Claims And Issues

COVID REPORT: IMAGINE YOU'RE IN REHAB AFTER YOU'RE TOLD YOU'RE FREE.

 

"A Los Angeles Fire Department crew, amid a sleepless 24-hour shift, gives a report to a County-USC emergency physician on the ambulance ramp." (Dr. Scott Kobner / Los Angeles Times)

The effects of Covid-19 can last for weeks in what might be called the "ordinary" or mild case.

           "Long haulers," as I understand the term, refers to people who have contracted a severe case of Covid and have lingering effects for many weeks.  This seems to me to be different from the description of people who are in the group which have had these severe effects, have been released from the hospital, and yet need rehab long after they have already suffered things like life-threatening organ failure or nerve damage.

"While resuscitating a patient in cardiac arrest, Dr. Molly Grassini stares at the cardiac monitor during a pulse check, hoping her patient shows any signs of life." (Dr. Scott Kobner / Los Angeles Times)

           In severe cases, even after "surviving" a stay in the Intensive Care Unit being treated for Covid, many people need long-term rehabilitation.  Some people experience atrophied muscles, or damage to their kidneys or lungs.  This may require physical rehab because people with these conditions have a hard time leaving home or even getting out of bed.

           Other people come "away" from a stay in ICU in the hospital for Covid, with cognitive issues, even psychological/behavioral changes such as loss of memory, depression, or anxiety.

           There is even a term for this condition:  PICS or post-intensive care syndrome.  It applies particularly to hospitalized Covid patients who may have spent a lot of their time in the ICU on ventilators, under sedation, or have experienced pneumonia turn into acute respiratory distress (extreme difficulty breathing, a syndrome known as ARDS).

"Nurse Doris Roldan, right, reaches for a dose of epinephrine as nurse Jeremy Hill performs CPR and Dr. Ruben Guzman prepares to intubate a patient dying of COVID-19."  (Dr. Scott Kobner / Los Angeles Times)

   The natural feelings of any person in such a situation, having already "conquered" the illness only to realize that it has left its mark on you physically or psychologically or both, have got to include anger tinged with perhaps a sense of despair, and understandably so.  Last night I suffered muscle spasms in my left leg, which I endure from time to time.  Last night, I tried rubbing it and it did not stop the spasms.  In the past, I have tried heat and cold, and they have not worked, either.  My point is not that the muscle spasms I experienced last night in my left leg are somehow on the same order of pain as having Covid-19, but to serve as a stimulus for me to imagine the level of frustration and even bitterness that can confront a person who has survived Covid thanks to the treatment she or he received at an ICU, only to realize that there is more to go through.

           The more we live with Covid as a society, and the more people we know who experience Covid, the more we learn that having Covid is not like having an ordinary fever, so that when the fever breaks, for example, we can take that as a sign that we are on the mend.  Having a clearer view of what Covid can bring to us if we contract it, can make all the difference.

           A big part of being a Covid-19 patient includes acceptance without resignation.  That can be tough to do, but knowing that it is included in the experience makes us alert to the demands that Covid may make upon us.

The remarkable and newsworthy photographs taken by Dr. Scott Kobler of Covid patients and medical workers in an ICU, along with captions provided via The Los Angeles Times, are a part of this story by Hailey Branson-Potts, Armed With a Camera, a Young ER Doctor Captures the Faces of the COVID War, LOS ANGELES TIMES Online Feb. 15, 2021.

Please read the disclaimer.  ©2021 Dennis J. Wall.  All rights reserved.

THE PANDEMIC REPORT: VACCINATIONS ARE COMING. OR ARE THEY?

COVID CHRISTMAS FACETIME (Francine Orr / Los Angeles Times)

I was planning on writing a series.  First, I would write about the patients of COVID.  Next, the medical workers who work with the patients.  Finally, the families.

           My ideas for a series were abruptly put on hold by something that grabbed my immediate attention.   I hope it grabs your attention, too. 

           States have rapidly expanded the categories of people who qualify for vaccines.  I know it does not seem like that to people who are still waiting to qualify, but it is a thing.  It is happening.  More groups of people are qualifying by the day to receive vaccinations.

           At the same time, the previous regime just did not produce enough vaccines by a long shot, for some reason.  Some people want to explore the reasons.  That is not my purpose in this particular article.

           The expanding numbers of people who can get vaccinated, and the small amounts of available vaccine, have been major causes of frustration for those of us who are getting in line for vaccines.  Older people are generally not familiar with computers, and minority groups generally do not have access to computers.    Yet, computers are the default tools for getting an appointment to be vaccinated.  Don't ask why it is that way, perhaps it is the result of worshipping a tool as a god, and a computer is only a tool, not a god.  For whatever reason, like the "missing" vaccines problem, it is the case.

           A few help many navigate the vaccination appointment systems.  These few are computer-savvy while the people they help are not, or these few have the time it takes to navigate the system while the people they help do not, and both:  They are computer-savvy and they have the time.

           It would be useful to update a famous saying from the days of the Battle of Britain, and apply that updated saying today.  "Never before have so many owed so much to so few."

           Here's to "the few."  The whole story is covered in an excellent report by Jennifer Steinhauer, Frustration About Shot Access / A Crossroads Between the Vaccinated and the Waiting, NEW YORK TIMES, Monday, February 15, 2021, at A4.

Please read the disclaimer.  This blog article ©2021 Dennis J. Wall.  All rights reserved.

"THE COVID REPORT": THE PRONING PATIENT EDITION.

COVID Proning (Jae C. Hong / Associated Press)

Can you imagine what proning is?  The term applies to people who cannot breathe.  Medical workers change the patient's position in bed so that, hopefully, she can breathe easier.

           Proning means that you are being turned from lying in bed on your back, to lying in bed on your stomach.  Try that.  Find it easier to breath when you lie on your stomach than when you were lying on your back?

           Proning works in large part because of gravity.  Lying on our  stomachs helps most of us by opening airways in our lungs.  If we have contracted COVID, natural forces that may be compressing our lungs are enhanced by the compressing effects of fluid and inflammation that come from the infection.

           When we human beings lie on our backs, our hearts are now sitting on top of our lungs.  Naturally, the lungs compress in that position.  Our rib cage cannot move the way it usually does when it is flat against the bed.  Flipping over to our stomachs tends to free the back of our lungs to open, allowing our bodies to breathe easier.

           Proning takes much hard work.  And a lot of hands to do it.  Before COVID came, the standard protocol for proning teams sometimes involved as many as 8 workers.  Most of the time, workers were experienced and trained in the technique.

           Proning teams formed before COVID could have fielded a team under traditional sandlot baseball rules, which provide either that the other team provides the missing player (who plays a position carefully chosen by the short-handed team) or that one of the outfields (usually right field) is out of bounds for play.

           The reason for so many hands being involved in proning is what can happen if it is done wrong.  It is the product of anxiety, to be frank about it.  Care has to be exercised during proning lest a patient's breathing tube come loose during the procedure, or a person's intravenous lines detach while she is being moved from her back to her stomach in her hospital bed.

COVID Proning and Supinating (Hilary Swift / New York Times)

           But the rules regarding proning have changed since COVID arrived.  There just aren't enough workers.  Since the pandemic began, proning teams have sometimes been fielded with only 3 or 4 people.

           Another way to look at proning is that before COVID, proning was used for only about 15% of patients diagnosed with acute respiratory-distress syndrome (ARDS) and embedded with breathing tubes accordingly.  The technique can result in compressing nerves in limbs including shoulders and legs.  This increases the chance of disability.

           There is also reportedly a lot of evidence that proning actually decreases the patients' life-spans.

           The jury is out on whether proning shortens COVID patients' life-spans, or to what degree proning COVID patients results in disabilities, but in the meantime there may not be any good options but to go ahead and prone the COVID patients.  Proning can save our lives today even if we are uncertain what it will do to us tomorrow.

           Obviously, proning is a procedure of choice only when there do not seem to be any better alternatives.

           In terms of procedures, supinating is the opposite of proning.  Like proning, supinating still applies to people who cannot breathe, but the term means something different than proning does.  That term, supinating, refers instead to changing a patient's position in bed from lying on her stomach, to lying on her back.

           In my case, I prefer to lie on my back.  I sleep on my back or on my side in fact.  Having tried a few positions on my back and on my side as an experiment for this article, it is easier for me to breathe when I am in those positions.  So proning is an extreme measure.

COVID19 ICU Help Turning Sign (Marcus Yam / Los Angeles Times)

           So extreme that proning carries with it important protocols.  It's used during the coronavirus pandemic because hospitals have never had so many patients at the same time that are so sick that their lungs have essentially stopped functioning.  Respiratory distress is the chief sign that the coronavirus is present.  At the present time, the anxieties involved with proning patients including the possible after-effects of the procedure, pale in comparison to a patient's inability to breathe because of COVID.

Please read the disclaimer.  ©2021 Dennis J. Wall.  All rights reserved.

"THE COVID REPORT". PART ONE, Continued: I IMAGINE I'M A PATIENT.

COVID ICU (Francine Orr / Los Angeles Times)

  The Imagined Beginning, Continued.

This article is written as an act of imagining what COVID patients go through.[1] 

    A mild infection of COVID lasts for 1 to 2 weeks.  According to the reports, severe infections last much longer, 6 weeks or more.  People with severe cases of COVID often sustain heart damage for the rest of their lives.  Worldwide, the latest statistics reveal that 1% of COVID victims die.

    These things do not compare well with my experience in a cast when I tore knee ligaments and cartilage during high school football.  When my convalescent time was up, my cast came off and I was back on my feet.  Rehab, probably, but no severe infections, no chills to speak of, and certainly no heart damage.

    When I try to imagine the experience of having COVID, the experience I have had in my own life that comes closest, I think, is having had pneumonia and bronchitis. 

    When I had pneumonia and bronchitis, I had them at the same time according to the docs.  I recall night sweats and intense fevers.  My bed sheets had to be changed every day because they were wringing wet with my sweat.

Outside an ICU Treating Covid (Francine Orr / Los Angeles Times)

During the night, I was often awake.  There was nothing for me to do but think and pray.  During the day, I could not concentrate.  Reading has always been one of my greatest pleasures and I could not do it.  I could not read because I could not concentrate.  I would try to read, but little or nothing stuck with me.

    Staring at the ceiling.  Staring into space, staring at nothing much, really.  Closing my eyes and staring at nothing at all.  This is how I spent much of that time.  I guess I kept my glasses on most of the time during the day, which would be normal of course, but there was not a lot of variety to see in my sickroom.   This is part of what it was like, as I recall now, from my experience with pneumonia and bronchitis.

    Is this what it is like for COVID patients?  Just lying there, waiting for the joy of reading to return, with nothing to think about except feverish thoughts, sometimes repeated over and over again, forgotten nearly as soon as they happened or when the fever came down?

    Breathing came hard at times.  Expectorating was part of my program at that time.  That means coughing up phlegm.  At first I expectorated occasionally, and after a while it happened on a pretty regular basis.  I recall the wastebaskets vividly.  I forget if we used something to induce my spitting up phlegm, but in my recollection of the event we did not have to. 

COVID ICU Treatment (Bernat Armangue / Associated Press)

Is this what it is like for many COVID patients who try to catch their breath?  Is this what it is like for lots of COVID patients who try to breathe, but whose breathing is hampered by the virus?

    There was nothing for me to do but get through it.

    There was no refining the experience, no way out of it except to go through it.  My mother did what mothers do, and she tried many things to make my condition at least tolerable.  She is the one who changed the bedsheets every day I had the pneumonia and bronchitis, for example.  Her many efforts came at a cost, looking back on it, to her own sleep and health all while she held down a full-time job.  What she did helped, a great deal.

    Still, there was nothing for me to do but get through the pneumonia and bronchitis.  After a week or two, I got better.  I recovered. 

    From those experiences, I can try to imagine what a mild case of the Covid might feel like. 

    However, I cannot even imagine what a severe case feels like.  For one thing, I have never been on a respirator despite my difficulties breathing in the past.  Being on a respirator is one of the signs of severe COVID infection.

    Another sign is when the patient and her loved ones learn what "proning" and "supining" mean to their lives and to the lives of the medical workers who help them.   We shall see proning and supining, through words and pictures, in the days ahead.  Unfortunately, so will many COVID patients, their families, and their caregivers.

To be continued.  Please read the disclaimer.  ©2021 Dennis J. Wall.  All rights reserved.

 

[1] The many symptoms of COVID are mentioned in many articles published over the last 11 or 12 months.  See also the article posted here,  "THE COVID REPORT."  PART ONE:  THE PATIENTS.  The Beginning.  That was written as a summary of what patients, doctors, nurses, and families have reported about their real-life experiences with having or treating COVID from the onset through the first several days following admission to the hospital.

"THE COVID REPORT". PART ONE: I AM A PATIENT.

(Jae C. Hong / Associated Press)

  The Beginning, Imagined.

I have never been a COVID patient, but I want to understand what it is like to be one.  Imagination must thankfully take the place of the virus for me.

           The many symptoms of COVID are mentioned in many articles published over the last 10 or 11 months.  See also the article posted here this week, "THE COVID REPORT."  PART ONE:  THE PATIENTS.  The Beginning.  That was written as a summary of what patients, doctors, nurses, and families have reported about their real-life experiences with having or treating COVID from the onset through the first several days following admission to the hospital.

           The present article is written as an act of imagining what COVID patients go through during that time.  If I get COVID, I imagine that I will probably run a fever for days.  Some people run a fever of 103º or more for three or four days before they go to the hospital.  I can imagine what it is like to have such a fever, because I have experienced my own bedsheets wringing with sweat.  Wringing with sweat the way a face cloth in a sink is wringing with water, so that they both need to be wrung out. 

           I imagine too that I will have chills to go with this fever, if I get COVID.  Chills are part of my own experience with fever, so I know what chills can do to a body.  I have also gone septic as they say, when it is impossible it seems either to stop shaking or to feel warm.

           And then from among all the other symptoms that so many people get (and so many people don't get) with COVID, I expect that I will have fatigue and sleep deprivation.  However, I also expect that I may not recognize the difference any time soon after the onset of COVID.  Perhaps because of the stage of my life, or because I am a cancer survivor, or for other reasons, fatigue and sleep deprivation are often my companions.  Unlike the effects of fatigue and sleep deprivation on COVID patients, which can be severe, I will have to imagine fatigue so great that I cannot concentrate on watching the television and to imagine sleep deprivation so great because it is the result of aches all over my body, particularly in my joints.

           The key symptom of COVID, shortness of breath in the sense of difficulty breathing, is frightening to me.  I don't believe that I have ever experienced shortness of breath in that extreme.  Oh, sure, I have experienced shortness of breath during and after exercise and things like that.  However, that is not what people mean when they talk about difficulty breathing because they have COVID.

(Victor J. Blue / New York Times)
     

    They mean gasping for air.  Sometimes they mean that they have so much difficulty in breathing on their own that they need outside help, a machine like a respirator, in order to breathe.  I have difficulty imagining  that from my own experience.

           I am left to imagine that from the experiences of others, from the experiences of people who have had COVID and from the experiences of people who have treated COVID, but there are few stories and understandably there are no videos that I have yet found showing exactly how respirators make COVID patients able to breathe.  It may be too personal an experience, having a respirator help you breathe.  I do know it is so extreme a procedure that at his press conferences in 2020, New York Governor Andrew Cuomo said that if you have to be on a respirator, that's pretty much it for you because your chances of surviving COVID are not good after you have been put on a respirator.

           That does not help me imagine it any better.  It does add to making the difficulty breathing part of COVID scary.

           But wait a minute.  I had pneumonia and bronchitis together when I was in high school.  I just remembered.  That was a time of wringing sweats, chills, high fever, and many times, difficulty breathing.  That may be comparable to having a mild case of COVID, sufficient at least for the task of imaging what having COVID would be like.

           So far, I continue to be fortunate to only imagine what having COVID is like.

To be continued.  Please read the disclaimer.  ©2021 Dennis J. Wall.  All rights reserved.

"THE COVID REPORT." PART ONE: THE PATIENTS.

(Irfan Khan  / Los Angeles Times)

The beginning.

I want to say at the beginning why I am writing this piece.  I am doing this to keep my focus as a writer, of course, but more importantly I am doing this to keep my focus as a potential patient of COVID-19 in a pandemic.

If I get the Covid, my symptoms will be too many to choose from, too many to list in a short piece like this.  These symptoms have escaped my memory, truth be told, because there are so darned many of them.

Before I mention the common-denominator-symptom or the one symptom known to be common to every case of COVID-19 so far, I will mention a few others that not every Covid patient has.

Very common symptoms include fever.  Some patients run a relatively high fever of 103 or 104 degrees for days.  But not all.

A cough is another common symptom.  What shows up as a sign of Covid infection is much more than an everyday cough.  The sign of Covid is a cough that is not helped for days by over-the-counter products that have ordinarily been effective for you in the past, like Advil or Tylenol.  That kind of a cough is a common symptom of the Covid.  But not always.

Fatigue is also a common symptom of Covid.  Again, not simple fatigue in the case of COVID, mind you, but fatigue that hits you so hard that you cannot watch TV because you cannot concentrate even that much.  But this does not happen with every Covid patient.

Then, of course, there are lost senses of smell, taste, and often, feeling in fingers or toes.  But again, not every Covid patient loses these senses or has these experiences.

(Jae C. Heng / Associated Press)

The one symptom that all Covid patients seem to have, along with one or more of the other symptoms, is shortness of breath.  That phrase, "shortness of breath," separates the mild cases from the severe cases.

Most people with mild cases of COVID-19 should rest and isolate from neighbors and the general population, and they can do so at home.  That is what most of us do anyway even if we do not have a case of Covid at all.

However, if "shortness of breath" means for you that you have difficulty breathing, there are one of two solutions that should be taken immediately:  Call 911 or go to a hospital Emergency Department under your own power.

COVID is mostly transmitted through the air.  This bit of knowledge illustrates how much the world knows about COVID that the world did not know 10 or 11 months ago, when the COVID virus started announcing its presence in the world population.

We know now -- or think we do, realizing more or less that our knowledge is accumulating and ongoing, not given to us like a post or a tweet that doesn't depend on facts -- that people inhale the virus when it is transmitted by someone else's cough, sneeze, speech, or song.

Less often, a person can catch the Covid from touching something or a surface, and then touching their face.  Thus, the urgent need to wear masks--for them who are in the world around you and for yourself alike.

Once established, COVID hangs around in mild cases for 1 to 2 weeks.  That is one marker for what kind of COVID case you have got, but you pretty much know even without that marker if you have a severe case.

Severe cases of COVID last for 6 weeks or more.  And their effects may last even longer.  Some people experience heart or nerve damage for the rest of their lives.  Some people die from the COVID.  About 1% worldwide of people diagnosed with COVID die.

At every stage, COVID can flip from good to bad in an instant.  This is consistent with knowing so little about this virus.  This is something to keep in mind when I personally might feel tempted to ask what seems to me like basic questions, namely, whether I should go to the hospital or if it is okay for me to stay home, and how I can tell when the time is right for either one.

Before I can answer these questions, I should keep something else in mind:  This is not the flu, no matter who told me otherwise and no matter how many times they said it.

Going to the hospital is the flip side of the same question as when it is no longer wise for me to stay home.  One of the other things that we have learned during this pandemic, and we have learned it at a cost, is that most patients wait too long to make this decision, hospital vs. home, until they are really sick.

(Francine Orr / Los Angeles Times)

That said, a sure sign of which way to go is to head to the hospital if your oxygen levels drop.  I learned that you and I can measure our oxygen levels with a simple device that can be purchased online, called a "fingertip oxygen meter."  Quick searches came up with various prices online at different sites, running from $20 to $55.

One Covid patient, an E.R. doc, knew that it was time for him to go to the hospital when his oxygen levels dropped to 82.  A normal range is apparently 95-100.  The day before the doc's oxygen levels dropped to 82, his oxygen levels were so good that it looked like he was coming out of it.

Another measurement of your ability to breathe is called "lung compliance," which means that your longs are elastic enough to breathe air in and let it out.  Standard measures are over 100 for healthy people, and under 30 for people with severe respiratory failure.

How can people who are not doctors or do not have machines that measure these things, tell that their oxygen levels are dropping dangerously?

Don't wait for a machine to measure you.  If you cannot breathe without difficulty, that's all the test result you may need to tell you that your oxygen levels are dropping.

©2021 Dennis J. Wall.  All rights reserved.

COVID-19 AND THE FLORIDA CONSUMER IN THE PANDEMIC.

For information about Covid-19 and the coronavirus pandemic response in Florida, check the options for consumers at https://www.fdacs.gov/Consumer-Resources/COVID-19-Information.

(Photo by Irfan Khan / Los Angeles Times)

Please read the disclaimer.  ©2021 Dennis J. Wall.  All rights reserved.

THE VACCINES ARE COMING. AND WE'RE STILL HERE FOR NOW.

COVID Christmas FaceTime (Francine Orr / Los Angeles Times)

The good news that vaccines are on the way is welcome.  Welcome, even though the good news is tempered by the news that inoculations are not moving very fast at all, and as usual, there is no plan.  So 2020.

Still, it is good news that vaccines are on the way.  And in the meantime, we're still here.  Pundits pundit -- isn't that what pundits do, namely, pundit? -- that it may be Spring, it may be Summer, or maybe they don't really know when large numbers of people in the United States will get inoculated.

And in the meantime, we're still here.  We can do this.  We have been waiting so long that a few more months of waiting will not kill us.  Reports continue of deaths and hospitalizations even as we wait to receive the vaccines.

COVID Coffins (Associated Press)

We hope and pray.  For ourselves and for one another.  So help us God.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

NURSING HOME WORKERS FIGHT TO PROTECT PATIENTS.

(Francine Orr / Los Angeles Times)

Nursing home workers fight to protect patients.  They fight the pandemic, they fight conditions, and they stand up to nursing home management to protect patients.

 

Nursing home workers are heroes.

(Genaro Molina / Los Angeles Times)

 

 

See Joe Mozingo, Surrounded by Death, Nursing Home Workers Battle Management and Fear to Protect Patients, LOS ANGELES TIMES (online Dec. 27, 2020).

 

Please read the disclaimer  ©2020 Dennis J. Wall.  All rights reserved.

LOTS OF MASKS, DISTANCING, ISOLATION IF WE'RE ALL IN DENIAL.

The truth is we are not all in denial.  Most of us in America accept wearing masks, social distancing, and isolation for the good of the country.

Some do not.

Guess who ends up getting the headlines?  The ones who wear masks, or the ones who don't?  The ones who socially distance, or the ones who don't?  Or the ones who isolate themselves from public congregations as much as they reasonably can, or those who don't even try?

Well, the good guys are actually and overwhelmingly in the majority just as they were in the presidential election regardless of the reports driven by fear.

The stories of "pandemic denial" are the stories that are told in the corporate media.  Pandemic disruption despite compliance by the vast majority of people in America is the real story.  See Jacob Hale Russell, Associate Professor at Rutgers Law School, and Dennis Patterson, Professor of Law and Philosophy at Rutgers, Let's Put the Straw Man of Pandemic Denial Out of His Misery, STAT (December 23, 2020), Let's put the straw man of pandemic denial out of his misery - STAT (statnews.com).

Please read the disclaimer.  This blog article ©2020 Dennis J. Wall.  All rights reserved.

HAPPIEST HOLIDAY NEWS: NOT ONE, TWO VACCINES & NEW ADMINISTRATION!

(Louis Sinco / Los Angeles Times)

The good news is in the title of this article.  Happy Holidays to All, and to All a Happy New Year every day throughout the year to come in 2021!

FOLLOW THE VACCINE MONEY.

(Bernat Armangue / Associated Press)

 

Vaccine distributors Pfizer, Moderna, and AstraZeneca are the Big Three in the race to promote vaccines.

Pfizer and Moderna are pretty certain to make the most money.  They have the inside track on having their vaccines purchased from governments.  Already, Pfizer's vaccine is now being bought by Britain for some form of distribution in the U.K.

Here's what the Big Three have reportedly said and contracted to do with regard to their vaccine sales in the U.S. and across the world.

PFIZER

The current U.S. federal government pre-ordered doses of Pfizer's  vaccine.  The federal taxpayers are paying, but for what price remains to be found.  Additional charges:  Free to the first 100 million doses, $20.00 charge to each user, added on to the contract price Pfizer charged to the American administration.

As is now being widely reported, Pfizer's vaccine treatment requires two (2) doses.

MODERNA

Moderna also contracted with the current federal government relative to its vaccines.  The amount Moderna is going to charge will depend on how much is ordered, but the range Moderna announced is $10.00 to $50.00 per dose, apparently after the lower-cost doses purchased by the current federal government are administered.

"The U.S. has secured 100 million doses for Americans at the cost of $15 per dose."  Higher prices are expected as the government programs come to an end. 

Moderna too requires two (2) doses of its vaccine.

AstraZeneca

AstraZeneca has agreed that the current U.S. regime can buy its vaccine for something less than $4.00 per dose.

Less effective than either Pfizer or Moderna report in press releases so far, AstraZeneca has done something that neither Pfizer or Moderna has done, or will do:  AstraZeneca announced that its vaccine will be sold at cost "in perpetuity" to the developing world.

AstraZeneca belongs to a group called Colvax which aims to distribute Two Billion doses to 92 low- and middle-income countries with a price cap of $3.00 per dose.

Pfizer has not joined the Colvax vaccine distribution initiative.

Neither has Moderna.

See Sissi Cao, COVID-19 Vaccine Prices Revealed From Pfizer, Moderna, and AstraZeneca, OBSERVER, posted online Nov. 23, 2020.

Profits are priorities for many people, even in a business that affects the health of the rest of the world's people.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

PRAISE THE LORD AND PASS THE PHOTOS.

Registered Nurses at Candlelight Vigil for COVID-19 patients in hospital.  (Luis Sinco / Los Angeles Times)

We know the statistics.  As of last Thursday, the United States reported more than 216,000 confirmed COVID-19 infections. 

Reportedly there were more than 2,800 deaths that day alone.  The official death toll in my State, Florida, is reported as 19,000 now but this is in doubt.  Some read Centers for Disease Control (CDC) studies as suggesting that the death toll in Florida could have been as high as 23,000 just as of October.

Also, there were some 101,000 people in hospitals in the United States with COVID-19 as of last Thursday, December 3, 2020.

Enough with the statistics.  They have already sunk in with most people.  As with all things, it seems, a loud but definite few still need to see pictures before they will believe.

On this Pearl Harbor Day 2020, it is therefore appropriate to say "Praise the Lord and Pass the Photographs."

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

THE PANDEMIC MADE PPE EACH HOSPITAL'S UNIFORM EVERY DAY.

Now PTS is part of the pandemic's daily hazard to frontline health care workers.

COVID19 ASSISTED LIVING FACILITY NURSE CATHERINE BEST, in AARP Article on COVID19 (Courtesy Catherine Best).

Frontline health care workers are tired.  More than tired.  They take precautions against Covid every day, but every day they endanger their own health and their own lives, and the lives and health of their loved ones.

Frontline health care workers have been combatting the coronavirus pandemic for 9 or in some cases 10 months now.  Yet significant numbers of the potential patient population have not been combatting Covid.  Not even by the simple act of wearing a mask, or using hand sanitizer, or even keeping a social distance, all to avoid infecting others and being infected themselves.

Potential patients become patients.  When people enter hospitals, frontline health care workers care for the Covid patients.  It's their job.  And they watch patients die.

That's not their job.  It should not be anyone's job to watch people die who did not need to die especially if all they needed to do in life was wear a mask and depend on others to wear a mask too.

"Jill Naiberk, a nurse at the University of Nebraska Medical Center, has spent more of 2020 in full protective gear than out of it."

"'I keep telling everybody the minute I can safely hug you again, get ready,' she said.  'Because I'm never letting go.'"  Nurse Jill Naiberk, quoted in Combat Fatigue, NEW YORK TIMES (Print Dec. 1, 2020; online Nov. 25, 2020).

"Because I'm never letting go."  Among the many wrongs done by Mitch McConnell and the Republican Senate in silently following the Occupant's lead is the effect they have had on frontline health care workers.  Medical workers keep seeing so many people hurt and die for so many months that they think that they are not making a difference. 

Mitch McConnell and the Senate have done the pandemic too little, and have confirmed unqualified judges too much.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

GETTING VACCINE, SETTING PRIORITIES.

(Florida Consumer Protection Law Committee announcement for Holland & Knight webinar.  October 2020)

As these words are written, the current head of the Federal Food and Drug Administration is on his way to a meeting with the current Occupant.

They are reportedly going to discuss the distribution of COVID-19 vaccines, including of course how the Occupant wants vaccine to be distributed.

Vaccines.  Once a distant thought, they are now on the tip of everyone's tongue.  Suddenly they do not seem so distant.  Instead they are nearly upon us, so much so that today the subject of discussion is setting  priorities to distribute COVID-19 vaccine.

That's a lot to get your head around in a pretty short time.

One initial thought:  This is yet another opportunity to be fair, to be just, to set priorities based on objective need.  In the past, priorities have been set many times, if not always, because of money and power rather than objective need.  This is another opportunity to recognize objective need and in the process, to act with fairness, justice, and courage.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

 

 

WHERE ARE THE PICTURES OF WHAT COVID-19 DOES TO US?

This kind of echoes what was said before but bears repeating, not just here but in many venues.  See SPARE THE PROSE AND PASS THE PICTURES (Nov. 24, 2020).  Some people do not believe in a fact unless they can see it.

Where are the pictures of the toll that COVID-19 is taking on us?  Has taken, is taking, and will take on us?  Of what COVID-19 does to us?

?

Show us the pictures.  We want this to end.  We want to fight COVID-19 together.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

THANK YOU, AMERICA! HAPPY THANKSGIVING!

Happy Thanksgiving!

America won, we beat back the first plague!  Now let's win the battle against COVID-19.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

 

WELL, THAT'S DONE. NOW LET'S GET TO WORK ON COVID.

God Bless the people with COVID.  That could be us.  That is us.

Let's get to work on COVID, together.

(Ted S. Warren / Associated Press)

Please read the disclaimer.  This article ©2020 Dennis J. Wall.  All rights reserved.

SPARE THE PROSE AND PASS THE PICTURES!

Spare the prose and pass the pictures!  E.g., 

https://www.cbsnews.com/news/ohio-covid-case-growth-exponential/  CBS News, ©CBS Interactive, Tuesday, November 24, 2020.

Covid Fatigue sounds new to the ears.  It describes all of us who are tired of a pandemic and all the ways it has disrupted our daily lives.

Social distancing.

Masks.

Hand sanitizers.

And more, much more.

Yet we live in a country now which does not respond to words as much as we respond to pictures.  Sometimes we act as though "it did not happen" if there are no pictures of it.

So spare the prose about what it means to be in a hospital ICU with COVID.  Show us the pictures.

If you show us the pictures, we may travel a little less this Thanksgiving, some of us.  Millions are on the road this Thanksgiving carrying the infection with them all across the nation.   "This is a recipe for disaster," says one of the people interviewed on the CBS News video clip in this article.

The report shows some of what it's like inside a COVID ward in a hospital, but only briefly.  It's a beginning.  But it's not enough, yet.  8 months into this, and it's not enough yet.

Show us the pictures.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

THE DUST SETTLES AT NOTRE DAME. OR IS IT COVID?

(Image via Fighting Irish Wire)

The Notre Dame football team won a big game for the first time under Coach Brian Kelley.  The Fightin' Irish beat the Number One-ranked team in the nation, Clemson, in South Bend on Sunday in the game's Second Overtime.

Reports described the game as a triumph for Notre Dame's defense.  The final score was 47-40.

Reports also describe the chaotic invitation to the coronavirus after the game ended.  Fans jammed the field, ignoring measures to defeat the pandemic.  Father John Jenkins, the university president, declared that students must be tested if they want to be re-admitted to Notre Dame and, if they are not tested, they will be refused readmission.  Jenkins has his own issues with the spread of COVID-19, having gone maskless with students earlier in the year and at a White House event in September.

No word yet on whether Jenkins will wear a mask or practice social distancing or otherwise take measures at future events to defeat the pandemic.

In the meantime, all eyes are on the football team and whether the Fightin' Irish will test positive.  Games scheduled earlier in the year had to be cancelled because football players tested positive.

The pandemic has made it clear that ignoring it is not a defensive triumph.

Please read the disclaimer.   ©2020 Dennis J. Wall.  All rights reserved.

 

IT'S NOT ABOUT POSITIVE TESTING. IT'S ABOUT SICKNESS AND DEATH.

(Ted S. Warren / Associated Press)

The number of people who test positive is not a measure of the pandemic.

The number of sick people is a metric.  7 Million at last count in the United States.  Many more throughout the world.

The number of people who died from COVID-19 is a metric.  217,000 is the latest number in the United States.   Again, many more throughout the world.

The measures of suffering are sickness and death.  Those are the measures of the coronavirus pandemic.

They cannot be replaced.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

UNFORTUNATE PHOTOS AT AN EXHIBITION, PART 3, THE FINAL PHOTO.

Judge Amy Barrett's son exposed to COVID19 Positive Man, Sept. 26, 2020 (Doug Mills / New York Times).

COVID and brown shoes with a dark blue suit?  Both of them wearing brown shoes with a dark blue suit, the 8-year old boy and the much older than 8-years-old man?

Please read the disclaimer.  This blog article ©2020 Dennis J. Wall.  All rights reserved.

ABOVE THE LAW, OF NATURE THAT IS. UNTIL THEY WEREN'T.

Above the Law, of Nature that is.

Amy C. Barrett, J., and The Occupant, Sat., 09.26.20.  (Jabin Botsford / Washington Post)

 

Until They Weren't.

Amy Coney Barrett, J., and the Assembled Ones Sept. 26, 2020.  (Alex Brandon / Associated Press) (Positive-test ID AS OF APPROX. OCTOBER 5, 2020.  Text ["P"] added by New York Times).

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

MAKING AMERICA GASP AGAIN.

Can you identify any of the people exposed to COVID by The Occupant in this photograph who have come down with COVID?  Who knew that would happen?

(Doug Mills / New York Times)

See Kathleen Gray and Shawn Hubler, Notre Dame’s President Faces an Angry Campus After Getting the Coronavirus / Students and faculty are furious that the Rev. John I. Jenkins failed to wear a mask at a White House ceremony and then later tested positive for the virus, NEW YORK TIMES online, Wednesday, October 7, 2020.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

AT NOTRE DAME, SENATE KEEPS PRESIDENT IN OFFICE. JENKINS, THAT IS.

(Notre Dame Campus photograph by Luis Sinco / Los Angeles Times)

This past week, the Notre Dame student senate reportedly refused a student petition that John Jenkins, the university president, should resign because he didn't follow Notre Dame's own pandemic guidelines for wearing a mask and social distancing.  Jenkins tested positive for COVID19 after he attended the closely-packed, largely unmasked crowd at the White House rally last Saturday for Judge Amy Coney Barrett.

(Jabin Batsford / Washington Post)

    Reportedly, students have been threatened with disciplinary action, even threatened with being expelled from Notre Dame, for their failure to follow the guidelines.  Those voting against the petition said that it is important to keep a dialogue open with the president.  The university president, that is.  

    "With these considerations in mind, the majority voted against the resolution with further discussion on formerly {i.e, formally] condemning the president’s actions and opening up dialogue on the situation slated for next week’s meeting."  The Observer, The Notre Dame Student Newspaper, Fri., October 2, 2020.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

CONTACT TRACING, ISOLATION, AND QUARANTINE BEFORE ASCENDING TO HIGHEST COURT.

(Judge Amy Coney Barrett / University of Notre Dame)

The self-professed announcement by the Occupant testing positive for COVID-19 set off a number of reactions.  Assuming this announcement to be true, and accepting it without question, it means certain things for everyone potentially exposed.  That includes Judge Amy Coney Barrett.

At an announcement at the White House last Saturday, Judge Barrett came within the social distances that will lead to contact tracing, isolation, and quarantine.  She herself came very close to the Occupant during the ceremonies and she used some of the same tools including the same, unwiped microphone.  She needs to be isolated.  Isolation is not just for the exposed person's protection, of course.  Isolation of an exposed person is also for the protection of other people, which as we know is a very important value to Judge Barrett.

Her husband and seven children came very close also.  They should be quarantined, perhaps isolated depending on their degrees of contact with the Occupant and others who are also now said to test positive for COVID-19.  As we all know only too well by now, quarantine is not just for the protection of the person who may or may not be infected themselves; it is for the protection of other people by preventing the virus from spreading.

The Judges of the Seventh Circuit who did not socially distance from Judge Barrett at and after the White House ceremony announcing her selection, must also be isolated or quarantined, as the case may be.

The Republican Senators she visited this week when she made the rounds on Capitol Hill, lining up support that was never in doubt; they too should be isolated or quarantined, whether or not they vote for it.

Notre Dame professors, students, and employees with whom she may have come into contact within the proscribed social distances for everyone  exposed to someone in the position of Amy Coney Barrett.  She is one of many in the United States who have been exposed in the last seven months to someone else who tested positive for COVID-19.  That means, as we all know, that the Domers too must be part of Judge Barrett's contact tracing, and they should be isolated or quarantined if indicated, even if they want to skip the class.

Priests, altar boys, congregation at whatever services she attended following the White House announcement:  They too are part of contact tracing for sure.  Remember that the announcement was staged on a Saturday.  Amy Coney Barrett certainly would have gone to religious services to express her faith, at the very least, the following day, which was a Sunday.  If these good people came into range of her exposure, then they also must be isolated or quarantined.  "Resist evil and conquer it with love," as Paul wrote in Romans 12.

Whew.  There may be more.  All that has been said so far focuses on the exposure of one person to the virus:  Amy Coney Barrett.  We should know more soon.  Well, let's put it this way:  There are some things, at least, that we will definitely know soon.  Other things may take a little longer.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

"If you do not help in this effort, who will?"

The Consumer Financial Protection Bureau has proposed a new rule that would contradict what Congress wrote in the Dodd-Frank Act.  They don't have the votes in Congress.  So, they are trying to make law in proposed rules like this one.

Injustices like this must be opposed.  The success is in the opposition, not always in the result.  Feel free to use, paraphrase, or rephrase my own Comments below.  I was inspired by a National Consumer Law Statement on this proposed new rule, myself.  The important point is that proposed new rules like this one must be opposed.  If using my language is inspiration, too, for you to leave your own Comments in opposition, that is all to the good.

To rephrase the writer and philosopher Albert Camus who wrote about actions during a Plague among other things, this may be a country now in which people suffer.  We may not be able to do anything about that at the moment.  But we can lessen the number of suffering people.  If you do not help in this effort, who will?

The CFPB's Notice of Proposed Rulemaking is on www.regulations.gov where you can leave your Comments.  The docket number is CFPB-2020-0028.  The RIN is 3170-AA98.

Thank you.

This rule proposed by the CFPB would immunize lenders from legal liability for making mortgage loans without regard to borrowers’ ability to repay if the borrower remains current for the first three years of the loan and the loan meets other requirements. This proposed new rule and new immunity for lenders is contrary to the Dodd-Frank Act.

In the Dodd-Frank Act, Congress required that before booking a loan so to speak, that lenders must make a good faith determination of a borrower’s ability to repay it. Further, Congress expressly allowed borrowers to defend foreclosure by asserting a defense that the lender ignored the borrower’s lack of ability to repay in making the loan.

There are many reasons a homeowner can make payments even for years and even when their mortgage is unaffordable. Examples drawn from real-world experience have been reported including "payments from roommates who are not on the mortgage, borrowing money, or even going without essentials such utilities or medical care." The Congressional choice to enact protections to homeowners to save their homes in the Ability-to-Repay rule already contemplated this situation and allowed for it. That is a policy choice. It is the policy choice made by Congress in the statutes that make up Dodd-Frank. No mere administrative agency including the CFPB has authority to repeal statutes, and no mere agency including the CFPB has the power to enact this proposed rule.

Congress wrote the Ability-to-Repay rule to prevent market excesses that contributed to the Great Recession. Many communities, especially low-income neighborhoods and communities of color, still have not recovered from the Great Recession. It is never a good idea to induce a Second Great Recession, but it is particularly not a good idea during a Pandemic.

Thank you.

Please read the disclaimer.  ©2020 Dennis J. Wall.  All rights reserved.

MEATPACKING PLANTS ARE SLAUGHTERHOUSES. YOU CAN'T REFINE SLAUGHTER WITH NAMES.

"The evidence is strong that meat and poultry plants warrant more stringent oversight than other manufacturing facilities." Michael Hiltzik, Business Column: A Century Later, Meatpacking Plants Still Resemble Upton Sinclair's Depiction in 'The Jungle', LOS ANGELES TIMES online Tuesday, May 5, 2020.

    From the beginning, the evidence was strong that slaughterhouses are dangerous to worker safety. This does not necessarily mean that slaughterhouses should be dismantled. It does mean they should be watched. Carefully. They are not a mail drop. They have effects on people's health and safety.

    So they should be watched carefully. They were not seen for the most part until Upton Sinclair's book was published 100 years ago. They should be seen -- and watched -- now. The evidence is strong that action is required and also that assessing the risk before acting is a necessary part of the pandemic response.

Please read the disclaimer. ©2020 Dennis J. Wall. All rights reserved.

WHY DO REPUBLICANS WANT YOUR SOCIAL SECURITY?

As part of the economic recovery from the effects of the pandemic, Republicans propose that people should take out loans against future Social Security payments.  The intent is to propose a loan instead of direct payments from the federal treasury to replace all or part of the wages that workers have lost during the pandemic shutdown.  This comes from concern that has developed after large corporations and their wealthy executives have already gotten their bailouts.  See, e.g., Michael Hiltzik, Column:  Republicans Seek to Exploit COVID-19 Crisis to Cut Social Security Benefits, LOS ANGELES TIMES online Monday, May 11, 2020;  Helaine Olen, Retirement in America is Already Uncertain.  Republicans Want to Make it Worse, WASHINGTON POST online Wed., May 13, 2020.

    Apparently this thought was inspired by the familiar use of taking out a loan against your life insurance policy.

    But here's a huge difference between the two kinds of insurance:  You never collect your own life insurance.  Somebody else always does.  Life insurance only pays when you die.  The proponents of this plan are right that Social Security Old Age Insurance is insurance, but they are wrong to compare it to life insurance.  Social Security Old Age Insurance is wage insurance or old age insurance.  It pays only when you reach retirement age, to replace part of the income the ordinary person loses when they reach old age.

    In essence, the Republican proposal is to make future Social Security collateral for a loan now.

    Corporations and wealthy people usually have life insurance policies available.  Corporations famously take out life insurance on their executives, pay the premiums, and name themselves as the sole beneficiaries.  Yet they are not asked to put up their own insurance as collateral to get money from any federal stimulus plan so far.  There is no reason to ask normal people to put up their retirement as collateral for the income they are losing now.

    Treating these people differently would not solve problems.  It would make them.

    Most important, it would not be American.  See generally Dennis J. Wall, § 9:38, Try Taking it Away:  Social Security as a Right, in Volume 2 of LITIGATION AND PREVENTION OF INSURER BAD FAITH (3d edition Thomson Reuters West, 2020 Supplements in process), accessible at https://www.dennisjwall.com/works.

Please read the disclaimer.   ©2020 Dennis J. Wall.  All rights reserved.

 

 

"The Alternative to Solidarity is Death."

George Packer has valuable insights in his article in the forthcoming June 2020 issue of The Atlantic.  He has looked deeply into where we have been as a country, where we are today, and where we can go if we choose.  Packer's article is titled and subtitled, We Are Living in a Failed State / The coronavirus didn't break America.  It revealed what was already broken.

    Here are excerpts:

 It turns out that everything has a cost, and years of attacking government, squeezing it dry and draining its morale, inflict a heavy cost that the public has to pay in lives.  All the programs defunded, stockpiles depleted, and plans scrapped meant that we had become a second-rate nation.  Then came the virus and this strange defeat.

    The fight to overcome the pandemic must also be a fight to recover the health of our country, and build it anew, or the hardship and grief we're now enduring will never be redeemed.  Under our current leadership nothing will change....  But putting an end to this regime, so necessary and deserved, is only the beginning.

 ***

We can learn from these dreadful days that stupidity and injustice are lethal; that, in a democracy, being a citizen is essential work; that the alternative to solidarity is death.  After we've come out of hiding and taken off our masks, we should not forget what it was like to be alone.

Please read the disclaimer.  This blog article ©2020 Dennis J. Wall.  All rights reserved.