Category Archives: health

Religious Exemption – What Religious Exemption?

I keep hearing about people claiming they have a religious objection to (1) wearing a mask and/or (2) getting a COVID vaccination. I have asked the Twitterverse to identify the religion that contains such prohibitions in its doctrine, so far without response.

To be clear, I am not writing this to belittle anyone’s religious faith. I write to raise the highly relevant question in the pandemic of what exactly qualifies as a valid “religious exemption” to masking and/or vaccination.

My thesis is that (1) the sudden discovery during the pandemic of one’s “religious doctrine” is just too convenient and is not a valid claim; (2) to make a valid religious exemption claim, at least two things must be demonstrated: (a) an established discoverable documented statement of clear doctrine opposing the use of masks/vaccinations to prevent/limit disease on the basis of an identified moral/ethical code, and (2) evidence that the claimant has in actual fact practiced the doctrines of the asserted religious for an extended period prior to the pandemic.

Point (1) should not be that hard. Established religions that have such doctrines can be expected to have produced writings/speeches/published practice directives that make these assertions and tie them to some “higher power” ethical controlling principles. I am not aware that such religions exist. Christian Science may be one, though I am not clear that it actually rejects vaccination conceptually. But I am not an expert on religions and there may be others. Waiting.

Point (2) may be much harder for many people. I do not accept that a person may make a valid religious exemption claim if they suddenly discover that their “religion” has some doctrine that may be used as an exemption support, and they then decide to assert it when the reality is that they never followed the doctrine before.

I am astonished and perplexed to learn that the Equal Opportunity Employment Commission has adopted as policy in its Compliance Manual on Religious Discrimination the “principle” that in practice means a religious exemption is in most cases whatever the person says it is, regardless of past practice of adherence or any other considerations. I am not going to elaborate on my judgment of that – if you’re interested, you can find the details here: https://bit.ly/3yUWlIh I do believe it is conceptually and otherwise preposterous.

But that such muddled thinking is part of government policy, at least in one domain, it is small wonder that people are using religious exemption claims to cover their political or merely ignorant resistance to public health measures that have been shown to limit COVID infection spread. The resisters – the anti-makers and anti-vaxxers – are not only dying at much higher rates than the vaccinated, but they are facilitating the “evolution” of the virus into more virulent strains, such as the Delta Variant that is ravaging the country now. Breakthrough infections, with sometimes deadly outcomes, are increasing also. This is virtually certain to result from vast numbers of unvaccinated people walking among us.

My limited understanding of religion is that any legitimate one has an ethical/moral foundation of principles to live by. Whether it’s one deity or many, a set of principles to live by is the central idea. If so, I can’t help wondering what foundation of ethical/moral principles the people who suddenly found religion think they are asserting. Their new “religion” has the effect of exposing themselves and, worse, others to a deadly disease. What principle of ethics/morality justifies that? How do they square their supposed adherence to a set of ethical/moral principles while basically lying about their “sincerely held religious beliefs?”

The Road Not Taken

Kudos to President Biden for taking the hard but right path to restoring the physical and economic health of the country. Shame on those who continue to harp on the ignorant and irrationally resistant themes of “my rights” at the expense of the health and welfare of others. ENOUGH!

We’re at the fork in the road. Nothing short of a full-on frontal attack on the virus is going to get us out of this mess. The great American poet Robert Frost captured the idea in his famous poem, The Road Not Taken:

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;

Then took the other, as just as fair,
And having perhaps the better claim,
Because it was grassy and wanted wear;
Though as for that the passing there
Had worn them really about the same,

And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.

I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I –
I took the one less traveled by,
And that has made all the difference.

Biden has taken the road that many politicians would eschew – the one that will, and has, inevitably create another furor. Rather than the “safe path,” Biden has shown the courage of a leader by doing the right thing rather than the safe or easy route. You can hide from destiny only so long, as this great story reminds us:

A merchant in Baghdad sent his servant to the market.
The servant returned, trembling and frightened. The
servant told the merchant, “I was jostled in the market,
turned around, and saw Death.

“Death made a threatening gesture, and I fled in terror.
May I please borrow your horse? I can leave Baghdad
and ride to Samarra, where Death will not find me.”

The master lent his horse to the servant, who rode away,
to Samarra.

Later the merchant went to the market, and saw Death in
the crowd. “Why did you threaten my servant?” He asked.

Death replied, “I did not threaten your servant. It was
merely that I was surprised to see him here in Baghdad,
for I have an appointment with him tonight in Samarra. 

The choice we face now, that we must face, is between aggressively striking at the virus with all the tools at our disposal or continuing to beg the irrational and uninformed to do the right thing. The former has a chance to stop the pandemic, to take advantage of the astonishing opportunity that the rapid deployment of vaccines has provided. The latter approach has virtually certain terrible consequences: more illness, more death, more permanently damaged bodies.

The reality is that the vaccines are safe and effective. The reality is that the rapid spread of the Delta variant has again overwhelmed the nation’s medical capabilities. COVID infections that are mainly in unvaccinated individuals are denying needed medical services for people with other medical conditions.

I have read some of the insane rantings of primarily right-wing and libertarian “authorities” who claim to have inside knowledge that the virus was released deliberately by agents of the federal government who are cashing in on the vaccines. These people claim that the vaccines contain various poisons, microchips and who knows what else.

It seems that one can always find someone who claims to have the inside track on awful secrets and conspiracies that are constantly being plotted against the rest of humanity. These sometimes include people with “medical credentials,” but often they are former workers in the pharmaceutical industry who are certain that they have inside information to expose the crimes being perpetrated in the name of … whatever. They readily accept the plausibility of conspiracies involving many thousands of people around the globe, no one willing to spill the beans, all in the name of “follow the money” or some other cliché that substitutes for actual thought.

We see this same theme played out in science fiction movies and what I call “caper movies” in which bad guys pull off, at least temporarily, extraordinary schemes to steal, blow up, capture huge sums of money, power over the world, etc. Movies like Air Force One, Die Hard and so many others. I have struggled through a few episodes of a TV series called Eureka that is loaded with utterly implausible, preposterous concepts and science-like doublespeak and gibberish. Some people apparently take such stories to be true. It’s an easy shift from one phantasmagorical storyline to another. Harry Potter is real, flying broomsticks and all.

Reality is more mundane. Two kinds of sickness pervade the country. One is the COVID-19 virus. We’ve learned a lot about it and about how to prevent its worst manifestations. Vaccines, masks, social distancing – that’s pretty much the essence. Study after study confirms the validity of these measures, if, at least, they are applied broadly and consistently.

But it’s damned inconvenient and mighty annoying. COVID has shuttered many businesses, interfered with our fun and instilled a deep-seated fear in many people that they and their loved ones, including children for whom they are responsible, are being exposed to an invisible, highly transmissible and deadly disease. More than 648,000 dead from a disease that our former president assured us would “soon disappear like magic.” Damned annoying.

The other sickness is the resistance to the solution. We know what to do but for many Americans, the disease isn’t the real enemy. The real enemy is the government. Many people appear to believe the government unleashed the virus. Why would the government do that? Did the government want to destroy the economy? Weaken our national defenses? Reduce the population? End civilization? Apparently, many believe so.

Logic and reason have little to do with this mindset. It’s analogous to those who argue that the January 6 insurrection was actually the work of the winners of the election who wanted to stop the certification of their win so that the loser, whom they hate, would be installed as the winner. That make sense to you? If so, take two giant steps to the right.

Along comes the new president who starts an unprecedented and initially successful campaign to deliver life-saving and pandemic-ending medicine into tens of millions of citizens without any meaningful adverse consequences and at no cost. And yes, yes, I understand we can’t prove that ten years from now there won’t be some inexplicable adverse outcome for somebody. There is no scientific or medical reason to suspect that could or would happen, but we can’t predict the future with 100% certainty, so ….

But, you know, in the long run we’re all dead anyway. In the meantime, we can return to “normal life.” All we have to do is get vaccinated and comply with a few annoying but otherwise trivial practices a while longer with a few minimal restrictions on our behavior.

But, no, this is apparently asking too much for millions of Americans. They have their “rights” to protect, regardless of the consequences. “Freedom” is their watchword. Don’t tell me what to do even if it’s for my own good. Sounds like a teenager who thinks he knows everything already and is invulnerable. Or the guy with the boat who insists on going out in the hurricane because he can “handle anything.”

Many of these people end up in the ICU, begging for the vaccine, only to be told by doctors, “it’s too late for you. You should have taken the vaccine earlier. It can’t help you now. Nothing can help you now.”

The solution is in our hands, if only our minds will allow us to see it. I despair of it, after engaging yet another person who on first encounter seemed reasonable and thoughtful, but then insisted “we are being lied to” and that the vaccines contain deadly poisons that make them magnetic. She argued with me that the vaccination program was unnecessary because “natural immunity” was superior protection to the vaccines and lasted longer. How she knows this: read on the internet.

I end where I began. History will record that Joe Biden acted justly and rightly in ordering mandatory vaccination programs, with, in most cases, very generous opt-outs for people with true medical conflicts and genuine religious objections (I don’t know what religion that is, but the exemptions are available).

I find some inspiration in these closing words from Ulysses by Alfred, Lord Tennyson:

Though much is taken, much abides; and though
We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

 

First, Nothing – Then ….

In the beginning, the Earth was a void. Just a roundish rock, really. Lots of volcanoes and other nasty things in the early times. How it came to exist, or more importantly, why it came to exist is a question to which mankind will almost certainly never have the answer. Some people are happy to simply believe that some spirit put it here and then planted humans and all the other biological forms. Whatever.

In my worldview, over an unimaginably long time, evolution took its course. Single-celled “creatures” formed, evolved … you know the story in general outline. That’s more than enough for most of us. We could continue to struggle with the question of how to reconcile those biological facts with the spirit mythology but, for me at least, that’s a waste of time. It turns out that evolution gave humans the ability to believe two or more inconsistent concepts at the same time. We live with the cognitive dissonance, partly by compartmentalizing. You can pray on your knees in your worship space on Sunday to the spirit of your choice (there are many to choose from) and then drive in your high-tech car or search for information on your computer/smart-phone and never give a thought to how both are valid. So be it. It’s who we are.

But on this day, this day of terrible memories, on which many say they are inspired to new hope, we should be reminded of the intersection of inconsistent ideas and what that can mean. Men claiming to be men of faith who believed we were evil incarnate decided to teach us a lesson. They used their “faith” to justify killing almost 3,000 people and had hoped to kill many more.

In truth, the actions they took on 9/11 led to many, many more deaths and much, much more suffering. The words of the prince in Shakespeare’s Romeo & Juliet come to mind:

See what a scourge is laid upon your hate,

That heaven finds means to kill your joys with love!

And I, for winking at your discords, too

Have lost a brace of kinsmen. All are punished.

Evolution produced the cerebral cortex in the human brain. Over millennia, homo sapiens became the Earth’s dominant species. With that came the capacity to change everything. We could do much more than just kill another animal or eat another plant to survive. We were way smarter than that. We learned agriculture, invented tools and machines, built enormous cities, how to fly in machines, how to write and share knowledge.

But there were hard times too. Times when food was scarce. Times when another “group” had access to resources other “groups” wanted. Dominance rather than sharing was apparently critical to survival and thus the prime instinct, to live on, led to competition, fighting, killing. More for me, less for you. I win, you lose. Too bad. At least for today.

Mankind evolved to be the smartest and dumbest creature on the planet. Able to perform miracles of learning and healing and loving, mankind also learned to hate, to fight even when the fight was self-defeating. To change the planet in ways that now make it likely to become uninhabitable. Yet, we continue. The same mistakes. The same hates.

Compartmentalizing.

Love your fellow man. Love nature. Then kill them both if you think it’s necessary to survive … or maybe just to have more. Acquisitiveness – another human trait. Get more stuff because more stuff is better than less stuff, and it shows other humans your superiority. Your dominance in the hierarchy. Humans are very invested in hierarchies. Animals, too, are invested in hierarchies and one might conclude that hierarchies are essential elements of life. But, of course, animals generally don’t just go invade their neighboring animals’ territory.

Is there another way? I don’t know. As a species, humans have the capacity to do the right thing. We’ve created countries, nation-states, wrapped ourselves in “national identity,” “ethnic identity,” “cultural identity,” “sexual identity,” take your pick. So many identities.

Identities help us know who is in our group and it doesn’t take much thought to see how this can be important in the world we have made. But identities are, by their nature, separating. Categorizing. If you’re X and I’m M, we’re in different groups and never the twain ….

So, here we are. Smart and stupid at the same time. Victims of our own intelligence. Suffering now from an unseen enemy, the coronavirus. Most of us are grateful for the science and scientists who brought us a life-saving vaccine. We are grateful for the healthcare workers who put themselves at risk when we are most desperate for their help and comfort. And some of us, a remarkably large number, believe in conspiracies, in dark images of evil people doing insane and immoral things. This group turns away from vaccines and other established public health measures and consumes instead known poisons and unknown other substances, placing their faith in politicians rather than scientists.

Those people walk among us. Many are our friends and neighbors. Many are dying. Yet they persist in believing the unbelievable. Compartmentalizing to prevent being told what to do or to have their “rights” diminished. These people don’t care much about the rest of us, though many often attend religious services and say many prayers. When there is a mass shooting, they send “thoughts and prayers,” but they resist meaningful measures to control violence, and the poverty and desperation that often precedes it, because … they have “rights.”

I am rambling so I will stop soon. I am distraught, I confess, at the idea that years of my inevitably shrinking future life are being stolen by ignorance and deceit. I’ll never get those years back. Neither will the victims of 9/11, the dead and the families and friends of the dead. Never get them back. The permanent silence that awaits us all draws closer by the day, and I wonder why it is that the smartest creatures on the planet continue to be the dumbest. I wonder why we can’t see and correct the self-destructive paths down which our evolutionary history has driven us. We can look back and see history. Other animals can’t. We can look ahead and predict the future. Other animals can’t. We don’t have to wait until the planetary water hole has completely dried up before figuring out a way to stop the loss. What is holding us back from using our intelligence to do what intelligence demands?

Maybe we’re just not intelligent enough. I don’t know.

 

Facing the Abyss – What Should CDC Do Now?

The COVID-19 virus that Trump predicted would “just go away” has now killed More than648,000 Americans out of more than40 million cases. https://wapo.st/38PnK3N

The leading states in new deaths are, unsurprisingly, South Carolina (+36%), Florida (+32%) and Texas (+24%). As cooler weather approaches and more people stay indoors more of the time, the cases/deaths toll can be expected to rise, especially in places with low vaccination rates and persistent refusal to follow national health guidance on masking and distancing. It is what it is.

Predictions now always face opposition from the determined crowd of COVID deniers, anti-maskers and anti-vaxxers who are doing their best to ignore reality and push the country closer to the abyss. This is happening despite the overwhelming evidence that the vaccines are safe and effective and that masking works to reduce infection rates. The excuses offered for rejecting vaccines, masking, etc. are too well known to warrant recital.

The CDC and the leaders of the healthcare community that know the most about all this have, to be sure, made “mistakes” during the runup from early 2020 to now. Those mistakes are an inevitable part of the steep learning curve during a novel virus epidemic, especially when combined with inept and corrupt national leadership promoting bogus cures and inspiring resistance to promising candidates to contain the spread. We are where we are.

The question now is what could be done to change the national narrative. I address this with full awareness that millions of Americans would rather risk a horrible death than be seen to “comply” with national health guidance. There may be nothing we can do about them, but I think there are some things we haven’t tried yet.

Starting with the CDC, setting aside the chaotic approach in the early days when Trump’s political pressure seemed to influence CDC’s public posture, I have been troubled by what I label “website data bloat.” The CDC Data Tracker [https://bit.ly/3hd72A0] is the object of my derision. The site is an extraordinary trove of information for Job and others with much patience, consisting of a multitude of boxes and lists and maps, many of which are redundant or require some study to fully understand what is being shown.

I speculate that the site is the product of turning over the communication function to programmers who believe more is always better and just don’t know where to stop or how to organize information to tell a story rather than “show what we’ve got.” But, whatever the root cause, the site, for all its robustness, does not communicate the story as dramatically as it could. And if anything cries out for dramatic storytelling, it is the continued, and avoidable, rampage of COVID through America.

It should come as no surprise at this late date that, having been blunted in impact among most older people (who, generally, have a higher percentage of vaccinated individuals than other cohorts), is turning its mindless “attention” toward other groups, including children, many of whom are too young to be vaccinated according to the latest protocols.

In my view, parents of young children who refuse vaccination should be prosecuted for child endangerment, but we know that’s not going to happen. We can, however, more effectively communicate the danger.

This is how. It will require a fundamental change in the way the government does things.

Instead of presenting a vast array of charts/graphs/pathways to still more charts/graphs and offering data in various formats (gross, per capita, per this and that), focus on one thing: the message. This is a situation in which the data should be used not just to inform but to persuade. To teach. To affect.

So, what to do?

First, move all the “just data” charts/graphs to the back of the site with a simple index of what’s there.

Second, in the front, using graphs backed by data, show the key facts in a direct comparison of, for example, deaths of vaccinated versus deaths of unvaccinated people over time. Include data on adverse effects of vaccinations to the extent it exists.

Third, add to the data on cases and deaths, the data on known cases of adverse health impacts (heart, lung, brain, etc.) for COVID “survivors,” information that has largely been ignored.

Fourth, stop focusing on the number of people with one shot. We know that for the main two vaccines, two shots are essential and that’s the key number to show. Focusing on one shot is misleading.

Fifth, show the damn videos!

A wealth of videos exists showing, especially, the end stage of COVID experience in hospital ICUs: the ones where the unvaccinated, wired and tubed beyond recognition, are facing intubation and medically induced comas and are begging doctors and nurses for vaccination and “do anything to save my life.” Show those videos in TV ads in lieu of the bland “please do the right thing” messages now in use. Show the healthcare providers, dressed like aliens from Planet X, saying, “I’m sorry but it’s too late. Vaccines can’t help you now.”

 Some people will see this as unacceptably harsh. To them I say, if you don’t like it, don’t watch. But if done properly (get some experts in this kind of dramatic communication on the task), this stands some chance of jolting resisters into doing the intelligent thing and rushing to get vaccinated.

Make the message simple and clear and unmistakable – if you don’t get vaccinated, this is what may await you. Or your family. Your children. Do it now.

We know from experience that presenting the public with vast quantities of unconsumable statistics is not achieving the level of success we need to stop the pandemic. It is time to pull out all the stops. Stop acting like the government and act like you’re trying to sell something: public health. Survival.

Do it now. We’re almost out of time. The abyss is nearer by the day. It doesn’t have to be this way. Act like it’s the emergency it really is. Just do it.

Texas, the Handmaid State

Texas, through its legislature, has now made unmistakably clear that women are not equal to men. It is no exaggeration to say that Texas has moved from being the Lone Star State to being the Handmaid State. The reference, for the small number of people who don’t know, is to The Handmaid’s Tale, the dystopian novel by Margaret Atwood in which women in a theocratic authoritarian society are forced into what amounts to sexual slavery for the benefit of the men who run the country.

The headlines about the adoption of SB 8 by Texas are still fresh and resonating around the country and the world. The U.S. Supreme Court has refused to enjoin the enforcement of the law while its constitutionality is considered on the merits. Thus, Texas, proud Texas, has become the leader in subordination of women. Through the back door in Texas, a Republican (53%)/male (73%)/aged (67% over 49/14% over 69)-dominated state legislature has introduced a version of Sharia Law to the United States.

There are, of course, significant reasons to believe that SB 8 is unconstitutional under both the Texas Constitution and the U.S. Constitution. Whether Texas likes it or not, the established federal constitutional principles of the Fourteenth Amendment “equal protection of the laws” and “due process” still apply to the states:

No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

The dissenting opinions in the Supreme Court’s astonishing back-handed approval of the Texas maneuver say as much. If the Court’s current view of the law stands, states will be encouraged to adopt similar laws on other subjects, insulating such laws from judicial review. That, as with the current case, is simply unsustainable and would undermine the separation of powers, among other things.

It’s important to understand that Texas thinks it’s been very clever in crafting this statute so that it will escape meaningful judicial review on the merits. It had the audacity to represent to the Supreme Court that it was entirely realistic to believe that the entire elaborate text of SB 8 would have been enacted but that no one would take up the opportunity to earn a quick $10,000 (the minimum statutory damages). In perhaps the most ridiculous legal position I have seen in years, the Texas Attorney General told the Supreme Court, “This Court cannot expunge the law itself. Rather, it can enjoin only enforcement of the law.” He argued since government officials “explicitly do not enforce the law,” the abortion providers “have not shown that they will be personally harmed by a bill that may never be enforced against them by anyone.”

Thus, Texas would have us believe that it passed a law giving private citizens standing to bring lawsuits against other citizens with a minimum payoff of $10,000 plus attorneys’ fees and costs, with zero risk of having to pay fees & costs for the defendant if the suit were judged frivolous, but no one will bother to file suit under the law. That’s a whopper even by Texas standard.

There are a multitude of serious substantive problems with SB 8. Here are just a few of the big ones:

    • The medical premise for the law is not scientifically accurate;
    • The essence of the statute is to confer “standing” on the entire civilian population of Texas to bring actions to sue physicians who perform abortions in conflict with the many non-medical details of the statutory scheme and to sue any person or entity that aids and abets the violation, with the assured award of not-less-than $10,000 in damages for each successful case brought, plus reimbursement of attorneys’ fees and costs incurred;
    • Plaintiffs may not be assessed attorney’s fee and costs even if the suit is thrown out because the statute is ruled unconstitutional, so the millions of potential plaintiffs incur no risk in bringing such suits;
    • Being an aider or abettor is determined without regard to the actor’s knowledge of the legality of the procedure;
    • Relying on some unspecified mind meld, the law authorizes suits against aiders/abettors who merely “intend” to assist forbidden abortions;
    • The clear intent of the legislation is to stack the legal deck against people who would help a woman with an abortion and thereby prevent abortions from being performed in Texas;
    • The statute in the words of Justice Sotomayor, “a breathtaking act of defiance—of the Constitution, of this Court’s precedents, and of the rights of women seeking abortions throughout Texas,” dissenting from the Court’s decision to allow the Texas law to be effective Sept. 1 without appellate review;
    • The Supreme Court’s decision to allow SB 8 to become effective was based on a complete distortion of the holding in California v. Texas, a 2021 case addressing whether injunctive relief could be had against a statute whose key operative provision had been removed by Congress. The Court there said, “to find standing here to attack an unenforceable statutory provision would allow a federal court to issue what would amount to “an advisory opinion without the possibility of any judicial relief.” That is plainly not the case with the Texas statute which is not only enforceable but is drafted precisely to induce massive enforcement by citizen bounty-hunters. The fact that enforcement may occur at the hands of private persons inspired and enabled by a state law does not affect the impact of the law on its targets. Further, the cause of action created by the statute is fully effective and ready to be used, totally different than the tax provision removed from the law at issue in California v Texas.
    • Texas devoted much legislative language trying to (a) prevent federal court review of the statute and (b) control the nature and effect of the review. The very obvious goal was to have the law continue to apply to everyone who had not yet been sued, even if judicial review held the law facially unconstitutional in one case. Texas-sized hubris here, trying to tell the federal courts what they can and can’t do. Texas has decided to simply ignore the Supremacy Clause of the Constitution.

Justice Sotomayor’s eloquent dissent in Whole Woman’s Health v Austin Reeve Jackson, Judge, joined by Justices Breyer and Kagan, said everything that should have been needed to stop the law in its tracks:

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.

It cannot be the case that a State can evade federal judicial scrutiny by outsourcing the enforcement of unconstitutional laws to its citizenry.

… the Court has re- warded the State’s effort to delay federal review of a plainly unconstitutional statute, enacted in disregard of the Court’s precedents, through procedural entanglements of the State’s own creation

I am going to go out on a limb here and predict that after further briefing and argument, a majority on the Supreme Court will find its way back to reality and reason by rejecting the Texas law on multiple constitutional grounds . Meanwhile, the women of Texas will have to live with the white hoods of handmaidens under the thumb of their totalitarian masters.

*****

For those with the interest and fortitude to understand the details of this astounding act of legislative hubris, here is an unfortunately long explanation of exactly what SB 8 purports to do.

The key scientific idea on which the law is based is that the presence of a fetal heartbeat “has become a key medical predictor that an unborn child will reach live birth.” Texas tries to tie this idea to a further finding that “the pregnant woman has a compelling interest in knowing the likelihood of her unborn child surviving to full-term birth based on the presence of cardiac activity.” Based on my limited review, those “findings” are of limited relevance, since there are other significant predictors of ultimate viability and nothing in the law specifically addresses the communication of this specific information to the pregnant woman considering an abortion.

Instead, absent a “medical emergency,” the statute bans abortions after the mere detection of a fetal heartbeat and nothing more. Adding to the pretextual nature of this, the statute conveniently fails to define “medical emergency,” thereby creating a condition in which both the physician and the pregnant woman can never be certain that later litigation will not reject the physician’s determination and expose the physician to an intolerable financial risk.

It’s important to understand that the statute does not directly expose the pregnant woman to lawsuits – the targets of the legislative scheme are the doctors, clinics and anyone else who,

Knowingly engages in conduct that aids and abets the performance or inducement of an [prohibited] abortion, including paying for or reimbursing the costs of an [prohibited] abortion through insurance or otherwise … regardless of whether the person knew or should have known that the abortion would be performed or induced in violation of this chapter….

The sweep of this language encompasses every imaginable form of support for the abortion process and is plainly designed to intimidate medical personnel, insurance companies as well as friends and family of the pregnant woman.

But that’s not all. The statute authorizes civil damage suits against any person who “intends to engage” in forbidden aiding and abetting of a prohibited abortion. No, I’m not making this up. We are in the land of science fiction, popularized by the movie Minority Report in which a special police force is authorized to arrest murderers before they commit their crimes. In Texas’ case, the “offense” is civil, not criminal but the penalties are large enough to deal a death blow to the finances of many people (minimum statutory damages of $10,000 plus costs and attorneys’ fees).

The damage provisions apply to every forbidden abortion the defendant performed or aided/abetted. If multiple parties are sued for aiding and abetting a single abortion, it appears the plaintiff stands to collect the minimum damages against each one.

Under the special statute of limitations applied by Texas, the specter of being sued will hang over potential aiders/abettors for six years.

The drafters anticipated that there might be other defenses presented to courts in the civil cases and have preemptively eliminated them. Thus, the following are rejected as possible defenses: a good faith belief in the unconstitutional nature of the law, reliance on court decisions that are later overruled or reliance on federal court decisions that are “not binding” on the state court where suit is brought.

These provisions are designed to prevent judicial review by federal courts of the state’s statutory law as written and as applied. Texas has, apparently seceded from the U.S. Constitution, or at least thinks it has.

In a cynical twist, Texas added a provision that seems at first look to mitigate the intimidation created by the rest of the statute: it provided an “affirmative defense” for those sued under the statute if (1) the defendant conducts a “reasonable investigation” and (2) then “reasonably believes” that the abortion physician “had complied” or “would comply” or “will comply” with the statute. I say this is cynical because the Texas legislators may be presumed to understand that that whatever a “reasonable investigation” means, an aider/abettor trying to conduct such an investigation will almost certainly be stymied by the privacy provisions of HIPAA (the federal Health Insurance Portability and Accountability Act of 1996), not to mention the natural distaste any doctor will have to being embroiled in a lawsuit. The burden of proving an “affirmative defense” is on the person asserting it, so this looks like a Texas head-fake.

Not content to stack the deck against women, their physicians and their families and friends, Texas has added a provision barring absolutely the award of attorneys’ fees and costs against a defendant. This means that the most egregious unfounded lawsuits brought by damage-hunting lawyers and others can be brought with impunity. Which is, of course, exactly what Texas wants – a legal unchallengeable in terrorem regime that will force Texas women to take significant health risks and/or incur staggering expenses to get an abortion regardless of the reason or need. The statute also enables bounty-hunting plaintiffs to bring suits where they live against defendants who live across the state, with the proviso that venue can only be changed if the plaintiff agrees.

The statute also immunizes the state of Texas and its officers from any legal challenge to the statute and further provides that if a court finds the statute unconstitutional in its application to one person, the statute may still be enforced against everyone else. This is an obvious attempt to deprive the federal courts of jurisdiction to adjudicate the constitutionality of the statute as written and not just “as applied.” The courts of Texas may stand for such a violation of the separation of powers, but it is hard to imagine that the federal courts will accept it.

Perhaps the most extraordinary aspect of SB 8 is the provision that purports to instruct the courts in the nature and scope of their decisions and in the meaning of “unconstitutional:”

No court may decline to enforce the severability requirements … on the ground that severance would rewrite the statute or involve the court in legislative or lawmaking activity. A court that declines to enforce or enjoins a state official from enforcing a statutory provision does not rewrite a statute, as the statute continues to contain the same words as before the court’s decision. A Judicial injunction or declaration of unconstitutionality: (1) is nothing more than an edict prohibiting enforcement that may subsequently be vacated by a later court if that court has a different understanding of the requirements of the Texas Constitution or United States Constitution.

This is Texas-size hubris that banks on the willingness of the Supreme Court of the United States to permit a state to decide for itself the nature, scope and effect of the Court’s decisions as regards the U.S. Constitution. Maybe the current Court will buy that nonsense, but I will be surprised as it would seem to overturn the very foundations of the federal system and the separation of powers, among other things.

Texas gives prevailing parties in any constitutional or other challenge to the abortion law three years to file for award of attorneys’ fees and costs. This opportunity applies even if the plaintiff in such suit wins the case on grounds that the severability provisions are unconstitutional or preempted by federal law!

It appears that the desperation of the Texas legislators to insulate SB 8 from federal court review has led them to a strange and untenable place. The statute contains a confused and obtuse section that appears to say that even if a court finds the statute facially unconstitutional, the statute shall still be severed, and the “unconstitutional applications” shall remain enforceable. Further, in such case the statute “shall be interpreted as if containing language limited the statute’s application to the persons, group of persons, or circumstances for which the statute’s application will not violate the United States Constitution and Texas Constitution.

That seems like an overt invitation for the courts to rewrite the legislation to help the Texas legislature save it. There may be precedent for such an astonishing approach, but I am not aware of it. That is, I believe, precisely what courts don’t, and should not, undertake. If the legislature writes an unconstitutional statute, it is the responsibility of the legislature to rewrite the law to repair the damage, unless some form of severance is possible that satisfies the court that it is not in fact just rewriting the law.

The legislation forces the physician to try to talk the woman out of going through with an abortion. This occurs through a series of compulsory disclosures and medical advice that the law declares, ipso facto, to be medically accurate and sound without any specific knowledge of the health condition of the woman in question.

The law addresses the issue of rape/incest and developmental abnormalities by exempting the woman from being forced to hear an explanation of the sonogram images, but rape/incest/developmental abnormalities, and, for that matter, threats to the woman’s life, are not otherwise treated as relevant to the process by which the woman gives consent to the abortion.

Finally, note that the Texas Constitution includes the following:

Sec. 3. EQUAL RIGHTS. All free men, when they form a social compact, have equal rights, and no man, or set of men, is entitled to exclusive separate public emoluments, or privileges, but in consideration of public services.

But it also includes this:

Sec. 3a. EQUALITY UNDER THE LAW. Equality under the law shall not be denied or abridged because of sex, race, color, creed, or national origin. This amendment is self‑operative. (Added Nov. 7, 1972.)

But also this:

Sec. 32. MARRIAGE. (a) Marriage in this state shall consist only of the union of one man and one woman.(b) This state or a political subdivision of this state may not create or recognize any legal status identical or similar to marriage. (Added Nov. 8, 2005.)

But there’s also this:

ARTICLE II

THE POWERS OF GOVERNMENT

Sec. 1. SEPARATION OF POWERS OF GOVERNMENT AMONG THREEDEPARTMENTS. The powers of the Government of the State of Texas shall be divided into three distinct departments, each of which shall be confided to a separate body of magistracy, to wit: Those which are Legislative to one; those which are Executive to another, and those which are Judicial to another; and no person, or collection of persons, being of one of these departments, shall exercise any power properly attached to either of the others, except in the instances herein expressly permitted.

I predict the ACLU and other entities that are going to challenge SB 8 are going to have a field day with these contradictory provisions, some of which are inconsistent with existing Supreme Court precedent and, of course, the U.S. Constitution.

American Ignorance is Killing Us

Dr. Anita Sircar, an infectious disease physician and clinical instructor of health sciences at the UCLA School of Medicine, has published an opinion piece in the LA Times, “As a doctor in a COVID unit, I’m running out of compassion for the unvaccinated.” https://lat.ms/2W9yrLp

I’m with Dr. Sircar.

Conditions continue to deteriorate in Florida and other states of the former Confederate States of America. The Governor of Florida continues to act like Donald Trump – basically taking the position that this virus is no more than a common cold. He preaches that some vague idea of “freedom” is more important than stopping the worst pandemic in modern history that is now, once again, ravaging the country. #DeathSantis, as he is often called on Twitter, claims that parents should be able to make all decisions regarding the health of their children, just because they’re parents, without regard to their knowledge or the impact their decisions may have on others.

Florida seems to have adopted as its unofficial motto: “my body, my choice,” a favorite mantra of the anti-vaccination mob. Ironically, Texas simultaneously has placed into law SB8 that effectively bans abortions regardless of rape, incest and so on. So much for “my body, my choice.” But that’s for another time.

Here I want to address the widespread ignorance that has left the United States and much of the world in a position of failing to stop a deadly viral pandemic even though the means to do so is readily available and free. I readily confess up front that at my late stage in life I am profoundly resentful of the arrogant and ignorant decisions being made by people that have effectively stolen two years of my life and threaten to continue doing so indefinitely.

Dr. Sircar’s op-ed tells a gruesome story of a patient under age 50, normally in good health (just some mild blood pressure issues). He tested positive 10 days before, began coughing with severe fatigue 8 days before and, after doctor-prescribed antibiotics did nothing, turned to … hydroxychloroquine, the drug promoted by Donald Trump and multiple medical quacks despite compelling evidence of its ineffectiveness against COVID. That, of course, also failed. As his health continued to decline, he was, Dr. Sircar reports, a “shell of his former self.” By the time he arrived at the clinic, treatment with monoclonal antibodies also failed.

He finally ended up in the ER with dangerously low oxygen levels, exceedingly high inflammatory markers and patchy areas of infection all over his lungs. Nothing had helped. He was getting worse. He could not breathe. His wife and two young children were at home, all infected with COVID. He and his wife had decided not to get vaccinated. [emphasis added]

Dr. Sircar goes on,

Last year, a case like this would have flattened me. I would have wrestled with the sadness and how unfair life was. Battled with the angst of how unlucky he was. This year, I struggled to find sympathy. It was August 2021, not 2020. The vaccine had been widely available for months in the U.S., free to anyone who wanted it, even offered in drugstores and supermarkets. Cutting-edge, revolutionary, mind-blowing, lifesaving vaccines were available where people shopped for groceries, and they still didn’t want them.

Outside his hospital door, I took a deep breath — battening down my anger and frustration — and went in. I had been working the COVID units for 17 months straight, all day, every day. I had cared for hundreds of COVID patients. We all had, without being able to take breaks long enough to help us recover from this unending ordeal. Compassion fatigue was setting in. For those of us who hadn’t left after the hardest year of our professional lives, even hope was now in short supply.

The man claimed not to be anti-vaxxer.

I was just waiting for the FDA to approve the vaccine first. I didn’t want to take anything experimental. I didn’t want to be the government’s guinea pig, and I don’t trust that it’s safe.

Dr. Sircar, notes that,

The only proven lifesaver we’ve had in this pandemic is a vaccine that many people don’t want. A vaccine we give away to other countries because supply overwhelms demand in the U.S. A vaccine people in other countries stand in line for hours to receive, if they can get it at all.

Dr. Sircar turned to remdesivir, explained its status among approved treatments with long-term side-effects unknown:

“Do you still want me to give it to you?”

“Yes” he responded, “Whatever it takes to save my life.”

It did not work.

 Dr. Sircar concludes the story:

My patient died nine days later from a fatal stroke. We, the care team, reconciled this loss by telling ourselves: He made a personal choice not to get vaccinated, not to protect himself or his family. We did everything we could with what we had to save him. This year, this tragedy, this unnecessary, entirely preventable loss, was on him.

She is exactly right about that. The op-ed goes on to lay out the likely outcomes for the unvaccinated going forward. If you, or members of your family, are like the patient described here, read the full story at the link above.

We are headed swiftly back into the abyss of a raging out-of-control pandemic, widespread deaths and long-term impairments, loss of businesses, collapse of the economy, failure of the education system and more. Many parts of the world are declining again to admit Americans. The travel industry, among many others, is reeling as business disappears.

The CDC has just issued another warning about Labor Day travel, asking the unvaccinated not to travel this weekend and suggesting that even vaccinated individuals carefully reassess the risks of travel.

Here are the reported facts, per CNN’s summary [https://cnn.it/3kIudDh]:

US is surpassing an average of 160,000 new Covid-19 cases a day

38.6% of eligible people (everyone 12 or older) are not yet fully vaccinated

Hospitalization rates for unvaccinated are 16 times higher than for vaccinated people

180 new COVID cases were traced to a multi-night church camp and a men’s conference, neither of which complied with CDC recommendations

More than 200,000 kids test positive in a week – infection rates in children are increasing exponentially

Less than half of children 12 to 15 are vaccinated with even one dose

More than 200,000 children tested positive for Covid-19 in the last week, a five-fold increase from a month ago, with corresponding increases in hospitalizations

Between August 20 and 26, an average of 330 children were admitted to hospitals every day with Covid-19 — highest rate of new Covid-19 hospitalizations among children in more than a year

Hospitals and staff are again being overwhelmed and some are running out of oxygen

If the virus had a personality, it would be laughing out loud at the folly of humans who are so able and willing to ignore reality in favor of conspiracy theories and myths perpetrated by other humans who have no credentials or other authenticity as authorities on health decisions. What else is there to say?

Well, here’s something. A respiratory therapist, Karen Gallardo, described the Seven Stages of Severe COVID in a Los Angeles Times article at https://lat.ms/3yzlGan. It’s not pretty. Heavily summarized, they look like this:

Stage 1: Debilitating breathing problems force you to the ER

Stage 2: You’re drowning. Transfer to ICU

Stage 3: Breathing is worse. You are put on a “positive pressure ventilator” velcroed tightly to your face

Stage 4: In preparation for full intubation, from which most patients never recover, you are advised to call your loved ones, likely for the last time. Then,

You are sedated and paralyzed, fed through a feeding tube, hooked to a Foley catheter and a rectal tube. We turn your limp body regularly, so you don’t develop pressure ulcers — bed sores. We bathe you and keep you clean. We flip you onto your stomach to allow for better oxygenation. We will try experimental therapeutics.

Stage 5: If you’re not one of the few Stage 4 survivors, you may need special machine that bypasses your lungs and oxygenates your blood, if your hospital has one.

Stage 6 (Ready?):

The pressure required to open your lungs is so high that air can leak into your chest cavity, so we insert tubes to clear it out. Your kidneys fail to filter the byproducts from the drugs we continuously give you. Despite diuretics, your entire body swells from fluid retention, and you require dialysis to help with your renal function.

The long hospital stay and your depressed immune system make you susceptible to infections. A chest X-ray shows fluid accumulating in your lung sacs. A blood clot may show up, too. We can’t prevent these complications at this point; we treat them as they present.

If your blood pressure drops critically, we will administer vasopressors to bring it up, but your heart may stop anyway. After several rounds of CPR, we’ll get your pulse and circulation back. But soon, your family will need to make a difficult decision.

Stage 7 (End Game):

After several meetings with the palliative care team, your family decides to withdraw care. We extubate you, turning off the breathing machinery. We set up a final FaceTime call with your loved ones. As we work in your room, we hear crying and loving goodbyes. We cry, too, and we hold your hand until your last natural breath.

The End

Fix Stupid

Position of Republican Governors who fight to prevent implementation of strong, sensible public health measures recommended by federal and other health experts:

WAPO Undermines Public Health Confidence – Again

I understand that the Washington Post and other so-called mainstream media think they have some obligation to report both (or many) sides to news matters of public interest. A lot is happening all the time so there is the difficult problem of triage – what do you choose to report and how much coverage do you give the chosen subjects?

In the latest problematic example, I am mystified as to the thinking behind the choice to devote 1,930 words to an item with the click-bait headline, “Biden team tries to get ahead of the virus — and maybe the science — with decision on booster shots.” https://wapo.st/2UChWHg The byline for this piece shows four names, all senior writers for WAPO with some degree of specialization in health policy.

To make the point of why this type of “journalism,” if that’s what it is, is so concerning, I am going to analyze the piece in some detail. Bear with me if you can.

The opening lines state the subject matter and point of view of the article:

President Biden vowed to “follow the science” in fighting the coronavirus pandemic, but some scientists say his decision to recommend widespread coronavirus vaccine booster shots relies on incomplete data and will put pressure on regulators yet to approve the plan.

You understand right off that the message is that the President has not lived up to his word, that “some scientists” think he’s made a major public health mistake in the fight against COVID-19 and is mixing politics with health science to get inappropriate approval from government health experts.

To support that thesis, WAPO quotes Vincent Racaniello, a professor of microbiology and immunology at Columbia University that the data thus far do not support the need for a COVID booster shot. I checked out Prof. Racanciello. He is a major figure in virus science. He sided with Dr. Fauci in his fight with Moron Sen. Rand Paul about whether Chinese researchers were doing “gain of function” research with bats that led to COVID-19. He is not, therefore, one of those random “doctors” who are dredged up by right-wing media to contradict whatever the CDC and other important health authorities have said.

Prof. Racaniello has tweeted his position on the sustaining power of COVID vaccines thus:

Science tells us that most Americans do not need a COVID-19 vaccine booster 1. With time, vaccine-induced antibodies wane but the same happens with all vaccines and infections. 2. It is not correct to conclude that COVID vaccine efficiency is waning. What is going down is protection against infection. Most human vaccines do not prevent infection. Results of studies have shown that despite waning antibody levels, most fully vaccinated people are protected against severe disease, hospitalization, and death. What we need to do is get everyone fully vaccinated!

The delta variant is NOT in itself causing cases to surge in the US. That is being driven by unvaccinated people, failure to mask, and a return to physical interactions. ANY SARS-CoV-2 variant would behave in the same way.

Those messages were met with considerable hostility by many Twitterfolk – this is a sensitive subject in which nuances of language can have huge emotional effects.

Returning then to WAPO, the article noted that,

While Biden acknowledged the plan was “pending approval” from the Food and Drug Administration and experts who advise the Centers for Disease Control and Prevention, the president mostly portrayed it as a done deal, saying that tens of millions of booster shots would become available the week of Sept. 20.

Thus, while the President expressly acknowledged that health policymakers’ approval was needed, WAPO’s writers assert that the President is dissembling. But then the article notes that he was not dissembling:

The president’s top science and medical advisers — including senior CDC and FDA officials — concluded last weekend that widespread booster shots were necessary, drawing on an array of data from the United States and Israel that suggested immunity from a two-dose regimen of coronavirus vaccine declined over time and that greater protection might be needed against the highly contagious delta variant.

Based on the rest of the article and on many other sources, the “dispute,” if there is one, is about whether to announce the booster program ahead of the surging infection numbers or wait until “more data” is available. Biden’s approach is supported by multiple health experts, including

  • Francis Collins, director of the National Institutes for Health, and
  • Claire Hannan, executive director of the Association of Immunization Managers

But, WAPO goes on, “a number of outside experts faulted Biden’s timing and said the White House was acting prematurely based on the latest vaccination data.”

For instance, the administration focused on multiple research studies showing that vaccine effectiveness against mild to moderate illness wanes over time, while boosters ramp up antibodies tenfold or more. Most, although not all, of the recent data shows the vaccines continue to provide robust protection against severe disease….

Many prominent figures in the scientific and medical communities said that’s the key measure of vaccine success. The vaccines’ main purpose is not to prevent infection, so much as to keep people from getting severely ill or dying, they note, and recent concerns about breakthrough coronavirus infections have been overblown….

It may be that WAPO and the White House may be talking about two different things. As a matter of national emergency planning, the President is concerned about waiting until the resurgent virus (Delta Variant and possibly others) is even more widespread before beginning to boost resistance. The “dissenters” are making technical points about what the data shows right now about the continued strength of the vaccine.

“The metric that matters is the protection against severe disease, hospitalization and death among people vaccinated,” said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia. He said the booster decision was premature and potentially misleading. “It tends to portray that we’ve lost confidence in the ability of this vaccine to prevent severe infection. And I don’t think that’s the case,” he said.

Given that case counts are surging in multiple states, vaccinations are lagging, and health resources are being overrun yet again in multiple states, why is this “conflict” being written about as if the President were being dishonest or has, like his predecessor, attempted to politicize national health policy?

WAPO cites efforts by Dr. Fauci and others to reassure health policy staff but then “some experts said the White House was backtracking on its pledge to allow regulators to shape coronavirus policy,” citing Biden/Harris’s criticism of Trump for “publicly pressuring regulators to approve the first coronavirus vaccines.”

Does WAPO really believe that disagreement over whether it’s timely to talk about a booster program is the same as Trump’s declaration that the virus is “their new hoax” or whether hydroxychloroquine is a real treatment for COVID?

WAPO keeps doing the dance, first stating why the White House wants to get ahead of the virus, then citing more people who think it should wait for more data and trying to equate the push for a booster program to the “pressure the Trump administration exerted on scientific agencies, like a threat to fire then-FDA Commissioner Stephen Hahn if he didn’t move quickly to approve the Pfizer-BioNTech coronavirus vaccine.”

I can just imagine the reaction if a booster program becomes critical – “why didn’t the White House plan ahead and get on top of this instead of waiting until the catastrophe was obvious?”

WAPO continues both-sidesing this for many paragraphs, almost as if the authors were told they had to produce a certain volume of words. Granted, both sides are covered, but is this just a question of two honest differences of opinion when the political machinations of the prior administration are repeatedly injected into the discussion? Is WAPO really unaware of the differences between the Trump administration’s denial of the existence of a pandemic, and all that followed, versus the Biden administration’s effort to plan ahead and prepare for worst-case scenarios which are already present in places like Florida, Tennessee, Texas and Louisiana?

I have argued before that the main-stream press needs to be more cognizant of the effects of the words they use and how those words can be misused by people whose goal is not to protect the public but to score political points. WAPO seems intent upon feeding the misinformation media rather than focusing on critical issues of what is truth and what is not.

Norwegian Cruise Line Fights the Right Fight Against Ignorance

The case is Norwegian Cruise Line Holdings, Ltd., et al. Plaintiffs, vs. Scott Rivkees, M.D., Defendant, in the United States District Court for the Southern District of Florida. The opinion was written by U.S. District Court Judge Kathleen Williams acting on the Plaintiff’s Motion for Preliminary Injunction. The defendant is the Surgeon General of Florida and the head of the Florida Department of Health.

The lawsuit was brought to enable Norwegian to protect its customers to the maximum extent possible in the face of directives from the Republican “small government” Governor of Florida who has forbidden cruise lines operating there on international itineraries to require use of face masks, vaccinations and proof of vaccinations.

Judge Williams’ thorough and carefully crafted 59-page opinion grants the plaintiff’s motion. This allows Norwegian to establish its own COVID health protocols, including requiring proof of vaccination as a condition for cruising. The opinion skewers the defense for its failure to present evidence on key issues. While it’s always tempting to blame this on the lawyers, the reality in this case is that the evidence for the defense simply doesn’t exist. The state’s attempt to prevent cruise lines from adopting safe health standards is a political maneuver, not a rational health policy decision with demonstrable roots in local health needs or medical science.

Judge Williams’ opinion should stand up well in the appeal that Governor DeSantis, known on Twitter as #DeathSantis, has announced he will file. DeSantis’ statement about the case included this gem, “A prohibition on vaccine passports does not even implicate, let alone violate, anyone’s speech rights, and it furthers the substantial, local interest of preventing discrimination among customers based on private health information.”

That suggests the good governor did not read the District Judge’s opinion or lacks understanding of the legal principles involved. His lack of awareness extends to the growing public support for “vaccine passports,” and he is also unaware of federal ventilator resources sent to his state by the federal government to help relieve the crisis caused by the Delta Variant and his refusal to recognize the challenges it poses. Delta threatens to overwhelm the health facilities of multiple, mainly southern, states, including Florida, that have largely ignored the danger still posed by COVID-19. Florida’s governor is earning his moniker as #DeathSantis every day.

Norwegian Cruise Line is on the right side of health science, health policy and rational business behavior. Kudos to NCL’s management for standing up to the Florida Governor’s rejection of all of those as he plays to his right-wing political audience, the same base that thrives on adoration of Donald Trump (you remember him, speaking about Democrats: “the virus is their new hoax.”)

In an op-ed in TravelMarketReport, https://bit.ly/2VKcfri, way back in October 2020, long before anyone had heard of the Delta Variant, I argued that the path to travel industry recovery required restoration of consumer confidence but that the path then in play was more chaos than order. I suggested an approach that, in those troubled times, I thought might work:

I suggest that the atomization of the industry’s approach must be replaced with an across-the-board cooperative regime of joint decision-making to which individual firms commit to total compliance for a significant period into the future. For example, and as a great beginning, the cruise industry players (of which there are relatively few independent entities) have undertaken a collective effort to establish firm rules about how ships will be sanitized, how masking and social distancing will be applied and so on. Obviously, the science behind this is still evolving, but much is already known about how to manage indoor environments. I believe that the new rules should be vetted with a representative sample of cruise travelers to evaluate whether the rules are understandable, practical and reassuring. The likely outcome is not a return to full-on unlimited cruising and many economic challenges will remain. The concept is not a cure-all but an attempt to establish a common and trustable arrangement that will permit business to resume on some scale.

Call me a dreamer if you like. We are not close to what I had envisioned. Nowhere is this clearer than in the battle Norwegian Cruise Line is fighting, alone, with Florida. Downloadable CDC data for Florida, from August 6, paints a grim picture. https://bit.ly/3lU94rX This will not deter Florida’s governor from resisting science and common sense as he continues his efforts to stop the cruise lines from using the best defenses available to control the virus and resume safe cruising.

The chaos will thus continue for a while longer. I am confident Norwegian Cruise Line will continue the fight and hopefully will succeed, however long it takes.

 

 

 

Lost in Space

I am harping a bit about the failure of the mainstream media to recognize the peril in which the country, and the MSM itself, finds itself. This failure is reflected in numerous ways, the latest being the decision of favorite New York Times to publish on page 21 of Sunday’s edition a story about the astonishing direct efforts by Donald Trump to suborn the Department of Justice to support his unfounded claims that the 2020 election was invalidated by fraud. Not only is Trump guilty of this effort to subvert the election, but compelling evidence has been produced that he had secured the support and active cooperation of Jeffrey Clark, the acting head of the Justice Department’s civil division. https://nyti.ms/3iy3Gsw

This story is related to the on-going attempts of Trump and his enablers in Congress and the Republican-controlled states to overturn the lawful election of Joe Biden for President. That is the most important story of our time, right up there with the pandemic. If Trump had succeeded (or succeeds in the future), the democratic republic known as the United States of America would be finished. Seriously, is there a more important story than that?

As usual, the key players at the Justice Department have gone dark, refusing to comment substantively. But the testimony of Jeffrey Rosen, who was Acting Attorney General at the time, indicates that despite being directed otherwise, Clark continued having private conversations with Trump while Trump was still president. Clark even “drafted a letter that he asked Mr. Rosen to send to Georgia state legislators, wrongly asserting that they should void Mr. Biden’s victory because the Justice Department was investigating accusations of voter fraud in the state.” The proposal was rejected but the apparent fact remains that Clark engaged in multiple violations of DOJ policy, and possibly federal law, in working collaboratively with Trump to overturn the election.

Clark has a spectacular resume. https://bit.ly/2VG7yi4 That fact does not mean that he was incapable of the acts to which Rosen, with a similar resume (https://bit.ly/37vlgqu), has testified. The story mentioned almost in passing the suggestion by one of Trump’s lawyers that Trump “might take some undisclosed legal action if congressional investigators sought “privileged information.” That is, of course, a huge issue, but privilege (executive or attorney-client or whatever) cannot be used to coverup conversations about the commission or attempt at commission of a crime.

I well understand that there are many other big stories afoot at the same time. The Times front page this morning covers some of those: the Cuomo scandal, Republicans supporting infrastructure legislation, problems attributable to children being denied in-classroom learning, restaurant struggles in New York City and, of course, the Olympics. But page 21 for the inside story of attempts to defeat the lawful transfer of power?

Meanwhile, my other favorite publication, the Washington Post, has once again elected (it clearly had a choice) to publish an op-ed that undermines the effort to rid the country of COVID-19 through vaccinations and other public health measures. https://wapo.st/3iwpgxx This piece was written by Drew Holden, a public affairs consultant in D.C. and a former Republican congressional staff member. There is no surprise, therefore, that he objects to the recently re-established mask mandate in Washington, including those already vaccinated. Typically, he downplays the significance of the Delta Variant that is sweeping the country and overwhelming medical resources in numerous states. He focused on a “slight uptick in local cases” and “only three deaths from the coronavirus in the past two weeks and with a positive test rate hovering around 1 percent.Only three dead in two weeks, so who cares?

The author’s data, however, is massively contradicted by the Center for Disease Control’s COVID Data Tracker, https://bit.ly/3Cs8qrt. And, of course, the author dredges up the usual Republican talking points about overbearing government (ignoring, for example, the new Red Hero, the Governor of Florida, who has worked around the clock to defeat public health measures in his state that might help control the virus — #DeathSantis doesn’t hesitate to overrule local officials and to prevent Florida jurisdictions from following CDC guidance). So much for the principle of limited government.

Apparently no fan of logical consistency, Mr. Holden argues that while indoor mask mandates will reduce viral transmission, they will undermine the effort to persuade more people to vaccinate. He argues that more vaccinations are the “best way” to prevent more deaths, a view that most rational humans would accept, but Holden argues that vaccination is the only viable path forward, so the solution is to use the “best message” by repeating over and over again that vaccines are safe and effective.

Mandating masks even for the vaccinated sends a clear (if unintended) message to the contrary: Even when you have the vaccine, you aren’t really safe to yourself or others, even if we just told you the opposite was true. How can those already deservedly distrustful of the medical wisdom of the government overcome their skepticism if the government itself can’t seem to get the story straight?

Wow. If the author were really paying attention, he would understand that no one has claimed that vaccines were 100 percent security against COVID infection. This has been clear since the earliest public disclosures of the vaccines. The author also confuses mask requirements with other forms of incentive to vaccinate.

I could go on and on about this piece, but the real issue I want to raise is: why does the Washington Post continue to give credence and exposure to views like this? Is the Post’s commitment to truth tied to both-sides-ing issues of public health? Does the Post really believe that this type of message is essential to understanding the public health risks of another, and perhaps yet another, surge in COVID cases? If the Post is going to continue both-sides-ing COVID messaging, should it not explain its editorial policy to its readers?  If the issue were whether it is in the national interest to maintain a union of 50 states or whether we’d be better off as a nation by having multiple states secede, would the Post also both-sides that issue? How about smoking? Does the Post intend to publish both-sides commentary on the benefits and detriments of smoking tobacco? Wearing seat belts? How is this different?

Vaccinate or Else!

Somewhat, and only somewhat, like the Most Interesting Man in the World from the beer ads, I don’t usually curse but when I do, well …. run.

As the world crumbles around us, I am sick to f*cking death of the whining, immoral, selfish, ignorant, indifferent fools who refuse to get vaccinated because of … what? Their “rights?” Their “freedom to choose?” I am not interested. I don’t want to hear it anymore. We now have people seriously saying we should pay these people to vaccinate. Or just be nice and understanding of their concerns. Or just leave them alone because they’re Americans and have the right to decide how to protect themselves and their families, never mind the impact their intransigence and ignorance may have on others, including children who are, for all practical purposes, entirely at the mercy of decisions made by adults.

No, no and more no. I lost a relative to COVID. I lay her death at the feet of Donald Trump and the mob of lying, sniveling cowards who supported him while he knowingly downplayed the severity of the coronavirus, promoted the use of medically unsound remedies, and generally allowed the country to sink into near oblivion. More than 600,000 dead in the United States alone. Most of them On Trump’s watch.

In early 2020 we lived in New York City, the epicenter of the initial coronavirus explosion in the United States. Within days of my wife’s office in midtown Manhattan closing (in mid-March,) I experienced what turned out to be mild symptoms of COVID as then understood. A local clinic doctor, dressed like a spaceman, said, “You almost certainly have COVID, but we have no tests for people like you who are still standing. Even if we confirmed it, we would just send you home. So, go home, stay there and good luck.” Given my health history, this was a terrifying direction that felt like a potential death sentence.

My wife was not as lucky as I was. She had been incredibly healthy, worked out all the time, ate right and all the rest but within days was in extremis with every known COVID symptom except the very worst ones – she had no lung or brain involvement. Some days you just get lucky. It was terrible. No other words for it.

I did what I could to help her through long nights when she was unable even to walk unaided, fevered, with severe body aches and all the other horrors you have likely read about by now. We lived about 50 yards from the Emergency Room entrance to Mount Sinai West hospital and, on many nights, I thought we were on the verge of having to take her in, knowing that she would be alone under the “no visitors” policies. The horror went on for over two weeks around the clock. People were dying left and right. Many of those who survived had permanent heart, lung and brain damage. The sirens bringing victims to the hospital blared throughout the day and night, day after day. It felt like the end of the world.

We were among the most fortunate in that we both recovered, long before much was even known about the virus, long before there was any realistic suggestion that a vaccine might be developed in less than a year. We were, of course, in lockdown. Our essential needs, and a few luxuries, were met by a stranger in our building, with a big heart and a lot of courage. [See the text of Angels In New York reposted below, originally in my discontinued blog AutumnInNewYork.net]

COVID is thus not an abstraction for us. It has taken the life of someone we knew and loved. It destroyed our sense of security in life – that if we worked hard and subject to the usual ups and downs, all would somehow be well. The pandemic stole more than a year of my waning lifetime. We burrowed in like animals, waiting for an invisible monster to slide silently into our lives again and possibly destroy us. We were afraid of everything: the mail, the Amazon boxes, the concierge at the front desk, the neighbors.

But, as I said, we were among the very fortunate who survived, almost entirely intact. When we moved to Washington in late 2020, a flukish circumstance enabled us to be vaccinated in January-February of 2021. We joined the growing legion of the saved, eventually able to walk outside without masks, to eat outdoors in restaurants without feeling we were placing our lives on the line and generally to resume a semblance of normal life. This was true freedom.

Now, inevitably it seems, the Delta Variant of COVID has arrived, reaching the United States virtually overnight, and is rampaging through the country. And what happens? The former president, who downplayed the virus at the outset, called the virus a “Democrat hoax,” secretly had himself vaccinated and is focused entirely on promoting the Big Lie that the 2020 election was stolen. His voice could have been influential in altering the course of the Delta Variant infection but, no, he only cares about himself. One of his chief sycophants, Ron DeSantis, Governor of Florida, has taken up the mantle of COVID-denier-in-chief, while the Delta Variant ravages his state. His continuous mixed messages just end up reinforcing the resistance.

And on and on it goes. If this keeps up, we are facing another wave of avoidable deaths (almost all current COVID deaths are from unvaccinated people) and possibly nationwide lockdowns that would deal a death blow to the economy and to hope itself.

I am in no f*cking mood for more of this ignorant nonsense. This is like sitting in theater watching a group of fools enter the haunted house, knowing they are headed into dangers they don’t see even though the evidence is everywhere. The feeling of impending doom can be a high for fans of horror movies, but I always hated them. My new sense of impending doom is far more profound and realistic now.

And, so, what is happening? CHAOS. The Republican Governor of Alabama has awakened from her self-induced political coma to say “it’s “time to start blaming the unvaccinated folks.” https://wapo.st/3x2eOSo Why now? Here’s why: her state has had a “92 percent increase in coronavirus infections and a 72 percent rise in hospitalizations over the past week.” But just one-third of Alabamians are fully vaccinated, one of the lowest levels in the nation. Meanwhile, “exhausted health providers say they are bracing for case spikes that are largely preventable, driven by the hyper-transmissible delta variant.” And, once again, and totally predictably, “hospitals are becoming overwhelmed in states with low vaccination rates.” And, also predictably, “a number of prominent Republicans and conservative media voices continue to shower vaccines with skepticism, and social media disinformation continues largely unabated.”

Examples of failed strategies abound. The National Football League adopted new rules that a team

“could be forced to forfeit a game if there is a coronavirus outbreak linked to unvaccinated players. The move has both competitive and financial implications: Players won’t get paychecks for forfeited games, the NFL said. About 80 percent of all NFL players had at least one shot before the rules took effect, said league spokesperson Brian McCarthy, who credited seminars about the vaccines’ benefits, on-site vaccinations and other tactics.”

The operative word is “could,” because the policy has two conditions: a game must be canceled because of a coronavirus outbreak among unvaccinated players or staff members and cannot be rescheduled. In any case, many players among the college-educated vaccination holdouts may well be prepared to take the chance. The policy applies to mostly very well-off athletes and staff for whom the risk of financial sacrifice may be a small price they can easily afford to pay. If the NFL wants to stop the virus, it needs to tell the players: “vaccinate or you’re off the team.” More on that in a moment.

A well-meaning article in the New York Times, Should Vaccinated People Start Wearing Masks Again?  https://nyti.ms/3BBvaoq has a lot of nice advice and information about masking and distancing practice in the face of the Delta Variant, but the problem now is that the complexity of the situation has worsened.  People generally don’t do well with such complex decision-making. The article presupposes freedom of choice, deep understanding of risks, a multitude of factual situations and more. It’s just too much to expect.

Contrast that with the decision of more than 400 colleges and universities requiring returning students for in-person classes to be vaccinated. The schools have simplified the decision-making: vaccinate or study elsewhere. Period. Hospitals and health systems are now also lining up to mandate vaccination or strict testing regimens that could lead to being sent home without pay or termination of employment.

The federal government has stated, correctly in my view, that private companies may require vaccination to return to work in offices. Failure to return could result in loss of employment and unemployment benefits.

Meanwhile, the data on the benefits of vaccination is overwhelming:

As of July 12, more than 159 million people in the United States had been fully vaccinated against Covid-19. Of those, just 5,492 had breakthrough cases that resulted in serious illness, including 1,063 who died. That’s less than 0.0007 percent of the vaccinated population. Meanwhile, 99 percent of deaths from Covid-19 are among the unvaccinated.

 In this one instance, I find myself partially aligned with Dr. Leana S. Wen, a regular WAPO columnist who seems always to find grounds for disagreeing with Democratic health policies. https://wapo.st/3iK5ddB  Dr. Wen says, “the Biden administration needs to strongly urge a return of covid-19 restrictions.” She’s not referring to lockdowns, at least not yet. She notes that “the CDC’s honor system didn’t work” but that “vaccinated people are still well-protected” and thus “in settings where everyone is known to have immunity, no additional restrictions are needed.”

In all other contexts, however, where the risk of infection spread is present, “indoor mask requirements should be reinstated.”

The problem, yet again, is that urging jurisdictions to follow science is no longer a realistic option. Los Angeles County issued a new mask mandate, only to find that its sheriff declined to enforce it. At the risk of letting some reality creep in, Dr. Wen notes, correctly, that “the areas with the lowest vaccination rates are also the ones least likely to implement mask mandates.” Nevertheless, she sticks to the “Biden administration can make a difference” theme.

Then, Dr. Wen makes what I believe to be a classic mistake:

The federal government could also use this opportunity to — finally — incentivize vaccination. It could say that areas with high vaccine uptake do not need to reimplement mask mandates, and mandate vaccination on planes and trains and in federal buildings.

Incentives have been tried in various places and they don’t solve the core problem. And a random policy on travel will just confuse everyone even more and lead to further non-compliance. Wen gets its right with her next suggestion:

And [the Biden administration] can finally get behind a vaccine verification system that would allow restaurants, gyms, workplaces and universities to create safe, maskless environments where everyone is vaccinated.

But, it’s going to require more than encouragement and cheering from the sidelines to get this done. We need, must have, a nationally mandated policy on vaccination.

I’m with Max Boot on this. https://wapo.st/3i55mt4: “Stop pleading and start mandating.”

…. even as evidence grows that vaccines are safe and effective, resistance to them is also growing. A recent Post-ABC News poll found that 29 percent of Americans said they were unlikely to get vaccinated — up from 24 percent three months earlier. Only 59 percent of adults are fully vaccinated.

…. the biggest obstacle to vaccination is now Republicans who are being fed a steady diet of anti-vaxxer propaganda by Fox “News” Channel, Facebook and other social media, and reckless demagogues such as Sen. Rand Paul (R-Ky.) and Rep. Marjorie Taylor Greene (R-Ga.).

This is madness. Stop making reasonable appeals to those who will not listen to reason. (According to an Economist/YouGov poll, a majority of those who refuse to get vaccinated say vaccines are being used by the government to implant microchips.) It’s a waste of time. Start mandating that anyone who wants to travel on an airplane, train or bus, attend a concert or movie, eat at a restaurant, shop at a store, work in an office or visit any other indoor space show proof of vaccination or a negative coronavirus test.

I understand the argument that Republican Governors may resist a national vaccine passport, but that’s too damn bad. The federal government has the authority under the Commerce Clause, among other powers, to compel compliance. It should act before it’s too late.

The argument that the federal government should step in with financial awards for getting vaccinated suffers from multiple problems. Principles developed in behavioral economics tell us that people are more concerned about loss than about gain. Offering some modest amount, declining over time, as recommended by Charles Lane in WAPO, https://wapo.st/3kSyfue, not only rewards the wrong behavior, it assumes that the recalcitrance of anti-vaxxers and COVID-deniers can be overcome with a few pieces of silver. For some, maybe that’s true, but it seems unlikely for the vast majority, and we have little time to lose with such experiments.

Adopting a strong, mandatory federal policy that supersedes all conflicting state laws, regulations and mandates (recall the Constitution’s Supremacy Clause), with significant consequences attached to non-compliance, is now the fastest path to assuring the bulk of holdouts are vaccinated in time to prevent the worst consequences of an uncontrolled pandemic resurgence. The mandate must be accompanied by clear and specific instructions on the acceptable proof of vaccination.

Anticipating the objections, yes, of course, the plan would require some form of exception for limited religious and demonstrable medical issues involving people with relevant co-morbidities, small children and the like. Compared to the consequences of an uncontrolled and continuously morphing viral pandemic, those are small problems. Some of those affected would, however, experience limitations on their behavior until we can be satisfied that herd immunity has been achieved.

Will this approach have implementation issues? Very likely. We have fiddled around so long that a rational, well-executed plan may be nearly impossible, but that’s not cause to shy away from trying. At this stage, we are grasping at straws, but it seems apparent that nothing of a “voluntary nature” is going to overcome the suicidal tendencies of, mainly, Republican anti-vaxxers. They are unmoved by the data showing that most of the deaths and other serious consequences of COVID infection are among the unvaccinated.

We must, therefore, remove the question from consideration: you want to drive, you get a license. You want to go to restaurants, movies, bars, travel, etc., you get vaccinated. Otherwise, stay home in lockdown. Our lives depend on it. End of story. If the vaccine resisters don’t approve, well, return to the first sentence of my second paragraph ….

************

Repost of Angels in New York [from April 20, 2020]

Just when you least expect it and are sinking into the despair of self-isolation with a sick spouse and extreme personal vulnerability to the coronavirus, someone appears as if by magic to save the day. It’s not magic, of course; it’s human kindness and generosity at its best. I referred to her as an angel in an email and, with no prompting from me, my wife used the same terms. It must therefore be true.

The story is simple enough. My wife has come down with what appears to be COVID-19. We don’t know how it happened. We’ve taken all the precautions. Nonetheless, a doctor in a televisit said she thought it was COVID. It fits the symptoms list perfectly. Fortunately, so far, there are no breathing issues. But you may take my word for it – this virus is mean as a junk yard dog. Everything bad you’ve heard about it is true.

Anyway, my own vulnerability has led my wife to vehemently object to my leaving the apartment. Since she became ill six days ago, I have left only twice to pick up food deliveries and packages at the concierge desk and that was over her protest. When she started to need some things we had consumed, like ginger ale, I found that it is impossible to order online at CVS for delivery of items sold “only in store.” We then recalled that a few people in our building (700 apartments in two towers) have volunteered through the resident portal to help people like us. One of them was recent. I found her message and we began to communicate.

Skipping some of the details, she instantly agrees to trek to the CVS around the corner to buy whatever we need. Faced with imminent store closure (it’s Saturday night at 8 pm and the normal “open 24 hours” has apparently been suspended), she makes them stay open until she gets everything we asked for and delivers it to our door. She exhibits no impatience whatsoever as we text back and forth about the options/brands, etc. She wants us to have exactly what we want, not just what is convenient for her to grab and go. I am a bit overwhelmed.

This leads to a second trip the next day when we discover other needs. She texts me from the store to recommend an over-the-counter medication that may help my wife’s nausea (it did) after consulting with the pharmacist about it. She sends photos of various options so I can choose specifically what she should buy.

She patiently helps me struggle to reimburse her through her website (standby re that), but refuses to accept anything beyond the actual cost of the purchases. She says: “no way I’m taking anything other than exact amount.  Grandpa, who stormed the front in Battle of Bulge, would be horrified and embarrassed if I were to dishonor family name during time of national crisis.”

Now, I know I’ve encountered someone very special. An angel in human disguise. In New York City. We exchange a bunch more emails and texts after I check out her website where she manages, as a hobby, a meditation/mindfulness training program for working people. My wife in particular is interested in this for her post-recovery work life. It turns out this new friend-by-text and I are both alums of Yale University (me, Yale College, she the Law School) and Harvard (me the law school, she the Business School). To respect her privacy, I will not identify her by name. Her resume is intimidating. I joke that I and members of my class often observe that we probably couldn’t get into Yale now and her background shows why. She finds this amusing. She has a sense of humor and an infectious positive attitude toward life. [Is it a pun to refer to “infectious positive attitude” during a pandemic?]

I explain that since there is an immutable rule of life that no good deed goes unpunished, there will be two consequences to her work as Good Samaritan for us: one is that my wife must make dinner for her when the lockdown ends and life returns to some semblance of normality. The other is that I will write about her in this blog.

This is a story that must be told and included in my tales of life in New York City. She demurs on the blog but we agree she will bring dessert of her choice to the dinner. She sends me a remarkable photo of a multi-color dessert cake she had baked and says, “be afraid.” Date to be determined but I am optimistic we will make this happen.

And, for sure, my wife and I will be made better by having known this generous, ebullient, kind-hearted person, an unexpected benefit from the pandemic. As I conclude this post at 7 pm, I hear the New Yorkers that have balconies applauding, banging pots and cheering for that other group of angels working in the Emergency Rooms and ICUs around the city. This happens every day and apparently has started a national “movement,” as well it should. Giants and angels come in all sizes and in many disguises. If you’re lucky enough, an angel will find you too. I hope so.