Tuesday, October 6

Risk


 

 

 

 

 

 

 

 

The advice from public health experts on Covid-19 is to wear mask and practice social distancing, avoiding crowds. 

Those who deliberately ignore these guidelines are not taking on risk solely for themselves. Instead, their actions also place everyone around them at risk without their choice. 

By now, Americans understand that many Republicans – those who take their lead from President Donald Trump and mock masks and insist on attending events and going about business as usual – are placing anyone around them at risk of contracting the virus. The United States has more than 7 million cases, more than any other country in the world, and reports more than 200,000 deaths.

Too many current leaders neglect their responsibility to protect public health. "Public health promotes and protects the health of people and the communities where they live, learn, work and play," reports the American Public Health Association. "While a doctor treats people who are sick, those of us working in public health try to prevent people from getting sick or injured in the first place. We also promote wellness by encouraging healthy behaviors."

The president has Covid-19, and his medical team resists criticizing his reticence to wear a mask or maintain social distancing. They did not reject a car ride to see supporters that could bring risk to his Secret Service agents. They do not lead on contact tracing for the White House staff exposed to the president or the other multiple staff exposed to the virus. Likewise, they refuse to disclose the president’s test schedule or results. 

Sean Conley, the US president’s physician who famously denied that the president was not “now” on oxygen immediately triggered curiosity from the media and public at large. Had he been at oxygen at all since testing positive for Covid-19?

“I was trying to reflect the upbeat attitude that the team, the president, the course of this illness has had. I didn’t want to give any information that might steer the course of illness another direction. And in doing so, it came off as we were trying to hide something – which wasn’t necessarily true.” The comment was an effort to extend blame, suggesting the entire team was might be responsible for the deceptive comments he alone made. 

Conley backtracked the following day, after the medical team reported the president was receiving the steroid dexamethasone, reported to help people with severe cases of Covid-19.  

Conley's denials and upbeat assessments harm not only the president but anyone near him. Conley and the rest of the White House report that the president has since been resting and symptom free, otherwise sharing few details, including the dates and results of his Covid-19 tests.

The president’s doctors should strive to protect public health, stressing guidelines from the World Health Organization that follow and do a public service by pointing out the president’s willful violations.

Those guidelines:
•    Regularly and thoroughly clean hands with alcohol-based rub or soap and water.
•    Practice social distancing by maintaining at least 3 feet of space between yourself and others.
•    Avoid crowded places.
•    Wear a fabric mask when physical distancing cannot be maintained.
•    Avoid touching eyes, nose and mouth.
•    Follow good respiratory hygiene, covering mouth and nose with bent elbow or tissue when coughing or sneezing. Then dispose of used tissues and wash hands.
•    Stay home and self-isolate with symptoms such as cough, headache and mild fever, until you recover.
•    Seek medical attention for a fever, cough and difficulty breathing
•    Keep up to date on the latest information from trusted health authorities.

Wednesday, September 30

Fast talker


 

 

 

 

 

 

 

 

 

 

The first question in the first 2020 presidential debate focused on Donald Trump’s effort to place a third justice on the US Supreme Court – and the topic quickly turned to health care and Republican efforts to end the Affordable Care Act. 

The Affordable Care Act, aiming to increase preventive care and curb the rising costs of health care, imposed regulations on the industry. The Trump administration and a group of states have asked the US Supreme Court to strike down the Affordable Care with arguments scheduled for November 10, a week after the election. Trump hopes to have his nominee on the court by then.  “The case centers on Republicans’ move to use the 2017 tax overhaul to nix the law’s penalty for most Americans who don’t get health coverage,” reports Todd Ruger for Roll Call. “The Trump administration and the Republican-led states argue that move made the mandate to buy insurance unconstitutional.”

Ruger raises the possibility that the court will resist wiping out the entire law even if it finds that a small sliver is unconstitutional. Trump and the Republicans who oppose the law suggest the mandate is central to the Affordable Care Act – and that the entire law should be scrapped. 

As was emphasized during an early exchange in the first presidential debate, the administration has no substitute health plan waiting in the wings.

Moderator Chris Wallace: You have promised to repeal and replace Obamacare, but you have never in these four years come up with a comprehensive plan to replace Obamacare…
President Trump: Listen, listen … of course, we have…  I got rid of the individual mandate… excuse me, we got rid of the individual mandate, which was a big chunk of Obamacare…
Wallace: That is not a comprehensive plan.
Trump: That is absolutely a big thing…that was the worst part of Obamacare.
Wallace: I didn’t ask, sir…
Trump: Chris, that was the worst part of Obamacare.
Wallace: Let me ask my question.
Trump: Well, I’ll ask Joe. The individual mandate was the most unpopular aspect of Obamacare.
Wallace: Mr. President...
Trump: I got rid of it and we will protect people with per-existing conditions...
Wallace: Mr .President, I’m the moderator of this debate and I would like you to let me ask my question and then you can answer.
Trump: Go ahead.


That exchange of about 150 words lasted 35 seconds, about twice the pace of that for the average US speaker. The speed, tone and many interruptions reflect why the debate was so painful to follow.

Studies suggest that people judge individual intelligence based on one's voice and how fast one speaks - though "Not too fast, of course, or they won’t understand a word you’re saying," reports Ian Lee for Lifehack. "Nevertheless, faster speakers are perceived to be more confident..."  

Ending the Affordable Care Act without a suitable replacement during the Covid-19 pandemic would be unconscionable. The individual mandate – while ensuring that society could pay for affordable care and efforts to ensure all – was not the biggest or most notable aspect of the Affordable Care Act. A decision to discard the entire law due to the mandate would eliminate the many benefits associated with the Affordable Care Act over the past decade. 


 Those benefits apply to far more than the than the 23 million Americans who would otherwise be uninsured and would also hurt Americans who have employee-sponsored insurance, including: 

-    Allowing parents to keep adult children on family health plans until age 26.
-    Reducing health care costs for small businesses with a care tax credit
-    Expanding mental health treatment
-    Eliminating annual and lifetime coverage limits
-    Preventing denial of coverage due to pre-existing conditions
-    Limiting  administrative costs and profits of insurance companies to no more than 20 percent for plans sold to small employers and 15 percent for plans arranged by large employers. 

 

 

 

 

 

 

 

 

 

 

Health care is a business in the United States and represents about 18 percent of the economy. Companies make money on patients, and the careers of thousands of doctors, nurses, pharmacists, insurers and many more workers in the health care field depend on the system, too.

All is not lost and analysts expect the US Supreme Court – even with an additional conservative justice to replace the late Ruth Bader Ginsburg – to support the law.  “Constitutional litigation is not a game of gotcha against Congress, where litigants can ride a discrete constitutional flaw in a statute to take down the whole, otherwise constitutional statute,” wrote Justice Brett Kavanaugh in the majority opinion on another aspect of the case in 2015.

Source: Affordable Care Act benefits, The Balance.
 

Monday, September 28

Public trust

Voters in swing states confront not only a barrage of advertising but also applications for mail-in ballots. So far, this household in Michigan has received six applications for mail-in ballots for each of the two adults, along with five more applications for a previous occupant who sold the home more than a decade ago. We are planning on voting in person.

With Joe Biden leading in most of the swing states, incumbent Donald Trump is clearly desperate, indicating that he may resist leaving office if his campaign deems the voting to be unfair. A pattern emerges, though – especially troubling as the country continues to wrestle with the Covid-19 pandemic:  Trump consistently blasts voting by mail for blue states, but offers no complaints about such procedures in red states.   

Analysts have expressed concern that some partisan officials may point to close races and disputes as a reason for not relying on each state’s popular vote for choosing electors who will then cast deciding votes through the Electoral College.

“The US constitution gives state legislatures the authority to appoint the 538 electors to the electoral college who ultimately elect the president,” reports Sam Levine for the Guardian. “States have long used the winner of the popular vote to determine who gets the electoral votes in their states, but Republicans anonymously told the Atlantic the campaign has discussed the possibility of using delays in the vote count as a basis to ask Republican-controlled legislatures to appoint their own electors, regardless of the final vote tally.”

All eyes are on swing states – Arizona, Florida, Iowa, Michigan, Nevada, North Carolina, Ohio, Pennsylvania and Wisconsin. A problem for Biden and the Democrats is that Republicans control legislatures in eight of the nine key swing states. 


The secretary of state is the lead election official in most states; Democrat fill the role in five of the swing states while Republicans serve in four. The country is placing its trust in election officials throughout the country. Members of the National Association of Secretaries of State have approved and reaffirmed a resolution to “ensure that elections are run in a fair and non-artisan manner so that all voters, regardless of political affiliation, are well-served” and together “strive to create a system of checks and balances that ensures the fair and equal application of election laws and procedures."  

A heavy turnout is key to success for a democratic election, determining the winner of this crucial 2020 presidential race. But record voting, by mail or by person, could also result in delays for counting and announcing results.

Plenty of observers will be on hand, and states, including Michigan, have detailed rules for challengers and poll-watchers.

Data source, Ballotpedia and the Guardian; US image, FreeVectors

Wednesday, September 23

Needless suffering

It was well documented in early April: Nations that acted swiftly to contain the spread of Covid-19 could lift economic restrictions more quickly. 

And most individuals  can exercise great control over preventing the illness for themselves, their loved ones and anyone they contact. Preventive measures include wearing masks and practicing social distancing, at least 6 feet especially when indoors along with avoiding crowds and staying home when displaying symptoms including coughing or fever.

Again, this was well documented in mid-March after governments in East Asia responded swiftly with discipline to the virus.  

The United States has less than 5 percent of the world's population and represents more than 20 percent of global Covid-19 cases and 20 percent of deaths. Analysts offer a mix of reasons for the country's high Covid-19 rates: impatience and, in some cases, desperation to open businesses and return to normal; failure of leaders to allow public health officials to establish timelines for reopening; a yearning quick fixes including vaccines and medicines; assumptions that healthy, comfortable and young Americans could not possibly succumb; inattention to lag times after infection and exponential rise; and politicization of the simple precaution of wearing a mask along with a lack of self-discipline or consideration for the elderly and others who might be vulnerable.

Ed Yong writes for the Atlantic:

"Many Americans trusted intuition to help guide them through this disaster. They grabbed onto whatever solution was most prominent in the moment, and bounced from one (often false) hope to the next. They saw the actions that individual people were taking, and blamed and shamed their neighbors. They lapsed into magical thinking, and believed that the world would return to normal within months. Following these impulses was simpler than navigating a web of solutions, staring down broken systems, and accepting that the pandemic would rage for at least a year.

"These conceptual errors were not egregious lies or conspiracy theories, but they were still dangerous. They manifested again and again, distorting the debate around whether to stay at home, wear masks, or open colleges. They prevented citizens from grasping the scope of the crisis and pushed leaders toward bad policies." 

Denial and political polarization have disrupted the Covid-19 response, this despite the many future unknowns anyone infected, even those who are asymptomatic, as warned by researchers since the pandemic's beginning.

The pandemic will continue throughout the winter, and a new normal is unlikely before spring of 2021. Still, as other countries demonstrated earlier this year, individuals hold immense power over preventing the rapid and deadly spread of this disease. Hundreds of new cases and deaths each day are simply unacceptable and unnecessary.

Source for data in graphs: Worldometers

Thursday, August 27

Diversity

For marketing, color is said to influence mood and atmosphere. yet Gregory Ciotti writing for Psychology Today has suggested such analyses of color's influence can be controversial. “The reason: Most of today’s conversations on colors and persuasion consist of hunches, anecdotal evidence and advertisers blowing smoke about 'colors and the mind.'" The influence of colors on human behavior is an inexact science.

 Another reason? Many studies on color psychology focus on standalone colors – red or blue, black and white – rather than combinations and patterns that are key to the beauty of a quilt or a stained glass window.

 Vivid displays of color fascinate people, and a glorious mix can become an indispensable whole. The world is full of brilliant scenes – some natural and others formed by human hand. Combinations and juxtaposition, patterns and chaos, attract and command attention.

And such is the allure of a diverse community. “We all should know that diversity makes for a rich tapestry," noted Maya Angelou, "and we must understand that all the threads of the tapestry are equal in value no matter what their color.”  

No color thrives on its own in the most pleasing presentations. When encountering a colorful collection, most individuals will struggle to select just one – whether a quilt, scarf, flower or vase.  

Even an endless stretch of beach, ocean, canyon, meadow or sky is composed of multiple if subtle shades.  

Diversity should be treasured, especially in the United States, a nation of immigrants. Too many have forgotten the value in differences and the contributions of many.

“We need healing,” noted Julia Jackson, whose son struggles for his life after being shot seven times in Kenosha, Wisconsin. “I’ve been praying for the healing of our country. God has placed each and everyone one of us in this country because he wanted us be here….

"How dare we hate what we are. We are human. God did not make one type of tree or flower or fish or horse or grass or rock. How ware you ask him to make one type of human that looks just like you. I’m no just talking to Caucasian people. I’m talking to all people… no one is superior to the others.” 

How Americans handle diversity will determine the nation's destiny. As Mahatma Gandhi once said, "Our ability to reach unity in diversity will be the beauty and test of our civilization."

Photos: Underground railroad quilt, Smithsonian; glassware, Susan Froetschel; wildflowers, American Meadows; and sunset, Petr Kratochvil Public Domain Pictures.

Thursday, August 20

Thoughts on suspense

The yearning to read and learn, constantly seeking truth and better ways, may be as crucial as any number of years spent in a classroom, earning grades and credits. The path to improvement depends on a willingness, even eagerness, to absorb and analyze new bits of information by any means necessary. People who want to learn more and solve big problems that others might avoid are stronger, more prepared to encounter inevitable change. They embrace rather than avoid uncertainty or feign to know it all.

Action and emotion intersect as emotions drive actions and actions drive emotions.  Likewise, there is intersection between emotion and reason in driving human judgment, as explained Chelsea Helion and David Pizarro in an essay for Handbook of Neuroethics: "The inner conflict that humans experience between their moral selves and their more unrestrained, egoistic selves has been a consistent theme in literature for centuries. While (largely) discarding the good-versus-evil aspects of this dichotomy, moral psychology has nonetheless embraced the basic division of mental processes into two general types – one mental system that is cold, rational, and deliberative, and another that is emotional, intuitive, and quick." 

The pursuit of knowledge is linked to suspense and R.J. Jacobs explains the allure of reading that provokes anxiety for CrimeReads. Readers seek a vicarious experience that offers a sense of control, the opportunity to explore possibilities in finding new methods to complete a story and the joy of solving problems.

Suspense spans a long list of emotions including fascination, hope, anticipation, envy, anger, rejection, hatred, anxiety, tension, fear and more. Aaron Smuts analyzes four theories on "The Paradox of Suspense" for the Stanford Encyclopedia of Philosophy and points out points out that Robert Yanal suggests that "suspense is best thought of as a composite emotion," "better described as an emotional amalgam, comprised of fear and hope, where uncertainty, if it is required, is implied in the components." Smuts goes on to describe the broad nature of suspense: "The intensity of our feelings of suspense seems to rely on two features of an event's outcome: (1) its uncertainty and (2) the significance of what is at stake."  

Suspense novels encourage readers to form strong opinions and become invested in the narratives and characters. Sheila O'Neill graciously included Fear of Beauty in her video list compiled for a Ezvid Wiki - "9 Suspenseful Reads Full of Real Emotion." Sofi, the protagonist in Fear of Beauty, is desperate to learn how to read after finding some papers not far from a cliff where her son fell to his death. "Some mysteries and thrillers focus on emotionally detached sleuths and cases where the killer is simply after money. The titles on this list go a step further, tackling difficult relationships and characters facing hard truths, allowing readers to really get invested in the twists that come. Here, in no particular order, are nine books that are as emotional as they are thrilling."

Despite the prevalence of suspense in literature, the condition is rare in the modern world ... except maybe for the processes of learning and critical thinking. Learning serves as both trigger of suspense and antidote as people generally anticipate impending challenges and quickly discern possible approaches. Perhaps the readers who relish suspense literature are best adept at taming suspense, keeping this feeling at arm's length in everyday life. 

Friday, August 7

School safety

Chronic conditions among US schoolchildren: Diabetes	0% Heart and other debilitating conditions	2% Learning disabilities	5% Asthma	10% Obesity	19%

Public health experts suggest that school re-openings can go smoothly if parents and families prepare and heed precautions to prevent the spread of Covid-19. 
Yet schools cannot neglect the most vulnerable students. At least 25 percent of children in the United States aged 2 to 8 years have at least one chronic health condition – and as many of 30 million children with one or more of such conditions could be especially vulnerable to Covid-19 infection. Some families may not realize that their children are vulnerable as some ailments like heart conditions can go undetected for years. Heart disease is the fifth leading cause of death for US children ages 1 to 5.

The American Academy of Pediatrics reports more than 300,000 cases of Covid-19 among US children, with rates rising by 40 percent during the last two weeks of July. Three states - California, Florida and Arizona - represent about a quarter of those cases. There are inconsistencies in how states collect data along with disagreements over the definition of a child. Most cases among children are asymptomatic but the long-term consequences are unknown. 

Mixed messages and inconsistencies in data collection do not help during a pandemic.

The UN Global Compact points out that the pandemic is “testing the world’s humanity and resilience at a time that is already marked by acute inequality.” Poor planning for the Covid-19 pandemic – and the failure of some communities to mandate masks and social distancing – could threaten learning and delay economic productivity for years to come.

All individuals must come to terms that schools, work and other social interactions will not return to normal any time soon, not until cases subside or public health experts develop efficient treatments and vaccines. Attempts to hide the pandemic’s consequences are futile as more families lose loved ones to the disease and communities confront ongoing hospitalizations and deaths.

crowded hallway in Georgia school in student photo
One high school in Georgia learned this after administrators made donning masks a “personal choice.” At least two students posted images of a crowded school hallway – no social distancing in effect. The school suspended at least two students before swiftly, warning the student body about "consequences" for such public posts. The school swiftly reversed the punishment after the story received national attention. Communities want to know what schools look like - and will hold those political and school leaders who rush economic re-openings and skimp on protections accountable.

One suspended student explained to CNN that she understood school rules prohibited recording and posting school scenes on social media during the day without an administrator’s permission. But referring to the words of the late Congressman John Lewis, she expressed concern for vulnerable students, staff members and family members and said she regarded posting the photograph as “good and necessary trouble.”

Secrecy is not protection. School children represent about 18 percent of the US population. Communities and families pay taxes, fees and tuition for education and want to ensure that schools engage in safe practices not only for the children in attendance but also the staff and parents, grandparents, neighbors and other family members who might care for them.  The school superintendent notified parents that the district will provide staff with masks and reduce crowding in school hallways, reports the Washington Post.

Children, parents and staff will speak up because their health is at sake. All are armed with phones and cameras. Protecting schools is essential as children represent the future of society. As Mohandes Gandhi noted, “A nation’s greatness is measured by how it treats its weakest members.”

 This post was updated on August 11, 2020.