Stay safe, stay informed

Posted by on 2020-03-18

People in the Trump administration like Reagan’s joke: be very afraid when someone says “I’m from the government and I’m here to help.” But anyone who remembers government responses to Hurricane Katrina or Hurricane Maria ought to be doubly afraid when it’s a Republican offering the help. Only with the recent appearance of the Trump administration’s apparently only competent public health official, Dr. Anthony Fauci, are we now beginning to get some truth from the White House. There is still a lot of misinformation regarding both the Coronavirus and the government’s response to it.

COVID-19

COVID-19 is the 2019-2022 manifestation of the SARS-CoV-2 virus. The virus is most dangerous to people over 70 who are immune-compromised, have existing heart, circulatory, or respiratory problems, and who are habitually exposed to pollutants or do not have reliable medical care. COVID-19 is more deadly than the average flu but nothing like the 1918 Spanish Flu. That said, the 1918 Flu illustrates how a global pandemic unfolds, what helps to save lives, and the sorts of denial and stupidity that kill people.

Some readings on the virus itself:

Effects and Responses

Poor people suffer the greatest during pandemics and the United States stands alone as a nation without a national health care system or universal health care. Worse, Trump fired government global pandemic experts as soon as he came to office. Why? Well, because if Obama thought taking global pandemics seriously was a good idea, well then, it had to be reversed.

The strategy of “shelter in place” or self-quarantine is designed to slow down the transmission of the disease so that the American healthcare ‘system’ is not overwhelmed by too many hospital admissions. The entire United States has 924,000 hospital beds and only 45,000 acute care beds, so we are going to be in deep shit big trouble if too many people are sick at one time, as happened in China, Iran, and Italy. You can show no symptoms and still be a carrier, so it is important — not just for you — but for your grandparents and elderly friends to note expose them to a virus you don’t even know you are carrying.

The death rate in Italy is extremely high — not because Italy has a national healthcare system — but because the average age in Italy is 10 years greater than in the US; the average age of an Italian COVID-19 fatality is 81. So stay at home if you can. For 97.5% of us the virus is survivable. But for the very sick and very elderly, COVID-19 can be a death sentence.

New York expects the number of Coronavirus cases to peak in 45 days, the White House is saying this first wave of the virus may persist “well into July” and German researchers think that the entire course of the virus might repeat the 1918 pattern, taking possibly two years to die out. In some places school is being cancelled until next August or September. People really need to take this thing seriously and devise ways of staying in touch and checking-in with friends and family — without exposing high-risk people.

This is not a two week event. You are going to be bored and inconvenienced and stressed and freaked out for at least a few months.

Despite the science, there has been plenty of stupidity, especially by those who deny the risk to an aging population or who regard the risks as exaggerated or, worse, a plot to smear the president. There are currently several attempts to develop a vaccine, but it’s going to take at least several months to test and produce large-enough quantities to deal with it.

Legislation

The virus will hurt people’s ability to earn a living, stay in their houses, feed their kids, and has already damaged an economic system that loves corporations but is not structured to help human beings. 63% of all Americans are $500 away from financial ruin, and the Coronavirus is going to take that $500 from most. For this reason Democrats have proposed a bill, H.R.6201, the Families First Coronavirus Response Act.

Families First Coronavirus Response Act

This bill responds to the coronavirus outbreak by providing paid sick leave and free coronavirus testing, expanding food assistance and unemployment benefits, and requiring employers to provide additional protections for health care workers.

Specifically, the bill provides FY2020 supplemental appropriations to the Department of Agriculture (USDA) for nutrition and food assistance programs, including

  • the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC);
  • the Emergency Food Assistance Program (TEFAP); and
  • nutrition assistance grants for U.S. territories.

The bill also provides FY2020 appropriations to the Department of Health and Human Services for nutrition programs that assist the elderly.

The supplemental appropriations provided by the bill are designated as emergency spending, which is exempt from discretionary spending limits.

The bill modifies USDA food assistance and nutrition programs to

  • allow certain waivers to requirements for the school meal programs,
  • suspend the work requirements for the Supplemental Nutrition Assistance Program (SNAP, formerly known as the food stamp program), and
  • allow states to request waivers to provide certain emergency SNAP benefits.

In addition, the bill requires the Occupational Safety and Health Administration to issue an emergency temporary standard that requires certain employers to develop and implement a comprehensive infectious disease exposure control plan to protect health care workers.

The bill also includes provisions that

  • establish a federal emergency paid leave benefits program to provide payments to employees taking unpaid leave due to the coronavirus outbreak,
  • expand unemployment benefits and provide grants to states for processing and paying claims,
  • require employers to provide paid sick leave to employees,
  • establish requirements for providing coronavirus diagnostic testing at no cost to consumers,
  • treat personal respiratory protective devices as covered countermeasures that are eligible for certain liability protections, and
  • temporarily increase the Medicaid federal medical assistance percentage (FMAP).

Republicans seem less inclined to help the most vulnerable among us, oppose language in the legislation providing help to single-sex families, generally oppose paid sick leave, and seem to be unduly concerned with the airline and travel industries. Senate Speaker Mitch McConnell has told his GOP friends in the Senate to “gag and vote for it anyway.” But McConnell has not yet convinced them. Negotiations drag on.

The limitations of the plan are significant. Even thought the Coronavirus is a global pandemic that will last many months, the Families First bill only provides 10 days of paid sick leave — and only if you are employed with a company with 500 or more employees. The estimated cost of the legislation was originally $750 billion but was negotiated down to $104 billion by timid House Democrats. To provide a little context, Professor Deborah Lucas at MIT’s Sloan School estimates the 2008 financial bailout to Wall Street ended up costing taxpayers $498 billion. The Families First bill is an insignificant gesture that is unlikely to help much in a crisis of this magnitude expected to linger for many months.

Trump’s Economic Bailout

Trump and Treasury Secretary Steven Mnuchin have unveiled a separate $850 bailout program for business and Wall Street. The plan was first discussed at a private lunch with Senate Republicans and provides help to small businesses, retailers, hotels and the airline industry, as well as more tax breaks. The airline industry alone will receive $50 billion in aid. The rest of America must be happy with a one-time $1000 check and 10 days of sick leave. When you hear “we’re all in this together” realize that some are in this thing more than others.

Other Legislation

There are a few other pieces of legislation: modifications of the War Powers Act to help manufacturers in yet unspecified ways; rulings on tax filings (April 15 is Tax Day); and the invocation of the Stafford Act, which (among other things) authorizes Alex Azar, the secretary of Health and Human Services, to:

  • Waive laws to enable telehealth services, for remote doctor visits and hospital checkins.
  • Waive certain federal licensing requirements so doctors from other states can provide services
  • Waive requirements that critical-access hospitals limit the number of beds to 25 or the length of stay of 96 hours.
  • Waive a requirement for a three-day hospital stay before transfer to a nursing home.
  • Allow hospitals to bring additional physicians on board and obtain additional office space.
  • Waive rules that severely restrict hospital care of patients within the hospital itself, ensuring that the emergency capacity can be enhanced.
Readings

None of this legislation has yet been signed into law. Stay tuned.

Miscellaneous

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