,000 confirmed COVID-19-related deaths – and that’s likely an undercount – the case fatality rate is around 0.49% to 0.78% or about four to eight times that of the flu.

Brazilian President Jair Bolsonaro, who also downplayed COVID-19 as the death toll grew, calling it a “little flu,” announced on July 7 that he had tested positive for the coronavirus.

5 COVID-19 myths politicians have repeated that just aren't true

 

Myth: Cases are increasing because testing is increasing

At one point, the idea that COVID-19 case numbers were high because of an increase in testing made intuitive sense, especially in the early stages of the pandemic when people showing up for tests were overwhelmingly showing symptoms of possible infection. More testing meant health officials were aware of more illnesses that would have otherwise gone under the radar. And testing predominately sick and symptomatic people can result in an overestimate of its virulence.

Now, with millions of tests conducted and fewer than 10% coming back positive, the U.S. knows what it is facing. Testing today is essential to finding the people who are infected and getting them isolated.

Unfortunately, Trump has been a leading purveyor of the myth that we test too much. Fortunately, his medical advisers disagree.

Myth: Lockdowns were unnecessary

Given the current spike in infections after reopening the economy, more people are arguing that the lockdowns were unsuccessful in crushing the virus and shouldn’t have been implemented at all. But what would the country look like today if state governments had tried to build herd immunity by letting the disease spread rather than promoting social distancing, prohibiting large gatherings and telling the elderly to stay home?

Most epidemiologists who study pandemics believe that reaching herd immunity could only be achieved at enormous cost in terms of illness and death. About 60% or 70% of Americans would have to become infected before the spread of the virus diminished. That would result in 1 to 2 million U.S. deaths and 5 to 10 million hospitalizations.

These are horrific, yet conservative estimates, given that mortality rates would surely rise if that many people were infected and hospitals were overrun.

5 COVID-19 myths politicians have repeated that just aren't true

Myth: The epidemiological models are always wrong

It is not surprising that many people are confused by the proliferation of predictions about the course of the virus. How many people become infected depends on how individuals, governments and institutions respond, which is hard to predict.

Faced with the warning early in the pandemic that 1 to 2 million Americans could die if the U.S. simply let the coronavirus run its course, federal and state governments imposed restrictions to constrain the spread of the virus. Then, they relaxed those restrictions as new cases ebbed and pressure mounted to reopen the economy.

Now, they must consider reimposing some of those restrictions as infection rates rise in a majority of states, including Texas, Arizona, Florida and California. The models were based on data and assumptions at that time, and likely influenced responses which in turn changed underlying conditions. For example, new cases of COVID-19 are rising in the U.S., while fatalities are falling. This reflects a shift in infection rates toward younger populations, as well as improved treatment as providers learn more about the virus.

Just like an investment disclaimer that past returns do not guarantee future performance, modeling a pandemic should be seen as suggestive of what might happen given current information and not a law of nature.

Myth: It’s a second wave

Sadly, the myth here is that we have contained the virus enough to buy time to prepare for a second wave. In fact, the first wave just keeps getting bigger.

A second wave would require a trough in the first wave, but there is little evidence of that from either an epidemiologic or economic perspective.

5 COVID-19 myths politicians have repeated that just aren't true

During the 1918-1919 flu pandemic, the weekly UK death toll from influenza and pneumonia, shown here, reflected three clear waves. Taubenberger JK, Morens DM. 1918 Influenza: the Mother of All Pandemics. Emerg Infect Dis. 2006;12(1)

The U.S. recorded a record number of new cases during the first week of July, exceeding 50,000 per day for four straight days. The rising number of cases led several states to halt or roll back their reopening plans in hopes of stemming the spread of the virus.

Meanwhile, most consumers are reticent to return to “normal” economic activity: Fewer than one-third of adults surveyed by Morning Consult in early July were comfortable going to a shopping mall. Only 35% were comfortable going out to eat, and 18% were comfortable going to the gym. For almost half of the population, an effective treatment or vaccine may be the only way they will feel comfortable returning to “normal” economic activity.

COVID-19 is an immediate threat that requires a unified, science-based response from governments and citizens to be successful. But it is also an opportunity to rethink how we prepare for future pandemics. Some misinformation is inevitable as a new virus emerges, but perpetuating myths for political or other reasons ultimately costs lives.

 

 

Coronavirus’s painful side effect is deep budget cuts for state and local government services

https://theconversation.com/coronaviruss-painful-side-effect-is-deep-budget-cuts-for-state-and-local-government-services-141105

Coronavirus's painful side effect is deep budget cuts for state ...

Nationwide, state and local government leaders are warning of major budget cuts as a result of the pandemic. One state – New York – even referred to the magnitude of its cuts as having “no precedent in modern times.”

Declining revenue combined with unexpected expenditures and requirements to balance budgets means state and local governments need to cut spending and possibly raise taxes or dip into reserve funds to cover the hundreds of billions of dollars lost by state and local government over the next two to three years because of the pandemic.

Without more federal aid or access to other sources of money (like reserve funds or borrowing), government officials have made it clear: Budget cuts will be happening in the coming years.

And while specifics are not yet available in all cases, those cuts have already included reducing the number of state and local jobs – from firefighters to garbage collectors to librarians – and slashing spending for education, social services and roads and bridges.

In some states, agencies have been directed to cut their budget as much as 15% or 20% – a tough challenge as most states prepared budgets for a new fiscal year that began July 1.

As a scholar of public administration who researches how governments spend money, here are the ways state and local governments have reduced spending to close the budget gap.

Cutting jobs

State and local governments laid off or furloughed 1.5 million workers in April and May.

They are also reducing spending on employees. According to surveys, government workers are feeling personal financial strain as many state and local governments have cut merit raises and regular salary increases, frozen hiring, reduced salaries and cut seasonal employees.

Washington state, for example, cut both merit raises and instituted furloughs.

survey from the National League of Cities shows 32% of cities will have to furlough or lay off employees and 41% have hiring freezes in place or planned as a result of the pandemic.

Employment reductions have met some resistance. In Nevada, for example, a state worker union filed a complaint against the governor to the state’s labor relations board for violating a collective bargaining statute by not negotiating on furloughs and salary freezes.

Most of the employee cuts have been made in education. Teachers, classroom aids, administrators, staff, maintenance crews, bus drivers and other school employees have seen salary cuts and layoffs.

The job loss has hurt public employees beyond education, too: librarians, garbage collectors, counselors, social workers, police officers, firefighters, doctors, nurses, health aides, park rangers, maintenance crews, administrative assistants and others have been affected.

Residents also face the consequences of these cuts: They can’t get ahold of staff in the city’s water and sewer departments to talk about their bill; they can’t use the internet at the library to look for jobs; their children can’t get needed services in school.

Most of these cuts have been labeled temporary, but with the extensions to stay-at-home orders and a mostly closed economy, it will be some time before these employees are back to work.

Suspending road, bridges, building and water system projects

As another way to reduce costs quickly, a National League of Cities survey shows 65% of the municipalities surveyed are stopping temporarily, or completely, capital expenditure and infrastructure projects like roads, bridges, buildings, water systems or parking garages.

In New York City, there is a US$2.3 billion proposed cut to the capital budget, a fund that supports large, multiyear investments from sidewalk and road maintenance, school buildings, senior centers, fire trucks, sewers, playgrounds, to park upkeep. There are potentially serious consequences for residents. For example, New York housing advocates are concerned that these cuts will hurt plans for 21,000 affordable homes.

Suspending these big money projects will save the government money in the short term. But it will potentially harm the struggling economy, since both public and private sectors benefit from better roads, bridges, schools and water systems and the jobs these projects create.

Delaying maintenance also has consequences for the deteriorating infrastructure in the U.S. The costs of unaddressed repairs could increase future costs. It can cost more to replace a crumbling building than it does to fix one in better repair.

Cities and towns hit

In many states, the new budgets severely cut their aid to local governments, which will lead to large local cuts in education – both K-12 and higher education – as well as social programs, transportation, health care and other areas.

New York state’s budget proposes that part of its fiscal year 2021 budget shortfall will be balanced by $8.2 billion in reductions in aid to localities. This is the state where the cuts were referred to in the budget as “not seen in modern times.” This money is normally spent on many important services that residents need everyday –mass transit, adult and elderly care, mental health support, substance abuse programs, school programs like special education, children’s health insurance and more. Lacking any of these support services can be devastating to a person, especially in this difficult time.

Fewer workers, less money

As teachers and administrators figure out how to teach both online and in person, they and their schools will need more money – not less – to meet students’ needs.

Libraries, which provide services to many communities, from free computer use to after-school programs for children, will have to cut back. They may have fewer workers, be open for fewer hours and not offer as many programs to the public.

Parks may not be maintained, broken playground equipment may stay that way, and workers may not repave paths and mow lawns. Completely separate from activists’ calls to shift police funding to other priorities, police departments’ budgets may be slashed just for lack of cash to pay the officers. Similar cuts to firefighters and ambulance workers may mean poorly equipped responders take longer to arrive on a scene and have less training to deal with the emergency.

To keep with developing public safety standards, more maintenance staff and materials will be needed to clean and sanitize schools, courtrooms, auditoriums, correctional facilitiesmetro stations, buses and other public spaces. Strained budgets and employees will make it harder to complete these new essential tasks throughout the day.

To avoid deeper cuts, state and local government officials are trying a host of strategies including borrowing money, using rainy day funds, increasing revenue by raising tax rates or creating new taxes or fees, ending tax exemptions and using federal aid as legally allowed.

Colorado was able to hold its budget to only a 3% reduction, relying largely on one-time emergency reserve funds. Delaware managed to maintain its budget and avoided layoffs largely through using money set aside in a reserve account.

Nobody knows how long the pandemic, or its economic effects, will last.

In the worst-case scenario, budget officials are prepared to make steeper cuts in the coming months if more assistance does not come from the federal government or the economy does not recover quickly enough to restore the flow of money that governments need to operate.

 

 

 

The Constitution doesn’t have a problem with mask mandates

https://theconversation.com/the-constitution-doesnt-have-a-problem-with-mask-mandates-142335?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20July%2022%202020%20-%201684316250&utm_content=Latest%20from%20The%20Conversation%20for%20July%2022%202020%20-%201684316250+Version+A+CID_3a4842bdc1542ab5ad1725fad090f099&utm_source=campaign_monitor_us&utm_term=The%20Constitution%20doesnt%20have%20a%20problem%20with%20mask%20mandates

The Constitution doesn't have a problem with mask mandates

Many public health professionals and politicians are urging or requiring citizens to wear face masks to help slow the spread of the COVID-19 virus.

Some Americans have refused, wrongly claiming mask decrees violate the Constitution. An internet search turns up dozens of examples.

“Costco Karen,” for instance, staged a sit-in in a Costco entrance in Hillsboro, Oregon after she refused to wear a mask, yelling “I am an American … I have rights.”

A group called Health Freedom Idaho organized a protest against a Boise, Idaho, mask mandate. One protester said, “I’m afraid where this country is headed if we just all roll over and abide by control that goes against our constitutional rights.”

As one protester said, “The coronavirus doesn’t override the Constitution.”

Speaking as a constitutional law scholar, these objections are nonsense.

The objections

It is not always clear why anti-maskers think government orders requiring face coverings in public spaces or those put in place by private businesses violate their constitutional rights, much less what they think those rights are. But most of the mistaken objections fall into two categories:

Mandatory masks violate the First Amendment right to speech, assembly, and especially association and mandatory masks violate a person’s constitutional right to liberty and to make decisions about how to their own health and bodily integrity.

They’re not mutually exclusive claims:lawsuit filed by four Florida residents against Palm Beach County, for example, argues that mask mandates “interfere with … personal liberty and constitutional rights,” such as freedom of speech, right to privacy, due process, and the “constitutionally protected right to enjoy and defend life and liberty.” The lawsuit asks the court to issue a permanent injunction against the county’s mask mandate.

Responding to a reporter who asked why President Donald Trump appeared unconcerned about the absence of masks and social distancing at a campaign rally in Tulsa, Vice President Mike Pence said: “I want to remind you again freedom of speech and the right to peaceably assemble is in the Constitution of the U.S. Even in a health crisis, the American people don’t forfeit our constitutional rights.”

What the First Amendment does – and doesn’t – do

The First Amendment protects freedom of speech, press, petition, assembly and religion.

There are two reasons why mask mandates don’t violate the First Amendment.

First, a mask doesn’t keep you from expressing yourself. At most, it limits where and how you can speak. Constitutional law scholars and judges call these “time, place, and manner” restrictions. If they do not discriminate on the basis of the content of the speech, such restrictions do not violate the First Amendment. An example of a valid time, place and manner restriction would be a law that limits political campaigning within a certain distance of a voting booth.

Additionally, the First Amendment, like all liberties ensured by the Constitution, is not absolute.

All constitutional rights are subject to the goverment’s authority to protect the health, safety and welfare of the community. This authority is called the “police power.” The Supreme Court has long held that protecting public health is sufficient reason to institute measures that might otherwise violate the First Amendment or other provisions in the Bill of Rights. In 1944, in the case of Prince v. Massachusetts, for example, the Supreme Court upheld a law that prohibited parents from using their children to distribute religious pamphlets on public streets.

The right to liberty

Some anti-maskers object that masks violate the right to liberty.

The right to liberty, including the right to make choices about one’s health and body, is essentially a constitutional principle of individual autonomy, neatly summarized as “My body, my choice.”

The 1905 case of Jacobsen v. Massachusetts shows why mask mandates don’t violate any constitutional right to privacy or health or bodily integrity. In that case, the Supreme Court upheld a smallpox vaccination requirement in Cambridge, Massachusetts.

The court said that the vaccination requirement did not violate Jacobsen’s right to liberty or “the inherent right of every freeman to care for his own body and health in such way as to him seems best.”

As the court wrote, “There are manifold restraints to which every person is necessarily subject for the common good. On any other basis, organized society could not exist with safety to its members.” In a 1995 New York case, a state court held that an individual with active tuberculosis could be forcibly detained in a hospital for appropriate medical treatment.

Even if you assume that mask mandates infringe upon what the Supreme Court calls “fundamental rights,” or rights that the court has called the “very essence of a scheme of ordered liberty,” it has consistently ruled states can act if the restrictions advance a compelling state interest and do so in the least restrictive manner.

Rights are conditional

As the Jacobsen ruling and the doctrine of time, place and manner make clear, the protection of all constitutional liberties rides upon certain necessary – but rarely examined – assumptions about communal and public life.

One is that is constitutional rights – whether to liberty, speech, assembly, freedom of movement or autonomy – are held on several conditions. The most basic and important of these conditions is that our exercise of rights must not endanger others (and in so doing violate their rights) or the public welfare. This is simply another version of the police power doctrine.

Unfortunately, a global pandemic in which a serious and deadly communicable disease can be transmitted by asymptomatic carriers upsets that background and justifies a wide range of reasonable restrictions on our liberties. Believing otherwise makes the Constitution a suicide pact – and not just metaphorically.

 

 

 

 

Coronavirus numbers confusing you? Here’s how to make sense of them

https://theconversation.com/coronavirus-numbers-confusing-you-heres-how-to-make-sense-of-them-142624?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20July%2021%202020%20-%201683216237&utm_content=Latest%20from%20The%20Conversation%20for%20July%2021%202020%20-%201683216237+Version+A+CID_b109e0db9fc0132f981f087222693bc8&utm_source=campaign_monitor_us&utm_term=Coronavirus%20numbers%20confusing%20you%20Heres%20how%20to%20make%20sense%20of%20them

Coronavirus numbers confusing you? Here's how to make sense of them

Turn on the TV news, or look at a news website, and you’ll see charts, graphics, and dashboards that supposedly indicate the latest with COVID-19 – statistics revealing the number of tests, cases, hospitalizations and deaths, along with where they happened and whether they are rising or falling.

Different stories are told depending on the dashboard. But one thing is certain: These indicators lag behind the actions we take, or don’t take, on COVID-19. As researchers who focus on public health, we can tell you that a fully accurate, real-time snapshot of the progress of the virus isn’t possible.

Some don’t get tested

There are many reasons for this. Here’s one: diagnostic testing data are incomplete. Someone infected with COVID-19 must first come in contact with the virus either through the air or (less likely) environmental surfaces. Symptoms show between two and 14 days later. But at least 40% of those infected will never manifest symptoms, or show such mild ones they don’t even suspect they have COVID-19. So they may never get tested, which means they won’t show up in the total number of tests, or the total number of cases.

Another example: because of the lack of testing availability – a widespread problem in the U.S. since the start of the pandemic – not everyone who should be tested gets a test.

And another: the tests themselves are not perfect. Up to one-third who get a negative result may actually be infected. This happens because they are tested before they have a viral load sufficient enough for detection. Or maybe the sampling is not adequate. Or perhaps the test itself simply failed.

In Florida, people wait outside a COVID-19 testing station.

Case numbers don’t tell the full story

This is why problems arise when we use case numbers to determine disease levels in a community. Case counts actually reflect what was happening in a community weeks earlier. Four weeks, for instance, could elapse between the time a person is exposed to the virus and when they are reported as a case. Even the best testing results often take a week to report to public health authorities, and longer to appear on dashboards. Some testing results, seriously delayed, may take ten days or more.

Other factors impact the metrics. Laboratory results, often released in batches, may introduce artificial variation in case numbers. Someone who tested two days ago, then got a result back immediately, might be added on the same day as someone who was sick two weeks ago, but whose test results were delayed. To smooth out these variations, it helps to look at a rolling seven-day case average.

Hospitalization is a clearer metric for assessing the level of community disease. Those who are seriously ill, in most cases, will be hospitalized whether previously tested or not. Data suggests roughly one in five infected persons are hospitalized. Individuals seem to do okay for the first week, with more life-threatening symptoms showing in the second. That means hospitalizations represent exposures that happened three or four weeks earlier.

Again, a seven-day rolling average evens out artificial variations. There is one caveat for this: Though hospitalization is a useful metric, only about 20% of infected people need it. That means hospitalization numbers alone underestimate the number of people infected and what age groups they represent.

States vary on cause of death

The death numbers are not a reliable indicator either. In some states, to count as a COVID-19 death, the deceased must have had a test reporting positive. In other states, probable cases are reported.

As clinicians learn how to better treat COVID-19, fatality rates are dropping. Deaths, the longest lagging indicator, reflect people who were infected six or eight weeks earlier. When comparing one region to another, deaths are best expressed as rates – a ratio of deaths to population.

Another issue: News reports do not always clearly distinguish between diagnostic testing, which shows if you currently have COVID-19, and antibody testing, which shows if you had it in the past, and now harbor antibodies that can fight it. So far, however, antibody testing has not provided a useful picture of who has been infected and who has not. Once that happens, it could provide researchers and clinicians with some indicators on how widely the virus has spread.

Though the dashboards are ubiquitous on television, none of these frequently used indicators they feature is perfect. Still, taken together, they provide a reasonable approximation of COVID-19 transmission in communities. But as authorities make decisions, they should take into account the numbers are weeks old.

What does this mean to you? Understanding these limitations may help you understand your risk. We are still in the midst of a pandemic that is not under control. Being educated will help all of us from becoming a part of tomorrow’s lagging indicators.

 

 

 

 

Former Fed Chairs Bernanke and Yellen testified on COVID-19 and response to economic crisis

https://www.brookings.edu/blog/up-front/2020/07/17/former-fed-chairs-bernanke-and-yellen-testified-on-covid-19-and-response-to-economic-crisis/?utm_campaign=Economic%20Studies&utm_source=hs_email&utm_medium=email

Former Fed Chairs Bernanke and Yellen testified on COVID-19 and ...

In many respects this recession is unique. Most recessions result from developments inside the economy, but an external shock—the public health crisis—caused this one. To avoid getting sick, people have curtailed working, shopping, and attending school. Whatever the cause, the coronavirus recession, like all recessions, is imposing heavy costs. Many workers have lost jobs and income, and many business owners’ financial survival is at risk. The economy’s extraordinarily rapid decline earlier this year—as well as the sharp but incomplete rebound following the first steps toward reopening—reflect this recession’s unusual source. In addition, the sectors suffering most differ from past recessions. The heaviest blows have fallen on service industries that involve close personal contact (including retail trade, leisure and hospitality, and transportation) rather than, as is more typical, on the housing, capital investment, and durable goods sectors. Lower-paid workers, as well as women and minorities, are over-represented in the most-affected sectors, and thus have borne a disproportionate share of the job and income losses. And, the virus has affected almost every country, with potentially devastating consequences for trade and international investment.

Because this recession is unprecedented in so many ways, forecasting the recovery is difficult. The course of the pandemic itself is by far the most important factor. As long as people fear catching a potentially deadly illness from other people, they will be cautious about resuming normal activities, even after state and local governments lift lockdowns. Thus, controlling the spread of the virus must be the first priority for restoring more-normal levels of economic activity—but, more importantly, for saving possibly tens of thousands of lives. Members of Congress, local leaders, and other policymakers need to do all they can to support testing and contact tracing, medical research, and sufficient hospital capacity, and they must work to ensure that businesses, schools, and public transportation have what they need to operate safely. Both authors of this testimony are serving on state re-opening commissions, which has provided us insight into the substantial challenges to safe re-opening.

If the pandemic comes under better control, economic recovery should follow. However, the pace of the recovery could be slow and uneven, for several reasons. First, in the face of ongoing uncertainty, households and businesses may remain cautious for a time. They may increase saving and reduce spending, hiring, and capital investment. The longer the recession lasts, the greater the damage it will inflict on household and business balance sheets and the longer it will take to repair the damage. Second, the depth of the recession may leave scars—business closures and the deterioration of unemployed workers’ skills—that will affect growth for several years. Third, depending on the course of the virus, some restructuring of the economy may be needed. For example, people and resources will need to be redeployed out of the sectors most damaged by the pandemic, and business operations will need to be reorganized to protect workers and customers. All of that will take time and money. Fiscal and monetary policies must aim to speed the recovery and minimize the recession’s lasting effects.

ACTIONS BY THE FEDERAL RESERVE

The Federal Reserve has moved swiftly and forcefully in this crisis. It eased monetary policy in March by lowering the federal funds rate, the overnight interest rate on loans between banks, nearly to zero and indicating that it plans to keep rates low for several years. Low interest rates probably had limited economic benefits in the spring. Lockdowns prevented people from spending or working more. However, we expect low rates will spur spending in sectors like housing as the economy reopens. And the Fed may well do more in coming months as re-opening proceeds and as the outlook for inflation, jobs, and growth becomes somewhat clearer. In particular, to maintain downward pressure on longer-term interest rates, the Federal Open Market Committee (FOMC) likely will provide forward guidance about the economic conditions it would need to see before it considers raising its overnight target rate.  And it likely will clarify its plans for further securities purchases (quantitative easing). It is possible, though not certain, that the FOMC will also implement yield-curve control by targeting medium-term interest rates. It could, for example, target two-year rates by announcing its willingness to buy two-year Treasury notes at a fixed yield. The completion of the Fed’s internal review of its tools and framework in coming months will help guide these decisions.

The Fed also has been active beyond monetary policy.

First, the Fed has served as market maker of last resort by acting to stabilize critical financial markets when capital or other regulatory constraints have interfered with normal market-making or arbitrage. The Fed has served this role for repurchase agreements (repos) since September, when intermittent liquidity shortages led to spikes in repo rates. Banks did not provide liquidity to offset these spikes, as they normally would, citing balance sheet limits and other constraints. Because repo markets are critical to the functioning of broader financial and credit markets, as well as for the transmission of monetary policy, the Fed has restored more-normal function in repo markets by conducting large-scale repo operations and by steadily increasing the quantity of reserves in the banking system.

An even larger shock occurred in March, when uncertainty about the pandemic led hedge funds and others to scramble to raise cash by selling longer-term securities. The upsurge in the supply of longer-term securities, including Treasuries, was more than dealers and other market-makers could handle. Key financial markets, including for Treasury securities, experienced substantial volatility. To stabilize these markets, which like the repo market play a critical role in our financial system, the Fed purchased large quantities of Treasuries and mortgage-backed securities, again serving as market maker of last resort. It also set up a new repo facility to allow foreign official institutions to borrow dollars, using their Treasury reserves as collateral, thus avoiding the need to sell those Treasuries. Although risk and liquidity premiums in these key markets have returned closer to normal, at some point the Fed and the Treasury will need to review why the market-making facilities in place before the pandemic hit did not work more efficiently.

Second, the Fed has served as lender of last resort to the financial system, a classic function of central banks. Banks and other financial intermediaries typically borrow short and lend long—that is, they rely heavily on short-term funding to finance long-term loans and investments. If they lose their short-term funding—because their funders lose confidence or for other reasons—they can be forced to sell their assets in fire sales, restrict credit to customers, and, in extreme cases, become insolvent. Central banks can short-circuit that dangerous dynamic by lending to financial institutions against good collateral, replacing the lost liquidity. In the 2007-2009 crisis, which centered on the financial system and included a global financial panic, the Fed as lender of last resort took many actions to provide liquidity to financial institutions, with the goal of stabilizing the system and preserving the flow of credit to the economy.

Fortunately, the financial system is in much better shape today than in was during the financial crisis. Banks in particular are strong, with much higher levels of capital and liquidity. The Fed nevertheless has once again taken steps to ensure that the financial system has sufficient liquidity. Largely replicating our playbook from the crisis era, the Fed has eased terms on the discount window (which provides short-term loans to banks); re-established the Primary Dealer Credit Facility (which lends to broker-dealers); and established a facility that lends indirectly to money market mutual funds, ensuring that the funds can meet depositor withdrawals. In a novel step, the Fed also created a facility that lends to banks, without recourse, against Payroll Protection Program loans, ensuring that banks have sufficient funds to make those loans.

Under the heading of lender of last resort to the financial system, establishing currency swap lines with fourteen foreign central banks was one of the most important actions the Fed took in the 2007-2009 crisis. The Fed has revived this program. Currency swap lines allow foreign central banks (who assume all the credit risk) to lend dollars to banks in their jurisdictions. The broad availability of dollar liquidity is essential because most global banks do substantial borrowing and lending in dollars, including lending within the United States. The swap lines sustain the flow of dollar credit and reduce volatility in dollar-based markets, to the benefit of the U.S. economy.

Third, the Federal Reserve, with the support of the Congress and the Treasury, has also served during the current crisis as a lender of last resort to the non-financial sector, backstopping key credit markets facing the prospect of severe disruption from the pandemic. To take on this role, the Fed invoked its emergency lending powers under Section 13(3) of the Federal Reserve Act. Since those powers require that the Fed’s lending be well secured, it has had to rely on funds appropriated by the Congress and allocated by the Treasury to cover possible losses. Using these authorities, the Fed revived financial crisis-era facilities to stabilize commercial paper and asset-backed securities markets. Going beyond the financial crisis playbook, the Fed has also added new facilities to lend to corporations and state and local governments and to buy outstanding corporate bonds.

These programs have not extended much credit, so far, but that does not mean they have not succeeded. By establishing the programs, the Fed gave private investors the confidence to re-engage by reassuring them that the government would not allow these critical markets to become dysfunctional. Indeed, the corporate and municipal bond markets largely stabilized after the announcements, before any loans were made. Of course, if these markets seize up again, the Fed’s programs can extend credit.

The Fed also established the Main Street Lending Program to lend (through banks) to medium-sized companies. It is too soon, however, to judge its performance. This program is very different from anything the Fed has attempted before and poses difficult technical challenges. Although the Fed took many public comments while setting up the program, and made substantial changes, questions remain about how many banks and borrowers will participate. The Fed and Treasury may have to further ease terms for borrowers and increase incentives for banks for this program to have the desired effect. Or, the Fed and Treasury could add a new facility, along the lines of funding-for-lending programs run by the Bank of England and the European Central Bank, that simply subsidize banks for making additional loans to qualifying borrowers (for example, businesses below a certain size). That approach leaves the underwriting decision completely with the banks, while the size of the subsidy can be adjusted as needed to achieve the desired level of lending.

Finally, the Fed has also taken actions as a bank regulator—for example, encouraging banks to work with borrowers hobbled by the pandemic. It decided recently, based on stress test results, to bar stock buybacks by banks and to limit—but not eliminate—their dividends.  Based on our experience in the global financial crisis, we think the Fed may find it needs to go further. Although banks are currently strong, it is possible the pandemic will so damage the economy that credit losses mount rapidly. For a successful recovery, the banking system must remain strong and able to lend.

Is there more the Fed could do? As we noted, the Fed likely will provide more clarity about its monetary policy plans, and it may need to adjust the terms or borrower eligibility requirements of its various lending facilities. Broadly speaking, though, the Fed’s response has been forceful, forward-looking, and comprehensive. But, as Chair Powell often notes, the Fed’s authorities allow it to lend, not spend. Some households and firms will need subsidies or grants, rather than loans, and spending is, of course, the province of the Congress.

WHAT FISCAL POLICY MIGHT DO

The fiscal response to the pandemic has thus far been quite effective. Enhanced unemployment insurance and the Paycheck Protection Program have helped unemployed workers and their families, together with many businesses, survive the spring shutdowns. The fiscal support for the Fed’s lending programs likely will help preserve credit availability, possibly with only a portion of the allocated funds being spent.

However, some programs authorized by the Congress are ending, and new actions are necessary. Our recommendations for further fiscal action are:

First, Congress should develop a comprehensive plan to support medical research; increase testing, contact tracing and hospital capacity; make available critical supplies; and support state and local efforts to safely open businesses, schools, and public transportation.

Nothing is more important for restoring economic growth than improving public health. Investments in this area are likely to pay off many times over.