Source: Johns Hopkins via Kevin Drum
NYT, In Alaska’s Covid Crisis, Doctors Must Decide Who Lives and Who Dies: Amid the nation’s worst Covid-19 outbreak, patients are trapped in remote communities and doctors are prioritizing treatment based on who is most likely to survive.
Mike Baker writes,
There was one bed coming available in the intensive care unit in Alaska’s largest hospital.
It was the middle of the night, and the hospital, Providence Alaska Medical Center in Anchorage, had been hit with a deluge of coronavirus patients. Doctors now had a choice to make: Several more patients at the hospital, most of them with Covid-19, were in line to take that last I.C.U. spot. But there was also someone from one of the state’s isolated rural communities who needed to be flown in for emergency surgery.
Who should get the final bed?
Dr. Steven Floerchinger gathered with his colleagues for an agonizing discussion. They had a better chance of saving one of the patients in the emergency room, they determined. The other person would have to wait.
That patient died.
“This is gut-wrenching, and I never thought I’d see it,” said Dr. Floerchinger, who has been in practice for 30 years. “We are taxed to a point of making decisions of who will and who will not live.”
Of course, it’s a red state and vaccination rates are low, and cases are spiking.
Previously: Death Panels Spotted in Idaho.
Gov. Ron DeSantis, R-Fla., questioned Tuesday if the United States should rethink its diplomatic relationship with Australia given its strict, military-enforced COVID-19 lockdowns…
“You know, you guys, look what’s going on in Australia right now. You know, they’re enforcing, after a year and a half, they’re still enforcing lockdowns by the military.”
“That’s not a free country. It’s not a free country at all. In fact, I mean, I wonder why we would still have the same diplomatic relations when they’re doing that. Is Australia freer than China, communist China, right now? I don’t know. The fact that that’s even a question tells you something has gone dramatically off the rails with some of this stuff.”
So, real or Onion? You decide, then click through for the answer.
Since the beginning of the COVID-19 pandemic, California and Florida have stood as polar opposites in how government should respond to the coronavirus.
California Gov. Gavin Newsom last year backed sweeping stay-at-home orders, and this summer supported targeted vaccination requirements and indoor mask rules. In Florida, Gov. Ron DeSantis led efforts to ban health rules: he issued an order prohibiting mask requirements and signed a law banning vaccine passports — requirements by businesses or government agencies to show proof of vaccination to gain services.
A Los Angeles Times analysis found that of the nation’s 50 states, Florida had the worst COVID-19 death and coronavirus case rate for the summer.
California, by contrast, for the summer had only about one-sixth of Florida’s COVID-19 death rate, and one-third of Florida’s case rate.
For every 100,000 Floridians, 70 residents died over the summer, while for every 100,000 Californians, 12 residents died.
Higher vaccination rates and mask use indoors “have helped to blunt this fourth surge in California as compared to Florida,” said Dr. Robert Kim-Farley, medical epidemiologist and infectious diseases expert at the UCLA Fielding School of Public Health. “We are seeing better application of public health measures in California compared to Florida.”
Of the nation’s 10 most populous states, Florida now has the second worst cumulative COVID-19 death rate since the pandemic began, with 262 deaths for every 100,000 residents. Only New York has a higher death rate — 281. California’s rate is 176.
In other words, if California had Florida’s cumulative COVID-19 death rate, an additional 34,000 Californians would have died. And if Florida had California’s death rate, 18,000 fewer Floridians would have died.
Some epidemiologists and infectious diseases experts say Florida was hurt by leaders there making statements contradicting those made by leading scientists and the U.S. Centers for Disease Control and Prevention, which advised by late July that masks again be worn again in indoor public settings.
DeSantis, Florida’s governor, has made statements contradicting the CDC, stating in an executive order that “forcing students to wear masks lacks a well-grounded scientific justification.” In fact, there is plenty of evidence suggesting masks help: a study published last week by the CDC found that, in Arizona’s two most populous counties, schools without mask requirements were 3½ times more likely to have coronavirus outbreaks than those with mask rules.
In Florida, [University of Florida epidemiologist Cindy] Prins said she and other public health experts found their work and expertise criticized, misconstrued and politicized around whether masks work, vaccine efficacy and the merits of social distancing.
[Ali Mokdad, an epidemiologist at the Institute for Health Metrics and Evaluation at the University of Washington, which runs a widely cited forecast of pandemic projections] lamented key steps that could’ve inspired more people to get vaccinated. DeSantis, for instance, notably declined to get vaccinated in front of news cameras, and held an event criticizing government vaccination requirements, where he stood along side several workers employed by the city of Gainesville who said the government shouldn’t force them to get vaccinated, according to the Associated Press.
Thank you Governor DeSantis!
The news has been full of French anger and petulance over the US swooping in and stealing its sub deal with Australia. French anger has been described as a combination of loss of a deal (the French, I suspect, are more used to stealing other people’s arms sales than having the rug pulled out from under theirs) and the sense that their Pacific Ocean/Asia policy has just taken it on the chin. Most US news coverage has operated in the frame that the news of the US sub deal came a surprise to France, thus motivating the somewhat, er, energetic reaction.
For this reason, I was intrigued to see a very different narrative offered by the blog Balding’s World. I can’t endorse it, or this analysis, as it’s not my area, but this certainly isn’t what I’ve been seeing in my newspaper or my news feed:
First, this appears to first and foremost be a commercial and bilateral dispute between France and its naval construction company and Australia. Despite the best attempts of France to broaden it to a European or Asian coalition dispute, there is little evidence this is happening. The commercial dispute stems from disagreements over progress, cost, and strategic importance of the subs France would be building. While France has talked about compensation, reports state, and I would be surprised if it was otherwise, that there are clear exits within the contract that do call for specific compensation but are clearly defined by time and work product. Despite what France may say, there is little strategic change from France opting out of cooperation with Australia, the UK, or US to the Indo Pacific region. It would of course be better if they joined the burgeoning coalition but there is little downside risk to them leaving.
Second, this break up appears to have been a long time in the making. While France may claim they were completely blind sided by Australian discontent, there were public reports of meetings at the highest level going back years about Australian discontent. The most recent in June gave the French side until September (now) to turn around the project. There were issues of massive cost increases, the strategic value of the dated subs by the time they would be delivered, delays in delivery, technology transfer, and how much would be locally produced in Australia just to name a few. These are just the issues about which there are public records. This should not have been a surprise.
Third, one widely overlooked point is how much the broader geopolitical landscape has changed from when this deal was first initiated. Signed in 2016 with likely years of planning before hand, for simplicity sake let us assume 2012 when Xi Jinping came to power, Australia finds itself seeking very different naval capabilities from 2016 to 2021. That is not France’s fault that is simply the reality. An underlying factor here is Australia believing they needed significantly greater capabilities than the French models offered.
Fourth, the reports are that Australia initiated the conversation seeking merely to do a basic swap out of the existing class of subs they would purchase from France for US/UK models. However, it quickly evolved into a significantly broader and more significant upgrade of Australian naval capabilities. There are a couple of sub reasons this is important. For instance, this appears to be a coalition of the willing of 5 Eyes essentially becoming 3 Eyes with increased security integration and access to resources. This is building out a coalition of countries willing to cooperate with an eye towards China. Additionally, this (and I should say this is somewhat speculative) appears not to be the Biden administration jumping in to try and snag a deal but rather being approached and putting something together to work with an ally. The reason that matters is that I would not expect this to become a pattern of hard ball real politik for the Biden administration. I would hope I am wrong and that they would do more deals like this but I doubt that is likely. One final sub note is that the exact timing remains somewhat unclear here so if I am wrong, I will gladly correct. Some reports have talks on this commencing 12-18 months ago and some have the talks initiating 6 months ago. For something of this complexity, I’m guessing 12-18 months ago but that would again provide different implication in that the Biden team is receiving a hand off and sealing the deal rather than managing the deal themselves front to back. Again the details here remain a little murky but something to watch.
Fifth, it is very hard to see French complaints. The business case was pretty clear for quite some time that Australia was very unhappy with the project. When, as it appears, Australia reached out to the US and UK, they brough much larger, broader, and deeper resources to the table to help Australia. On a strategic level, though France is talking of multilateralism, it needs to be emphasized that they are using that word very differently. They have pointedly refused to join the US and other countries in seeking to challenge China preferring almost a more go it alone strategy that has hall marks of the US, UK, and Australia but pointedly not joining with those countries over China. They have actively sought to increase trading links with China through among other initiatives as the CAI to the consternation of the US and even the Parliament. Now France is a sovereign state and pursue whatever policies it feels are in its interest but when your entire foreign policy is labeled “strategic autonomy” it is difficult to take seriously calls for a return to multilateralism.
Today’s Exponential View by Azeem Azhar contains an arresting chart, sourced to a paywalled article in the Wall St. Journal, Individuals Embrace Options Trading, Turbocharging Stock Markets :
The WSJ article suggests that individual
bettors investors on Robin Hood are the driver of the growth of options; to the extent that increases volatility, then old school securities firms feel driven to hedge more, which also adds to the options boom.
Somehow, this explanation feels inadequate to me, but I don’t know why.